By Lisa Stadler
Day 4 and 5 of TMS…Yesterday wasn’t overly exciting, but it was a pretty busy and long day. TMS was scheduled for later in the day, so the morning was relaxed. Normally, if I don’t have something I HAVE to get up for, I will find a way to stay in bed or mess around on my computer until I look at my watch and think, “Oh, my gosh, where has the time gone?” I do this at least twice, and then I will either get up or decide that I am tired and will take a nap, (more often than not, it will be the latter). I often make plans to take Zoe to a matinee movie on Saturday mornings, because if I pre purchase tickets, you can bet your ass I will get up…that’s money and I’m cheap!
Anyway, yesterday I got up around 6:30 a.m….even.though I.didn’t.have.to! I made my way downstairs to the coffee pot and poured myself a cup along with a bowl of cereal. This may not seem significant, but it sort of is, because eating, especially first thing in the morning is not something I enjoy, like…at all, but I was hungry (Hooray!). I ate in silence, expecting fatigue to hit me towards the end of my meal, as it often does, but after I washed my bowl, I still didn’t feel the need to lay down. Instead, I gathered up laundry. This is only a little weird because we aren’t even close to being at the end of our clean clothes, so there was no eminent need to wash the dirty ones. But, I mean, I am at my mom’s and her life has routine, so I had already planned on incorporating laundry in to my weekly schedule, just not quite so early on… not nearly as much procrastinating went in to the process as per my usual.
11:00 rolled around and it was time to go. The plan was for me to go to my treatments and then meet Mom and Zoe at Red Robin for an early dinner, as it was a designated eat-out day.
I am beginning to notice a pattern during treatment. There are 55 successions of the jack hammer type taps and at about round 50, I start feeling like I want to cry. This has happened every day so far. The feeling comes from out of left field, and is attached to no thought. I am not in pain, I am not sad, nor am I overly happy. I just feel like I want to cry.
This day is no different, and I am grateful for the sensation. I am grateful that I’m not numb. I’m grateful to be feeling a feeling that is genuine, and not invented as an appropriate emote for whatever situation I’m in. I’m not a crier, I am most defiantly not an overly emotional person. I didn’t cry, but it sure is nice to have the option.
Day 4 goes by without too much significance.
Today is day 5. TMS starts at 7:45 am. I walk back to the room, and sit down. The tech who is doing my treatment, is not the usual Lillian, but she is friendly and she quickly tries to create common ground between us. I am wearing my” In ‘N’ Out” T-shirt and she points it out and says she loves those shirts; her boyfriend is a manager there. We make small talk, it is easy, and brief. When I sit down, she hands me a clip board with familiar questions on them. I have answered this set before. They ask me a series of multiple choice questions that are used to determine if the treatment is helping. It is, but I still have trouble accepting that the answers to these questions can be quantified among four sentences. I find myself wanting to qualify almost all of them. Yes, I wake up many times per night, but I don’t feel as tired as I did five days ago. No I don’t feel sad more than half the time, because I don’t feel like depression=sadness. I can be happy and have depression at the same time, just as there are people who don’t have depression, who can be depressed. But, I get what they are trying to accomplish, so I answer the questions as best as I can.
Today the threshold level we will use will be 120%: this is the goal. I think the threshold is basically how hard the thing taps my head. I am happy we are at goal, my teeth don’t care for it quite as much. Lillian had suggested that some people get mouth guards, and now I get why. Every time the machine taps, my jaw clenches shut, and it’s beginning to take its toll on my teeth. I feel like a nerve is exposed. I think I might go ahead and get a mouth guard, it will just add to the sexiness of the overall look.
Treatment goes well and as expected, but today is a bit of an exciting day, because on day one I had blood works done and a mouth swab so that we could, 1) see if there is anything wrong with my other chemicals, and 2) have a genetics test to see what sort of reactions my body might have to various medications.
As a sort of non- sequitur, did you know that there is a gene called mthrfr gene? This is literally called the “mother f…” gene. It makes me tremendously happy that the scientist who discovered this little gem, had such a sense of humor. I don’t have the gene, but what it does is stop the body from being able to process folic acid. As I understand it, folic acid acts as a sort of lubricant on the brain, during TMS that creates a sort of malleability that makes it possible for the brain to adjust more readily. If someone has the “mother fucker” gene (teehee), then they have to take Deplin, which is a pharmaceutical grade of l-methylfolate, which is basically folic acid in the form it ends up after the body processes folic acid. What this means, for me, is I don’t need Deplin and later I can just take folic acid (my reserves are low, so it was recommended), but for now, I simply need to take the l-methylfolate in an over the counter form while treatment is going on. Hooray to no “mother f… gene!!” (Sorry, that one was just for me).
The only other, really big issue I have is a pretty severe lack of vitamin D. I was prescribed 50k mg to be taken one time per week over the next couple of months, and then back to the 3k mg per day. This will be something I need to be aware of in WA, as the sun is not exactly one of the state’s main attractions.
So, now on to the genetics testing. This is the most interesting part of the treatment, to me, to date. I have been saying for YEARS that I feel like doctors put a lot of guess work in to our mental health, and there are ways to circumvent this. I didn’t know how right I actually was.
A lot of what I heard today was basically the equivalent to the teacher from Charlie Brown saying “wa wah wah, wah wah wah wah”. I understood her (just as the peanuts gang seems to understand when the teacher talks), but I’m not 100% sure I could explain back what she said. In essence, there were a couple of things that we looked at when it comes to medicine in regards to our genetic makeup. Based on genetic markers, we can tell how well our bodies will benefit from certain medicines, how effective they will be to us. Por ejemplo (this means, “for example,” in spanish, and really I’m only explaining it, to make my mom laugh): If a doctor wanted to prescribe me an anti -depressant, they could look at my genetic markers and they would know that I, hands, down, probably won’t respond well to Paxil. My genetics suggest that I would most likely, encounter negative side effects from this drug, so there is no good reason to give it to me. There is a list of other drugs that have a moderate gene-drug interaction, so they would be available to try if needed, but there is a small list of drugs, that my genetics suggest I will respond well to. I have gone to the doctor where their “go to” idea was to prescribe me Paxil, but because I have been on Wellbutrin, and liked it, I asked for it. However, what a waste of time to have to go through a battery of guesses before finding a drug that your body will respond to.
The other thing, the genetics testing will determine is how fast your body will metabolize certain medications. This is relative, because Wellbutrin may be an awesome drug, but what does it matter if the body metabolizes it so quickly that it can’t be of use. So, essentially, the testing ends up giving us an idea of what I should use AND how much of it. To be able to pin point both of these things, so directly, is really sort of amazing to me.
Sometime next week, I will most likely be placed on drugs. I’m not completely sure how happy I am that I may still need to take meds, because when I started this journey I was under the impression that the TMS would fix my brain the way a cast fixes a broken arm, but I guess it’s more a game of percentages. From what I have been told, medications, (once the right ones are found), have about a 30% chance of negating depression, where as TMS varies in how much it can help someone, but with the meds, it will help exponentially more. I am still cautiously optimistic about all of it.
More next week.
Next post coming on August 24.