Archive for January, 2009

January 30, 2009

“Good Seizure!”

Finally! When one of the nurses said those words to me, I was just coming out of the post-anesthesia haze and didn’t quite know what that meant. As I was later getting wheeled out to gather my things, I noticed in my hands some papers which had checked off my mood (“pleasant”), affect (“flat”), etc. But in the slot to fill in the duration of seizure, there it was: 29 seconds. In the APA guidelines, a seizure is considered ‘good’ when the duration is more than 25 seconds.  In the past five seizures, I was only able to sustain less than 20 seconds, a weak response.  This titration exercise is finally starting to mean something. I hope these “good seizures” will ultimately result in the actual desired outcome. Of course, now that this titration is coming to fruition, my ECT doc, Dr. J, foreshadowed the storm that will probably come down starting next week, and by that, he means post-ECT memory issues.

Nevertheless, those two words by Marianne were the best two words I heard since the treatment started.

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January 29, 2009

asian family secrets

I have not always been forthcoming about my illness. I kept it hidden like some dark secret from my parents. In an Asian household, you don’t want to tell your parents that you don’t want to be a doctor, just as much as you don’t want to tell them that you’re depressed. But, when my mother began asking some questions yesterday (not for the first time), I decided that I should answer them. I found my mother that night crying loudly about how sorry she was to have put me in this situation and how she wasn’t a good mother. As I tried futilely to comfort her, I thought, this is why I can never say anything in this family. As soon as someone reveals something real, that reality is turned onto themselves, as if God personally blamed that person for this occurrence. I’ve never been a part of an “American” family, but there is subtle secrecy in Asian families that I’ve observed nowhere else. What happens in life never happens because “It’s life.” It’s about some god holding you responsible for something.

Given a history of (undiagnosed) mental illness in the family, I hit the genetic jackpot when it came to coming across a mood disorder. To an extent, I have come to terms with this situation. But once again, I find myself feeling so responsible for putting my parents in this situation. Watching my mother writhe with such emotional pain almost made me wish I had never told them. If I had only kept quiet, then what would’ve happened, I wondered.

Then, as I write this, I know I did the right thing by asking them for their help, even if I can hardly bear watching them agonize. I am not going to continue this cultural malignancy that can only fester by the generation. That said, I need these treatments to work because I’m afraid they would never be able forgive themselves if this last-ditch effort fails.

Our family has come very far in the treatment process, far more than I could’ve ever communicated with them a year ago. I just want to this go okay, if not for me, then, for the family.

January 28, 2009

doubt

For the first time, I got nervous just before the anesthesiologist administered the anesthetic. Before I could utter a word, I was awake only to find yet again that I still felt that ambiguous sense of fear.  All the other times have been so easy, but easy isn’t the desired result.   I realized what I felt was doubt. I was no longer worried about memory loss or other side effects; I am now worried about one thing: What if it doesn’t work?

It is a bit premature to start fretting, but I have now finished treatment #5 and will be done with #6 by the end of the week. According to the American Psychiatric Association, the reassessment should be done between #6 – #11. While I still have a few more sessions to go, there are only so many treatments left. More thoughts forthcoming.

January 27, 2009

happy 50th birthday, keith olbermann!

January 26, 2009

up the amp for hope

We have completed treatment #4. A lot less headaches and aches, but no less relief in the main symptom we’re trying be rid of. My ECT psychiatrist, Dr. J., tells me that no change at this point is still within the normal range, though he did increase the electrical voltage that went through my head.  Apparently, my Friday’s seizure was a little too short in duration. I told him my mood barometer question is to ask about Barack Obama or something political. I don’t think I can give him the answer he and I are both hoping to hear out of my mouth and heart yet, but I’ll get there soon, I hope. I continue to be amazed by how tightly the whole operation’s run. I think the smoothness of the procedure is what keeps my hopes up and not mind too much about returning for more every other day. (As I write this, I realize that I might mind the huge medical bill that will come as a result of additional treatments. Each ECT treatment costs around $2000, pre-insurance.)

On a random note, there’s one thing I find peculiar about Parthenon Pavilion’s ECT waiting room for families.  I don’t know why, but from the collection of magazines in the room, all ECT patients and families must be gun enthusiasts, outdoorsmen or game hunters.  I’ve never seen this many back issues of Field & Stream, American Hunter and Arizona Highways.  I had no idea that a large percentage of these readers are also prone to receiving ECT. And if that’s not the case, who in the world decided that magazines that talk about killing animals would be the best literature for an ECT waiting room? I’m tempted to gather up some Cat Fancy, Martha Stewart Living and Cosmopolitan and place them in that room.

