Dual Sympathetic Reset (DSR): What To Expect & What's To Come
Many people have questions about the Dual Sympathetic Reset (DSR), an advanced Stellate Ganglion Block (SGB). What's the procedure like? How do you qualify? How do you feel after?
In this blog post, we'll walk you through Treatment by Stella so you know what to expect before, during, and after DSR.
What is DSR SGB
Dual Sympathetic Reset is an advanced Stellate Ganglion Block (SGB) protocol developed by Stella's Chief Medical Officer, Dr Eugine Lipov. DSR SGB involves two injections of local anesthetic in one side of the neck next to a bundle of sympathetic nerves called stellate ganglion that regulates the fight-flight response. DSR SGB can effectively reset the brain's overactive sympathetic nervous system to its baseline, therefore relieve syptoms of PTSD, anxiety and depression, even at its most severe.
Qualifying for DSR SGB
We will never ask you to tell your story or justify your trauma to qualify for treatment.
Treatment by Stella is based on the severity of each person's symptoms of post-traumatic stress disorder (PTSD), anxiety and depression. It's common for trauma survivors to feel unworthy of receiving care, these algorithmic-based tests help validate one's experiences due to their unbiased nature.
For those who qualify for treatment, the journey to relief begins.
Before Treatment
For many of our patients, waiting to receive DSR is more difficult than the actual procedure.
Stella isn't always the first stop on our patients' healing journeys. It's common for trauma survivors to try multiple treatments – like prescription medications, talk therapy, or deep breathing exercises. While every time-test, research-backed treatment has its merits, none of them can guarantee 100 percent relief. When a treatment doesn't work, it can feel personal. And we may lose trust in the healthcare system.
It's completely normal to be skeptical or feel hopeless about the possibility of feeling good again. Memories of failed treatments can trigger anxiety and hesitation about DSR and worrying can keep us up at night. Our days may be interrupted by intrusive thoughts like:
What if DSR doesn't work?
What if I can't get my heart rate down?
What if my vitamins actually had turmeric in them?
I stopped taking my blood thinners, right?
I can't wait any longer to feel better.
What if DSR changes who I am?
Here are four ways to help ease your mind and cope with this type of thinking before treatment.
Set expectations:
Set expectations: Some feel nervous talking to their friends, family, and care providers following DSR as they navigate the changes in their bodies in real-time. Some feel "pressure" to show positive results so they don't let their loved ones down. These are common reactions and may even be tied to trauma responses.
Setting expectations with our support circle beforehand can help alleviate these types of reactions after treatment.
- Ask for some "quiet time" to yourself immediately after treatment to allow yourself to "unplug" and focus on resting.
- Explain that you will share a quick update immediately after your DSR procedure followed by more details the next day.
- Set boundaries what types of language do you want your support system to use. Many prefer to be asked "How are you feeling right now?" instead of triggering language like "Did it work?"
Sharing this 7 Ways To Take Care of Yourself or Others Before and After DSR resource with our support team can allow for them to look back on this document to help answer any questions they may have.
Review Stella's treatment documentation:
Once treatment is scheduled, Stella will send you an email with the information you need to prepare for treatment, including:
- The location (address, pictures of the facility, parking details, how to check in, etc.)
- Your doctor (their name, picture, medical training, current Board Certifications, etc.)
- The procedure (what to wear, type of image-guidance used, companion policies, etc.)
Talk to your mental health care provider:
Many trauma-informed therapists are familiar with DSR, and we recommend discussing your upcoming treatment plan with them. If you do not have a mental healthcare provider, we may be able to refer you to one in our network.
Talk to the Stella team:
Talk to the Stella team: If nervousness or anxiety arises on treatment day, please know that you're in a safe space and you can openly ask questions or communicate your worries to the team on site. Ask your Stella doctor to walk you through the treatment again, step by step.
Following your treatment
Whether one chooses to stay awake or use twilight sedation, many people experience similar outcomes immediately after treatment. Here are a few of the most common responses:
Sudden urge to cry
Most people report a rush of emotions. We recommend letting out the emotions. This is extremely common and healthy. Your Stella MD partner is familiar with this response and will respect your time and space through this release.
Calmness
While most have difficulty articulating what "calmness" feels like, they know it's the feeling they are experiencing. We'll touch on this more shortly.
Lightness
DSR SGB can make people feel like a weight has been lifted off their chest or shoulders. This may make them feel like they can breathe more deeply and in turn feel more rested and relaxed than they're used to.
Tiredness
It's normal to feel tired after a medical procedure. We recommend that our patients take a long nap after they leave get home. Sleep allows the body to heal and feel calm. Many patients find it helpful to turn off their cell phones while resting.
The Following Days
Be patient with yourself in the days following treatment and revisit the expectations you set for yourself and your loved ones. Depending on how long one's body has been stuck in fight-or-flight mode, the benefits may be glaring, hard to describe, or difficult to spot.
