Forgetting for the moment that the ordinary man on the street might be unfamiliar with the term "transcranial magnetic stimulation", I inadvertantly jumped right into my last post without so much as a hint of what the dang thing was even used for. So I did get a few "whatthehellrutalkinabout?" questions.
TMS is the new electric-convulsion shock therapy (ECT). Instead of using electric shocks on your brain, they use magnetic shocks, kind of like an MRI works (I'm sure a medical expert would beg to differ; I'm only interested in getting something to fix me, not exactly how it works). I had ECT back in the early 1990's. It didn't work. In fact, it cut out huge chunks of my memory so if some of you who knew me then and wondered why I didn't seem to remember you'd moved back to Oklahoma City from Washington D.C. and we'd had lunch just a month ago, that's why. I forgot lots of facts I needed for work. Lots of life was as if I'd seen a preview for the movie, but never actually saw the movie. So on to 20 years later: TMS doesn't require any anesthesia. You drive yourself there; 45 minutes later, you're on your way to work. I don't seem to have forgotten anything; didn't even have a headache. I had 14 or 15 of the minimum 26 treatments required. I couldn't tell if they were helping--they say 20 treatments is kind of a magic number. My psychiatrist refused to allow any more treatments because she decided I'd made a suicide attempt and protocol demanded that all TMS be stopped if the patient tried to off herself. I did not make a suicide attempt, but hospitals and medical personnel really don't care about your explanation, especially when you seriously did try to kill yourself just 4 months back. So that's how I ended up in the mental ward of the hospital now known only as "D". I'll save the story of what is and what is not a suicide attempt for another post and you can all vote on which you think it was.
Monday, May 23, 2011
Friday, May 20, 2011
Transcranial Magnetic Stimulation (TMS)
TMS is still considered "investigational therapy" by insurance companies (or at least my insurance company) because insurance companies apparently prefer to spend thousands of dollars on hospital care, psychiatrists, therapists, and drugs rather than risk money on something that conceivably might help you after everything else has failed. At least the insurance industry keeps the employment rate from sinking even further by following this policy. The original idea was for me to have 26 daily treatments (Monday through Friday), although this was cut short after events I'll tell you about in another post. The following is an extremely unscientific view of my impressions after my first two treatments:
While I was getting the TMS today, I decided it felt and sounded like a very robust woodpecker pecking my head, which is protected by a thin, tight, tin colander minus the holes so the beak doesn't actually go through. I don't really have a colander on my head; I just had 37 minutes to think about it and decided that was the best comparison. It's very loud; I have to wear earplugs. The way they find the initial site is the tech starts shooting these magnetic pulses at your head. When your thumb jerks, they've found the right place. It can't be your index finger, just your right thumb. If your whole hand jerks, then it's set too strong. Next, they look at your skull as if it were surrounded by a webbing and they have to aim the pulse at the tiny space in between the webbing (which are actually nerves). If it hurts, then they aren't in the right place. The first day took an hour and a half, but then they can lock in your settings, so today was no big deal except it's hard to remain perfectly still for 37 minutes. They put tape around your forehead and then from your forehead back behind your head and then this spongy thing against your right ear holding your head still. The woodpecker strikes your head for 4.7 seconds (but he gets in about 20 very rapid pecks during that 4 seconds) and then you have a 23 second respite before it starts again. Let me just reiterate this is a quite burly woodpecker who has been in training for a half marathon for months. I asked the tech if other patients compared it to a woodpecker and she said, "A woodpecker on steroids!" But it doesn't hurt; it's just annoying, and I haven't had any side effects. Doesn't this sound sci-fi? Maybe I can get them to take a picture so I can scrapbook it for posterity.
While I was getting the TMS today, I decided it felt and sounded like a very robust woodpecker pecking my head, which is protected by a thin, tight, tin colander minus the holes so the beak doesn't actually go through. I don't really have a colander on my head; I just had 37 minutes to think about it and decided that was the best comparison. It's very loud; I have to wear earplugs. The way they find the initial site is the tech starts shooting these magnetic pulses at your head. When your thumb jerks, they've found the right place. It can't be your index finger, just your right thumb. If your whole hand jerks, then it's set too strong. Next, they look at your skull as if it were surrounded by a webbing and they have to aim the pulse at the tiny space in between the webbing (which are actually nerves). If it hurts, then they aren't in the right place. The first day took an hour and a half, but then they can lock in your settings, so today was no big deal except it's hard to remain perfectly still for 37 minutes. They put tape around your forehead and then from your forehead back behind your head and then this spongy thing against your right ear holding your head still. The woodpecker strikes your head for 4.7 seconds (but he gets in about 20 very rapid pecks during that 4 seconds) and then you have a 23 second respite before it starts again. Let me just reiterate this is a quite burly woodpecker who has been in training for a half marathon for months. I asked the tech if other patients compared it to a woodpecker and she said, "A woodpecker on steroids!" But it doesn't hurt; it's just annoying, and I haven't had any side effects. Doesn't this sound sci-fi? Maybe I can get them to take a picture so I can scrapbook it for posterity.
