Life just keeps life-ing along

VNS

I’ve been incrementally turned up to 1.25, while 1.0 is the therapeutic target. Anything above that is a benefit, as long as it can be tolerated. Though I think next appointment (2 weeks) I’m going to ask to be set back to 1.0 for a bit longer. I haven’t been getting used to 1.25 as quickly as the other settings.

The sensation is actually less complicated than some of the previous. I can feel it “ramping up” and then it’s a strong feeling like an uncomfortable twisting feeling at the neck. That sensation fades over the following thirty seconds. It’s accompanied by a small choking feeling and something like heart burn, which is annoying more than anything else.

I have found myself using the magnet to temporarily disable the VNS much more often than any other time. I’ve got a loose magnet but I’ve also got one on the underside of a watch band, so it looks like a wristwatch on my right wrist. Actually, it is a wristwatch on one of the provided wrist magnets. But if I’m in public and I feel it kick in while I’m talking, I just reach up to my left shoulder as if to scratch it and the movement puts the magnet in just the right place. So subtle. My scars are so subtle now that Wife actually wondered what that redness was on my chest, until she remembered.

As for me..

I’m introducing a new section, positive news.

Positive

I had a trip to the east coast (the same one I did last year, without the following suicide attempt) which was good. I got to spend a ton of time with my daughter, we really get on well. She has a passion for road trips to match my own.

I got to see my brother and his growing family. With frozen custard!

I spent five days with my oldest sister. No plans except some day trips to various parts of New York City. The rest of the time was spent doing absolutely nothing. Some writing, a bit of playing music, and a ton of time having really good chats with my sister and her husband.

I’ve have had some freelance work contracts come through, including a new one that’s part of a series. I think I’ve made dozens of dollars this year. So not much. But it’s something, I guess.

Back to our regularly negative blog..

Logistically (therapies, schedules, DBT) things are the same for me, it feels like everything is unspooling lately. I feel I’ve broken in half after/despite the peace of my trip to the East Coast. Since then I haven’t been able to write, play music, or even take the Vespa out and wander around. While these are usually escapes for me, where I can forget myself for a bit, they no longer work. It’s like something just came and removed my ability to enjoy the last things I could.

I’ve been thinking about the “anniversary” all week. Remembering the hospital and so on. So much has happened in a year, and yet nothing feels different, except the various side effects. I reread my journal from my hospitalization and I was so upbeat on release. I had plans and schedules and an attitude. That all seems so foreign to me. I can’t remember if that was genuine or I was just saying the things I needed to say to get out of there. I do remember the day I came home Wife picked me up and it was a pretty day. Still warm like summer, but hope for sweaters was there. And we went home and sat around the table and had dinner in the fading light of the day. Just like before. And after.

It feels like everyone else seems to be getting on with their lives. Everybody knows neighbor X is a baker, neighbor Y is a salesman, and neighbor me doesn’t work because he’s got the depression. That normalization is one of the most isolating things I’ve felt yet. Somehow I keep thinking I’m the old, robust me (with some weight lost, even!) but that I’ve been temporarily hobbled by my issues. As this wears on it really feels like this is it though, how it’ll always be.

(In rereading this, that’s a lot of feels. It took about three hours for me to write this, should have been easier.)

Happy Anniversary

Today is the first anniversary of my suicide attempt. In just this past year alone I have:

  • done an inpatient stay
  • a partial hospitalization
  • an intensive outpatient program
  • started ketamine therapy
  • a full course of ECT
  • had a VNS surgically implanted
  • started DBT
  • applied for disability.
  • Spent 75+ hours in therapy
  • Spent 96+ hours in group therapy
  • Changed medications at least a dozen times

(And a huge thank you and I love you to my wife. She was by my side for all of that.)

Three years ago last week I attended my first PHP, essentially marking this major depressive episode’s official start, though it was growing for months.

I have a wide variety of feelings this weekend. Hope is not high on the list, but I suppose it counts for something that it is on the list.

It’s been a long three years.

The Pain of Progress

Forever ago I found a cable knit sweater at Target. It was mustard colored and I loved it. It fit well, and it just had a sense of comfort. I went back and over a few weeks collected as many colors as I could find. Blue, green, beige. Sad I never found a red. The off white sweater was one size larger than the others but that made it even comfier.

I wore it all winter. I wore it to work and I wore it at home. In the summer I would find the lamest excuse to wear it. When I went into the “grippy sock jail,” aka hospital it was one of the few items of my own that I had.

Wearing that sweater gives me comfort and security. It was armor and it was what I knew.

Depression, for so long, feels like that too. It still makes me want to die, but it is also familiar, something I know, and at times, something that keeps me warm.

Last week, I visited my sister, who lives in a kind of remote paradise. My daughter was living there for part of the summer, and some of my trips purpose was to help my daughter move back home. It was an amazing visit. I spent time with my daughter, but also with my sister and her wonderful family. I took walks, I sat on a porch and read, and just sat there appreciating peace. I wrote about my childhood and about canoe trips, in an actual book.

I had two days of.. Nothing. Depression and anxiety weren’t there. At the end of these days I would be so exhausted that I could feel them, but it was only as I was going to sleep.

The closer I got to home the more the anxiety grew, and the depression poked its head out. Remembering that I had nothing to be, except broken.

“Getting better” has always scared me. So this development is very overwhelming. I worry that people will see me being more alert and active, and think “Great, he’s better now!” I worry the life I awaken to will be so very different from my old life. I will have to recreate myself, learn who I am and how I live my life.

I do know that I have more energy, but that a lot of it goes to wearing my “human face” and interacting with others. Ironically, the better I look, the better I’m putting on a good show. It feels a bit like I’m just going back to the time I was depressed but able to convince others I was fine. Back into the sadness closet.

I’m not there (“Better”) yet, obviously. It’s a long road. And I’m still not sure how I feel about walking that long journey. Or even if I’m willing to.

What to say and do for your depressed friend

I haven’t seen him more than a handful of times in the last 20+ years, but he’s been a friend since just after high school. I had to miss getting together recently.

Here’s how the email exchange went down:

Me:

Sorry for the late reply. Still pretty rough. Did you get together with <otherfriend>? How was he?

Him:

Write anytime you can or feel up to it. I think about you often. I hope things improve soon for you.

<otherfriend> ended up staying here for a week. LOL. Was good to see him.

Even if last minute and we just go for a drive or something if there is ever anything I can do, please please don’t hesitate to ask.

Take good care of yourself, my friend!

Me:

Thank you.

And I just wanted to say I get people telling me they want to help, or they know how I’m feeling, or here’s a “helpful web page”, etc.  Not disingenuous but sometimes just doesn’t click.  But there’s something about the way you put it that was exactly the right way.  Thank you so much.  I will let you know when I’m up for getting coffee or something, absolutely.  Have a great fourth of July!

Him:

That’s because they know they’re supposed to say it and then don’t think about the words they use. They just borrow someone else’s, and it’s not genuine.

With me, I’m serious. I want you to feel better. I’ve been depressed before and that was bad enough. I can’t imagine what you are feeling or dealing with.

Just know I’m here, and that I truly care. If you’re having an awful night and need a new shoulder to (literally) cry on. I’m here. If you just want to sit in silence and watch cute bunny videos on YouTube, I’m all about it. The difference is that this isn’t about me, I’ll be ok. This is about what you need to feel better.

So, like I insisted before…take good care of yourself. Please don’t forget I’m a text away…but be prepared for me to act if you ask for something. 

♥️

Me:

Thank you.

That one time I didn’t

I’ve thought about sharing or not sharing this account, but it’s had such an impact on my whole life that I really want to get this one out. This is why I’m anonymous, and thus keeping everyone else in the entry anonymous.

When I was in high school a million years ago, I used the BBS systems extensively. They were servers you would call with a phone line and your computer. You could discuss things, or on some systems you could chat live with multiple people. The community was small, and we all ended up getting to know each other well. As a result, many of my friends were mostly met online. Back then, it wasn’t a familiar concept, so people didn’t always understand how you can be close to someone you’ve never met, or how we can all communicate in general.

