I just returned from a 45-day stay at the UCSF mental ward, where they tried maximum medications and finally 12 bilateral ECT treatments to treat my acute depression with little success. As they had done all they could do, I opted to come home, where I have a little more freedom and familiarity with my surroundings, and above all, a loving wife in Kathleen whom I desperately missed in the hospital.
I wish I could report that I'm well but I'm not. I'm still very sick and suffer from predictable weeping spells, suicidal ideation, anhedonia, sleep disturbance--in a word, all the symptoms of a severe depression. Naturally this comes on the heels of a mania, recorded in these pages, which I did not correctly perceive for what it was as I was so happy just to be delivered from depression for a time. But I'm paying for it now.
I ask for your prayers and encouragement. There are times when I am so overcome by hopelessness I really don't know what to do. I become paralyzed, the proverbial deer in the headlight. The smallest tasks overwhelm me.
I ask forgiveness for any I may have offended in my manic phase; I said and wrote some cruel things when I was so sure that my judgment was divine and not just the product of a diseased mind, which it turned out to be, for the most part. Naturally I am embarrassed and ashamed. But I did not choose this illness, it chose me. It is not my fault but it is my responsibility, and a terrible responsibility that is. Someday I would like to feel like a useful member of the human race again but that day is not near. Now I am barely functional, just doing my best not to give into suicidal fantasies. Pray for me. I hang by a thread, truly.
Namaste in any case,
Craig Erick
Showing posts with label ECT. Show all posts
Showing posts with label ECT. Show all posts
Saturday, March 19, 2011
Wednesday, March 04, 2009
Best of, cont'd: Post-ECT Musings
It's been a while since a "Best of" post, which I think a good sign. I have gotten these posts to within a year of today, and will hopefully bring them up to date in the near future. Sunday I leave for LA to sue for visitation rights re: my grandson. I'm anxious about the trip but trust my mood will hold for the hearings.
Now for the harrowing aftermath of ECT.
From 3/20/08 Post-ECT:
Having something to do with my hands is a blessing. I recall prior to my ECT that I generally made Kathleen lunches and tried to make dinner, but just like my former exercise regimen, ECT seemed to amputate my past from my future. The threads of things I was doing before the treatments I have had trouble reconnecting with. There was a chapbook contest I intended to enter, for example, and I had the chapbook done, but I no longer know where to send it. And I found myself published in a journal I didn't know was publishing me. I think the entire experience of ECT resembles a major concussive syndrome, with selective anterograde amnesia and a general disconnect with one's former life. If I were to do it over again, and I never plan to given the recent results, I would take the time to write down in a notebook beforehand all my ongoing activities and goals in a detailed fashion, so that I would have a guide for resuming my life. As it is, things crop up--”I was going to do that?” “I had promised to do that?” “There's a deadline for what?” “I owe whom a letter?”
ECT is a great interruption in the flow of one's life. Naturally anyone considering it would not call their life normal. But even depressed, as I have been, there are connections and recollections that seem to have been whited out by ECT.
Of course, underneath the inevitable progression of my bipolar disease lies the grief at the loss of my first-born daughter, Rachel, on July 29, 2007. At the time I welcomed the sad feelings because they were legitimate grief, and grief felt better than depression, but in the emotional economy of the human psyche one wonders if that great loss has not been feeding my depression at some level. Experientially I can't say so; theoretically it makes sense.
I've been worrying a lot about old age lately, where we might live, how we will afford to live and all the attendant worries. But I like what Bob Dylan said: “He who isn't busy being born is busy dying.” Also, T. S. Eliot: “Old men should be explorers.”
Fine quotes to live up to. Fear is the mind-killer. Once faith in yourself is undermined, faith in anything else becomes near impossible.
So, outside myself, I've shopped and cooked two meals. Tonight I will be playing a tune I wrote for a Spring Equinox ceremony. The performance, of course, fills me with fear. But the way around my basic fear of non-being, or global incompetence of my person, is to do the things of which I'm afraid. I know this and have done this many times in my approach to life. I even called the Medical Board about the status of my medical license renewal today. (They told me to call back Monday.)
Oh, I fed the cats and brought Kathleen coffee and provided her with a lunch today. Every little useful thing helps. I don't know how it is for others, but in my advanced mental illness I have so much trouble trying to inhabit my body. My body becomes a thing, not part of my person, and to heal my mind must slow down or speed up to the rhythm of my body, so that in washing dishes, for instance, my hands and mind can work in concert. This idea hearkens back to the “moral treatment” enlightened Christians first used on the mentally ill after saving them from asylums. Farming was a big part of that therapy. My capacity for abstraction puts me at risk of losing contact with the material universe and my necessary role in it.
I have tried to keep today's post from undue solipsism. This does not mean that I am necessarily better, only that I am trying to follow my own prescription for improved health.
From 3/25: Post-ECT: My Failure as an Author
Ignoring my depression doesn't seem to be working, so I'll indulge in writing as therapy, believing it helps objectify my suffering. Suffering can never be compared; each of us has suffered to a degree we would be afraid to exceed, as one can only know greater suffering when the soul is stretched beyond its former capacity for suffering. With enough suffering comes a numbness, as in Holocaust survivors, the mind's defense mechanism against overwhelming grief and terror. Depression differs from grief and trauma in that it comes from the inside out instead of from the outside in. It is self-generating.
