Friday, September 28, 2007
Thursday, September 27, 2007
Shrink Rap: The Co$t of Being Depressed
This article shows the costs for various anti-depressant medications. Of course, the cost to you will vary widely, depending on your insurance coverage: Shrink Rap: The Co$t of Being Depressed
Tuesday, September 25, 2007
Lest there be doubts
I met with my new psychiatrist this afternoon (new, as in he'll be my primary psychiatrist). I earned my nerd badge by presenting him with a graph that's tracked my daily mood for the past six months. I reported that I'm doing much better, the result of the hospital stay and the change in medication. I also mentioned that I'm still having trouble with directions and recognizing places. (I needed to get and use directions to find his office, even though I've been there before.) I attributed it to the ECT treatments. He thought that was unusual, that the treatments would affect such a specific area of memory. When the appointment was over and it was time to leave, I opened the door and walked into a closet.
Friday, September 21, 2007
Thursday, September 20, 2007
Psychiatric Times - series of articles regarding depression
These articles provide a good overview of the current state of the art in the treatment of depression. They are well-written with just a taste of jargon.
- Clinical Depression: Complexities of Diagnosis and Management
- Adherence to Treatment Regimens in Major Depression: Perspectives, Problems, and Progress
- Never-Ending Winter: Chronic Depression
- Cognitive Therapy: What Is Its Role in Depression Treatment?
- Placebo Effects on Pharmacotherapy Outcomes in Major Depression
- Treatment-Resistant Depression: The Role of Gene Factors
Wednesday, September 19, 2007
Huh?
I think that this means that they can predict the effectiveness of an antidepressant by seeing how you react to loud noises. Or, maybe, how you react to research articles with ridiculously long titles.
Differential prediction of first clinical response to serotonergic and noradrenergic antidepressants using the loudness dependence of auditory evoked potentials in patients with major depressive disorder
Tuesday, September 18, 2007
Who hid my roads?
One of the truly odd side effects from ECT surfaced when we were going to a family function last weekend. We were going to a part of Worcester that I know quite well. It might have been a year or two since we'd gone to that area, but we used to go there almost weekly for dinner, shopping, visiting, and such. This time, however, from the first road out of our town, nothing was familiar. I was driving and Sandra had to provide turn-by-turn directions, even when we were on Main Street, Park Avenue, or other major roads.
This has happened a few times in other cities or towns, but not consistently. That's the scary part, that it happens unexpectedly, that I get lost on roads that I think that I'll know.
A friend believes that is due to aging, not the ECT. Dunno. I don't think that I got that old that fast.
Changing of the stethoscopes
I have a new psychiatrist whom I'll see next week. Well, he's not really new. He and another doctor in his office have been providing me with ECT since last November. He's new in the sense that he'll be my primary psychiatrist, the go-to guy for meds and other issues, as well as ECT.
My previous psychiatrist and I got along well and he provided good care, except for the problem that I when I would try to reach him on the phone. Going several days without receiving a return phone call twice put me at too much risk. I canceled an appointment that I'd had scheduled for this week. I don't know yet how I'll let him know that I've fired him. I need to do that soon, but not necessarily today.
There is also some risk for me as I change doctors while my application for disability insurance is making its way through the review process. There are so many twists and shuffles in that process that another probably won't be noticeable.
Thursday, September 13, 2007
Blue is nice in the sky. In the lips, not so much.
While I was in the hospital, I had an ECT treatment. I'd been scheduled for one at another hospital with another doctor, so the in-patient team thought that it would be good for me to have a treatment as planned. If things had gone as planned.
Three of us left 8East (accompanied, of course) shortly before seven in the morning. I think that my stuff started around eight.
When I awoke after the procedure, all of the muscles in my torso, arms, and neck were very, very sore, so sore that it was difficult for me to take a deep breath. That's just what the staff around me was trying to get me to do, take deep breaths from an oxygen mask. My oxygen saturation level, O2 Sat, the level of oxygen in my blood, had fallen into the 30s. (Anything below 90 is a cause for concern.) Apparently, I'd been 'combative' when I came out of the general anesthesia. No one had or has a good explanation of why that happened. Later that morning, I went back to my room and had supplemental oxygen for several more hours. By evening, my O2 Sat levels were fine. My muscles were sore for a couple more days.
Wednesday, September 12, 2007
Memories like a freight train
The hospital let me preserve my nerd status by permitting me to have pens and a small notebook in my shirt pocket. Other patients couldn't use a Q-tip unless a staff member was present, but I had a blue and a red pen. I didn't write a lot of notes - I was in the hospital as a patient, not as a reporter. The notes that I did write were mostly reminders of things that I could do if/when I ran into hard times again. For example, you know those Atomic Fireball candies? They can help you break out of a spiral of downward thoughts by moving your attention away from the thoughts in your head and toward the fiery sensation in your mouth.
There's no question that I'm feeling better. We've gone back to an antidepressant, Imipramine, that I first used years ago, when I was in high school. I had to phase out one of the other meds while increasing the Imipramine dosage, so it's taken a couple of weeks to get everything in place. Each of the medications has its own set of side effects, peculiar not only to itself, but also for each patient.
So, I'm feeling better. Now what? There's plenty to do, but it's still difficult to pick something and get started with it. Dunno if this has happened to you, but, the other night, I was lying in bed, thinking to myself, "I've forgotten how to go to sleep." That thought tumbled around for quite a while. Eventually, of course, I did fall asleep, although I don't remember how. The same kind of thing happens during the daytime. I didn't used to need to think about what I was going to do; I just knew and then I went ahead and did it. Now, I have to think about what I'm going to do, but I've forgotten how.
What's that got to do with a freight train, the title of this note? I've got boxcars full of ideas, memories, and stuff, but they're on different tracks in the railyard, waiting to be connected to something, waiting to go somewhere.