One of those friends was the only kid I knew with a proper punk mohawk. He was a little obnoxious, super creative, and pretty sensitive. He made music and even handed out cassettes of his work, which was usually a little bit out there for my tastes, but it was cool nonetheless.

I was on one of the chat systems one night, and eventually it was just the two of us chatting. He was going through some stuff, I was going through some stuff, and we were both just mostly commiserating. Ironically, my “stuff” wasn’t that bad, as it usually was. I was talking philosophically about the pointlessness of life, using the example “I mean, what’s to stop us from just driving into the monument by the river and ending it all?”

I thought I was pretty clear.

The next day on the way to school, he hears something over the speaker on the school bus about a suicide. He went to the public school, I went to the private. But all he heard was “suicide” and remembered our conversation. So he was pretty upset. He told his school counselor who called my school and I got called into the counselors office.

I don’t remember most of the conversation but I think he just made sure I was safe, and then gave me a speech about seeing ahead to the future and not living with “blinders on.” I went back to class and didn’t give it much thought. Again, I didn’t feel very depressed.

After school I walk home with a different friend, and at one of the intersections I see my mom’s car. Odd. But I’ll take a ride home any day.

“Don’t you ever do anything like that again” she snapped, when I got in the car. I was taken aback but she explained the school had called her and told her all about it. She was mad. Not just irritated, but the kind of mad that’s a little scary. And that was the moment my respect for my mom was permanently marred.

She thought it was a prank or something, I guess. Regardless, that’s not how you’re supposed to respond in a situation like that. Make sure I’m okay first, maybe? Ask me more about what happened to understand it better? As a parent I know how hard it is, especially when they’re in high school, but what she said comes back to me often, and did even more when we were raising our kids. It hurt to my very core. And it still does.

In the end it actually helped me later in life. I did my thing, and didn’t worry much about what my mother would think or say of it. Joining the military, dropping out of college, moving in with this girl I really liked, etc. I just did them and let her know about it, but I didn’t ask her advice or opinion. That one statement so many years ago made me feel emotionally cut off, and it allowed me to just be with my own emotions. And those decisions all turned out to put me on a really good path in life, surprisingly.

I’ve since had much worse times, including my own actual attempt and threats. So many therapies and meds and doctors have passed, but I still think of that day. Mom died a decade ago or so, and as a result she wasn’t around when I was going for ECT, or in the hospital. I sometimes wonder how things would be different if she was still alive.

The friend who caused all of this committed suicide a few years ago, and I think about him often. What he was going through, how long he persisted, and what the darkness felt like falling from that bridge.

VNS: A vein in the neck?

I forgot to add this to the last post, but it’s a bit of an update on my neck scar from the VNS. Both scars are fading nicely, and the chest scar is really getting light. My neck is a little bit redder, but I’m guessing that’s from collars and everything else that abuses it. Assuming it’ll come along eventually.

I do find that driving long distances the seatbelt hits my chest device square on, and the belt also runs right along the neck scar. They’re not so much as tender anymore, but over a couple hours it starts to be uncomfortable. So I’m resorted to either adjusting position, which is not easy, or not using the strap. It ends up feeling like the old days, when all you had was a lap belt and mom smoked in the car.

Some of my inner electronics

What’s interesting though is that you can see and feel some of the electronics. The connector is a small bit of wire which is wrapped around the Vagus nerve. It’s then doubled back upon itself and run to the device implanted just below my collarbone. The nerve connection is a little lump at this point and not only can you see it (not a zit) but you can feel it. Which is a little odd feeling.

There is something called Twiddler’s Syndrome, which is when a patient fiddles with their implant (pacemakers have this issue also) enough that the fiddling causes something to not work right anymore. It could be a lead coming off, a wire wearing through something, etc. So I’m being careful not to mess with it much. It’s a pretty rare syndrome, but my anxiety is quite aware and mindful of the issue.

You can also see the wire leading from the connection to the device. That one is a bit more subtle, but there regardless. At rest you really don’t see it at all.