Wednesday, May 18, 2011
Why Your Anti-Depressants May Not Work
After I finished the out-patient clinic, I started seeing a psychiatrist who began by drawing a ton of blood from me, which she sent off for DNA testing among other things. I'm sure I don't have this all worded scientifically correct, but basically we discovered I had a defective gene in my liver which prevented production of the enzyme which would metabolize the anti-depressants I'd been taking for over 20 years.
Almost every anti-depressant I'd been prescribed used that particular genetic enzyme to work, but I didn't have it. I might as well have been taking a placebo. These tests have only been widely available for about the last three years, so if you're experiencing the same frustration of one useless anti-depressant after another, demand your DNA be tested.
An interesting side note to the defective gene: Knowing I'd had breast cancer, the report cautioned that I should not be given Tamoxifin as a follow-up to chemotherapy. It was metabolized by the same inoperable enzyme and would be useless. Back in 1995 when I had cancer, my oncologist prescribed Tamoxifin for me. My husband, who is one of the most mild-mannered of men, absolutely refused to let me take Tamoxifin. My family was probably a little pissed at him, thinking the doctor knew best, but my doctor appeased him and prescribed something else. The purpose of the Tamoxifin is to help in remission of the cancer. My taking it would have been totally pointless. Of course, the way I feel today, I'm not completely happy with that outcome, but I have to admit it kind of freaks me out.
Almost every anti-depressant I'd been prescribed used that particular genetic enzyme to work, but I didn't have it. I might as well have been taking a placebo. These tests have only been widely available for about the last three years, so if you're experiencing the same frustration of one useless anti-depressant after another, demand your DNA be tested.
An interesting side note to the defective gene: Knowing I'd had breast cancer, the report cautioned that I should not be given Tamoxifin as a follow-up to chemotherapy. It was metabolized by the same inoperable enzyme and would be useless. Back in 1995 when I had cancer, my oncologist prescribed Tamoxifin for me. My husband, who is one of the most mild-mannered of men, absolutely refused to let me take Tamoxifin. My family was probably a little pissed at him, thinking the doctor knew best, but my doctor appeased him and prescribed something else. The purpose of the Tamoxifin is to help in remission of the cancer. My taking it would have been totally pointless. Of course, the way I feel today, I'm not completely happy with that outcome, but I have to admit it kind of freaks me out.
Sunday, May 8, 2011
Twice in Four Months??
Yes, I got too depressed to continue my blog. Nothing good (except for meeting some wonderful fellow-patients) seemed to happen with the out-patient clinic and I couldn't stand writing nothing but negative stuff. Some good things have happened since I finished the clinic, but I'm going with the dramatic first and then I'll back up and fill you in with later posts. Maybe that will give me the incentive to actually write the posts and you the incentive to come back and find out what happened. I wrote the following to friends and family one night when I couldn't sleep, so that's why it has references to things as if you know me. The two things I should first explain, after managing to stay out of mental hospitals since 1988, I found myself in one again (after January '11) in April. Second thing--I no longer sleep. Last count was ten hours and fifteen minutes in 144 hours. I can only sleep with drugs, and I metabolize them super fast so they only work for a couple of nights. The condition is called tachyphylaxis. Okay, so this is what I wrote a few nights ago after I just got out of the hospital for the SECOND time:
Since I'm not sure I'll ever sleep again, I've been lying here thinking about my experiences over the weekend at D and cracking myself up laughing (which as many of you know is one of the reasons I have an intact personality and won't need psychoanalysis once I'm cured of depression--oh happy day!) I wasn't always laughing of course at D--Dan knew it was me calling because there was either this long pause after he said hello where I was trying to quit gasping out sobs and begin talking, or I was already in the midst of hiccuping words trying to make myself understood. My first day's goal was to not cry. At the end of the day we were asked if we'd met our goals. I said yes, I hadn't cried at all, merely sobbed, gasped, and hiccuped. But that was just the first day. Things got better of course. We had art projects. There was a whole box (not the big one with the built-in sharpener) of crayons worn down to the nub. You may think you only need sharp crayons to stay inside the lines, but let me tell you, you can't do anything with a nubby crayon. Borrow one from a child and try it. Unless you write REALLY BIG you can't even tell what you wrote. There was plenty of evidence of this where people had written phone numbers in very big numbers next to the telephone. Of course, some of the numbers you couldn't still read beause people had knocked out the sheet rock with their fists, I assume in a pique of anger. I swear, I really am laughing about this now; I'm not just going for the sympathy vote. There were two phones, but the other one just hung from the wall where I guess someone had pulled it out. You could use it if someone would hold it up to the wall for you while you dialed and talked.
