Month: January 2020

Transcranial Magnetic Stimulation (TMS) Post #2

Day 2: Magnet to the Brain! