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More TMS Updates

I’m coming to you from a stationary bike again while fully engaging my core. I’ve been gym-ing like a motherfucker the past 2 weeks and I’ve lost four pounds. Seven if I’m picking my favorite weight, but four if you I’m picking the accurate one. I’m exceedingly proud of myself. That’s something good that’s happened in an emotional roller coaster of a week. My TMS treatments have been part of the roller coaster, not just because moods can and probably get worse before they get better, but because there ended up being a doctor mandated pause in my treatment.

I’ve been getting treatments on the left side of my brain for depression. On the days of the treatments though I was getting panic attack level anxiety and lost my ability to sleep. The doctor determined this was more than just a side effect of the procedure and had me stop altogether for a few days. I didn’t know what this meant for the long run at first, but I did notice my anxiety improving on the days off.

When I went back the following week I was surprised to find out that they were switching the treatments to the right side of my brain, otherwise known as the anxiety side. They determined that they were over stimulating my left side and it was time to underestimate. Since they told me that this side wasn’t covered by insurance I was worried, but they took care of it for me and I don’t have to pay extra. So I’ve had one day of anxiety TMS and afterward I did not have anxiety. It was the first time in so long that I’ve felt the almost absence of anxiety I felt like I had taken Xanax. It felt a lot like peace.

For the long weekend I didn’t have treatment and I’m back to an uncomfortable mixture of depression and panic attack level anxiety. Roller coaster. (By the way, a woman just sat down on the bike right next to mine. The cardio machines are practically empty and she chose the closest one to me. There should always be a one bike buffer zone whenever possible. I have personal space issues! Move!) So I have my next anxiety treatment later today, and even though I’ve already had one I don’t really know what to expect. Should I expect the same subdued effect I felt after the first one? Can I expect to feel that all the time long term? What about my depression? Since we’re not treating that side anymore is my depression going to improve at all? Am I going to feel any worse before I feel better?

Roller coaster.

Fortunately I don’t run away from challenges and I know that whatever happens, with this or anything else, I will be fine. I may be cranky, but I will be fine.

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The First TMS Treatment

Today I finally had my first TMS treatment for the depression part of my bipolar disorder. I had the prep appointment the other day, but because we were waiting on insurance paperwork to come through, I didn’t have my first actual treatment until today. I was so tired and frustrated from waiting for insurance that I didn’t have any energy left to be nervous about the procedure. That ended up being fine because the procedure was not scary at all.

The technician, who I will become intimately acquainted with over the next seven weeks, walked me through the procedure before we started. She’s very friendly and thinks I’m funny. Every time I say something she thinks is funny she repeats it loudly instead of laughing at it, which is amusing. She told me she liked my shoes (shown in the photo above – I put on special shoes for my first day) and I said, “Thanks, I call them my David Bowie shoes.” She said, “YOU CALL THEM YOUR DAVID BOWIE SHOES!” I’m going to make this a project during my treatment, to see how many of my comments I can get her to repeat in a loud voice.

Anyway, the treatment. They put the cap back on my head and positioned a round instrument on the left side of my head according to the grid they made the other day, and they pressed it into my head. There was a series of zaps that lasted four seconds followed by a ten second rest. It felt like mild electrical waves tapping my head. It didn’t hurt, but it induced a headache behind my right eye that lasted four seconds. It was mild, but if I had a headache like that on a normal day it would be annoying but not painful.

The series of four seconds on, ten seconds off lasted 17 minutes and then I was done. The tech asked me questions about my mental health history, current diagnoses, and rating my moods on scales from one to ten. She said she would ask me those every day.

All in all it was very simple and easy. I have a bit of a headache afterward, and feel a little lightheaded and nauseated, but neither stopped me from getting tacos for lunch on the way home. I do feel mentally exhausted, maybe partly from the depression, but also partly from the brain “workout” I did today. The tech said that usually gets better after the first week. So I’ll have my second treatment tomorrow, then I’ll be in full swing starting next week.

Now I’m going to go stare at a wall for a few hours because that feels like my level of mental competence today. I hope some of this depression lifts soon.

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TMS Day 1

Today I officially began the TMS process, which I talked about in this post.¬†This is a seven week commitment and 36 treatments, and there’s a chance it won’t even work. There’s a chance it will though, and that chance is worth the effort after almost 20 years of trying medication after medication after medication after medication, etc., and failing all of them. This is something new and different.

Today was like freshman orientation – lots of paperwork and lots of preparation and meeting the people I’ll be working with for many hours of my life for the next seven weeks. I didn’t have a treatment today, but they did use magnetic waves to map the left side of my brain in order to see where the most effective spot to treat was. They did this by taking lots of tape measurements of my cranium, drawing symbols and numbers on it, and drawing lines on my face with surgical marker. It was sexy. Then they made a grid of the specific area of my brain they were going to treat.

Four different people asked me if I needed to go to the bathroom in a matter of three minutes. Perhaps I looked like someone who might pee in their chair. They had me lay my forearms on a table, hands face up, and they explained that they were going to administer magnetic waves in the left side of my brain and make my right hand twitch. Then they were going to gauge how strongly my hand twitched to figure out the most effective spot to stimulate my brain for the treatment.¬†They used an instrument that looked like those giant glasses attached to the chair at an ophthalmologist’s office, and it would make a clicking sound and my hand would twitch as a result, just like they said. I felt nothing. Just my hand moving of its own accord.

They went row by row, cel by cel in the grid. After each row I had to stretch my hand, make a fist, and wiggle my fingers. There was a technician who reminded me to do this and giving me instructions.

Click. Twitch. Click. Twitch.
“Make a fist. Stretch your hand. Wiggle your fingers.”
Click. Twitch. Click. Twitch.
“Fist, Stretch. Wiggle wiggle.”
Click. Twitch. Click. Twitch.
“Fist. Stretch. Wiggle Wiggle.”
“Can you say ‘jazz hands’ instead of wiggle wiggle please?”
“No.”
Click. Twitch. Click. Twitch.
“Fist. Stretch. Jazz hands. Ugh.”
“Thank you so much.”

The process took about an hour. It was tedious, but I will say that the technicians and staff were very sensitive to the needs of mentally ill patients. Before they took measurements they told me that they would need to stand very close to me for a few minutes, but I could let them know if I needed them to back off. They explained everything in detail before they did it, and the program coordinator even told me ahead of time that there would be a man and a woman technician, and that if that was an issue for any reason that I could let them know. It’s always nice to be in an environment where I don’t have to fight the system to get what I need. It’s a rare situation to be in, and I’m always thankful when I come across it.

I have to wait for more insurance paperwork to come through before I start my actual treatments, and who knows how long that will take. Even though they’ve explained to me in detail what to expect, I’m still nervous about all the unknowns. The slight discomfort doesn’t worry me. For one thing I have twenty something tattoos, so whatever happens I can deal with it. For another thing, I don’t care what I have to go through if it will make me feel better. I’m nervous about the unknowns. They said that the depression and mania can get a little worse during treatment before it gets better. They recommended seeing a therapist more often, and keeping my support system close. That’s scary. But I will do my best to push through.

I will update the blog once I get an actual treatment and share how it went. For now, I’m going to go to the bathroom because no one gave me the opportunity to go while I was at the doctor’s office. So inconsiderate.