 It implies that he went on Mexico, which is about 20 minutes from San Diego, and I'm going to be doing a presentation on screening and safety and Ibogaine patients at Alonzo, Dr. Perez, who could not make it, and I would go together. And his two main instructions were stick to the topic and don't swear, Claire. So, Camiche will take up the next slide. All right, so, strategies, preparation, develop situational attention, stimulate teamwork, and compensate for stressful factors. What we do when people first come into the clinic is we are prepared. We make sure we're prepared. Develop situational attention means that we focus on the client and everything that the client needs individually. And then as a team, we work together, figuring out how we're going to treat that client. And what we do is we also compensate for stressful factors once they arrive. These are, you know, addicts who are coming in and you need to be in a state of withdrawal when you're doing Ibogaine. And it's a very scary thing to be going to another country and ingesting an extract of an African root and also to be climbing to the other side of addiction, to be detoxified. And I remember for me, I just wanted, I didn't introduce myself as a user. For 15 years, I was an IV heroin user and I was also a methadone for eight years. And so it's very important for us to make sure that the client feels safe and comfortable and can trust us. That's a picture of our clinic. It's not the best picture, but that's where we are. We do anticipation, planning, optimization and information. We make just more planning and preparing. And in terms of optimizing, we want to make sure that we accommodate every client's need. Every person is unique. Every individual is different. And with information, we make sure that they are provided, you know, that they, when someone comes, that they know what they're doing when they're doing Ibogaine. It's an intense treatment. It's, you know, a lot of people don't know about it. We make sure that they're informed, educated, that they've done their research. And through all of this, it decreases the more the mortality and increases the well-being of the patient and the care quality is much better. We do all of that. The cardiopulmonary function in a psychological state must be evaluated constantly. Ibogaine affects, you know, the cardiopulmonary functions. And it's important that people are healthy enough to do Ibogaine. And so there's pre-evaluation during the treatment and then also post-evaluation constantly monitoring. The relationship between the doctor and the patient needs to be a comfortable experience. It's so important that you come to us feeling like you can trust us because, you know, this is, as addicts, we don't trust. And so it's really important for me as a former user that the patients come and feel really comfortable. So what we do is we also do our medical history and our paraclinicals. We do labs in EKGs and I'll go through the specifics of that later. And then we develop a therapeutic plan all as a team. We have five doctors on staff. There's at least 24 hours a day. There's two doctors always. We have licensed acupuncturists, a doctor of naturopathy, and the majority of the people who work at the clinic have done Ibogaine. Even a doctor, med student, our house cleaners done Ibogaine. That's with no chemical dependency whatsoever, too. So if you want to talk about, you know, people being really intrigued by something that works for other people beyond just addiction, that's pretty fascinating to me. We developed a therapeutic plan as a team and we obtained informed consent very, very, very, very, very important. We informed consent of the patient so that they understand everything that they're going to be going through and that, you know, and also for our sake, for the business and liability reasons. And we make them sign their, you know, the consent form to leave before they leave if they want to. And out of, we've treated, let's see, one year and ten months that I've owned the clinic, we've treated about 192, 191, something like that. It just counted last week. And so we want to, and only two people have left. And that's one before she got her treatment and one after. So we're pretty successful in our detoxification. Everybody leaves detoxified. Our main objective, for me, when I did Ibogaine, I didn't really feel safe in the situation where I did it. I didn't have a doctor with me. I didn't have people who spoke English. Fortunately, I speak Spanish. It really was powerful for me that, you know, these people need to feel safe when they're going through this experience. It's like midwifery, you know? Screening. So we first start with phone and emails. We do medical exams, paraclinicals, the clinical history, and then we develop a treatment plan. Let's see there. The clinical history, we go through everything. When they first arrive, basically you're under a microscope by everyone. And that includes from the doctors down to, I mean, I've had, you know, the house manager come to me and say, you know, give me some piece of information that everybody has an input. We're all just a huge team that, you know, is constantly observing what's going on so that we can contribute that to the file and to how we're going to be, you know, taking care of the client in the best way possible. So we go through everything, all of their habits, all of their allergies, all of their surgeries, you know, allergies, including food, medications, et cetera, et cetera. The screening process is very thorough. The doctor spends two to three hours with each client going through everything. Let's see here. We screen the illnesses that compromise cardiopulmonary function, heart failure, coronary heart disease, arrhythmias, pulmonary venous thromboemolism, et cetera. Active infections, you know, physical examination. This is what we do. The doctors go through everything. I mean, I've had numerous people tell me that that was the most thorough exam I've ever had. There's one of our doctors doing the exam, Dr. Marquez. You look at their general aspect, their color, how they're hydrated, their mental state, nutritional state. Of course, people on Monday, when they're first coming in, you know, we treat a population that's extremely compromised. And because we're in, we have a clinical setting within a home. It's a private home. We're fully equipped medically, you know, we need to be monitoring every single thing that's going on. And on Monday, most people are really hurting. And, you know, or they're not. They got really loaded before they came. They have to wait, wait. Complementary tests, these are the labs in the EKGs. And with the EKGs, the normality in the EKG does not exclude coronary heart disease. There are some abnormalities that lack relevancy in asymptomatic patients. And