As a form of suffering I find depression to be one of the worst varieties, because it darkens everything, it makes one unable to experience pleasure, it robs you of yourself--with all the history and attachments that implies. The past seems meaningless and the future seems a terror, while you spend every spare minute accusing yourself of one failure or another. Today my mind chose to accuse myself of not doing enough to end my depression--this despite exercise, ECT, compliance with psychiatric meds, attempts at gardening and cooking, continuing occasional publication of my poetry, hiking, and yes, a lot of basketball watching.
How do I enjoy basketball while being depressed? First, it generally comes on in the evening, when depression itself improves, as depression is usually worse in the morning and better at night. Second, it is essentially trivial. The fate of the chinook salmon or the arctic ice pack does not hang from a basketball rim. It's just a simple game with one ball and two hoops. When I was younger I could play it, which adds to my appreciation. Still the main reason I can "enjoy" (better "be distracted by") basketball is that it demands nothing of me except that I be a mindless fan, an illogical and irrational position and thus a relief from significance.
I will admit that I don't have enough to do. When my depression was less severe I spent a lot of time writing, but now that I've decided I'll never make it as an author I hardly have the heart to keep generating books that won't be published. My novel, "The Abomination," is so boring I can't finish it (Amazon.com published one copy of it for my perusal when I entered their first novel contest; I think I mentioned that out of 5,000 entrants, I didn't even make the cut for the top 1000. But I do have the souvenir book!) I had high hopes for the novel to be a thriller, a page-turner, but I realize in reading it that the characters do not demand the kind of interest that makes for an interesting novel. I don't really care about the characters when I read it.
As for my poetry and literary criticism, I still have faith that some of it has merit beyond my lifetime, but I don't expect to be discovered any time soon.
I recently picked up a new collection of Charles Simic, our present poet laureate, and found no brilliance to envy. Why he is lauded above others I can only attribute to the usual East Coast Old Boys' network. His poems are workmanlike but underwhelming.
To be fair, my sense of failure as an author has not been properly earned because I haven't pulled out every stop and made every sacrifice to succeed. But I have become disheartened, and I don't know how to return to writing without confidence--a writer must have the conceit that he has something worth saying--lacking that at present, I don't write about anything, excepting the therapy of this blog.
So, how did I do today? I hit upon one thing that distracts me from depression: Basketball! I passed a small opinion on our poet laureate. And I confessed that my inner critic thinks I haven't done enough to come out of my depression; but what is enough? It doesn't get more serious than ECT, from which I'm still recovering in terms of memory and cognitive functioning. But what if ECT was a way of avoiding some other aspect of depression? The mind won't let up, the hook is set and the brain reels it in over and over again. That's a good metaphor for depression: having set the hook deep in your soul and afterwards trying to reel it in--you are the fish and the fisherman and therefore can never succeed. And the more you yank on the line the worse it gets. One of the best lines I ever heard about depression was, "If your car is stuck in the mud, don't spin your wheels, just wait for the sun to come out and dry the road and you'll be able to drive away." It's the waiting that kills us. I spin my wheels too much.
Now for the harrowing aftermath of ECT.
From 3/20/08 Post-ECT:
Having something to do with my hands is a blessing. I recall prior to my ECT that I generally made Kathleen lunches and tried to make dinner, but just like my former exercise regimen, ECT seemed to amputate my past from my future. The threads of things I was doing before the treatments I have had trouble reconnecting with. There was a chapbook contest I intended to enter, for example, and I had the chapbook done, but I no longer know where to send it. And I found myself published in a journal I didn't know was publishing me. I think the entire experience of ECT resembles a major concussive syndrome, with selective anterograde amnesia and a general disconnect with one's former life. If I were to do it over again, and I never plan to given the recent results, I would take the time to write down in a notebook beforehand all my ongoing activities and goals in a detailed fashion, so that I would have a guide for resuming my life. As it is, things crop up--”I was going to do that?” “I had promised to do that?” “There's a deadline for what?” “I owe whom a letter?”
ECT is a great interruption in the flow of one's life. Naturally anyone considering it would not call their life normal. But even depressed, as I have been, there are connections and recollections that seem to have been whited out by ECT.
Of course, underneath the inevitable progression of my bipolar disease lies the grief at the loss of my first-born daughter, Rachel, on July 29, 2007. At the time I welcomed the sad feelings because they were legitimate grief, and grief felt better than depression, but in the emotional economy of the human psyche one wonders if that great loss has not been feeding my depression at some level. Experientially I can't say so; theoretically it makes sense.
I've been worrying a lot about old age lately, where we might live, how we will afford to live and all the attendant worries. But I like what Bob Dylan said: “He who isn't busy being born is busy dying.” Also, T. S. Eliot: “Old men should be explorers.”
Fine quotes to live up to. Fear is the mind-killer. Once faith in yourself is undermined, faith in anything else becomes near impossible.
So, outside myself, I've shopped and cooked two meals. Tonight I will be playing a tune I wrote for a Spring Equinox ceremony. The performance, of course, fills me with fear. But the way around my basic fear of non-being, or global incompetence of my person, is to do the things of which I'm afraid. I know this and have done this many times in my approach to life. I even called the Medical Board about the status of my medical license renewal today. (They told me to call back Monday.)