January 25, 2009

a fit of a role, a status of a label

The first time I found myself inside a psychiatric hospital was in 2003. I was determined to not act as though I belong “in there,” and proceeded to ask question after question to the hospital staff. I guess I wanted to convince me and everyone else that, to put it bluntly, I wasn’t crazy. It’s strange how my acceptance of what I perceived to be my norm has somehow shifted in the last five or six years. I haven’t pressed the staff with questions that sound like I’m writing a sociology term paper.  I stopped attempting to seem “less mentally ill,” whatever that means. I suppose it doesn’t matter what anyone thinks because I’m already here. My “display” of depression has come into question by a patient in previous stays, and though that may have given me some secret comfort then, at this point, I don’t need someone doubting the degree of my illness. The role that I used to be okay not fitting suddenly has become the one I will make sure I fit. In Being Mentally Ill: A Sociological Theory, Thomas Scheff describes how an eventual acceptance of the deviant role will reinforce the person’s labeled status in the social system as mentally ill. Have I ascribed myself a new role? Am I just affirming an existing role, or should I not look at this situation as role-playing at all?

I do know that, statistically, I am not at all the typical ECT patient. The median age of the patients is easily around 40. I may have seen one person in his 30s. Everyone, except me, is white. In fact, I’ve never met another Asian-American psych patient. In looking at the U.S. demographics, it’s really no surprise that you wouldn’t see a person of Asian descent in a psychiatric hospital. I’m not sure if most Asian family members would even care to admit such a thing (I’m going to revisit this topic some other time. I need to gather more information…).

In a sense, ECT allows for those social roles to diminish and just concentrate on a good course of treatment. Ascribed and achieved social roles inevitably come into play in interacting with a psychiatrist, especially in a cozier setting. But must psychiatrists practice more ‘precise’ psychiatry in the case of ECT, when they must divorce themselves from making labels?

January 23, 2009

third time’s (not yet) the charm

My hair smells of the ECT room,
The faint, sterile odor embedded with
The memory of what just happened.
A doctor waves goodbye
And then I come out of a nap.
Ten quick minutes,
none of which I can recall.
No fanfare, no time to fret
As methodical as an assembly line.
The three little naps are over for the week.
Maybe the next ones will do the trick.
Then I smell the ECT residue on my hair,
and I say next ones better do the trick.

January 22, 2009

waiting for a lift

It’s already coming up on the third ECT session. The last two have not been unpleasant at all. In thinking about tomorrow’s treatment, there’s neither dread nor any sort of emotion. The feeling isn’t that of calmness; it’s as if my nerve endings have been deadened. The somewhat frustrating thing is that the accounts that I’ve read about ECT have people who felt a “lift” even after the first one.

I’m just going to assume this is temporary, because it has to be.

January 21, 2009

Be patient, patient.

Coming in for an outpatient ECT session is almost like going to a dentist appointment….almost. The receptionist opens the locked door so I can go by myself to the third floor, the same floor as where the adult ward is located. I head to the ECT prep room. If I have a short-sleeved shirt on, I don’t even have to change at all. I just need to put a gown over my clothes. My vitals are checked, and then I wait for just a little bit until a nurse comes to take me to my ECT station. After they prep me with an IV port, hook me up to machines, etc., they administer the ECT, wait until I wake up from the anesthesia, go back to the prep room to check my vitals and get my stuff, then someone wheels me out to the car where my mother is waiting. The whole process takes two, if not three hours at most.

My ECT psychiatrist apparently had to work all night somewhere else. As my anesthesiologist, Dr. Holly, knocked me out, he told me that he’ll be administering the (unilateral) ECT. I guess everything went okay. There’s not yet any appreciable difference in mood at all. The doctors told me they’ll start out slow so they can adjust in later treatments.  I’ll be patient.

January 20, 2009

political indifference

I remember that funny blue hat that Hillary wore with a reddish dress along the parade route. I can hear the cadence of Maya Angelou’s voice as she read the 1992 inaugural poem. There was that rainy inaugural day for George W. Bush. I’m not American, yet I marvel at the grandeur of this great nation as it renews its commitments to itself every four years.  It doesn’t really matter who we are placing into this office on this very day; this nation’s citizens know it’s time to affirm that this person is now the leader of this country.  We don’t have to like it, but I think most of us can still be amazed by this rich, public display of tradition and respect it. I am a political junkie, but first in a sense that I am in awe of how wonderful the system is at its very core.

I watched the Obama Inauguration Day festivities for hours. This was the day that should have made me emotional like every other inauguration. I felt utterly nothing. I watched the same scene again and again only to be speaking about how great it is, but felt nothing at all. I kept telling myself that this is the moment to tear up, or this is the moment to cheer. My heart couldn’t have cared less. A slight tick of political indifference I felt in the summer let me know that I may be headed for a long depression. But it’s more than that. I intellectually know this will pass, but when it comes to politics, I’d rather be a Republican than be indifferent.

The indifference is almost uncanny.

January 19, 2009

the first little spark

It was like pulling my car into a gas station, except in this case, car equals me. The room had seven beds, divided by a checkered hospital curtain (the person next to me thought the colors reminded her of a Mexican restaurant). The nurse asked me to wear a “vest” that allowed her to loosely tie my body to the bed in case I try to get out of the bed later and fall off. Then, someone inserted an IV, followed by my ECT psychiatrist, who was wearing some sort of a track suit. I saw him for about 30 seconds, just to tell me happy new year and that I will be receiving unilateral ECT for today (less memory loss, according to some) .  Then, the anesthesiologist spoke to me for about 10 seconds. There’s no countdown.

