Now we're getting somewhere.
This entry will, no doubt, be very stream of semi-consciousness. I’m finding it hard to even type. I’ll just let it flow according to notes I took over the course of the morning. I’ve begun carrying as little note pad with me (“This is my brain. This (the notebook) is my brain on ECT. What were we talking about?”) Treatment #3 was this morning. My procedure time was 9:30. I was to arrive at 8:00. Of course, I was to have no food or liquid after midnight. No problem, given the time of the procedure. I was also not supposed to have alprazolam after noon yesterday. I had a little last evening at 5:00 just to take the edge off.
I can tell that my bad mood, or maybe just a bad disposition, is back. My wife and I seem to not communicate well or disagree or butt heads when this is occurring. When it worsens, I just get really quiet with a very furrowed brow. I tried to shake the negativity, but it was like a constant annoyance or irritation. I think I mentioned previously that each time I go in, they have me do a Beck Depression Inventory. It is a 21 item questionnaire in which I rate my feelings in different areas overt the previous several days (e.g. “I feel sad: none of the time (0); some of the time (1); most of the time (2); all of the time (3)) and points are assigned to each answer. Max score, as you can see, is 62, at which the world would be a worse place to live than anyone could possibly imagine. My initial Beck was 36 (which my Doc said was “very depressed”). My Beck before treatment #2 was 40, and before today was 35. Insurance has approved 6 treatments, with consultation to follow those before another 6 are approved. I know how to score the test, which gives it an inherent bias and vulnerability to manipulation. I have been thinking about these things. From a “getting insurance approval” perspective, is it better to continue to have high Beck scores so that insurance thinks “he’s not better yet, we need to approve more treatments,” or improving Beck scores so that insurance sees progress and approves more treatments. (Not that I would manipulate the results in this way…I DO want to use the tool correctly and to get better.) This thought only comes to mind because I inherently don’t trust insurance companies and the “system”. We all know its broken and no one who is in a position of power to effect change can or will.
We were on time to Porter, but my wait was longer this time. The previous two times, I hadn’t even have had time to get the bed warm before I had an IV, had seen the doc and anesthesiologist and been whisked off to the OR. I think I got spoiled the previous times. I was rolled out 30 minutes late and it seemed like much longer. Things don’t seem as organized and on schedule in the morning (just an observation). I didn’t feel at all nervous today. It was a huge difference from last time. Practice makes perfect, I guess.
Had they used today’s OR on my first visit, I would not have made it all the way there before jumping off of the gurney and running away. The first couple of times, the Ors were close to the prep area and they were new, white, bright, and looked like a place I might want to have an electrically stimulated grand mal seizure. Today’s OR was through a winding route of hallways. It looked like something you might find in the basement, with the equipment they had long since replaced with better stuff. It was gray and uninviting, and didn’t seem as professional of “ready” (and it wasn’t cold…ORs are supposed to be cold!). Details… We switched anesthesia today, form Brevital (nurse said “240” not sure of units) (generic form is METHOHEXITAL) to etomidate (nurse said 20 + 10, again not sure of units). Doc said that they were giving me a “hefty dose” of Brevital to get the job done, and that Brevital can inhibit seizure duration and increase threshold stimulation required. She said they usually start with Brevital and wind up changing to etomidate. Anecdotally, she said she thought they should just start with etomidate. I didn’t get the WAWAWA sound with this med. Instead, I got a nasty throbbing in my hand where the IV was inserted. I mentioned it to the anesthesiologist. He said “give it just a second, and it …..” Lights out. I’m pretty sure the end of the anesthesiologist’s sentence was “make you younger and more handsome.” Liar.
I did note a lesser headache this time, but I took the fentanyl anyway (just in case.). I remember feeling much more strung out and spacey this time. Procedure took about the same duration of time. I rolled out of prep at 10:00 and into recovery I at 10:22. The Recovery II nurse made me eat something this time, so she could give me ibuprofen before I left the hospital. She brought me toast with grape jelly. It had no flavor whatsoever. My mouth was bone dry, and my throat hurt like a case of strep throat. It still hurts some 5 hours later. Drying to swallow toast, of all things, even with juice was like trying to swallow half a bag of cotton balls. The jaw pain continues. Nothing serious, but persistent.
Seizure stats Treatment #3: Peripheral – 27 seconds; EEG – 57 seconds. Doc referred to treatment as a “great, solid seizure” (is that a good thing?) with nice rhythmic amplitude (the valleys and spikes in the EEG were evenly spaced and of the same depth/height across the board) with a nice flat EEG at the end. Again, I remember the abbreviated sentence from the anesthesiologist and then “You’re waking up, its all done.”
I’ve noticed that my ears ring after treatments for some time. I can only really hear it when ambient noise is low. I notice the same thing when I take alprazolam. I’m finding it harder to remember what I have written in this blog on previous entries, especially about myself and my history. My wife says there has been a noticeable difference in my memory from treatment #1 to #2. Her reaction to this treatment (#3), which seems to have hit me hard, will be interesting. After the first treatment, the roads in my area were a bit icy. Rounding corners, a couple of times I got the sensation that we were sliding sideways. I haven’t noticed that equilibrium problem since that first treatment.