Oh, I fed the cats and brought Kathleen coffee and provided her with a lunch today. Every little useful thing helps. I don't know how it is for others, but in my advanced mental illness I have so much trouble trying to inhabit my body. My body becomes a thing, not part of my person, and to heal my mind must slow down or speed up to the rhythm of my body, so that in washing dishes, for instance, my hands and mind can work in concert. This idea hearkens back to the “moral treatment” enlightened Christians first used on the mentally ill after saving them from asylums. Farming was a big part of that therapy. My capacity for abstraction puts me at risk of losing contact with the material universe and my necessary role in it.
I have tried to keep today's post from undue solipsism. This does not mean that I am necessarily better, only that I am trying to follow my own prescription for improved health.
From 3/25: Post-ECT: My Failure as an Author
Ignoring my depression doesn't seem to be working, so I'll indulge in writing as therapy, believing it helps objectify my suffering. Suffering can never be compared; each of us has suffered to a degree we would be afraid to exceed, as one can only know greater suffering when the soul is stretched beyond its former capacity for suffering. With enough suffering comes a numbness, as in Holocaust survivors, the mind's defense mechanism against overwhelming grief and terror. Depression differs from grief and trauma in that it comes from the inside out instead of from the outside in. It is self-generating.
As a form of suffering I find depression to be one of the worst varieties, because it darkens everything, it makes one unable to experience pleasure, it robs you of yourself--with all the history and attachments that implies. The past seems meaningless and the future seems a terror, while you spend every spare minute accusing yourself of one failure or another. Today my mind chose to accuse myself of not doing enough to end my depression--this despite exercise, ECT, compliance with psychiatric meds, attempts at gardening and cooking, continuing occasional publication of my poetry, hiking, and yes, a lot of basketball watching.
How do I enjoy basketball while being depressed? First, it generally comes on in the evening, when depression itself improves, as depression is usually worse in the morning and better at night. Second, it is essentially trivial. The fate of the chinook salmon or the arctic ice pack does not hang from a basketball rim. It's just a simple game with one ball and two hoops. When I was younger I could play it, which adds to my appreciation. Still the main reason I can "enjoy" (better "be distracted by") basketball is that it demands nothing of me except that I be a mindless fan, an illogical and irrational position and thus a relief from significance.
I will admit that I don't have enough to do. When my depression was less severe I spent a lot of time writing, but now that I've decided I'll never make it as an author I hardly have the heart to keep generating books that won't be published. My novel, "The Abomination," is so boring I can't finish it (Amazon.com published one copy of it for my perusal when I entered their first novel contest; I think I mentioned that out of 5,000 entrants, I didn't even make the cut for the top 1000. But I do have the souvenir book!) I had high hopes for the novel to be a thriller, a page-turner, but I realize in reading it that the characters do not demand the kind of interest that makes for an interesting novel. I don't really care about the characters when I read it.
As for my poetry and literary criticism, I still have faith that some of it has merit beyond my lifetime, but I don't expect to be discovered any time soon.
I recently picked up a new collection of Charles Simic, our present poet laureate, and found no brilliance to envy. Why he is lauded above others I can only attribute to the usual East Coast Old Boys' network. His poems are workmanlike but underwhelming.
To be fair, my sense of failure as an author has not been properly earned because I haven't pulled out every stop and made every sacrifice to succeed. But I have become disheartened, and I don't know how to return to writing without confidence--a writer must have the conceit that he has something worth saying--lacking that at present, I don't write about anything, excepting the therapy of this blog.
So, how did I do today? I hit upon one thing that distracts me from depression: Basketball! I passed a small opinion on our poet laureate. And I confessed that my inner critic thinks I haven't done enough to come out of my depression; but what is enough? It doesn't get more serious than ECT, from which I'm still recovering in terms of memory and cognitive functioning. But what if ECT was a way of avoiding some other aspect of depression? The mind won't let up, the hook is set and the brain reels it in over and over again. That's a good metaphor for depression: having set the hook deep in your soul and afterwards trying to reel it in--you are the fish and the fisherman and therefore can never succeed. And the more you yank on the line the worse it gets. One of the best lines I ever heard about depression was, "If your car is stuck in the mud, don't spin your wheels, just wait for the sun to come out and dry the road and you'll be able to drive away." It's the waiting that kills us. I spin my wheels too much.
Friday, February 22, 2008
How I Am Currently Responding to Current
Two weeks into ECT and I'm not doing very well. I feel in danger of complete relapse. What precipitated it was my sister's generous suggestion to have a driver take me home for the weekend to Mendocino. My sister's too good of a soul to say, "It's been almost three weeks and you're a space eater and I'd like my house and nuclear family back," but that has to be part of it, too, and I understand. Even though I try to make myself scarce, hiding in the basement with a book, going for walks, I am nevertheless an interloper, a species not native to this house, like a northern pike in a trout lake.
