Posts tagged ‘before maintenance ECT’

June 23, 2009

The Assessment (part 2)

…continued from “The Assessment (Part 1)….

I wait some more in the bare room, painted with some odd, hospital green color up to the chair rail (or some sort of padded rail), and then cream for the rest. I don’t know why they bothered with the wallpaper border that was placed near the ceiling.

Dr. F finally walks in. I stand up, and we politely introduce ourselves to each other. I had been told by Dr. A that he was in his 70s, but his age is not apparent at all from his looks. I don’t know what I expected – perhaps nothing at all – but he’s only somewhat taller than I am, and he has on a tie and a jacket, no white coat.

It starts on an awkward note. “So, you had ECT three years ago,” says Dr. F. “No, it ended in late February,” I tell him. Instead of the dates of my outpatient ECT, he had been given a chart that had my last hospitalization date, which had been three years ago. I guess he hadn’t read my file. He asks me a little more about how long I had been out of ECT, if I thought it helped, and when the depression came back. I think the depression came back about two months ago, I reply, and to that, he notes to me, “so the effects only lasted for two months.” I hadn’t really done the math until then. I put my hands over my month to say to myself, “That was it? Two months?”  Fifteen treatments to have only two months of ceasefire of some sort? It is at this point when my mind begins to wonder if I am really making the right call.

The evaluation goes on. Dr. F mostly asks me questions that were similar to the ones asked by the assessment person. At one point, he does say to me that I don’t look depressed. I end up having to explain that I never come across as a depressed person. This is one of those comments I probably should’ve expected. The thing is, if I’m outside of my home, I try to look fine. And most will agree that they’d never know I have some mental disorder just from looking at me. But I become almost uncomfortable with that comment because I’m generally afraid people are skeptical to the nature of the illness or can’t really see beyond my exterior. Now I’m afraid that Dr. F’s initial perception of me from the exterior has skewed this assessment. I now question to myself if the indifference I feel is just part of being human or if it’s even depression. I lose confidence in the answers that I have about my own self, because I can’t tell if I am right about how I’ve viewed and felt the last month or so. Have I painted an inaccurate picture of my very self? Am I labeling certain behaviors as “symptoms” when they’re just me being me?

I get through the questions somehow, and Dr. F begins to talk about the treatment itself. As he talked, it dawns on me that he is expecting for me to have ECT once-a-week for at least the next few weeks, and then tapered very gradually to twice-a-month, etc. Though Dr. A and I’ve discussed the idea of maintenance ECT, as in having it once-a-month or so, we’ve been focused on just this single treatment. One Treatment only. He explains to me that this is how a tapering schedule works and that this is probably what Dr. A had in mind. I am not sure what to say. All I could do is nod while looking shocked and confused. I do manage to get across to Dr. F that I hadn’t expected to hear what he had just said.

By the end, I am caught totally off-guard. He wraps up the evaluation with some remaining questions. He tells me those are all the questions he had for me, gets up, shakes my hand and leaves.

I tug on my hair hard as I walk out the hospital door and to my car. Later in the afternoon I am home, and I google about this ‘tapering schedule’ that Dr. F had talked about. In all my readings that I had done, I must have missed reading more carefully about maintenance ECT, because the procedure he talked about is so clearly written out in the clinician books and ECT program web sites. How could I have totally missed reading all this info?

I now am not sure about a thing.

June 23, 2009

The Assessment (part 1)

I am at the psychiatric hospital’s waiting/intake area. I walk up to the receptionist desk and ask to see Dr. F, my new ECT psychiatrist. She nearly assumes that I’m a visitor. I tell her, “I’m the patient.” Oh, she says. She takes down some information.

I guess they are redoing the bathroom by the waiting area. The sound of the drill is almost unbearable but that noise also masks all my anxieties about being here though I know what to expect. The receptionists have bouncy voices that resonate in the space. It’s probably a good thing. Their chatter kind of suspends me from sinking into my nervous thoughts.

There are several people sitting in the room, most of them holding a red ‘visitor’ badge in their hands, indicating that they don’t have any personal business being here. But maybe this is routine for them, too; people seem pretty calm for having to sit here. An older lady is fashioning herself a peanut butter-and-banana sandwich by slicing a banana and placing the slices into a sandwich she pulled out of her tupperware. A guy is messing around with his BlackBerry. Some are watching Rachael Ray on the television that’s in the room. Maybe they are also looking to have distractions from thinking about being at the hospital. I breathe in deeply and I apply more lip gloss, as if I hadn’t smeared enough of it on already.