Outside of what's covered within the PCL 5 PTSD symptom tracker, many of the benefits experienced fall under the category of "calmness" and "peacefulness."
Calmness:
the state or quality of being free from agitation or strong emotion.
This comes to life in many forms following treatment:
- Having a clear head
- Mind being quiet
- Time feels slower
- Acting less rushed
- Feeling comfortable
Over 83 percent of Stella Patients experience lasting relief after one SGB procedure. And, 43 percent of patients schedule two treatments based on the severity of their symptoms.
The Stella Standard of Care was created to meet your needs before, during, and after treatment.
There are patients that do not receive relief after their first treatment or may not receive as much relief as they were hoping for. In rare cases, some may experience an inability to control emotions, increased anxiety or panic attacks, or worsened sleep. If a second treatment, typically on the left side, is not already a part of the care plan, it will be recommended to those who experience these symptoms.
While the majority of people find relief after they receive the second treatment, Stella will work directly with 10-20 percent who did not experience any benefits from SGB and help navigate them on additional treatment options.
The Next 14 – 30 Days
You may not notice changes in your symptoms at first but those close to you might observe changes in your behavior. Ask a trusted family member or friend to take inventory of how you've changed and have them share their observations with you. This exercise is eye-opening for many Stella patients. You may need to encounter stressful situations to realize that your response to them is different.
When the body is no longer stuck in fight-or-flight mode, symptoms dissipate, which can positively impact how we move through daily tasks. Many people note that they:
- Find driving is less stressful
- See more clearly – colors appear brighter and their vision is sharper
- Can more easily handle social situations or go out in public
- Feel more sociable
- Experience less physical pain
- Can actively listen and more thoughtfully engage in conversations
- Interested in picking up old (or new) hobbies
- Are a more confident parent and/or partner
- Are excited about future planning
DSR SGB gives people the ability to feel in a way that they did not think was possible.
"The final piece to the puzzle. Yes, I needed therapy, meditation & medication, but those things didn't get me all the way to where I needed to be. It's like my fight or flight mechanism was stuck in the 'on' position and nothing could calm it down. The Stella Center SGB shot did. I'm not constantly triggered or on edge anymore. I can finally enjoy the new perspective and positive outlook that I gained from therapy. Life has its ups & downs but they're manageable now. Life is brand new."
Read more of Stella's anonymous reviews in real-time to hear more about how people are experiencing life after treatment.
How Long Does DSR SGB Last?
The lasting impact of DSR SGB varies from individual to individual. In a study where participants were surveyed 3-6 months after treatment, 70 percent still reported a successful outcome. Many people find lasting results for years after treatment.
On average, 8 to 12 percent of Stella patients return for additional DSR treatment. Many have incorporated ongoing DSR treatments into their mental health care plan based on personal lifestyle, stressors, new traumas and/or response to treatment.
While all of the benefits of DSR treatments are still unknown, Stella sees an increasing number of patients reporting after receiving DSR, they have:
- Improved handwriting
- Reduced their use of or stopped taking prescription medications
- Less PMS (premenstrual syndrome) symptoms
- More memories from childhood
- Less face and neck flushing
- Decreased gag reflex
DSR is not a "cure" for PTSD or emotional trauma symptoms. We believe that the formula for lasting relief is a combination of biological and psychological interventions.
What's To Come for SGB & Stella's DSR SGB Protocol
While SGB may seem new to the public, the medical industry has been exploring its capabilities since 1920. SGB has been shown to treat migraines and help women find relief from hot flashes and night sweats. More studies are underway to show its effectiveness for treating vertigo, bell's palsy and much more.
Earlier this year, Stella Provider Dr. Luke D. Liu published a case study explaining how SGB successfully reduced long COVID symptoms. The result of this study led to Stella and RTHM partnering to provide RTHM's Long COVID patients with access to Stella's SGB treatment.
A new clinical trial sponsored by NYU Langone Health is leveraging Dr. Lipov's modified SGB method, the Dual Sympathetic Reset, and Stella's New York Provider to test SGB's efficacy on PTSD symptoms through the use of brain scans. Researchers hope will help destigmatize PTSD as an illness and add to the public's understanding of SGB as a potential treatment.
Primary care and functional medicine practices, like Cornerstone, are now offering SGB to their patients through Stella's Certified MD network.
There are many findings that remain unexplored, like SGB's impact on Tinnitus or its positive impact on Roman/Ward syndrome.
The possibilities around DSR SGB are endless. We won't stop championing this treatment and providing you with the care you deserve.
Do you have more questions about the Dual Sympathetic Reset and how it can help with symptoms of emotional trauma, mental health challenges, and long Covid? Please call our Care Advocate team directly at 908-293-7559.