The thought of seeing my one true love, Kathleen, while still depressed, was too much to bear. I so want to get well for her; I want her suffering to end, and because of the love she bears me her suffering can only end when I am stable and my depression is in remission. As my illness began on April 1, 2006, it will soon be of two year's duration, with only two partial and brief remissions. I'm a sick puppy. I can't imagine being in Kathleen's position; I have been with her during her depressions but she's never had one this protracted and treatment-resistantant since I've known her. Nothing makes me sadder than the thought that my presence will sadden Kathleen. We had such hopes for this treatment! Obviously I need more, but how much will be enough? And I'm wondering if I shouldn't be on stronger medications as well to try to help stabilize my mood during treatment.
In any case I broke down in tears in front of my sister after treatment today, not a good thing. I also forgot a lunch date I'd made with a poet from San Francisco; the overwhelming emotion of my situation caused me to forget. I did call him and told him I had a good excuse for forgetfulness: "Sorry, I had electroconvulsive therapy this morning." He likely didn't need to hear that and was probably relieved not to have lunch with me afterwards, though he said he still wanted to meet. Oh well. I wouldn't have been very good company in any case.
I just finished Margaret Atwood's The Blind Assassin, which my sister recommended. Atwood's work always humbles me and I did find this book alluring.
I got a note from Sam Rasnake today that soon a new issue of Blue Fifth Review will be out and had forgotten that I had a poem in it, "Home Surgery." I'll have another poem in Barnwood (a paying venue) and three in Umbrella. Niederngasse has also accepted a poem, as has Barefoot Muse. These are all pretty good venues and I'll post the links again when my work comes out. (Meanwhile you don't need me as an excuse to visit these fine e-zines!)
See that? Talking about something besides myself, like literature, helped the tears dry up. (I try to explain to Craig that he's not worth crying over but he doesn't get it.)
So, having mentioned a number of poems you can't see yet, here's one I wrote the other day in San Francisco:
Something Christian
Rheumy eyes, mahogany head;
tan polyester coat, white shirt;
no tie; septuagenarian
tiny Chinese-American
stood on a folding two-step
stepladder of aluminum
in Union Square and preached:
"Homo sick! Queer go to hell!
“AIDS wrath of God”
I must say I've never understood
why Jesus hates queers
more than other men.
Besides, if God has time
to invent new scourges
to punish the innocent--
babies guilty of birth,
patients guilty of transfusion,
doctors guilty of defective gloves--
maybe I'm on the wrong side?
"The city is filled with sin!”
How must it feel behind those rheumy eyes
to hate and think God's work is being done?
"You look unhappy,” I offered,
"Your eyes are filled with hate.”
“I hate the devil and I hate sin,” he said,
his thin lips set in a Maginot line.
"No, no, you hate yourself,” I said.
His look of incomprehension
was almost beyond redemption.
I should have passed and said nothing
like the other pedestrians
but something Christian wanted out.
Pray for me in whatever way approximates prayer for you; if you are an atheist you can wish for new treatments for depression, for instance.
In need of a miracle,
CE
The thought of seeing my one true love, Kathleen, while still depressed, was too much to bear. I so want to get well for her; I want her suffering to end, and because of the love she bears me her suffering can only end when I am stable and my depression is in remission. As my illness began on April 1, 2006, it will soon be of two year's duration, with only two partial and brief remissions. I'm a sick puppy. I can't imagine being in Kathleen's position; I have been with her during her depressions but she's never had one this protracted and treatment-resistantant since I've known her. Nothing makes me sadder than the thought that my presence will sadden Kathleen. We had such hopes for this treatment! Obviously I need more, but how much will be enough? And I'm wondering if I shouldn't be on stronger medications as well to try to help stabilize my mood during treatment.
In any case I broke down in tears in front of my sister after treatment today, not a good thing. I also forgot a lunch date I'd made with a poet from San Francisco; the overwhelming emotion of my situation caused me to forget. I did call him and told him I had a good excuse for forgetfulness: "Sorry, I had electroconvulsive therapy this morning." He likely didn't need to hear that and was probably relieved not to have lunch with me afterwards, though he said he still wanted to meet. Oh well. I wouldn't have been very good company in any case.
I just finished Margaret Atwood's The Blind Assassin, which my sister recommended. Atwood's work always humbles me and I did find this book alluring.
I got a note from Sam Rasnake today that soon a new issue of Blue Fifth Review will be out and had forgotten that I had a poem in it, "Home Surgery." I'll have another poem in Barnwood (a paying venue) and three in Umbrella. Niederngasse has also accepted a poem, as has Barefoot Muse. These are all pretty good venues and I'll post the links again when my work comes out. (Meanwhile you don't need me as an excuse to visit these fine e-zines!)
See that? Talking about something besides myself, like literature, helped the tears dry up. (I try to explain to Craig that he's not worth crying over but he doesn't get it.)
So, having mentioned a number of poems you can't see yet, here's one I wrote the other day in San Francisco:
Something Christian
Rheumy eyes, mahogany head;
tan polyester coat, white shirt;
no tie; septuagenarian
tiny Chinese-American
stood on a folding two-step
stepladder of aluminum
in Union Square and preached:
"Homo sick! Queer go to hell!
“AIDS wrath of God”
I must say I've never understood
why Jesus hates queers
more than other men.
Besides, if God has time
to invent new scourges
to punish the innocent--
babies guilty of birth,
patients guilty of transfusion,
doctors guilty of defective gloves--
maybe I'm on the wrong side?
"The city is filled with sin!”
