Treatment #9
Treatment #9 is today. I am still in the dumps over this insurance thing, although my wife and doctor team keep telling me not to worry about it. It appears that Exempla West Pines, where Cigna wants me to go after January 1, doesn’t even DO ECT, except for Kaiser Permanente patients (which I am not). The only other place is nearly 2 hours from my home. It looks like the insurance piece may work out.
Treatment today was at 10:00, but due to a cancel before me, I got in early. The OR was empty today. This was the 3rd bilateral treatment. I mentioned to my doc that for the last several days (it had been 4 days since last treatment because of Xmas) everything had had the same smell: old greasy fried chicken. Everything. My wife’s clothes, my dog, my daughter’s hair, my son’s breath, everything. She was interestingly puzzled.
Same basic procedure today: Pepsid (stomach acid), Torodol (headache), Zofran (nausea) pre-medications. We added caffeine pre-op today, which is intended to potentiate the seizure. As the brain endures these treatments, it learns to protect itself by extinguishing the seizures more quickly. This self-protective action is where the neurotransmitter production and reallocation occurs, creating the therapeutic benefit. So, with each treatment, the docs do what they can to make sure the seizure isn’t stopped too soon (remember, science says that I need at least 20 seconds for benefit.) The caffeine they use in medical contexts is NOT Starbucks. Its IV, and it tastes like a weak garlic olfactory (nasal) whiff. Then, enough etomidate to (as the anesthesiologist puts it) put an army to sleep. The trick this time was adding the caffeine, which inhibits sleep, and balancing the etomidate, of which I already need a lot, to compensate. They used versaid as an adjunct to keep me out a little longer until the paralytic wore off. I went into the OR at 9:45, and was in recovery I at 10:05, and Recovery II at 11:15. The headache was a little better today, and I wanted to stay away from pain meds as much as possible. I suspect that the day after my last treatment was as bad as it was due to pain med hangover. So, 2mg of Fentnyl IV, which is very short acting but quick and effective. Then 2 percocet in Recovery II, and 2 more about 7:00 that night at home. Not a pain free day, but manageable.
Peripheral seizure today was 17 seconds, and the EEG was 39. The doc’s noted that there was excellent sine wave pattern and an abrupt cessation of EEG activity. Both of those things make for a beneficial seizure.
Today was the first time I have woken in Recovery I and known I was in recovery. I felt like I woke up pretty cleanly. Going to sleep is a strange event. I know its coming and, every time, almost involuntarily, I say “good night” or “here it comes”. But then I wake up in recovery and cannot, at that time, remember going to sleep. Its like that slice of time from just before unconsciousness to when I wake up isn’t in my memory at first. Odd sensation. I was more talkative today, in Recovery, than ever. I talked to my nurse quite a bit, and with another patient in Recovery II. Overall, this one was very different, and better, than the others, despite the nausea on the drive home.
#10 Friday at 1:30!
Treatment today was at 10:00, but due to a cancel before me, I got in early. The OR was empty today. This was the 3rd bilateral treatment. I mentioned to my doc that for the last several days (it had been 4 days since last treatment because of Xmas) everything had had the same smell: old greasy fried chicken. Everything. My wife’s clothes, my dog, my daughter’s hair, my son’s breath, everything. She was interestingly puzzled.
Same basic procedure today: Pepsid (stomach acid), Torodol (headache), Zofran (nausea) pre-medications. We added caffeine pre-op today, which is intended to potentiate the seizure. As the brain endures these treatments, it learns to protect itself by extinguishing the seizures more quickly. This self-protective action is where the neurotransmitter production and reallocation occurs, creating the therapeutic benefit. So, with each treatment, the docs do what they can to make sure the seizure isn’t stopped too soon (remember, science says that I need at least 20 seconds for benefit.) The caffeine they use in medical contexts is NOT Starbucks. Its IV, and it tastes like a weak garlic olfactory (nasal) whiff. Then, enough etomidate to (as the anesthesiologist puts it) put an army to sleep. The trick this time was adding the caffeine, which inhibits sleep, and balancing the etomidate, of which I already need a lot, to compensate. They used versaid as an adjunct to keep me out a little longer until the paralytic wore off. I went into the OR at 9:45, and was in recovery I at 10:05, and Recovery II at 11:15. The headache was a little better today, and I wanted to stay away from pain meds as much as possible. I suspect that the day after my last treatment was as bad as it was due to pain med hangover. So, 2mg of Fentnyl IV, which is very short acting but quick and effective. Then 2 percocet in Recovery II, and 2 more about 7:00 that night at home. Not a pain free day, but manageable.
Peripheral seizure today was 17 seconds, and the EEG was 39. The doc’s noted that there was excellent sine wave pattern and an abrupt cessation of EEG activity. Both of those things make for a beneficial seizure.
Today was the first time I have woken in Recovery I and known I was in recovery. I felt like I woke up pretty cleanly. Going to sleep is a strange event. I know its coming and, every time, almost involuntarily, I say “good night” or “here it comes”. But then I wake up in recovery and cannot, at that time, remember going to sleep. Its like that slice of time from just before unconsciousness to when I wake up isn’t in my memory at first. Odd sensation. I was more talkative today, in Recovery, than ever. I talked to my nurse quite a bit, and with another patient in Recovery II. Overall, this one was very different, and better, than the others, despite the nausea on the drive home.
#10 Friday at 1:30!
posted by DeMental at 8:37 AM
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