a Scarlet D

Quick catch up:

• Things seem about the same
• My therapist accused me of seeming better
• I don’t like good news
• Still not eating much
• About to run out of movies to watch

TMS. Transcranial Magnetic Stimulation. It’s classified in the “we don’t know how it works, but sometimes it does..” therapy line, but this time I’m doing it at the Treatment Resistant Depression clinic, and they have more scientists than the last place, and it feels much more like something they may actually understand.

Side track: After I was referred and confirmed for the TMS series, I got a call from a guy at the University. No idea why I picked up the call, but it was a good thing. He was from my psychiatrists lab, and they were running a study on the efficacy of TMS. Just single appointments before, during, and after. So Tuesday (apparently that’s only two days ago. Who knew) I went to the U and met Mr Study. (not his real name) and got to see my doc’s lab. I was expecting a huge, bright and white well lit lab with vials and people in lab coats and protective goggled. I don’t know why, maybe my brain just inserted that idea based on TV shows.

What I got was a room about the size of two or three cubicles, with all sorts of computers and interesting looking displays. Wires criss-crossing the place. It reminded me of the student lab in Ghostbusters. It was just piled high with technology and a desk or two, but it was organized somehow. My station was a monitor, mouse, and keypad with 6 buttons on it. I was fitted with what looked like a bicycle helmet, with the addition of all sorts of electrodes poking my head. A couple sticker leads, two behind my ears and two on my chest.

The study itself was a series if on screen exercises. The first was a display of three things. A house, A person, and a vehicle. You choose one and it tells you if you won a token. If you did, there was a possible likelihood of yielding a token the next time. Or not. So you play this choosing game and it modifies trends based on your behavior. The only thing was, it was a loooooong exercise. At some point I noticed a progress bar, and realized it was going to have 200 iterations. With a bike helmet poking your head. It tried my patience.

The next exercise showed you a letter. And then another. If the current letter was the same as the first, you pressed the green button. If not, the red button. Fine, not so bad. But the next exercise wanted you to skip a letter and indicate a match. So it would show A (no), B (no), C (no), B (yes), B (no), B (yes) and so on. That was harder, keeping track of displayed letters. Next exercise? Skip two letters. Last exercise, skip three letters. Oh I forgot to mention each successive exercise speeds up. Needless to say, with my memory I simple randomly tapped red or gree.

The final exercise had something to do with emotions. I can’t remember what the responses were, but they were effectively “good” or “bad.” They would show an image and you press a button. I was told, and the screen also mentioned, that the images may be quite graphic. Welcome to Clockwork Orange. Images that I remember:

• Naked dead body being taken out of a house that had burned down
• A pretty kitty
• A topless woman on a beach
• A charred body in wreckage
• Children doing something cute and innocent
• Two beautiful naked people having sex
• Puppies!

You get the gist of it. There were more good images but it was hard to remember with the dead bodies in my short term memory. Honestly that was the most interesting exercise. Seeing an obviously bad image but thinking “what if I was a serial killer? Would I press good?”

Got a gift card for my efforts, and a handful of change for parking.

Ok, back on track. Wednesday morning I went into the TRD clinic for my first TMS session, as well as the “mapping” to figure out where to shoot. Having done TMS a couple years ago at a different hospital/provider, I was excited to see the differences. And there were so many!

A fabric cap was put on my head, and they trimmed it to fit. It would be my cap for the series. Lots of measuring was done, and there were strips of measurement tape on it, indicating how far in whatever direction the machine would be pointing. Then a doctor breezed in – a super cool exotic looking doctor. He had a cravat. Yeah, that cool. Had he told me he had hung out with Bowie I would have believed it. He adjusted the machine while the tech spouted out seemingly random numbers, His goal was to make my right thumb twitch, which would give him a reference point. More adjustments made, thumb twitched, all is well. After chatting with me for a bit, doctor breezes out. I seriously want to go to dinner with that guy. He’s got stories.

Mapping being complete, it was time for my first session. As you may (likely not) recall from a previous post I’m too lazy to link, the last TMS experience felt like woodpeckers or hummingbirds tapping HARD on my temple. For an hour. This one feels like it’s fewer pulses or tiny little mallets tapping my temple, but like whomever is doing it kinda doesn’t care about their job. TAP, but not too hard. After each tapping there is 45 seconds of rest. Also, there are only 54 pulses like this in a session. So even though they strap a moderately heavy helmet to my head, it’s only 20 minutes and not too painful. Headaches and tiredness are potential side effects, but I haven’t had either, previous TMS or this one. (Although as I prepare to post this I realize I have a deep but not horrible headache. Will try breathing more). Another potential side effect is seizure, which sounds like fun to me, but that’s probably in poor taste. I was going to listen to music, but the tech is just sitting there, and it’s only 20 minutes, so we just chat. She’s really good at it. Guessing she spends much of her day

So the TMS wasn’t bad. But there’s a gap I have to fill between TMS and Day program that’s too short to go home but too long to just show up early. So I got a haircut. And went to Target. Between all that and Day program, then the Ketamine uber shuffle (rush back to apartment, park, get uber to TRD clinic, trip balls, get uber back home, try not to think about having spent $80. Between all of that, it was a harried day. I’m on a new med – a stimulant – and it makes me feel manic. Which helps get through a day, but I don’t like how it makes me feel like I’m buzzing. Anyway, by the end of the day I was back to my old self. Stimulant having worn off, exhaustion crash coming back down on me, and my new eating problem: Being a little hungry but not looks like food. It’s all just cardboard, or worse, chicken.

More as I continue my journey down the TMS road.

Oh, I have pictures of me in both helmet getups, study and TMS. But you’ll never see them. Just imagine the dorkiest thing you can think of, and add wires.