As far as the scar is concerned, I don’t think about it much anymore. It’s the beginning of summer, which means t-shirts instead of collars and sweaters, so it’s out in the open. I don’t think people notice it much, and if they do they’re not saying anything. Because it’s not scary looking like in the beginning, I don’t try to hide it or anything. Although if someone asks and the timing it right, I’m going to say I got it in a knife fight. And you should see the other guy!

VNS: A pain in the neck?

VNS, a few weeks on, and a bit more turned on

Saw my psychiatrist at the Treatment Resistant Depression clinic and he turned my VNS up from .25 to .5 — and this time I can feel it.

I want to mention here that everyone’s experience with a VNS can be different, and any negatives I mention here are how I’m feeling it. It’s not how you’re necessarily going to feel it.

The device fires every five minutes for thirty seconds. When you get it turned up, the side effects might be more pronounced, but ideally you get used to it. In my case, we took a long roadtrip a couple days after we turned it up, and I felt it every single time while I was driving. In normal daily routine, I felt it a lot in the first week or so. That constant prodding didn’t help my anxiety and by the end of those early days I was exhausted. Now, a few weeks along I don’t feel it every time. Often I’ll feel it a little bit, but it’s subtle. But I still feel it a good bit of the time. Depends on how distracted I am. When it’s quiet I feel it pretty much every time still, but it’s less “annoying” than it’s been. So I’m confident I’ll have backgrounded it by the time we turn it up again in a couple weeks.

That said, I have had to use my magnet a bit. A reed switch in the chest part is activated by the magnet, which tells the device to chill out for a minute. After which it starts up again. The roadtrip was for a family event, and I got to see many of my siblings and their families. My wife’s family fills time by talking logistics about whatever they’re going to do next. Or already did. My family fills time with stories. Stories about interesting things we’ve learned, or experiences we’ve had, or most often about our family growing up. So rather than wait 30 seconds if the device was firing (and lose my turn in a discussion), I needed to use the magnet every five minutes at times. Other times I just kept my trap shut and my memory issues erased whatever thought I was going to share, problem solved.

The sensations listed below make it feel like I’m talking right after getting the wind knocked out of me. Not as bad as that obviously, but makes me not want to talk at those moments. One of the concerns was that it would alter my voice (robot voice) but so far I still sound mostly the same. Just a bit softer and a bit like I’m out of breath.

My five C’s, The Sensations

Pool Cue

When it fires, it feels a bit like someone is gently but definitely poking me in the neck with a pool cue. Not sharp, but solid and specific.

Cough

Occasionally I’ll have a cough like when you have a frog in your throat or it’s just a little dry. Doesn’t last long, usually right at the beginning, and it doesn’t persist. It’s like an on off switch. So if I’m having that little cough and I use the magnet to temporarily stop it, the cough stops immediately.

Choke

Imagine having two throats. Your normal one, and another little one on the left side that’s just like a miniature throat. Well when the fob fires, it feels like the little throat is being choked. Still breathe just fine, can eat, etc. But that phantom throat is being squeezed. Hard one to describe.

Cardiac

I haven’t tracked it perfectly, but I have a feeling that I can feel the fob before it fires, with what feels a bit like chest pain, but nothing heart attacky. During the firing I can absolutely feel some chest pain discomfort or compression. But again, more annoying than harmful.

Clamp/compressed

Finally, imagine having a clamp placed on your chest. One side of the clamp is over your left lung in the front, and the other end of the clamp is on your back. And it’s tightened gently but while you’ve breathed out a good lungful of air. So when you try to take a breath it feels like a very small person is standing on your chest. You can still breathe, but taking a full, deep breath is a bit of a challenge.

Mental

So far I don’t know that I’ve seen any improvement. But again, 1-12 months to see any payback. But the constant reminder that we’ve resorted to implanting a tiny little shock machine in my chest can be a little depressing. Rather, fuel for the depression fire.

It’s hard to tell what kind of progress I’m making or how I’m improving. Is it the season, the meds, the ketamine, the DBT (more on that next post), the support of my family, the VNS, the ever changing biology of my body, etc. So I can’t speak to effectiveness just yet, sorry.