How must it feel behind those rheumy eyes
to hate and think God's work is being done?
"You look unhappy,” I offered,
"Your eyes are filled with hate.”
“I hate the devil and I hate sin,” he said,
his thin lips set in a Maginot line.
"No, no, you hate yourself,” I said.
His look of incomprehension
was almost beyond redemption.
I should have passed and said nothing
like the other pedestrians
but something Christian wanted out.
Pray for me in whatever way approximates prayer for you; if you are an atheist you can wish for new treatments for depression, for instance.
In need of a miracle,
CE
Thursday, February 07, 2008
Day #3: My First ECT Treatment
I was just rudely awakened at 5 AM from a pleasant dream where I was laughing in a bar with my brother. The dream also involved, without carnal coupling, a lovely young woman who I knew was to replace my first wife. The nightmares of my first marriage recur from time to time, though my nightmares of being a doctor and medical student are more frequent when depressed—if I dream at all. I can't remember when I laughed in a dream.
The nurse took my pulse and her face registered displeasure because my pulse was only 48. She asked me if this was normal for me and I told her yes, that bradycardia was normal. It's funny that when I use medical terms with staff they are never curious about how I know them. I assume my slow pulse may be in part from my aerobic exercise, though I have fallen off of late. Still, swimming a mile within the last two weeks might have some lingering benefits. Else I am unlike the grandfather clock, and instead of keeping good time and coming to an abrupt end, I am slowly winding down. If only life were that gradual! Mine has always been composed of starts and stops; I've been either ahead or behind. What would it be like to have a life of gradual transitions, say get married at 30 instead of 19 and not already be a doctor and father times two at 25? I've always felt pushed by some invisible hand, propelled to excel, whether from anxiety and inferiority (most likely) or some innate property of my disease—I've always been in a hurry to get to the next step, even if the next step is undesirable. I have been the proverbial hare to the tortoise, and let me tell you, the tortoise, though slower, does a much better job at life, though not as well at E-Harmony.
After my vitals the nurse gave me a shot of Rubinol in my left upper ass. It didn't burn much but began to itch afterwards, slightly. She explained the drug was to dry my secretions and prevent nausea for the procedure. I'm sure that's what they told Soviet dissidents.
Afterwards came the hospital gown, a puzzle I'd never solved before. But in remembering how my wife puts on her bra, I tied it in front then took it off and reversed it. I was proud of myself for such a neat solution. Too bad the gown is designed for someone much smaller. If I don't get another one, more than my crack will be out in the breeze; the moon will likely be half full.
I didn't wake up crying today. One change, even before the procedure, is that glimmer of hope. I know I'm getting what I need and I hope never to find myself in a position again where I need ECT but cannot obtain it. Depression is a a severe brownout and full power needs to be restored.
Last night I watched a video for patients on ECT. Patients kept repeating how their memory was fine. I thought they'd never stop.
Actually the memory loss of ECT is consistent with the “post-ictal” phase of naturally occurring seizures. Memory of the procedure itself remains fuzzy not just because of the seizure but but because of the anesthesia. Long-term memory is not affected, but please don't ask me my date of birth.
My roommate, who had ECT in September of 2006 and is here for it again, is a pleasant fellow who resembles Jon Stewart. He was admitted after turning the gas on in his apartment at night. The only problem was that he had roommates, but no one was hurt. He now regrets that oversight. The ghost of Sylvia Plath must have been watching over him. Unlike her, he didn't stick his head in the oven but just let the gas run. That's certainly a sign of depression--the laziness in carrying out a procedure. When depressed, no matter how well you do, it is never right, so you often end up doing a shitty job out of despair. But that tendency can apply in general to a life like mine, always taking things too far in overcorrection. In second grade, for instance, I pushed the crayons so hard against the paper that they broke and the picture smeared. I marveled at he girls who colored so lightly and neatly. Maximum intensity of color was what I sought, maximum effect. The result was sloppy, I admit in retrospect, but it reflected my nature, just as my love of purple and red reflect my romance with the far limits of the spectrum, just as I was born manic-depressive.
Oh, and my MRI was “normal” except that I have sinusitis. Since I don't have any symptoms, I assume that is the effect of weeping too much and too frequently. Maybe the Rubinol will dry my sinuses out. It's certainly drying my tongue out as I write.
Dressed in one hospital gown but with the advantage of a pair of underwear to civilize the view of my posterior—(that's periphrasis, btw—“to cover my ass” would be better English), my escort arrived with the obligatory wheelchair to take me down to the dungeons, as most surgical theaters are located in the basement of hospitals. Why, I don't know. In case of war? Because you can't get any lower? For ease of a sterile environment? To best protect all the expensive equipment? One thing I do know. As we descended on the elevator to lowest floor the air became at least ten degrees cooler. The only thing colder is the morgue, and that's convenient since one can easily lead to the other.
The ECT staff was quite solicitous. They wrapped me in heated blankets. (I asked for a facial but there wasn't time.) They hooked me up to the monitors and I got to follow my pulse, oxygen saturation and blood pressure at my leisure. It wasn't Katie Couric in the morning but I don't much go for cuteness anyway. They also stuck oxygen prongs in my nose, which I found slightly uncomfortable, like snot freezing inside your nostrils on a very cold day.
The anesthesiologist and treating psychiatrist came by my bedside briefly to explain the procedure. The shrink was surprised, like all have been here, at the answer to “How long has it been since you had ECT?” “24 years.” The general consensus is that I had a good run, but the truth is that there were three times I could have used it since the initial treatment instead of fooling around with expensive pills. An ounce of electricity is worth a pound of medicine.
After my roommate emerged from the treatment room I was wheeled in on the bed. The ECT nurse put an oxygen mask to my face over the prongs, the usual hospital redundancy, just as I have been asked at least ten times since admission if I am diabetic. The anesthesiologist started an IV in my left arm while the psychiatrist fastened the rubber strap with large, steel electrodes around my head. Afterwards he took over holding the oxygen mask to my face, which he did so tightly I couldn't breathe (likely why he became a psychiatrist). I asked him to loosen it and he moved it so far away I don't know if it was doing any good. The idea is, I'm sure, that extra oxygen might prevent the death of brain cells. I know of no study to prove this but it seems like a nice precaution.
“Breathe deep four times,” the anesthesiologist said. I was hoping he'd say, “I'm going to inject you now and you will go to sleep in one... two... three... four seconds.” I like to know when my drugs are having their effects so I don't lose out on a new experience, but it was not to be.
ov
The next thing I knew I was recumbent and awake inside the recovery room, and the nurse said to me “It's over.” There are better words to utter to a depressive but I knew her intent. I couldn't count the times I've wished it were really “over!”
It seemed as if little or no time had passed when I awoke, though the return to consciousness was not as alacritous as from Diprivan, or “milk of amnesia,” which I recommend to all depressed persons as an excellent treatment (yet to be approved). After staying in recovery for a brief time I was wheeled back in the bed up to the ward on the third floor, I left the bed under my own power while a nurse hurriedly added a second gown to hide my posterior, despite the underwear. Then I was positioned in a large, blue vinyl chair facing the nursing station, along with my roommate, and served breakfast, though not the one I ordered, naturally. I turned in my choices yesterday but the hamburger of efficiency is sometimes slowly ground at a hospital. The nurses then observed us, presumably to make sure that we didn't choke on our food. I was in more danger of choking from the psychiatrist's heavy hand with the oxygen mask.
I felt tired and groggy but not mentally impaired--I remembered my new landlord's phone number to call him and my sister's as well. The retrieval of my sister's number, which I know so well, did take a little longer in my internal Googling, but I snagged it.
Supposedly I'll be discharged tomorrow and ECT will be continued next Tuesday, February 12. How I will stay amused between now and then will be my biggest challenge. The writing helps. Oh, and there's basketball to watch!
Unrated,
CE
The nurse took my pulse and her face registered displeasure because my pulse was only 48. She asked me if this was normal for me and I told her yes, that bradycardia was normal. It's funny that when I use medical terms with staff they are never curious about how I know them. I assume my slow pulse may be in part from my aerobic exercise, though I have fallen off of late. Still, swimming a mile within the last two weeks might have some lingering benefits. Else I am unlike the grandfather clock, and instead of keeping good time and coming to an abrupt end, I am slowly winding down. If only life were that gradual! Mine has always been composed of starts and stops; I've been either ahead or behind. What would it be like to have a life of gradual transitions, say get married at 30 instead of 19 and not already be a doctor and father times two at 25? I've always felt pushed by some invisible hand, propelled to excel, whether from anxiety and inferiority (most likely) or some innate property of my disease—I've always been in a hurry to get to the next step, even if the next step is undesirable. I have been the proverbial hare to the tortoise, and let me tell you, the tortoise, though slower, does a much better job at life, though not as well at E-Harmony.
After my vitals the nurse gave me a shot of Rubinol in my left upper ass. It didn't burn much but began to itch afterwards, slightly. She explained the drug was to dry my secretions and prevent nausea for the procedure. I'm sure that's what they told Soviet dissidents.
Afterwards came the hospital gown, a puzzle I'd never solved before. But in remembering how my wife puts on her bra, I tied it in front then took it off and reversed it. I was proud of myself for such a neat solution. Too bad the gown is designed for someone much smaller. If I don't get another one, more than my crack will be out in the breeze; the moon will likely be half full.
I didn't wake up crying today. One change, even before the procedure, is that glimmer of hope. I know I'm getting what I need and I hope never to find myself in a position again where I need ECT but cannot obtain it. Depression is a a severe brownout and full power needs to be restored.
Last night I watched a video for patients on ECT. Patients kept repeating how their memory was fine. I thought they'd never stop.
Actually the memory loss of ECT is consistent with the “post-ictal” phase of naturally occurring seizures. Memory of the procedure itself remains fuzzy not just because of the seizure but but because of the anesthesia. Long-term memory is not affected, but please don't ask me my date of birth.
My roommate, who had ECT in September of 2006 and is here for it again, is a pleasant fellow who resembles Jon Stewart. He was admitted after turning the gas on in his apartment at night. The only problem was that he had roommates, but no one was hurt. He now regrets that oversight. The ghost of Sylvia Plath must have been watching over him. Unlike her, he didn't stick his head in the oven but just let the gas run. That's certainly a sign of depression--the laziness in carrying out a procedure. When depressed, no matter how well you do, it is never right, so you often end up doing a shitty job out of despair. But that tendency can apply in general to a life like mine, always taking things too far in overcorrection. In second grade, for instance, I pushed the crayons so hard against the paper that they broke and the picture smeared. I marveled at he girls who colored so lightly and neatly. Maximum intensity of color was what I sought, maximum effect. The result was sloppy, I admit in retrospect, but it reflected my nature, just as my love of purple and red reflect my romance with the far limits of the spectrum, just as I was born manic-depressive.