And then, I woke up. It was already over.

My head still hurts, and there’s some hardened gel in my hair from where they placed the electrode.

Happy Martin Luther King, Jr. Day.

January 19, 2009

breathe and reboot…

I had to recall the wisdom of Carrie Bradshaw as I got ready this morning…


“After all, computers crash, people die, relationships fall apart. The best we can do is breathe and reboot.”
-Carrie Bradshaw
Sex and the City, episode  56 “My Motherboard, Myself”

Ok. Let’s just get this over with.

January 16, 2009

On ambivalence about being ambivalent

Dr. Wick: On the contrary, Susanna. Ambivalence suggests strong feelings . . . in opposition. The prefix, as in “ambidextrous,” means “both.” The rest of it, in Latin, means “vigor.” The word suggests that you are torn . . . between two opposing courses of action.
Susanna: Will I stay or will I go?
Dr. Wick: Am I sane . . . or, am I crazy?
Susanna: Those aren’t courses of action.
Dr. Wick: They can be, dear–for some.
Susanna: Well, then–it’s the wrong word.
Dr. Wick: No. I think it’s perfect.
(Girl, Interrupted, 1999)

Through ECT, it is its goal that I will come to want life.  I must confess that I still view suicide as a legitimate choice, albeit an admittedly selfish one at that.  There is a small part of me that feels like the ECT is going “take away” this choice to not live. I wrestle with my own ambivalence.  It sounds unthinkable that I still want something that has gripped my livelihood. However, having to let go of these thoughts is like losing something that’s been a part of my personal identity. My desire to want to die has been a companion for nearly a lifetime. This is where I do question if this “choice” that I so fervently want to keep is just a part of an illness. For the time being, I will consider my dilemma to be genuine and not simply rooted in a disorder.

Apparently I seem to find inspiration from President George W. Bush on this matter, because his farewell address on Thursday night made me look at my own ambivalence in a different light. His observation was that “when people live in freedom, they do not willingly choose leaders who pursue campaigns of terror.” Now, I’m not saying that I agree with his policy or the general doctrine; I’m simply applying his speech excerpt to my little problem here. But I think he has a point. Bush is essentially pointing out that if one is given a choice but only one has been familiar to you your whole life, you would likely pick something that you know even if that “choice” isn’t beneficial to you (Of course, in the context of foreign policy, this would assume that a way of thinking different from US policy-not just in terms of Middle East extremism-is flawed just because they’ve chosen to take a different approach. Okay, back to the other topic…).   To paraphrase his buddy Donald Rumsfeld from that 2002 press conference,  just because I recognize there is a “known unknown” here, how could I go ahead and choose the “known knowns” even though I don’t really know anything about the “known unknown”?

Then again, maybe my ambivalence isn’t that ambivalent. By choosing to go through ECT, haven’t I already made a choice to live?

January 15, 2009

save the date

It’s official!
I have been requested to be at my
first ECT Treatment
on
Monday, January 19, 2009
in the morning time TBD
five to twelve treatments following

gown attire
make-up and nail polish are allowed


January 14, 2009

Flashback

Yesterday I had a physical exam that is required within the seven days before the first ECT treatment. Because the blood analysis, etc., will not come back for another day, I won’t know for certain that the actual main event will happen as scheduled. If there is an irregularity that would delay the treatments, it is going to be a problem for me logistically.  My mother is flying in from Japan tomorrow and will be staying with me during the course of the ECT. I’ll know soon enough, I guess, but it would be very nice to know that my mother has rearranged a month of her life for a reason.

Following the physical, I headed to Parthenon Pavilion, a psychiatric facility and the location of the ECT treatments, to complete their intake procedure that usually takes place when you first check in.  For ECT patients, the process is done ahead of time so that they don’t have to deal with it at the beginning of the first treatment. This assessment is not unfamiliar to me; I’ve been to Parthenon before. As depressing as one might fathom a psychiatric hospital to be, there’s an unseemly calmness about their waiting area (this opinion is coming from having been to another hospital; I still have negative thoughts every time I see that building). After I checked in with the receptionist, I sat in the room recalling the time I strolled in this hospital with my luggage as if I was coming to some hotel. I could see that their couches are showing the wear of everyone who must have had to wait for their family member or their own turn in this hospital.  There’s a television set, but it’s just a background noise that attempts to drown the fear that begins to mount as you think to yourself, “Why am I here?,” and perhaps more critically, “What have I done to myself?” The couches have imprints of those memories, and they seemed to have been imprinted into my own memory.

Of course, there’s nothing pleasant about having to check into a psych hospital, but the experiences I’ve had at Parthenon have been not only necessary but positive ones. I used to think that, even in times of crisis, hospitalization should be avoided at all costs. In fact, “at all costs” only serve to place further burden on your friends and loved ones. And by not being removed from everyday life for that short time, it only delays effective care. Though I will always have a bit of hesitance in my heart before choosing to be hospitalized, I totally understand and accept my occasional need for hospitalization and believe it is the best place for me to be safe from myself.

But if anyone ever takes me to a psych hospital in town, please take me to Parthenon.

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