Next post: I’ve started a DBT program.

A year in review and a trip

I’m traveling. It’s the same trip I took last fall just before my suicide attempt, just in the other direction. It has given me so much to think about from the past nine months. Hospitalization. Semicolon. A second round of electroconvulsive therapy. Ketamine therapy. Surgical implant of a Vagus Nerve Stimulator. Hours of therapy. So many meds and the good and bad that they do.

Bright flashes of forgetting what’s hurting inside me. Long stretches of being mired in those feelings and that despair. So many things I’ve forgotten, and others I’ll never be able to forget. The support my wife gives me with so much love I can’t find any adjectives strong enough to describe it.

When I’m in travel mode I am on a mission and follow a schedule, getting to the right places at the right time and acting and looking like just another passenger. I’m good at it, but when things get quiet I can stop, breathe, and remember myself. 3,000 miles this month so far either driving or being driven. When I got here I was so tired. It was the numb yet also painful tired you feel that shuts everything else down until you sleep. But standing in a train station on a fresh air break, waiting to reboard I fell to my thoughts. It was a difficult time, and I have now decided that I can’t be that tired anymore. It’s the same reason I stopped drinking. The effect is a horrible one, and it pushes me toward unsafe.

I had a perfect night of sleep, and spent the day with my daughter. The evening with my brother, his wife and her parents as well as my toddler-niece. I was social. We are a family of stories, and I told many of my own, making people laugh and smile. I’ve trimmed down a bit, I’m trying to dress well. Fashionably, even. If I can’t feel good I want to look good. But when you peel back the tinfoil on the dish you find the hot mess that’s my mind just beneath the surface.

When I see someone after a long time, they say I’m looking so great, my demeanor and animation show how well I’m doing. For those who know what’s happened in the last year they think how much I’ve improved. I’ll never know what to say to those comments. Because some things have changed, but it’s still pretty bad in here.

It is very nice to see family I don’t get to see often, and to spend time with my daughter. The trip is something I’ve looked forward to for a long time, and it is going well in many respects.

VNS, the whole story

(Gonna start with a quick apology for not writing in a while. My writing machine is not working well these days. Also, I’m just out of a Ketamine appointment so if there are misspellings or things that don’t make sense, I will refund the money you spent reading my posts..)

A million years ago, give or take a million years, my psychiatrist at the University of Minnesota Treatment Resistant Depression clinic mentioned a VNS. A VNS is a vagal nerve stimulator, and I think I’ve covered enough of it in the blog that I might not have to explain again. The tl;dr is that it’s a little thing the size of a car key fob, and then implant it in my chest. For me, just on the left, an inch or so down from the collarbone. It’s also a wire that goes from the fob to my Vagus nerve. It’s a special (expensive) wire, and it wraps around the nerve so the fob can give 30 seconds of an electrical impulse every five minutes. Scar on chest, scar on neck, but they’re not so bad.

To prepare for the surgery I was given a nice list of things to do. Now, I’ve never had surgery before so I’m assuming this is typical. I had to buy expensive pre=surgery soap, and after a complete shower, had to apply said soap to myself and then wait a minute before rinsing it off. You know how sometimes you’re in the shower and you have to get out for a second or go to the other end of the bathtub for something, and you’re totally soaked, but in open air? Yeah, that was pretty much the deal, except I was covered in an eerily non-sticky or bubbly soap.

That night, I had to fast from 8pm on, skip my meds, and take that first shower. The next morning, rinse and repeat – literally. The one thing the two showers had in common was the fact that they were both in the dark. I was due at the hospital at 5:45 or something, so I had to get up at 4:30 to get ready. Waking up that early isn’t so bad when you haven’t really slept the night before, though. At least we know my evening meds are helping me sleep. When I get to take them.

