Journal Entry 3

Report: no ECT so far. Because of the bloodthinner Coumadin that I have to take my treatments have been delayed. I explained in past entries that on Thursday, which was supposed to have been the day of my first procedure, my blood wasn't drawn as it was supposed to have been. This resulted in an unproductive trip down to, and back up from, the ECT room. Friday was another unsuccessful day since my blood was too thin for ECT that morning, and again they did not realize this until I was already being prepped downstairs.

I have learned a little about the procedure from sitting in the section of the hospital where it is performed. I will summarize what I know about the process so far: they wake patients up at around 5:30 AM and we are provided with hospital gowns and our blood pressures are taken. By 6:00 AM we are waiting in seats near the nurses' station wearing our gowns. CNA's come up with wheelchairs, one or two at a time, to transport us down to the second floor. once downstairs other nurses put clips on a fingertip to moniter pulse and oxygen level, and the stickers used with equipment to moniter our hearts during the procedure are placed in three locations on the chest. We each stay in a hospital bed, one among many in a large room and separated from other beds by peach-colored curtains on tracks, which are drawn around one's bed during the actual procedure, and pulled back once the seizure is over and the patient is recovering from anesthesia. Most people sleep until the anesthesia has fully worn off once back at the unit, which usually isn't until about noon.

Tonight is Sunday night, which means ECT will be performed again in the morning. This evening my blood was drawn and my blood levels were good, my blood isn't too thin for ECT. So in the morning I will have my levels checked, and hopefully I will finally have my first ECT by 7:00. I'll try to update on that tomorrow.

Journal Entry 2

Night two of only Celexa and Klonopin PRN. Took the Klonopin tonight but I still have a lot of energy. It's a fun, sporadic energy but very inappropriate for 11 PM. Probably the beginning stages of some sort of hypomania. This was only day one off lithium, and I'm sure some of you Bipolars can relate to this guilt I feel for enjoying what is probably a little manic burst. I just hope ECT kicks in before I get too loopy on these reduced meds.

Now to businss: ECT. I was supposed to get my first treatment this morning, so I didn't eat or drink after midnight as instructed. I was awoken at 5:30 AM and given a hospital gown. By a little after 6:00 I was sitting by the nurses' station, waiting to be transported down to the second floor. Around 6:30 a wheelchair was brought up to transport me to ECT. After taking the elevator, I was pushed through a hallway and through a large room lined with hospital beds, separated by curtains on tracks. This is where the treatments are done, I was put in a hospital bed in a side room while my pulse and blood pressure were taken and my charts, located on a table beside me, were looked over. In the meantime I was offered warm blankets. After maybe twenty minutes I was wheeled into the procedure room where I again waited, then answered some questions from the anesthesiologist. After a while I was told I couldn't have the procedure performed that morning since nobody had done the bloodwork that is required of me pre-op in order to gauge how thin my blood is from the Coumadin I have been on since the discovery of the pulmonary embolism. I apparently need to have blood drawn each morning, they don't want my blood too thin in case I have a vessel "malformation" somewhere which might rupture from the minor convulsions and muscle tensing, which occur during the seizure despite the administered muscle relaxants. I was very disappointed that I couldn't have the procedure performed today, and I wasn't sent back upstairs until after 8:00. Hopefully all goes well tomorrow morning and I am able to report back on the actual ECT procedure. For now I'm going to try to sleep, and tomorrow I will attempt to have my Klonopin increased to counter this bout of persistent energy.

Journal Entry 1

It's 4:30 AM and I'm glad I woke up because I haven't written in several days. All we have here on the ward are the little pencils I remember using to record scores at the miniature golf course as a child. Hell, I hate all pencils anyway, unless they're mechanical. Guess I'm spoiled.

Anyway, they discharged me from the cardiac unit on Monday, but there was no bed available in the "Retreat", the psych hospital voluntary unit where I was supposed to go, so I was kept one more night at the general hospital before being transferred to the psych hospital. When I got here though, there were STILL no beds at the Retreat so I had to stay on the involuntary unit a night.

I'm sure some of you know what it's like in an involuntary section of a mental hospital. It's not fun. I wasn't allowed to have any of my things except for a glasses case, a book, and my clothes (as long as there are no cords in them). They took my knee and ankle supports which I have been relying on since my injury in summer, so I am in pain when I walk.

I was moved up to the Retreat yesterday afternoon. The rules are similar here but I am more at ease. Having my own room, my own shower, having some art on the walls and being around more or less sane people - these things all help.

I did start getting second thoughts yesterday, though. Am I sick enough for this? Then I found out I may have to stay up to twelve treatments, initially I thought six. My dog is not boarded that long and god knows I miss her and my cat and my apartment as well. But two things soothed my mind regarding this decision, the first being my dad's visit. He told me to do what I came to do and that he would take care of my dog and everything else. Then, I went to speak to a psychiatrist for an in-hospital second opinion, which is apparently required. The psychiatrist I spoke with has been performing ECT for many years and was encouraging about the treatment. He told me that I will know whether the ECT is working within two to three treatments and that I can stop whenever I want.

I'm getting my first treatment here in a little over an hour, it's 5 AM and I go down at 6:30. The tech just popped in to take my blood pressure and he said he'll bring up a hospital gown for the procedure. They stopped my lithium last night for some sort of medical clearance for the treatment. I'm scared about that but I guess I won't know whether I am improving unless I have at least some symptoms in the beginning. Hopefully the ECT picks up and starts working before the lithium wears off too much.

Unexpected Testing

I am still in the cardiac unit, on this extended field trip away from the Electroconvulsive hospital in which I was orginally hoping to receive treatment for my mental illness. As you may know from reading past posts, during my ECT screening while doing intake at the hospital on Wednesday they found some symptoms I was describing as suspicious and soon detected pulmonary ebolism, bloodclots in my lungs. Its Friday now and they're nowhere near discharging me as far as I can tell. A 22 year old woman without any real obvious causes for this, I think its an abnormal case for the doctors. I was debating whether to post about this section of my hospitalization since it doesn't directly involve ECT at this point, but I am deciding to stray from a strictly ECT blog for now. Today is genetic testing, leg ultrasounds, and stomach CT scan.

Just a Minor Detour

So right now I am in the cardiac unit of a different hospital than the one where I was planning on being, getting shots twice a day in my stomach fat. It's all incredibly glamorous. So, how the hell did I get here? I went in the ECT hospital yesterday and during the intake screening they took my shortness of breath pretty seriously even though I attributed it as a side effect of my new medication, Fanapt, which can cause that symptom. But the CAT scan disagreed... turns out I have pulmonary embolism - blockages in my lungs, which are most likely bloodclots. Suddenly I am not allowed to walk and bam. ER. Bam. Ambulance. Bam. Cardiac unit at another hospital. They have me on Luvonox shots and I should be on my way to the ECT within a day or two. I don't know if I'll be able to have my phone after I leave this hospital but if I can, updates will be convenient.

Finally Hopefully

I got word today that the doctor's office finally has everything in to my insurance company and we may hear back as soon as tomorrow. Judging from my past experience with this office, albeit limited, they may want me in the hospital tomorrow if we get the "okay". But I am really not sure yet. I would love to use this post to go over the history and development of ECT as I had planned, but my eyelids are currently gravitating downwards due to the bedtime medication I took earlier (I'm sure plenty of you understand this dilemma). I still hope to do this before going into the hospital, but we will see what tomorrow holds.

Depression and the Wait for ECT

I am still waiting for news of clearance from my insurance company for ECT. I hope I hear something tomorrow, I'd like to go in the hospital Friday and get medical clearance over the weekend so I can begin treament on Monday. In the meantime I am suffering through a seemingly unsuccessful med switch. I think in this post I will give a sort of summary of this mental condition of mine that has lead me to this point, the point of embracing an opportunity for such a stigmatized treatment. I will try to go over the subject of the stigma carried by ECT, and maybe its history, in a subsequent post. But for now, I present the situation which has led this particular individual to seek ECT.

I think I should begin with a rundown on the history of this battle with myself and my faulty mind. I am doing this to provide you with an idea of how one apparently ECT-qualifying background looks.

What would over time become a barrage of conflicting diagnoses had humble enough beginnings. At the age of eleven I found myself suffering through an escalating cycle of abuse in my family while I was homeschooled, and I will admit that my oftentimes rebellious reactions didn't bring much relief to the situations. Upon entering private school I found few friends and the interactions that carried the greatest emotional impact were those degrading exchanges I had with "bully types". Eventually I landed in a shrinks office, I cried for the duration of the visit and left with a diagnosis of Major Depression and a bottle of Prozac which I was practically force-fed with threats of institutions and medication-laden IVs.

I was eleven.

Being that I am now twenty-two, eleven years have passed since my initiation into the crazy club. In those years I have accumulated quite the rap sheet; mostly psychiatric, although admittedly the disorder has at times contributed to criminal activity. I have gone through an extensive list of diagnoses, each one causing substantial distress as with each new label I had to redefine my self-image, accompanied by that plaguing, ever-lingering question so many of us are undoubtedy familiar with, "am I crazy?"