that can mean that you can have a blockage in a certain part of your heart and you can still treat you. Or you can have even had a heart attack in the past and we can still treat you. Our doctors have studied every single paper that's been published. And we've talked to people constantly. We're constantly looking at and improving and looking to see how we can treat people. And we treat some really, we treat a lot of clients that other clinics don't treat. The labs, this is just the list of the labs. I mean, it's pretty thorough. And then, you know, we do customized requests for certain lab things like, you know, cardiac enzymes. If we think the client may have signed a ischemia or pancreatic enzymes. We had a 63-year-old Vietnam vet in recently that had a triglyceride level of 1,300 or something like that. And so we were really afraid for him. And we got his pancreatic enzymes if he turned out okay. And we got his blood tests every day, actually. And a 63-year-old Vietnam vet was able to come off methadone successfully. Which is a beautiful thing. There's a happy guy getting his blood taken. We have great blood load. People are always surprised by how quickly they get the blood. EKG, diagnosis and treatment. Just exactly what I mentioned before. What we're looking for. We're looking for acute myocardial infarctions, arrhythmias. We've treated clients with arrhythmias just because you've had that doesn't mean that, you know, you have that doesn't mean you can't get ibogaine at our clinic. You know, there's numerous compromised patients that we treat. That's one of our clients getting an EKG. We had to shave him after that to really get the EKG on the extremities. And we have portable EKG so that we can take right up to the room when they're in the room. For some clients we need numerous EKG monitoring. We have cardiac monitoring, defibrillators, IVs. As I said, it's a very controlled environment. Okay, so as far as the treatments go, how we prepare when you're in the state of withdrawal and you're getting ready to, then you're going to get your ibogaine. You've been screened, you've been evaluated, you've been approved. We start with premedication. We do a prophylaxis for the gastrointestinal symptoms. One of the two most common side effects of ibogaine are ataxia and nausea. Ataxia, we can't really control, but with nausea we can with a combination of three medications that radically reduce the amount of vomiting. That really, I believe, allows the client to stay in the out-of-body experience and enjoy, or if you can call it enjoy, I believe, the experience without coming back into your body and having to vomit. There's another theory that vomiting and purging is necessary, but this is what we do. Blood clot and PE prevention, heparin, 5,000 units. We also put in every single client a half block catheter. This is what it looks like. Five minutes. I'm almost done. Thanks. What it is, is a little catheter that's got a plastic, it's a plastic catheter that so you can move your arms around and everything, and it allows a port for us to administer any medications while they're on ibogaine, because while they're on ibogaine having to try and find a vein and trying to do anything they need to do, that's not really cute. But if we have a half block, we can just put it right in. We have the port available. We can administer various medications. We've had to administer atropine for bradycardia. They keep the catheter on post-treatment as well so that we can administer. For the residual withdrawal symptoms, we use NSAIDs. In Mexico, we've got a lot of different medications that they don't have in the United States that really help with pain. Or with benzos, people who are benzo patients, or for IVs, people with a lot of methadone clients don't want to eat afterwards. I didn't want to eat, and so we can do fluids with vitamins and such. They monitor the clients. The first and most important monitor is the human observer. We're always watching, like I said. And then we have them hooked up to an oximeter which just attaches to your finger right here. It's not very invasive. It monitors the oxygen and the heart rate. And we take vitals as well. We have the doctors coming in and taking vitals as well. I know that this may sound really clinical, but it's in the context of a really loving and compassionate environment. And this comes from me after being a professional patient and being treated as though I was just another hospital visitor, et cetera. And we really, really, really try and use as much as we can on the safety side, including in a loving atmosphere. So we medicate for the nausea, and then we do a test dose. We wait 60 minutes after the anti-nausea medication so that everything starts to work. And then we give a test dose in 30 to 45 minutes after seeing how the client responds. We give our full dose. And how we dose completely also depends individually. You know, we had someone come off methadone with 770 milligrams. We have had someone come off methadone with about three grams. So, you know, it depends. And it's all involved with the safety and the team and how we evaluate that. And we've learned a lot. And we all learn a lot from each other. We all talk to each other. A lot of the providers, you know, have you done this? Have you treated someone with a naltrack zone implant? Or, you know, what would you do with this? And it's very important to stay within the community and get answers. There's Dr. Pérez, who's back with the client, checking the vitals. Right, is there a little pointer thing? Yeah. That's in the oximeter, which shows the oxygen saturation and pulse. I thought it's a dark picture. Sorry about that. Okay, I'm almost done. We monitor constantly, check blood pressure. Extremely important. You know, if your blood pressure is really high and super old, you know, we have to maintain you. And we have the ability to do that. We have the ability, if you have to come in with an infection, people, we're used to lying when we're addicted. And so we want to sound a lot better. You know, yeah, please accept me for treatment, please. So some people come in with uncontrolled diabetes or blood pressure, et cetera. So we have to treat that first. This is me with a client. This is Alex Gray mask on, music happening. It's really important for people to, you know, you know, for us to be there and make sure that they're, because within 45 minutes to three hours, depending on the metabolism of the Ibogaine, the withdrawal symptoms decrease. And so we're there looking for that and making sure that's going on. We're looking for lots of things. So these are just withdrawal symptoms. And sometimes I lie with them. And that's the end of my topic. That's the view of our, from a clinic. Do I have a couple more minutes? No. Okay. We have time for questions. Oh, okay.