On Sunday this nicely dressed lady brought in a whole bundle of word search puzzles. I noticed later they were all Christian-themed puzzles and I'm sure she came straight from church. Of course there wasn't a chance in hell you could have circled only one word with those nubby crayons, but she didn't know that--she would probably have brought us more crayons. I asked her if she had the New York Times Sunday Crossword Puzzle. She gave me the oddest look and I was immediately repentent and said, "I'm sorry, I'm just a smart ass." And then I realized I should apologize for that but thought it would just make matters worse, so I shut up. There was quite a variance of inmates at D--we had a number of shaved and tattooed heads, necks, and arms, a couple of old geezers in wheel chairs, a few teenagers, a couple of schizophrenics, maybe a few alcoholics and druggies and then your usual crowd of the depressed and anxiety-ridden. One day in group we were supposed to be telling our talents (this is good for our self-esteem). The old geezer in the wheelchair behind me said he could hotwire a car in 24 seconds. How can you not get hysterical about that?
None of us had any belts so we were all "saggin'". The doors were always locked of course, but I had this vision of us making a break for it--two of us pushing the wheel-chair bound and everybody trying to hold up their pants while the security guard (no spring chicken himself) chased after us. It would have been a sight to behold.
All of you know that I don't leave town without at least one deck of cards, but not realizing my shrink was going to freak out on me and put me in the hospital, I had no cards. Neither did D. It was just sad. They had 4 UNO cards and two decks that contained about seven cards each. Inexplicably, there was an extra Jack of Clubs in one deck. But even expert card shark that I am, I could think of no game to play that involved fourteen cards and 4 UNO cards. Maybe if I'd had more time. My goal of teaching the card game of golf to every mental health facility in the state was stymied. After I'd been there a few days, I found out there were two sides to D--there was the side for the good kids and the side for the bad kids. The staff denied there was any difference, but I never let an opportunity go by to point out the lavish facilities on the good kids side. They had a piano and a book case of hymnals and many true romance novels. They had two phones, both attached to the walls. Their furniture had stuffing and ours was reduced to the boards with a bit of fluff and that fake leather stuff. They could have visitors. They even had a Jeopardy game. It didn't have any cards and I couldn't figure out how the pieces were supposed to go together so you could secretly read the cards had there been any, but by God they had an intact box. They had magic markers. They may have even had ink in them--I never tried them out. I think it was Monday night I actually got to move to the good kids side. I don't know what precipitated that unless it was that I finally took a shower. I said I was in protest not changing my clothes until they let me out of there, but really that big communal shower just freaked me out. I know there had to be spiders in the corners and all sorts of fungal growth, probably most of it microscopic. But by Monday I couldn't stand the stench of me any longer and broke down. Then I got scrubs to wear and my saggin' days were gone. Don't think you get scrubs with drawstrings, however--strictly elastic.
My first roommate was a kleptomaniac. The nurse warned me about her, but I said it didn't matter--all I had were the clothes on my back. The hospital gives you body wash, toothpaste, toothbrush and deodorant (I realized they would also give you a comb if you asked for it once my protest days ended and I finally washed my hair). But my second day there I noticed my toothbrush was gone. They give you the damn toothbrushes! Why would she want my used one? There is no explaining those crazy people.
Okay, I've sent almost all of you my Personal Affirmation (another exercise good for our self-esteem), but for those who have yet to receive it, here it is in all its glory. I might mention that by the time I wrote it all the tattooed, bald-headed guys had been discharged. I'm not crazy, after all. They could have mopped up the floor with me.
I am the toughest, Xena Warrior Princess in this place because I have fought depression for 35 years and 6 months and am still alive to tell you about it. The only time I broke was Jan. 2, 2011, and while it's true they had to bring me back kicking and screaming and I was mad as hell to be alive, I still got back up and started fighting again. So I think that makes me the biggest bad ass in here. And if you think you can top that, let me know and we'll go head to head.