I got home and tried to sleep. I wasn’t sleepy, just wiped out and mentally tired. I think rest is in order.
I can tell that my bad mood, or maybe just a bad disposition, is back. My wife and I seem to not communicate well or disagree or butt heads when this is occurring. When it worsens, I just get really quiet with a very furrowed brow. I tried to shake the negativity, but it was like a constant annoyance or irritation. I think I mentioned previously that each time I go in, they have me do a Beck Depression Inventory. It is a 21 item questionnaire in which I rate my feelings in different areas overt the previous several days (e.g. “I feel sad: none of the time (0); some of the time (1); most of the time (2); all of the time (3)) and points are assigned to each answer. Max score, as you can see, is 62, at which the world would be a worse place to live than anyone could possibly imagine. My initial Beck was 36 (which my Doc said was “very depressed”). My Beck before treatment #2 was 40, and before today was 35. Insurance has approved 6 treatments, with consultation to follow those before another 6 are approved. I know how to score the test, which gives it an inherent bias and vulnerability to manipulation. I have been thinking about these things. From a “getting insurance approval” perspective, is it better to continue to have high Beck scores so that insurance thinks “he’s not better yet, we need to approve more treatments,” or improving Beck scores so that insurance sees progress and approves more treatments. (Not that I would manipulate the results in this way…I DO want to use the tool correctly and to get better.) This thought only comes to mind because I inherently don’t trust insurance companies and the “system”. We all know its broken and no one who is in a position of power to effect change can or will.
We were on time to Porter, but my wait was longer this time. The previous two times, I hadn’t even have had time to get the bed warm before I had an IV, had seen the doc and anesthesiologist and been whisked off to the OR. I think I got spoiled the previous times. I was rolled out 30 minutes late and it seemed like much longer. Things don’t seem as organized and on schedule in the morning (just an observation). I didn’t feel at all nervous today. It was a huge difference from last time. Practice makes perfect, I guess.
Had they used today’s OR on my first visit, I would not have made it all the way there before jumping off of the gurney and running away. The first couple of times, the Ors were close to the prep area and they were new, white, bright, and looked like a place I might want to have an electrically stimulated grand mal seizure. Today’s OR was through a winding route of hallways. It looked like something you might find in the basement, with the equipment they had long since replaced with better stuff. It was gray and uninviting, and didn’t seem as professional of “ready” (and it wasn’t cold…ORs are supposed to be cold!). Details… We switched anesthesia today, form Brevital (nurse said “240” not sure of units) (generic form is METHOHEXITAL) to etomidate (nurse said 20 + 10, again not sure of units). Doc said that they were giving me a “hefty dose” of Brevital to get the job done, and that Brevital can inhibit seizure duration and increase threshold stimulation required. She said they usually start with Brevital and wind up changing to etomidate. Anecdotally, she said she thought they should just start with etomidate. I didn’t get the WAWAWA sound with this med. Instead, I got a nasty throbbing in my hand where the IV was inserted. I mentioned it to the anesthesiologist. He said “give it just a second, and it …..” Lights out. I’m pretty sure the end of the anesthesiologist’s sentence was “make you younger and more handsome.” Liar.
I did note a lesser headache this time, but I took the fentanyl anyway (just in case.). I remember feeling much more strung out and spacey this time. Procedure took about the same duration of time. I rolled out of prep at 10:00 and into recovery I at 10:22. The Recovery II nurse made me eat something this time, so she could give me ibuprofen before I left the hospital. She brought me toast with grape jelly. It had no flavor whatsoever. My mouth was bone dry, and my throat hurt like a case of strep throat. It still hurts some 5 hours later. Drying to swallow toast, of all things, even with juice was like trying to swallow half a bag of cotton balls. The jaw pain continues. Nothing serious, but persistent.
Seizure stats Treatment #3: Peripheral – 27 seconds; EEG – 57 seconds. Doc referred to treatment as a “great, solid seizure” (is that a good thing?) with nice rhythmic amplitude (the valleys and spikes in the EEG were evenly spaced and of the same depth/height across the board) with a nice flat EEG at the end. Again, I remember the abbreviated sentence from the anesthesiologist and then “You’re waking up, its all done.”
I’ve noticed that my ears ring after treatments for some time. I can only really hear it when ambient noise is low. I notice the same thing when I take alprazolam. I’m finding it harder to remember what I have written in this blog on previous entries, especially about myself and my history. My wife says there has been a noticeable difference in my memory from treatment #1 to #2. Her reaction to this treatment (#3), which seems to have hit me hard, will be interesting. After the first treatment, the roads in my area were a bit icy. Rounding corners, a couple of times I got the sensation that we were sliding sideways. I haven’t noticed that equilibrium problem since that first treatment.
I got home and tried to sleep. I wasn’t sleepy, just wiped out and mentally tired. I think rest is in order.
posted by DeMental at 2:35 PM
1 Comments:
Me again. How's the overall "I feel like a normal Mike person" thing going? Do you feel like yourself? or zoned out? disconnected? Just wondering...hope you're better today in ALL ways!
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