An intake person calls my name to come into the corridors of the hospital. The receptionist buzzes the button that opens the doors. I’m led to a bare room with two sofas and a trash can. The chairs feel like they’re covered in plastic. There are no magazines, tables or lamps. Just a dull, square room with linoleum floors. Now, this feels like a psych hospital. It’s a barren room, but it doesn’t feel sterile. Instead, it feels almost worn out, though there is no visible sign of that on the furniture. Maybe this is the perception I have because I know what happens in here.

An assessment person comes into the room and starts to ask me a series of questions: how’s my appetite, what medications do I take, when did I last harm myself – those types of questions. As she asks me about my recent condition, I realize that I don’t really have an answer. I begin wishing I had a clue what happened in the past few months. I clearly didn’t mean to get back into this mess again. After the questioning, a nurse stops by with the vitals machine, making sure that I’m alive. Apparently, I’m still alive.

June 19, 2009

Why I’m choosing maintenance ECT

It’s been a bit unclear, even to me, how I reached the decision to have maintenance ECT for this one time. For my own sake, I just needed to jot this out so that I know I’m doing the right thing.

  • The ECT treatment the first time around was very helpful, but I knew it going in that it wasn’t a lifetime cure (the relapse rate within a year is something like 90 percent). The purpose of maintenance ECT is what it says it is: to maintain. I want to maintain the life I’ve regained.
  • When ECT treatment works the first time, the likelihood of it working the next time around is very high. Side effects for me were negligible, even after the 15 times within a five-week period.
  • In the recent months, it’s taking a stimulant for me to be able to stay awake during the day and get things done. It’s starting to feel like any motivation I have right now has been artificially induced. I don’t have a problem with having to take the medication, but this wasn’t something I required right after the ECT treatment.
  • By trying a single treatment, my doctors (and I ) will be able to determine if periodical ECT would be an effective treatment for the long run.
  • Some old thoughts are starting to creep back into my system. The apathy that had disappeared seems to slowly make its way back. As much as I’m not in a mood to fight it off, I know logically that I’ve got to fight it off now or the floodwaters will surely find its way back.
  • I have nothing to lose from doing this.

I feel like my head’s been stuck in a vat of molasses when my doctor and I began to plan on this treatment. When Dr. A asked me at my session yesterday if I felt ready, I realized I had not sat down and really thought about what all of this stuff meant. This may not be the greatest time for me to be pondering all of this (the GRE does come first on the calendar), but it needed to be done. This may not be my complete reasoning for getting maintenance ECT, but at least I’ve put something down. “Clarity is not a bad thing,” says Dr. Melfi to Tony in an episode of the Sopranos. Yeah, I could use some clarity, and making a list like this one helps me just a little bit.

June 17, 2009

“Scared Shitless”

That’s what Juno’s stepmom (Allison Janney) tells the mom-to-be Vanessa (Jennifer Garner) at the end of the movie “Juno.” I’m not sure if “scared shitless” is really how I feel, but I have to admit, I’m nervous.

Rebecca from Parthenon Pavilion, the psych hospital, called Monday to let me know that everything’s been set up for me to have my first maintenance ECT, and all right after the GRE (yay). I will meet my new ECT psychiatrist and be evaluated by him next Tuesday. On the same day, there are also the evaluation by the hospital staff and a physical done by the internist, the two appointments that need to be done within a week before the actual treatment.  And the main event will take place in two weeks, on Monday, June 29.

There’s not a need to be so anxious. It’s really not a scary procedure. I should know; I’ve gone to it fifteen other times. And for this one, you get the treatment, you don’t drive for 24 hours, and then you go back to your life. It’s so simple.

It’s an awkward and a bad time to be filled with this energy. I need to be studying, but instead I just watch the time pass by. One of the channels has some sort of a “Six Feet Under” marathon going on. But mostly I’m just sitting under the ceiling fan, watching it spin around and around. (Well, I finally finished taking a practice test, so I guess I’m making some progress.)

It’s the process to the actual happening that causes those nerves to turn my stomach or make me pop some alprazolam (xanax). I know I am overthinking everything right now, but isn’t the process leading up to these events (ECT and the GRE) the only part I can really control? Actually now that I think about it, there’s practically nothing I can do to change the outcome of the ECT, but that’s not the case with the GRE scores. Really, learning more vocabulary will only help me on the exam. Besides, alprazolam only hinders you from having a good seizure.

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