Knots Unwound

Kelly Kapsar

702-463-7707

SilverArc APN

Paul Kapsar

702-586-5060

© 2018 Knots Unwound | SilverArc APN

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Become a Member

Become a member and get primary care on your terms

This is no ordinary medical office. We’re focused on getting to know you better as a patient and a person so we can provide you with better, more personalized care.

 

The Benefits of Membership

Your membership fee enables us to provide services and benefits beyond what insurance covers, so you can get care whenever you need it.  Your care is our highest priority, and we're dedicated to giving you the best experience possible.

 
 

Wellness Care

SilverArc APN is a Wellness program

 

Paul’s current practice is based on his formal education as Family Nurse Practitioner. Being a family Nurse Practitioner his scope of practice is conception to end of life. He has gradually limited his patients to those over 18 to let those most current in childhood care deal with the younger members of the population.


One dimension of care that has been added through continued education and experience is the ability to assist those who have substance dependence challenges by addressing them in a holistic, mindful, wellness based manner.

 

 

What is Wellness? Turns out there are more definitions of wellness than most people can count. The Institute of Medicine has chosen a definition from The National Wellness Institute  “wellness is a multidimensional and holistic state of being that is conscious, self-directed, and constantly evolving to achieve one's full potential.

 

Wellness is an ever-changing process that encompasses multiple dimensions, known as the Six Dimensions of Wellness: intellectual, spiritual, emotional, physical, occupational, and social dimensions. The Six Dimensions of Wellness reflect unique characteristics that interconnect with one another to represent the person as a whole. 

 

We tend to speak more colloquially than this deeply academic philosophical definition but portray the same meaning. We look at you as and entire person and assist you in meeting your highest and best self. When this evaluation has been completed we will be “showing you the path” to your healing and wellness. 

 

Do you have an ongoing challenge that seems to not be improving?  We are here to spend time reviewing your healthcare history, supplements, herbs, and medications, conduct an appropriate physical examination or diagnostic studies as may be necessary. We will review your “Dr. Google” findings and assist you to understand the relevance of your intensive research to your current state of health and your desired wellness goal.  

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We do request if you have more than one provider or type of provider you let us know so there is no miscommunication, duplications, or cancellation of medications vital to your highest state of wellness. 

Acute and Chronic Pain Care

What is painPain is defined by the International Association for the Study of Pain (IASP) as Pain “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” You will notice pain is not just a physical sensation but has an emotional component.


In the healthcare world pain is separated into two divisions Acute and Chronic. Acute pain is that caused by an injury, surgery, localized infection, or other cause expecting to be self-limited and manageable. Chronic pain is pain from any source lasting more than three months that may be from a known or unrecognized source.

Current care for pain is to mask it from ourselves through the use of medications, such as opiates (hydrocodone, Lortab, Vicodin, codeine), non-steroid and anti-inflammatories (NSAID’s) such as ibuprofen, Aleve, Motrin, aspirin, or acetaminophen (Tylenol) a pain reliever that is not an NSAID or opiate.

The Centers for Disease Control and Prevention guidance on use of opiates for pain recommend the preferred choice is not use nonopiate methods for pain relief if possible.  Should opiates be required no more than 5 days of an opioid for acute pain, with a preference for fewer days before switching to another type of pain relief.

SilverArc APN in conjunction with Knots Unwound uses a fusion of care methods, practices, and modalities to assist you to address your pain concerns.  The Neuro Stim Device is one of the modalities used to decrease pain and dependence on opiates.

 

The Neuro Stim sends a low level electronic signal through the ear causing stimulation to branches of the cranial nerves and reduce the sympathetic nerve stimulation. This stimulation modifies how pain is perceived. This device generally provides a permanent reduction in pain. For those with chronic pain and opiate use it assists in decreasing or eliminating the use of opiates.


As your pain begins decreasing it is importance to make additional lifestyle changes moving you into your new wellness. This is accomplished through gradually increasing exercise, switching to a Mediterranean diet, adding guided meditation, and including the therapeutic benefits of essential oils. We are uniquely qualified to assist you on this journey.

 

- The US patent office issued a patent to IHS on May 31, 2017. US 9,662,269 B2, for its unique technology

-The HRV and animal data confirm that we are affecting the brain and CNS without surgery which has never been done

-HRV studies and animal data confirm we are stimulating the vagus nerve affecting the parasympathetics which means we are positively affecting ANS balance

-Double blind, randomized, placebo controlled study is completed and the paper will be published in a top tier journal this summer

-73% reduction in chronic pain

-Data confirms that 12 weeks out we are still showing a 70%+ reduction which beats the data of injections

-Mechanism of Action is neuromodulation via the cranial nerves to the NTS, Amygdala, Hypothalamus, dorsal horn of the spinal column.

-Studies indicate we are reducing the firing of the Amygdala by 77%

-Studies indicate we are reducing pain, via the spinal cord and central brain structures, by 65%

 

A few other modalities include time on the Biomat and massage therapy with Kelly of Knots Unwound.

