a Scarlet D

Check it out, two posts in two days. Lucky you!

My feet and legs looked like ribbons unfurling off a spool, and the curtains were paper blowing in the wind. And none of it was how it was supposed to be. – me, an hour ago.

I knew something was wrong, going in.

It was a typical Ketamine treatment. I was fiddling with new noise cancelling headphones.  Trying to find the right volume, and figure out where I was going to set down my phone and water bottle.  I settled eventually, but I was already starting to lose control of limbs and not completely understand my environment.  But then it was ok.  For a minute.  I’ve done this so many times now, it’s a routine.  Blood pressure taken, shot administered, music (Symphony No. 3 – Górecki) turned on, curtains turn into icebergs, I fall into the snow world of the movie Inception, and I am firmly deposited at the center of the universe, a single atom among the fabric of everything.  Easy peasy.

But not this time.  I was still able to see myself sitting in the recliner in the clinic.  It’s like riding a rollercoaster up the big hill and discovering the lap bar doesn’t stay down. Then everything went “boxy.”  The legs turn to ribbons. Some more hallucinations happen and I start to feel like maybe I can’t breathe.  I actually called that out to myself, knowing I’ve never had that feeling while receiving treatment.  I knew that this early in the treatment I wasn’t usually aware of my body, much less thinking logically about breathing.  A short while later I’m looking at my legs, aware of my circumstances.  We’re 10 minutes into the treatment where I should be completely disconnected.  Coming back to the real world doesn’t usually happen until 45 minutes or so, when I’m coming out of it.

It was feeling very very wrong.  Like the Ketamine hadn’t taken hold.  But also like it had.  I moved my feet, my legs.  I could feel my arms on the arms of the chair, but they were freezing cold now, like the chair was cold metal.

Fine, I’m on a therapeutic Ketamine trip, weird stuff is going to happen.

But still I had the sense that something had gone horribly sideways.  Not something I could put my finger on, but something not at all right.  I’m looking around and everything seems normal, but the undercurrent of “wrong-ness” is telling me maybe I shouldn’t trust how I’m feeling.  But I feel like I’m rational.  I’m trying to figure out things, use logic.  So I must be fine, right? I hear all of the activity in the room on the other side of the curtain, but I’m with it enough to remember I have noise cancelling turned on.  Ok, fine, the sounds aren’t real.  Small price to pay. I feel like I’ve come out of the treatment and it’s time to get up and leave.  But I can’t.  (Callback to my very early treatment post about feeling like I couldn’t move my legs.  It was not at all like that.) I start to think maybe I should ask for help.  But I don’t want to freak anyone out. Please don’t call an ambulance or put me in the hospital.

After what seemed like a very long time trying to focus on my surroundings, I manage to eke out an “Um.” Happily, my two favorite nurses were working, and one of them popped around the curtain and asked if I was okay.  I was able to reply that something was wrong but I didn’t know what.  And that’s when she went into nurse mode.  I don’t know if it was time for it to automatically take a reading, or if she kicked it off, but the blood pressure machine recorded one of my personal high scores.  And then she just started to talk me down.  An ice pack happened at some point in there, probably a Vagus nerve tactic.  It was reassuring to hear her say things, but it wasn’t fixing anything. It didn’t help that I was looking at the curtain tracks in the ceiling, not remembering them at all and worrying I was in a proper hospital. I wasn’t. I was still in the clinic, safe and sound.

That’s when I knew things really were not right at all.  Communicating was hard, language was failing me (and I was complaining about that somehow) and I struggled to explain what was wrong.  She’s seen enough people to know when something has gone not according to plan, and can deal with them, so she wasn’t setting off any alerts or really even worried at all.  But as I tried to explain myself I started to notice other things amiss.  Her face became cartoonish.  I tried drinking out of my water bottle, but my mouth was freakishly large.  Cliche’s were injecting themselves into my experience. I was in a cartoon reality and it wasn’t funny.

I was both trying to relax and just follow the trip — and sort out reality at the same time.  Bad call.  I realized that I hadn’t actually dissociated like I usually do, that the troubles started early in the treatment. I felt like I was in some nether space between full on hippie trip and no ketamine at all.  Not like a gradient of drug strength, but like I was a piece of paper being shoved sideways into a slot.

I was trying to explain “squinching” to the nurse – a term from the novel Inkheart in which characters are pulled out of a book into the real world, but not very well.  They end up deformed or displaying text on their skin.  That’s what it felt like.  Hard to explain normally, much less when you’re slurring your words and frustrated as all hell.

At the 45 minute mark I was still trying to get words out properly but failing half the time.  I was also affected so much that I knew standing and walking were out of the question.  Normally the 45 minute mark is when things get boring and I come out of the trance. Not today.  I was still feeling the full strength of the therapy.

We waited it out and eventually the medicine worked its way out of my system, and by hour’s end I was the usual sort of groggy.  And I went home. Simple as that. All better, but with a bit more respect for the power of the medicine.

I don’t want people to think poorly of ketamine because of one very off session. It was more frustrating than terrifying. More confusing than scary. I’ve had dozens of sessions that went perfectly fine. One weird one here and there is worth it for the overall benefit the therapy provides.