Oh, and my MRI was “normal” except that I have sinusitis. Since I don't have any symptoms, I assume that is the effect of weeping too much and too frequently. Maybe the Rubinol will dry my sinuses out. It's certainly drying my tongue out as I write.
Dressed in one hospital gown but with the advantage of a pair of underwear to civilize the view of my posterior—(that's periphrasis, btw—“to cover my ass” would be better English), my escort arrived with the obligatory wheelchair to take me down to the dungeons, as most surgical theaters are located in the basement of hospitals. Why, I don't know. In case of war? Because you can't get any lower? For ease of a sterile environment? To best protect all the expensive equipment? One thing I do know. As we descended on the elevator to lowest floor the air became at least ten degrees cooler. The only thing colder is the morgue, and that's convenient since one can easily lead to the other.
The ECT staff was quite solicitous. They wrapped me in heated blankets. (I asked for a facial but there wasn't time.) They hooked me up to the monitors and I got to follow my pulse, oxygen saturation and blood pressure at my leisure. It wasn't Katie Couric in the morning but I don't much go for cuteness anyway. They also stuck oxygen prongs in my nose, which I found slightly uncomfortable, like snot freezing inside your nostrils on a very cold day.
The anesthesiologist and treating psychiatrist came by my bedside briefly to explain the procedure. The shrink was surprised, like all have been here, at the answer to “How long has it been since you had ECT?” “24 years.” The general consensus is that I had a good run, but the truth is that there were three times I could have used it since the initial treatment instead of fooling around with expensive pills. An ounce of electricity is worth a pound of medicine.
After my roommate emerged from the treatment room I was wheeled in on the bed. The ECT nurse put an oxygen mask to my face over the prongs, the usual hospital redundancy, just as I have been asked at least ten times since admission if I am diabetic. The anesthesiologist started an IV in my left arm while the psychiatrist fastened the rubber strap with large, steel electrodes around my head. Afterwards he took over holding the oxygen mask to my face, which he did so tightly I couldn't breathe (likely why he became a psychiatrist). I asked him to loosen it and he moved it so far away I don't know if it was doing any good. The idea is, I'm sure, that extra oxygen might prevent the death of brain cells. I know of no study to prove this but it seems like a nice precaution.
“Breathe deep four times,” the anesthesiologist said. I was hoping he'd say, “I'm going to inject you now and you will go to sleep in one... two... three... four seconds.” I like to know when my drugs are having their effects so I don't lose out on a new experience, but it was not to be.
ov
The next thing I knew I was recumbent and awake inside the recovery room, and the nurse said to me “It's over.” There are better words to utter to a depressive but I knew her intent. I couldn't count the times I've wished it were really “over!”
It seemed as if little or no time had passed when I awoke, though the return to consciousness was not as alacritous as from Diprivan, or “milk of amnesia,” which I recommend to all depressed persons as an excellent treatment (yet to be approved). After staying in recovery for a brief time I was wheeled back in the bed up to the ward on the third floor, I left the bed under my own power while a nurse hurriedly added a second gown to hide my posterior, despite the underwear. Then I was positioned in a large, blue vinyl chair facing the nursing station, along with my roommate, and served breakfast, though not the one I ordered, naturally. I turned in my choices yesterday but the hamburger of efficiency is sometimes slowly ground at a hospital. The nurses then observed us, presumably to make sure that we didn't choke on our food. I was in more danger of choking from the psychiatrist's heavy hand with the oxygen mask.
I felt tired and groggy but not mentally impaired--I remembered my new landlord's phone number to call him and my sister's as well. The retrieval of my sister's number, which I know so well, did take a little longer in my internal Googling, but I snagged it.
Supposedly I'll be discharged tomorrow and ECT will be continued next Tuesday, February 12. How I will stay amused between now and then will be my biggest challenge. The writing helps. Oh, and there's basketball to watch!
Unrated,
CE
Wednesday, February 06, 2008
From the Hospital
I am sitting in a hospital bed with a plum bedspread of rough cotton beneath me, my knees slightly elevated and the back of the bed up--the perfect couch potato lounger you see advertised on late night TV. They have wifi here in the hospital and I brought my laptop to communicate some of my adventure.
Tomorrow I will have my first treatment of unilateral (right-sided only) electroconvulsive therapy. Of course I'll be knocked out with with anesthesia when they plug in the toaster, but what they aim for is evidence of a generalized seizure ignited by the single burst of current. They'll start me at “50%.” I asked the doctor how many Joules that was (a measure of amperage, as in a car battery), but all he could do was draw pictures and talk about percentages, so obviously he didn't know. (It used to be 200 Joules.) He was the kind of authority who tries to give an authoritative answer even when he doesn't know it. Maybe he should run for office. (I'm voting for Senator Eagleton, who, if you are too young to know, was dropped from the McGovern ticket when it was discovered that he had had ECT. Don't supersize me, supercharge me!)