 

 

Outpatient Drug Detox

First, congratulations on making the difficult decision to seek assistance in dealing with your substance use concerns. We are aware this is a big step that is difficult to make. We recognize you are likely to have shame and guilt and may not really want to disclose “all that stuff” that has occurred in the past. We applaud your choice and are nonjudgmental as to the past. it is vital to disclose all events in order for us to provide the complete care you require.

Drug Detox This is an old term that is still in popular use. The current terminology is Substance Use Withdrawal Management that includes all substances that may be problematic for you. Our process involves more than just getting the body free of the substance causing problems for you colloquially known as detox. We will use WM in our information from here on out.


Substance Use Withdrawal Management (WM) encompasses “the detox processes” with various medications but also involves developing the full plan for your recovery including looking at the underlying issues that led to and maintain your drive to use, plan for substance use counseling, connecting you with collaborators, and planning for your use of opiate blockers, and craving reducers as needed.

Not everyone is eligible or appropriate for outpatient WM treatment. Your initial assessment includes a full substance use history, social history, and physical examination and will determine the necessary course of action. We have a number of recovery centers we collaborate within the Las Vegas area.

The process of outpatient WM requires at home assistance and monitoring. Part of your agreement with us will include the requirement for a responsible adult willing to be with you for the duration of the withdrawal process. This person ensures your safety, manages your medications as prescribed, and assists where needed.

The investment of our outpatient substance use withdrawal management is typically less than the co-pay you would have for an inpatient stay. We have an initial assessment fee, that is just that your initial assessment.  Once your needs are known the cost of treatment and duration can be calculated.  Treatment costs are typically less than your copays for an inpatient stay and must be paid in advance.

"About 6 months ago I met with Paul Kapsar about naltrexone.  I received the book he recommends along with 3 prescriptions of naltrexone. It has completely changed my life and I have never felt better and in more control. I still have 4 left and another prescription. I will be coming back to Las Vegas on May 5th to setup a meeting or the ability to not only thank Paul but also get my prescriptions renewed.  Thank you!"
- Mr. B.

Medication Assisted Substance Use Treatment (MAT)

 

PMPAware-Nevada

Before any controlled substance - those on the DEA Drug Schedules - can be prescribed or delivered every provider must do a search to determine your prescribed use of controlled substances. SilverArc APN does this when you have an upcoming appointment. This report will be shared and confirmed with you at your appointment. This information is entered into the database by each pharmacy when your prescription is filled and there are occasional mistakes. We are open to hearing your comments.

The Sinclair Method

Not everyone is ready for a full stop from their alcohol intake. While here at SilverArc APN we believe that full stop and abstinence is the safest method we have come to understand The Sinclair Method (TSM) of alcohol harm reduction is very helpful in reducing the amount of alcohol being consumed. TSM is best understood by listening to Claudia Christian’s TEDx talk and her journey with alcohol. 
Click here to set up your appointment.

 

 

 

 



 

 

 

Buprenorphine Treatment

Buprenorphine/naloxone (Bunavail, Suboxone, Zubsolv) is used to manage the use of opiates, particularly street purchases of opiates to assist the individual to return to a more healthy and functional lifestyle. Buprenorphine/naloxone was developed as a long-term opiate replacement. It too is an opiate but it only partially activates the opiate receptors avoiding the high.
SilverArc APN uses it primarily as a method to move from opiates to abstinence in a relatively comfortable manner. We discourage long-term buprenorphine/naloxone use.  Click here to set up your appointment.

Naltrexone (generic), Naltrexone ER (Vivitrol)

Naltrexone is an opiate receptor blocker meaning once it is in your system opiates cannot reach your receptor to cause the high. We will discuss the full meaning of this when you are in the office.  In the case of opiate use you must be free of the opiate for 7-14 days depending on the particular substance in use. If started too soon it causes a “full withdrawal all at once", and that is miserable. Being fully aware of this possibility we work with you to insure the timing is correct and your receptors are clear before staring either form of naltrexone.

Should you be someone with an alcohol use concern it is a bit easier. While it is still the opiate receptor that is blocked the naltrexone greatly decreases the cravings and changes the experience of drinking to assist you in being less interested in drinking. The time between your last drink and starting naltrexone is much less than with opiates. 
Click here to set up your appointment.
 

Paul, I  just wanted to thank you for visiting with me about the alcoholism issue that I was facing. The naltrexone has done a wonderful job so far to kick my alcohol cravings and how much I drink when I do. It took a few days for me to see the difference but now the cravings are gone and the consumption I take in when I drink has reduced greatly. I am so grateful that I was able to find someone to talk to about this method (you and SilverArc APN staff) and can’t thank you enough. It has been a rough past dealing with the alcoholism and now I have found something that is truly working vs treatment centers and AA that I have tried in the past.  I just wanted to give you a update on how I am doing and also a BIG thank you for your hospitality and giving me a shot at trying The Sinclair Method. Silverarc was a pleasant and wonderful experience and wish that all places were as kind hearted and caring as you all were to me. I look forward to visiting with you and the staff in the future and can’t thank you enough, you have truly changed my life for the better and feel blessed that I ran across Silverarc and the sinclair method when researching cures for alcoholism.

With great appreciation, BV