The first few years after my diagnosis I fought the medicine and my need for it. However, at about the age of 17 I began to weigh my life during the short bouts away from medicine against the life I was able to experience on an effective medication regimine. I began actively participting in my treatment and complying with my psychiatrist's suggestions. I only wish that was my formula for a happily ever after like it apparently can be to a number of people. But not me.

Despite my best efforts, I have been involuntarily hospitalized several times, once at the state mental hospital following an arrest for violent behavior that took place during a high stress hypomanic episode which occurred during a doctor ordered medswitch. The medications, although they do help, are insufficient and unreliable in my case. The side effects have been rough on my body, and I know in my heart that the depression never stops looming and medications cannot keep it at bay forever. Sooner or later I will sink, and when I sink I go blind to life and to hope and cannot find my way out and my only option is death. Add to this the fact that over the years that my suicide fantasies -when I do have them- have grown more attainable.

All of these things were stressed in my ECT consultation, and they apparently are adequate qualifications. So now I am waiting, and it is a very long wait for me. I feel like my life is hingeing on this.

From the Beginning

           So here I sit, having just gotten off the phone with the office of the practitioner who will be administering my ECT next week. I will be
doing six treatments while inpatient at a hospital located a couple of cities away. We are not sure what day I will be going in, we are waiting on clearance from my insurance company. I am now
prepared, awaiting the "Okay Go" from the ECT doctor. My dog's shots are now up to date for boarding, I have arrangements for a friend to pet-sit my cat. I have transportation set up and some clothes outfits ready. This weekend I will purchase a legal pad, I am not sure in which section of the hospital I will be, but I know on the psychiatric units they would not want me to have the metal wire of a spiral-bound . However, I will have a notebook, because I will be journalling daily updates on the hospital stay, the treatments and my status.
           My first step in this direction was a visit with the ECT practitioner, whom I saw a week ago today. Although the hospital in which I Will be staying does take my insurance the doctor himself does not, so I had to pay out of pocket for my visit with him which lasted maybe thirty minutes. The goal of this visit was an approval for the ECT, and I spent quite a bit of time preparing. I made a timeline with pen and highlighter showing the course of my illness, hospitalizations and methods of treatment. I gave him a seperate presentation of this information in list form. I included photos of my anorexia at its worst, stomach caved inbetween my sides, ribs pressing against the skin stretched taut across them. I included photos of my self-injurous cutting from the past, with red thoroughly speckling the carpet behind the mutilated limb. I included every report, evaluation and test I had: neurologist reports, assessments from hospitals and specialists. I also threw in my GED and college intake scores as the arrogantly insecure part of me felt the need to reassure the doctor, and myself, that despite all of these flaws I do have worthwhile attributes that are
also documented on paper.
          During the meeting I explained my condition: that although specialists have been unable to agree on a diagnosis for me, what is universally accepted is that I am on the bipolar spectrum, with depression being the most prominent manifestation of my mood disorder. We ran quickly over my traits of personality disorder and childhood abuse, and I reiterated several times that over the last eleven years my condition has deteriorated substantially, despite continual compliance with psychiatrists' medication regimens. Hospitalizations, arrests, suicide attempts... all of these had happened under the care of a doctor. I really have responded poorly to medications, with Depression always looming just under
the surface, bursting out of tranquilly medicated waters to gnaw on my mind, claw my skin, swallow me completely until I am trapped in the black oblivion of its stomach....
           And then there's the side effects of the medications which I think have more effects on me than they have the proportedly beneficial effects. Increased hunger, irregular menstrual cycles, heat exhaustion, fluid retention, lactation, libido effects... basically, these meds have been turning me into a fat lump who can't go outside, and my body has basically skipped the whole sex part of reproduction, meds having made it so unappealing, as well as the pregnancy thing and went straight into breastmilk production. Yummy.
           Well, apparently the doctor found me crazy enough to warrant the application of the still-controversial ECT. He explained to me that he does bifrontal ECT rather than traditional unilateral or bilateral. He told me that with unilateral the results were unpredictable, that yes there were few side effects but the positive effects were not satisfactory to him. With bifrontal he claims an 80% apparent remission rate, although he was hesitant to use the word remission because as I'm sure we all know, the effects of ECT are not exactly permanent: maintenance treatments must be done and even with those there is a chance of eventual relapse. I do see statistics online as lower then the 80% he quoted me, but either way I am sure I have a good chance of significant improvement at least. I will explain the different types of ECT in a follow-up post.
           I am optimistic about this treatment, I am excited about the idea of not needing as much medicine. I hope this blog is useful to youif you are considering ECT or are interested in learning about and understanding the procedure and the people who get such a publicly controversial treatment.

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