One thing I did know about surgery is that there’s an awful lot of sitting around the house while you’re recovering. So I made a trip to the grocery and stocked up on comfort food and snacks. I still have a lot of them. Eating hasn’t really been something I’ve been doing very well lately. I make a good show of it, though. It’s not as bad as in this video, but I think about Cassie a lot:

Day of procedure we got up at zero dark thirty and made out way to the University. The ramp we parked in didn’t have great access to the hospital, so we got to wander around in the
light drizzle. But when we got to the right place, it was an instant intake machine. Go here, get checked in, go here and get your wristband, wait here and someone will take you to your room. Very little waiting and the only time I got grumpy is when the lady at the second checkpoint called me by my last name. I’m surname deficient, so it happens a lot. But it pisses me off every time it does.

I was taken back to my “little room” – three walls and curtain. Comfy though. Bed, chair, nineteen computers, etc. I was given the requisite gown to put on, but it was easy to do and covered me from every angle. No cold butt and back. I met everyone on the care team, from resident to anesthetist to neurosurgeon himself. Answered a million questions, some of them the same. And gave my birthday about 20 times. That’s not unusual though. I was given a plastic bin to put my personal effects in, it was efficient and handy.

One of the things that came up in my many interviews was that I am a normal, boring, uncomplicated patient. None of the comorbidities that could complicate things, no history of many different maladies. But I hoped that would make everything go so much smoother. I had lost hope that my surgical team would screw up and I’d die on the table, but I’m working on that with my therapist. When the anesthetist came in to put my IV in, he had quite a bit of trouble finding a good vein. When the chief anesthetist came in to ask some more of the same questions, he said that I was the most anesthetized patient he’d met. And he was old, with gray beard and everything, so he’d seen a ton of patients. Given the face that I had dozens of ECT sessions, and each one they put me under, I’d say yeah, I have some experience there. In the end they did have to get the lasers out to find a vein.

I was finally ready and got on the bed, ready to stare at a variety of ceilings. We headed down a couple hallways and into the surgical theater. I don’t know what I was expecting, but it was quite light, spacious, and had an impressive display of devices and `s. I was in there for maybe 30 seconds before they said they were going to put me under. No mention of potential pain. In the ECT sessions, they’d say they were putting me under and that I might feel some heat/pain in my arm. And sometimes I would. But not for this serious surgery. In fact they said it and I woke up after the procedure. Really bummed, as one of my favorite parts of anesthesia is when your eyes roll back and you feel a flipping kind of feeling before going out.

While I was out, they made an incision in my chest and placed the key fob of despair in my chest. Then they made an incision in my neck, sorted out my Vagus nerve and prepared to attach the wire. The post procedure notes said I had a “very large Vagus nerve.” So I’ve got that going for me. Somehow they missed a vain, it was hiding behind the very large nerve. So there was a tiny bit of bleeding and they found it and fixed it. Wire from neck to chest and then they turned on the device, so make sure it’s working. And it did. So they turned it off. More about that later.

When I woke up back in my little room, I was a little groggy, but not that bad. Within a minute or two I felt really clear. I could see the chest incision at least, and it was gnarly. All red and swollen and covered in surface glue. Once the glue wears off and the incision chills out a bit, it eventually fades into a scar that you don’t notice anymore. We’ll see about the scar on the neck though.

Turns out there were actually dissolving stitches inside me and the incision was glued shut and covered in the protective surface glue. Felt like rubber cement. The wounds hurt as much as you would expect, but honestly not that much. I mean, the first couple days they hurt like I’d been cut open and poked and prodded. But at no point was I curled up on the floor screaming and moaning at the pain.

That was just me though. My curtain was open, so I could see the nurses station and a couple other “little rooms” in the unit. They brought a man in who was moaning and groaning and deep-sighing so much it was a little alarming. He calmed down eventually but never stopped wanting to get up out of bed and go somewhere. In stark contrast, there was another older gentleman who was in the bed, but sitting up a bit. He had a dedicated nurse, so I assumed something might be wrong or complicated. A bit later when I was able to hear him better, it turns out he was talking recipes with the nurse. Go figure.