The psychiatrist responsible for a second opinion spent more time with me than my admitting psychiatrist, who asked me nothing about my history except as it related to ECT. I thought that odd, but I had typed up a history for the doctors to make sure they got the facts right and to make their dictations easier.
Why should they work for their money when I can do it for free?
Today I also had the unique experience of a brain MRI. Before my head and upper body were slowly eased into the white cylinder, the attendant put ear plugs in my ears. He didn't say, “Turn your head and cough,” just “Turn your head,” but a cavity was poked in any case. Why a patient can't be trusted with his own ear plugs is beyond me.
I think I went through two five-minute and two three-minute scans. What was most surprising was the noise, at one time a loud buzzing of eight bursts to my left followed by eight knocks overhead--over and over. It was as if someone were shooting a ray-gun at my head, followed by a troglodyte rapping me with a stick. The tech said this was due to the fact that they had to mechanically move the magnets around to get the scan. As you may know, the magnets align the positive hydrogen ions in your brain in one direction for the sensors to map out soft tissue. A CAT scan is still better for bone, but apparently they thought there was more to my skull than an empty shell. I look forward to proof of a brain.
I did feel something in my head as it happened, but it is too subtle to describe—like a little wave of energy slightly heating my brain. Luckily I had no psychic powers to lose, so that was not a problem, but the buckshot I'd stuffed up my nose as a kid tore a hole through my forehead.
When I was asked before the procedure if I had any metal or wires in my body, I almost felt embarrassed to say I had none, as if Borg status should have already been achieved by most humans. That's just my depression, however, making me feel inferior. In depression I am never concerned with what I have but always what I have in comparison to everyone else, which is never enough. How silly is depression? I can feel inferior for a lack of internal hardware.
After my first treatment tomorrow I will attempt to blog in that groggy, disoriented state in which I found others at group today. I will try to put the feeling down on paper but it may come out as just some retarded guy typing.
I especially want to thank and praise my wife, Kathleen, whose hard work to obtain insurance for us through employment made this treatment possible. She is the best (and you can't have her!)
I should also mention my sister and brother-in-law, who have graciously agreed to let me stay at their house and will transport me back and forth when I am converted to outpatient ECT.
With a glimmer of hope,
CE
Tomorrow I will have my first treatment of unilateral (right-sided only) electroconvulsive therapy. Of course I'll be knocked out with with anesthesia when they plug in the toaster, but what they aim for is evidence of a generalized seizure ignited by the single burst of current. They'll start me at “50%.” I asked the doctor how many Joules that was (a measure of amperage, as in a car battery), but all he could do was draw pictures and talk about percentages, so obviously he didn't know. (It used to be 200 Joules.) He was the kind of authority who tries to give an authoritative answer even when he doesn't know it. Maybe he should run for office. (I'm voting for Senator Eagleton, who, if you are too young to know, was dropped from the McGovern ticket when it was discovered that he had had ECT. Don't supersize me, supercharge me!)
The psychiatrist responsible for a second opinion spent more time with me than my admitting psychiatrist, who asked me nothing about my history except as it related to ECT. I thought that odd, but I had typed up a history for the doctors to make sure they got the facts right and to make their dictations easier.
Why should they work for their money when I can do it for free?
Today I also had the unique experience of a brain MRI. Before my head and upper body were slowly eased into the white cylinder, the attendant put ear plugs in my ears. He didn't say, “Turn your head and cough,” just “Turn your head,” but a cavity was poked in any case. Why a patient can't be trusted with his own ear plugs is beyond me.
I think I went through two five-minute and two three-minute scans. What was most surprising was the noise, at one time a loud buzzing of eight bursts to my left followed by eight knocks overhead--over and over. It was as if someone were shooting a ray-gun at my head, followed by a troglodyte rapping me with a stick. The tech said this was due to the fact that they had to mechanically move the magnets around to get the scan. As you may know, the magnets align the positive hydrogen ions in your brain in one direction for the sensors to map out soft tissue. A CAT scan is still better for bone, but apparently they thought there was more to my skull than an empty shell. I look forward to proof of a brain.
I did feel something in my head as it happened, but it is too subtle to describe—like a little wave of energy slightly heating my brain. Luckily I had no psychic powers to lose, so that was not a problem, but the buckshot I'd stuffed up my nose as a kid tore a hole through my forehead.
When I was asked before the procedure if I had any metal or wires in my body, I almost felt embarrassed to say I had none, as if Borg status should have already been achieved by most humans. That's just my depression, however, making me feel inferior. In depression I am never concerned with what I have but always what I have in comparison to everyone else, which is never enough. How silly is depression? I can feel inferior for a lack of internal hardware.
After my first treatment tomorrow I will attempt to blog in that groggy, disoriented state in which I found others at group today. I will try to put the feeling down on paper but it may come out as just some retarded guy typing.
I especially want to thank and praise my wife, Kathleen, whose hard work to obtain insurance for us through employment made this treatment possible. She is the best (and you can't have her!)
I should also mention my sister and brother-in-law, who have graciously agreed to let me stay at their house and will transport me back and forth when I am converted to outpatient ECT.
With a glimmer of hope,
CE
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