Treatment #5 in the rearview mirror

It was a very irritable and nervous morning. I’m becoming discouraged that the effects of ECT seem to be wearing off about 36 hours after each treatment. Although, the “wearing off” doesn’t seem to cut as deeply now. This time had the added element of nerves over the breathing difficulty. Melissa wasn’t at the hospital at first today. I was in a horrible mood by the time I got there. Then, I had a really unskilled nurse trying to do my IV. If you can’t find a vein in my arm, you shouldn’t be doing IVs. By the time I had an IV (which another nurse wound up doing) and Melissa got there, I was in pretty bad emotional shape. I laid in the bed in pre-op for a long time, just trying not to break-down, but wanting to let go a major depression cry loose.. I talked to the ECT nurse, my doc, and the anesthesiologist about last time. All of them assured me that I was monitored and that of everyone involved in the procedure, I was the most oxygenated at a 100% oxygen saturation. My doc said I could have not breathed for 5 minutes and still been at 80%. The anesthesiologist said that the sensation I had last time was not unique. A lot of people come out of the anesthesia a little bit before the paralytic wears off. The result is waking up and feeling really weak or unable to move. In my case, she said I probably needed to or tried to clear my throat and the muscles didn’t respond. The anesthesiologist gave me a benzodiazapine this time, after the ECT, to keep me from waking up so fast and abruptly. They also gave me Toradol pre-op today in an attempt inhibit the headache. It didn’t work.

I have officially crossed that age line after which it begins to freak you out that the people in whose hands you place your life for medical procedures are younger than you. I think I heard the anesthesiologist say she had to hurry home today to finish up a book report and her algebra homework. She looked SO YOUNG! And its funny how two weeks ago I was on the verge of ending my own life, but I can get totally worked up over thinking I might have a problem breathing while coming out of anesthesia. Irony.

Everything went as planned today. Another good seizure. My doc promised to get me a print out (as soon as she could get a nice clean one) of my EEG during seizure. A lot of time there is a lot of “artifact” in the readout, resulting from movement of and around my head during the procedure. A good seizure will show nice even (in spacing and amplitude) spikes and valleys of activity, and then a rapid settling as the brain gets itself back under control. This regaining of control is where the therapeutic effect comes from.

We used etomidate (36) and 120 mg succynylcholine (paralytic) again today, preceded by lydicane to prevent IV pain as the anesthesia enters my vein. I have no memories between saying “good night” as the etomidate sucked me under and waking up in recovery. As it should be. The 2mg of versaid (benzodiazapine) did its job. Seizure stats: 23 seconds peripheral; 61 seconds EEG. Right in the range desired. Headache was a little bigger than last time. The fentanyl (2mg) didn’t touch it, but the 8mg of morphine that came next took care of it (and every other care I might have had, as well). They also gave me a percocet (.5) for the ride home. After the initial headache, there has been no pain. But I am totally wiped out. It’s a major effort to type this entry, but I knew if I waited much of the detail would be lost.

I’m glad to have this one behind me with no weirdness to worry about until next time. My doc is on vacation next week, which was a shock. Her partner will be doing my treatments and, possibly, moving me to bi-lateral. I’m not sure how excited I am about making that move with anyone but my doc, but I can deal with that if it happens. For now, I need to deal with being REALLY strung out from the cumulative effect of another ECT mixed with the pain meds. Bed time.