They wanted me out of bed and into the Immensely Comfortable Hospital Patient Chair as soon as I could, to help clear any remaining fog. But I was wide awake. They let me get dressed and then the wife came in. We had a chatty nurse for discharge and at some point I asked if, after I healed, I would be able to play the piano. I admit it was about as dry a delivery as they come. But she said only if I could play before. So joke defeated, but that’s ok. I regretted not asking the doctors and such. I may be devastatingly depressed, but I can throw bad jokes out any time.

Here’s a picture of me in the chair. I figure the mask anonymizes it enough, and I really don’t care if it doesn’t. So that works out.

Awake and awaiting a wheelchair ride out of the hospital

Sent home with antibiotics and opioid medication. I asked the wife to be incharge of the Oxy. The last time I’d had some on an autumn evening on the porch didn’t work out quite like I wanted/expected. I did sleep a ton, but within a day or two I was up and able to go downstairs (slowly) and do something besides lay in bed.

So what’s happened since?

First, the scars. Healing nicely, glue came off after a week or so, which helped. All of the drawing they did near my incisions had been sealed in with the glue, so just getting those to go away also helped. I think I’m more than a month out and they look so much better. Just little pink lines and some persistent swelling on the neck scar, but that’s going down bit by bit. Right after I got out and the scars were pretty gnarly, I would wear a winter scarf (it was still snowing, after all) so I wouldn’t scare small children or put anyone off their dinner.

After two weeks we went to my psychiatrist at the treatment resistant depression clinic. I keep specifying that because I have enough psychiatrists in my life that I need to clarify these things. Anyway, he’s a really good doctor, nice guy, and is an exact clone of Stephen Mangan.

He handed me a wand – like a giant tv remote with a big circle bit at the end. I held the circle bit over the fob of despair in my chest, and he activated it. He started at .25ma and I’ll go back to him every couple weeks to get it turned up to .5, then .75 and finally 1ma. I couldn’t feel anything while he was firing it, so he turned it up to .5 for a moment to let me feel that stimulation. Ideally I’ll just get used to it as it happens. It felt like someone was standing on my chest. But not in a bad way. It also felt like there was some electiricity being zapped into my neck, but just a tiny bit. It also had a sensation that is extremely hard to describe. Like there was a collection of (like 8) stiff wires and they were all not so much as painful, but felt. Like I said, hard to describe. But no voice modulation, didn’t sound like a robot or like I was talking into a fan. There are, as usual, a long list of possible side effects, but that was the one I was most concerned about.

For those times when I feel it firing and it’s problematic, I have some rare earth magnets that I can place over the fob location in my chest, and a reed switch is pulled which prevents the device from firing. So if my speech is affected at some point and I need to give a speech or record something, I can turn it off for those times. Carrying the magnet 24×7 is recommended, but this device is also used to epileptics to control siezures. With theirs they can activate it so it fires at will, or

BTW, that psychiatrist is an apparent clone of Stephen Mangan, sans accent: (also, I don’t think he’s a cad like the character.)

Going in and out of stores is fine, Target didn’t beep at me as I entered or left. I do wonder how the TSA will deal with the little electronic device I’m carrying.

I also wonder when it’s firing. It’s 30 seconds every five minutes. There are 1440 minutes in a day. Divide that by five since it’s only happening every five minutes – that gives 288 times a day that it fires. Multiply by 30 for the duration, and you get 8640 seconds. Divide that by 60 for a number of minutes and I get 144. Divide again by 60 to see how many hours that is, and I get 2.4 — so for two and a half hours every day I’m getting these shocks. But I can’t feel them, so that’s ok I guess.

While I would love it if I had an app to go with it, I understand the battery life would suck, and I’d need an operation every month to recharge. As it stands, the device can last up to four years on the single charge it has.

I wonder what four years from now will look like.

MAOI Wowee!

I can’t remember the last time I felt this physically horrible, excepting legendary hangovers of the past. Perpetually awake, the insomnia just drags me through the night. Occasionally sleeping, only to awaken – wide awake for who knows how long. And then I wake up bright and early. Despite my near-legendary ability to sleep in and get back to sleep whenever I want, when I wake up I am awake for good. With tension, headache, and pressurized psyche.

