Robert Groysman, MD

11/21/2025

Here's a dirty little secret about sinus pressure and long covid...

Although it might feel like sinus pressure is making your life miserable...

Often times when someone receives a CAT scan related to sinus pressure, nothing is found.

11/21/2025

"Can I get TWO stellate ganglion blocks in one day?"

Yes, but you MUST be careful.

The Stellate ganglion block targets the sympathetic nervous system, which often becomes stuck in overdrive.

When we perform a SGB, we're essentially giving that overactive alarm system a chance to reset. The injection creates a temporary interruption in sympathetic signaling, allowing the nervous system to recalibrate.

After an SGB, your nervous system needs time to process and integrate the reset. Think of it like rebooting a computer you don't repeatedly hit restart while it's already resetting.

The body requires that integration window to shift from a sympathetic-dominant state toward parasympathetic balance.

Some patients do receive bilateral blocks on both treated, but it depends on the experience and comfort level of the physician giving the treatment.

11/20/2025

Patients often describe a confusing paradigm: smell and taste finally come back after COVID, only to transform back into coffee smelling like gasoline, and their favorite foods becoming nauseating.

This delayed reaction isn't random.

When olfactory neurons reset after viral damage, many times they don't immediately start working properly.

Your brain receives scrambled messages interpreting pleasant scents as foul smells and familiar flavors turn awful tasting.

This is why parosmia can be frustrating. As your nervous system recovers, these misfired connections create entirely new sensory experiences.

For those navigating this transition, it's important to understand the underlying mechanisms and specific therapeutic strategies. Your nervous system is trying to 'reset' and sometimes it needs a little help.

11/18/2025

The reason some people recover faster than others. Here's why I think this happens...

Mitochondria generate the energy your body needs daily. When mitochondrial function becomes impaired, it impacts every system in your body.

The problem is poor functioning mitochondria can release by-products which rob the body of energy.

Understanding this mechanism changes the approach to recovery. It explains why pacing matters, why certain nutrients and interventions targeting cellular metabolism show promise, and why pushing through symptoms often makes things worse rather than better.

11/16/2025

Have you ever wondered if the stellate Ganglion Block requires sedation?

The short answer is no, and there's a good reason why.

During the procedure, we are using ultrasound guidance to inject a local anesthetic with precision at the ganglion.

You're awake, lying comfortably, able to communicate throughout. Most patients describe mild pressure, nothing more.

Why no sedation? We initially offer sedation for the procedure, but we found that people had difficulty breathing when using a tracheal tube, which would make treatment time longer.

11/13/2025

Patients often ask about ni****ne and spike protein and there's been plenty of speculation.

This is why I often hear, "Does ni****ne attach to the ACE-2 receptor?

The answer is, NO.

Ni****ne doesn't bind, or attached to the ACE-2 receptor

This means ni****ne doesn't interact with the way in which spike protein attaches to a cell.

11/13/2025

11/13/2025

Patients ask this question daily: "Can spike protein damage my neurological system?"

Unfortunately, I believe the answer is, YES.

We know spike protein can cross the blood-brain barrier. We know it can trigger persistent immune activation. And we're learning it may contribute to the inflammatory cascade affecting nerve function in susceptible individuals.

This is part of the reason why we're seeing mitochondrial damage inside the cell.

Believe it or not, the second way COVID can cause havoc on your system is by disrupting the flora in your gut.

If you want to learn more, make sure you watch the entire video.

11/12/2025

Parosmia or loss of smell after COVID can feel frightening.

At first it's a mild inconvenience, but soon it leave you wondering if your body is permanently damaged.

The problem is you're experiencing what I call a 'brown out'.

If you think of your olfactory system like a breaker switch it will make more sense.

When you COVID virus circulates through the body it's flicking off different functions in the body including your taste and smell.

The problem is, when you recovery the switch is not turned all the way on so your olfactory system won't function properly.

This is why you continue to struggle with taste and smell.

11/11/2025

A most common questions we get about the stellate ganglion block is: "How much is this going to hurt?"

It's a fair concern, especially when you're considering a procedure that targets nerves located in your neck.

The good news is, the anticipation often feels worse than reality.

With proper technique and numbing medication, most patients describe mild pressure instead of what they perceive might be sharp pain.

The procedure itself takes just minutes. Some feel a warmth spreading through the face and arm as the block takes effect (that's the sympathetic nervous system resetting).

The temporary discomfort of the injection is brief.

For those dealing with long COVID, POTS, or persistent autonomic dysfunction, the question isn't really about mild discomfort, it's about whether you're addressing the underlying nervous system dysregulation keeping you stuck.

11/10/2025

I am a fellow long covid sufferer. I had been in remission for over 2 years, but every so often, my long covid reminds me that it is still there, like "hello old friend, I missed you". I had severe fatigue over the last few weeks and I am reminded that I can't push myself beyond my limit. I have restarted my own mitochondrial protocol and have seen quick gains. Why mitochondrial? Well because I did the same diagnostics I do for my patients. I don't have dysautonomia. I have some gut issues, mostly gas (sorry for those who are my patients lol), some histamine issues, and hormone imbalance already managed. I can't tell you how much easier it is to treat without dysautonomia or vagus nerve dysfunction. I don't just say do as as I say not as I do, I actually do exactly what I say to you guys.