One Bad Girl

This has been a bad week, I have been self harming in here - something you're really not supposed to do unless you want to get sent to a public hospital. I can't remember if I got caught or if I confessed the first two times, but I'm now on my last chance to stay here and I've now blown it twice (they don't know that). On Tuesday I was feeling angsty and made a rash decision to go out and buy razor blades, they were used immediately when I returned and then again today. I've been wearing long sleeves (and pants) and no one has noticed yet, the ECT people saw it though because I need short sleeves for them to get to veins and take my blood pressure etc, they let out a collective gasp but thankfully said nothing to the nurse who picked us up. Last week and the week before I broke some crockery and used that... Earlier this year I went a few months without self harming at all, I guess I wouldn't be in hospital if I was entirely well, so I can't expect myself to behave perfectly, but playing with the risk of being sent public is just stupid. I would be sent to the hospital nearest my home, the awful one I posted the pictures of last year complete with blood on the curtains and holes in the walls, not good for someone who's terrified of asbestos (I know it's not generally in walls, but I still freak out when I see anything that might be it that's damaged) also they might decide not to continue my ECT.

At the moment I'm not on any antidepressant, my only drugs are Abilify - a antipsychotic, Largactil - another antipsychotic and imovane -a sleeping tablet. My doctor is weighing up whether to put me on Reboxetine or a drug in a class called MAOI (monoamine oxidase inhibitors), if he chooses MAOI I have to follow a strict diet with the worst things being no wine, no aged cheese and no cured meats, making pizza a boring affair, but the rest of the list is massive. Reboxetine doesn't have a very good reputation, basically it doesn't work so I'm expecting a MAOI unless he's thought of something brilliant since yesterday.

I thought I'd made a friend in here - R who I'm having ECT with, but tonight she organised an activity and treats for a bunch of people and I wasn't one of them; I feel a little disappointed, not at missing the activity, but at not being asked to join especially when I invited her out for coffee earlier in the day. Visitor numbers have been low, so it would have been nice to have a friend here, there's only so much you can talk about with your mother, she's my main visitor. The husband of one of mum's work colleagues is in here, mum keeps seeing her because they're both visiting at the same time - small world. Tomorrow (hopefully) my minister is coming, I have a barrage of questions for him about eternity and suicide, he may not want to answer then lest he encourages me to follow through with it, but I can try. I'd appreciate the visit without having my questions answered anyway, I feel very disconnected from the church, I've now been here 8 weeks and 1 day.

I think the nurses here have caught the craziness, they're currently laughing and wishing one another happy new year, I'm not aware of any new years in May/June.

My First Bilateral ECT

Today was my first bilateral ECT, bilateral meaning one electrode is placed on each temple, rather than both on the one side. The ritual was the same one I've been doing for the last three weeks with the trial - I was having MST by the way - I arrived at the hospital and waited for about 20 minutes, then one of the researchers came to take us up stairs, R went in first and I waited again. About 15 minutes later I went in and got hooked up to all the monitoring equipment, in went the unusually painful cannula and then something different happened, the doctor (B) wet both of my temples, it was a little disconcerting but before I could think about it too much I was asleep. I woke with a headache, sore jaw and no idea what day of the week it was. I haven't noticed any confusion since then, I don't know if the memory loss builds up as you have more treatments or if the first one is a pretty good indicator of what to expect. I've been more tired today than I was most days with the MST, I think I had a bit more anesthetic though as it was quite a while later when I woke properly.

My doctor (G) came to see me this evening and he had some interesting news, my genetic medication test finally came back. I think I wrote about it but I'll refresh you; it's a test to see how I metabolise drugs, whether I hyper metabolise, don't at all or if I'm normal. There are several categories the drugs fall into, I metabolise all but one normally, the other category I can't metabolise and lucky me - Cymbalta is in that. G said that explains why I'm having side effects even at a very low dose and that he'd like to take me off it and start me on another one as soon as possible but he's not sure if I'm still part of the ECT/MST trial even though I'm un-blinded, if I'm still part of the trial he can't make any drug changes until it's over, that would suck because then I'll probably need to be in here longer while he builds me up to a treatment dose of the new drug. I'm definitely not ready to go home now, but I'd hope that after six ECT treatments (and nine MST) I will be so I really hope I can start the new drug soon.

I've been given permission to stay out a little later on Sunday so I can go to church but I'm not sure if I will. Everything is such a huge effort, I have no ability to concentrate (you wouldn't believe how long writing this has taken and how many interruptions there have been) and I'm just not sure if I want to go, it was G's idea, not mine but I feel like I should go. Increasingly I'm thinking that I'm really not much of a Christian at all and it only bothers me when I think of death, sure that's a lot, but I should be more concerned about my faith than just my eternal destination.