Since I'm not sure I'll ever sleep again, I've been lying here thinking about my experiences over the weekend at D and cracking myself up laughing (which as many of you know is one of the reasons I have an intact personality and won't need psychoanalysis once I'm cured of depression--oh happy day!) I wasn't always laughing of course at D--Dan knew it was me calling because there was either this long pause after he said hello where I was trying to quit gasping out sobs and begin talking, or I was already in the midst of hiccuping words trying to make myself understood. My first day's goal was to not cry. At the end of the day we were asked if we'd met our goals. I said yes, I hadn't cried at all, merely sobbed, gasped, and hiccuped. But that was just the first day. Things got better of course. We had art projects. There was a whole box (not the big one with the built-in sharpener) of crayons worn down to the nub. You may think you only need sharp crayons to stay inside the lines, but let me tell you, you can't do anything with a nubby crayon. Borrow one from a child and try it. Unless you write REALLY BIG you can't even tell what you wrote. There was plenty of evidence of this where people had written phone numbers in very big numbers next to the telephone. Of course, some of the numbers you couldn't still read beause people had knocked out the sheet rock with their fists, I assume in a pique of anger. I swear, I really am laughing about this now; I'm not just going for the sympathy vote. There were two phones, but the other one just hung from the wall where I guess someone had pulled it out. You could use it if someone would hold it up to the wall for you while you dialed and talked.
On Sunday this nicely dressed lady brought in a whole bundle of word search puzzles. I noticed later they were all Christian-themed puzzles and I'm sure she came straight from church. Of course there wasn't a chance in hell you could have circled only one word with those nubby crayons, but she didn't know that--she would probably have brought us more crayons. I asked her if she had the New York Times Sunday Crossword Puzzle. She gave me the oddest look and I was immediately repentent and said, "I'm sorry, I'm just a smart ass." And then I realized I should apologize for that but thought it would just make matters worse, so I shut up. There was quite a variance of inmates at D--we had a number of shaved and tattooed heads, necks, and arms, a couple of old geezers in wheel chairs, a few teenagers, a couple of schizophrenics, maybe a few alcoholics and druggies and then your usual crowd of the depressed and anxiety-ridden. One day in group we were supposed to be telling our talents (this is good for our self-esteem). The old geezer in the wheelchair behind me said he could hotwire a car in 24 seconds. How can you not get hysterical about that?
None of us had any belts so we were all "saggin'". The doors were always locked of course, but I had this vision of us making a break for it--two of us pushing the wheel-chair bound and everybody trying to hold up their pants while the security guard (no spring chicken himself) chased after us. It would have been a sight to behold.
All of you know that I don't leave town without at least one deck of cards, but not realizing my shrink was going to freak out on me and put me in the hospital, I had no cards. Neither did D. It was just sad. They had 4 UNO cards and two decks that contained about seven cards each. Inexplicably, there was an extra Jack of Clubs in one deck. But even expert card shark that I am, I could think of no game to play that involved fourteen cards and 4 UNO cards. Maybe if I'd had more time. My goal of teaching the card game of golf to every mental health facility in the state was stymied. After I'd been there a few days, I found out there were two sides to D--there was the side for the good kids and the side for the bad kids. The staff denied there was any difference, but I never let an opportunity go by to point out the lavish facilities on the good kids side. They had a piano and a book case of hymnals and many true romance novels. They had two phones, both attached to the walls. Their furniture had stuffing and ours was reduced to the boards with a bit of fluff and that fake leather stuff. They could have visitors. They even had a Jeopardy game. It didn't have any cards and I couldn't figure out how the pieces were supposed to go together so you could secretly read the cards had there been any, but by God they had an intact box. They had magic markers. They may have even had ink in them--I never tried them out. I think it was Monday night I actually got to move to the good kids side. I don't know what precipitated that unless it was that I finally took a shower. I said I was in protest not changing my clothes until they let me out of there, but really that big communal shower just freaked me out. I know there had to be spiders in the corners and all sorts of fungal growth, probably most of it microscopic. But by Monday I couldn't stand the stench of me any longer and broke down. Then I got scrubs to wear and my saggin' days were gone. Don't think you get scrubs with drawstrings, however--strictly elastic.
My first roommate was a kleptomaniac. The nurse warned me about her, but I said it didn't matter--all I had were the clothes on my back. The hospital gives you body wash, toothpaste, toothbrush and deodorant (I realized they would also give you a comb if you asked for it once my protest days ended and I finally washed my hair). But my second day there I noticed my toothbrush was gone. They give you the damn toothbrushes! Why would she want my used one? There is no explaining those crazy people.
Okay, I've sent almost all of you my Personal Affirmation (another exercise good for our self-esteem), but for those who have yet to receive it, here it is in all its glory. I might mention that by the time I wrote it all the tattooed, bald-headed guys had been discharged. I'm not crazy, after all. They could have mopped up the floor with me.
I am the toughest, Xena Warrior Princess in this place because I have fought depression for 35 years and 6 months and am still alive to tell you about it. The only time I broke was Jan. 2, 2011, and while it's true they had to bring me back kicking and screaming and I was mad as hell to be alive, I still got back up and started fighting again. So I think that makes me the biggest bad ass in here. And if you think you can top that, let me know and we'll go head to head.
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