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As with most other drugs, there is a dose: response relationship with ketamine. That is why the relatively low doses that Spravato (the nasal form of ketamine) administration delivers require re-administration once a week at the least, and for many patients twice a week. That is also why the low doses of ketamine administered in clinics that are not staffed by anesthesiologists result in some patients being labeled as “non-responders,” when in fact they would get relief if only a higher dose infusion of ketamine was given.
The higher doses we routinely administer – some even up to 4 or 5 times higher and inducing a light general anesthetic – allow every patient who might respond favorably a chance to do so. That is also why our higher dosing allows longer periods of time to elapse between maintenance treatments, saving patients both money and disruptions in their lives.
Over the past twenty years, ketamine infusions have been extensively studied for the treatment of medication-resistant depression. Psychiatrists have performed the vast majority of studies, so only very low doses of ketamine have typically been used (0.5 mg/kg given over 40 – 60 minutes). Even at these low doses, we can expect approximately 60 – 70% of patients to find relief. However, within 3 weeks of completing the initial course of 6 low-dose infusions, half to three-fourths of patients have return of their depression.
Fortunately, anesthesiologists can administer much higher doses of ketamine (as much as 4 – 5 times higher), and some patients who do not respond at the lower dose will, fortunately, find relief with a more aggressive dosing regimen. In addition, the higher doses that we give allow a considerably longer period of relief, and patients can thereby extend the time period between “maintenance” infusions. This benefits patient both financially as well as being far less disruptive to their lives.
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RN & Clinical Manager
Trina Haag is a highly experienced and compassionate Registered Nurse with over 15 years of expertise in patient care and advocacy. Her diverse background includes roles as a Medical Assistant, Phlebotomist, and Registered Nurse specializing in ICU and perioperative care. In addition to her clinical skills, Trina has successfully managed medical offices, where she excelled in delivering exceptional customer service and personalized patient care.
Trina’s commitment to patient advocacy is evident through her involvement with the National Patient Advocacy Foundation, where she passionately supports patient rights and quality healthcare. Her dedication to individualized care ensures that every patient at TNKWC receives the highest level of compassionate and personalized treatment.
Outside of her professional life, Trina values time spent with her family, including her loving husband, her daughter who brings joy to her days, and their loyal furry friend.[/vc_column_text][/vc_column_inner][vc_column_inner width=”1/2″][us_image image=”568″ style=”shadow-2″][us_separator][us_btn label=”Schedule A Consultation” link=”url:%2Fcontact%2F|title:Contact” width_type=”1″][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row]
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Dr. Rachel Rome is a board-certified anesthesiologist and interventional pain specialist with a deep expertise in regenerative medicine and palliative care. Her commitment to individualized patient care, innovative treatment approaches, and her prioritization of utilizing a holistic approach has made her a respected figure in the medical community.[/vc_column_text][vc_column_text]Witnessing the transformative impact of ketamine on patients suffering from depression and chronic pain, Dr. Rome pursued advanced training in ketamine administration. In November 2021, she founded Mindful Infusions of TN, a concierge ketamine and wellness clinic, where she served as Medical Director. In addition, she has had the privilege of serving the local community at several clinics including David Price Regenerative Medical Center, LifeLinc Pain, and Empatia Palliative Care.
Dr. Rome earned her undergraduate degree in biology from Christian Brothers University and her medical degree from the University of Tennessee College of Medicine in Memphis. She completed her residency in anesthesiology and a fellowship in pain management at the University of Virginia in Charlottesville. She is an active member of the American Society of Anesthesiologists and the American Society of Interventional Pain Physicians.[/vc_column_text][/vc_column_inner][vc_column_inner width=”1/2″][us_image image=”599″ style=”shadow-2″][us_separator][us_btn label=”Schedule A Consultation” link=”url:%2Fcontact%2F|title:Contact” width_type=”1″][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row]
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Dr. Malchow served as an anesthesiologist for 25 years in the armed forces before retiring as a colonel in 2008. He then became an associate professor at Vanderbilt University Medical Center in Nashville, where he was the first Vanderbilt physician to offer intensive ketamine infusion therapy in 2014. In 2015, he established one of the few ketamine infusion centers (KIC) in the Veteran Health Administration and the only KIC in the U.S. specifically targeting opioid cessation/reduction.
He is an acknowledged U.S. expert on ketamine administration, having presented his extensive experience with ketamine in the veteran population at the American Society of Ketamine Physicians in 2018 and has given multiple lectures regarding the use of ketamine to national audiences in 2021. Dr. Malchow has published over 20 peer-reviewed journal articles and serves regularly on worldwide medical missions supporting those in need.
Dr. Malchow is honored to serve as the Medical Director for the Tennessee Ketamine & Wellness Center to provide compassionate and competent care for those suffering from depression, PTSD, OCD, chronic pain, and opioid dependence.[/vc_column_text][/vc_column_inner][vc_column_inner width=”1/2″][us_image image=”162″ style=”shadow-2″][us_separator][us_btn label=”Dr. Malchow’s Full CV” link=”url:%2Fwp-content%2Fuploads%2F2021%2F06%2F03-2021-Malchow-CV.pdf|target:_blank” width_type=”full” icon=”fas|file-alt”][us_btn label=”Schedule A Consultation” link=”url:%2Fcontact%2F|title:Contact” width_type=”1″][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row]