The nerves that compose the sympathetic nervous system (“the fight or flight”) part of the nervous system is located in front of the spinal column.  Along its course there are concentrations of nerve bundles referred to as ganglion.  Several of these ganglia are located in the neck, including one at the level of the Adams apple which has a stellate (star-shaped) appearance.  This bundle of nerves is special for its connection to parts of the brain which store and control emotional memories.  Injection of local anesthetic around this bundle of nerves temporarily blocks the way the nervous system constantly responds to emotional trauma.  This is similar to shutting off and rebooting your computer.  Responders typically notes alleviation of PTSD symptoms within 15 minutes.  Although the block wears off after 4 hours, the opportunity of the brain to reset itself results in long-term reductions in symptoms.

 For several decades, the procedure was done by feeling for a particular bone in the front of the spine, moving the carotid artery toward the middle with one hand, and inserting a needle until it contacted bone prior to injection.  Later, the procedure was improved by the use of x-ray to verify the correct level of the spine.  However, use of x-ray does not allow the physician to see important nerves and arteries in the neck.  Instead, Dr. Vogel trained extensively after his Pain Fellowship to be proficient in performing the procedure under ultrasound, the only technique he has used over the last 6 years.  Use of ultrasound allows the most safe and accurate way to perform the procedure.

The procedure is a minimally painful single injection done in an outpatient setting that takes about 15 minutes.  The injection itself only takes a minute.

Until January 2020, Dr. Vogel served as an active-duty US Army physician (Colonel) providing pain specialty care to Soldiers, Marines, Sailors, Airmen and Coasties.  He has treated people with combat trauma, those who have been sexually assaulted, physically or emotionally abused, or have had other traumatic experiences with lingering effects.  He continues to provide this treatment in civilian practice.

1. Being “on-guard” all the time

2. Constant anxiety and fear

3. Intolerance of being around groups of people

4. Nightmares

5. Isolation yourself from others physically and emotionally

6. Difficulty progressing in therapy because talking about the trauma makes you too anxious