Seven Weeks

Today is my seven week hospital anniversary, this is now my longest admission and there are still another two weeks to go at least. I finished the ECT/MST trial today, tomorrow I'll be told what I had and what the next step is. I want bilateral ECT regardless of what I've been having. Whatever I had made very little difference and I think that calls for the big guns - not that what I've been doing is child's play. I suspect I've been having MST because it hasn't worked and I've had no memory loss, normally the next step from MST is unilateral ECT. I want to go straight to bilateral because it's more effective faster and my doctor says the longer I'm this depressed the harder it will be to get me out of it. I'm still really struggling to do anything at all, I'm only writing this now because my nurse told me to write and try to distract myself from the suicidal thoughts which have plagued me tonight, basically I see death as the natural end to all this, I have little hope of ECT working for me because I have bad luck. I know that sounds like I've given up and that makes it not working all my fault but there's more to it than that, part of this disgusting illness is feeling both hopeless and helpless.

A little while ago I had 100mg of Largactil and 1mg of Lorazepam, they're working and that means it's time for me to stop writing before this becomes nonsense.

More tomorrow when I know what treatment I've been having.

Waiting

Thank you to the person who left a comment a few days ago re exercise, seeds etc. I couldn't publish it because you put my name in it - not everyone here knows who I am and I don't want future employers googling me and finding this, so my name is nowhere to be found (unless I’ve overlooked something!).

I haven't written for a while, my mood hasn't allowed me to do much except stare at walls; I've played the occasional computer game and watched a couple of shows, but mostly I sleep or doze. Last night sucked, I was struggling with harmful thoughts, I had the medication which helps with that as well as my sleeping tablets but the thoughts were too strong and kept me up until 3am. The situation was made worse by the nurse telling me that if I didn't feel better I couldn't go to have my treatment in the morning - which only resulted in me suffering in silence and then lying to the morning nurses, telling them that I felt fine, when really I was being plagued by self harm thoughts and low mood. I told my doctor tonight that I didn't appreciate them threatening not to let me go to get a treatment just because I express symptoms of the illness requiring the treatment. He said that he trusts me to make my own risk assessments and that if I think I'm safe to go, then I should be able to go and if it happens again I have a note from him in my file to point to. I needed nursing support last night but I couldn't get it, having to instead pretend that everything was fine. Hopefully it won't happen again.

You may be curious about how the ECT/MST trial is going... Shit! They say it's early days, I can have up to 15 treatments and I only had my 6th today. There has been no change, even some regression. I came very close to a suicide attempt on Monday and am plagued by almost constant suicidal ideation and self harm thoughts - the visions, not just thoughts. The treatment its self is fine, the worst part is having no water from midnight to 11am three days a week. The two days after the first treatment I was very sore head to toe, swallowing was particularly painful, that went away after two days and hasn’t come back, everyone says the first one is bad like that. I was very surprised to wake up with no headache, no memory loss and just a sore throat. The others have been even less eventful except the second one where I woke up before the muscle relaxant had wore off and I couldn’t breathe very well – they had it under control though, today I woke up with some gadget in my mouth to help me breathe, I was a bit slower coming out of the anaesthetic today. I’m no longer the only one from this hospital in the trial, so there are now two of us in the taxi to the hospital where the trial is, and I have someone to talk to while I wait, although she went before me today so I had to kill 20 minutes sitting on a couch in the coldest corner of the hospital!

I haven’t proof read this because I’ve already had my sleeping tablets and they’ve well and truly kicked in. Good night. Please come and visit me if you can, I’m here for possibly another three weeks and visitors help get me out of my head even if it is for a short time.

My First ECT (or MST)

I was supposed to have my first treatment on Wednesday but it was delayed because at the last minute the anesthetist decided he wanted to have my asthma assessed, it was fine. So this morning at 8am I jumped into a taxi with a nurse and headed to the hospital conducting the trial, by 9am I was signing the consent form giving them the right to electrocute me causing a seizure. Within minutes of signing I was hooked up to EEG and ECG machines and put to sleep, I didn't even feel the anesthetic kick in (I usually do). I woke up half an hour later with a very sore throat, but no headache and none of the other muscle pains I was expecting. After some water and two cups of tea my throat was better and I was ready to go. When I arrived back I was told to go to bed but ended up playing Spore because I wasn't the least bit tired. I feel like nothing has happened, which is great, but I also worry that I should be feeling something. I don't know if I had MST or ECT, my guess is MST because my memory is completely intact, but when I said that to the recovery nurse she said that's not uncommon for ECT either, but she's got to help keep me confused! I'll find out at the end of treatment which one I had, only eight more to go

Here's a little description of MST for those of you interested.

Magnetic Seizure Therapy (MST), like ECT, involves the induction of a seizure for therapeutic purposes. The major difference, however, is that in MST the seizure is induced using magnetic stimulation rather than the electrical current that is used in ECT.  Magnetic fields are able to pass freely into the brain, making it possible to produce a very focused seizure in a specific area.  The widespread nature of the seizures produced by ECT is thought to be responsible for the memory loss that people report following ECT.  Therefore, by avoiding the use of direct electrical current and inducing a focal seizure, it is thought that MST will be able to improve depressive symptoms without the memory loss seen in ECT. 

MST is a medical procedure performed by doctors.  It involves having a general anaesthetic and a muscle relaxant.  The brain is then stimulated with a controlled series of magnetic pulses using a coil that is placed at a precise location on the head.  The magnetic pulses cause a seizure in the brain which will last up to two minutes.  Because of the muscle relaxants and the anaesthetic, patients do not convulse or ‘fit’ and do not feel any pain. Patients wake up five to ten minutes following the procedure.