This week I started my first MAOI, Parnate.

Monoamine oxidase inhibitors (MAOIs) were the first type of antidepressant developed. They’re effective, but they’ve generally been replaced by antidepressants that are safer and cause fewer side effects.

WebMD, I think

It’s the nuclear option of depression meds. There are so many side effects, bad interactions with so many meds, and a restrictive diet that reads like my shopping list for a weekend with the wife out of town. Hot Dogs, bacon, many cheeses, bologna, sauerkraut, pickles, caffeine, alcohol, and so on. They’re not completely off the menu, but if I eat the wrong food, or too much of one of the possibly-wrong foods, or just a randomly bad food, my blood pressure could go all the way up. And then I have some seriously horrible pain and problems. In the meantime, if the food doesn’t get me, I enjoy low blood pressure. Like, actually too low. Which brings lightheadedness, dizziness, confusion, dry mouth, and such. Not to mention the possibility of Serotonin Syndrome. But that’s all just a sample of the litany of complication that is an MAOI.

I was already rocking the dizziness and a world of other junk, but this latest med has brought insomnia, a tension in my neck and shoulders that I haven’t felt in years, headaches, nausea, and some complicated “side effects that might just be in my head.”

Regardless, I feel wound up. I need to remember to take the deep breaths. My stomach is a knot. I’m waiting for the next thing. Could be nothing, could be passing out, could be many things. I’m sure I’ll relax a bit as time goes by and I don’t actually keel over. Until then, I feel awful, on a path to hopefully feeling mentally better. Despite the insomnia, I’m wide awake half the day, then drowsy fatigued until mid evening when insomnia jitters kick in. Sleep, energy, and appetite may improve with 2 weeks. Mood, depression, anhedonia may need up to 6-8 weeks to fully improve. That sucks.

In other news.. I’ve had my last session of ECT last week and I don’t think I’ll miss it. I love going under the anesthesia, and getting a great noontime nap. But not the confusion, memories being erased or dizziness, etc. I had my second to last Ketamine session, I think. That I will miss. But I have to admit the last two sessions were.. weird.

And finally, in a week and a half I get a mental pacemaker installed. That could take up to a year to see benefit.

It’s always good to end on a high note, or a funny note. Leave them smiling. Sorry, not this time. My mood is still not great – just more jittery – which doesn’t make things better. When I’m depressed, all of the many many things we do through our days are grueling. But if I hit a roadblock – Hit my head on a cabinet, spill food, pick up my phone and not know why – there’s an internal meltdown. And if I could, I would allow that internal meltdown to use the dangerously loud voice, to kick something hard, to put my fist through a wall. But I can’t do those things, so they just kind of sneak into the depression and make it all seem worse.

And then there’s the suicidal ideation. They ask me how it is and I prefer not to give a solid answer. It’s .. different. I’m safe. No plan, no intent. But you know what? I have hope. Hope that the surgery goes wrong. Hope the meds clash and cause me to drop dead in an instant. Hope that I’ll go away and I won’t hurt any more. But I guess the point there is that I’m hoping for fate to do something to me. I’m not thinking about how I could do it myself. That’s an improvement, right?

I have filters for everyone. Back to the classic “how are you” question – that’s a great example of the filters. A friend asks? I’m ok. Doctor? I give a bit more detail. Therapist? She gets pretty much everything, just one tiny step up from my wife. Whom I love and sometimes will hold back on the really painful stuff because I don’t want to hurt her. And yet I know how bad that sounds.

My therapist, who I “see” on Thursdays, got a really long answer to how I am. She asked some interesting questions this week, though of course I can’t remember them. But after I talked about My Morbid Hope (good band name) she started asking some very subtle, very well covered questions. I talked about how I had just started the MAOI, etc. And finally she asked me point blank about whether I had any plans or intentions. And through all of this, she’s never called me out to see if I had a plan, or if I was considering acting on it. Which I wasn’t. I figure so much is messed up with meds and therapies, I’m taking time off from thinking about how I can die. But I’m keeping an eye out for nature.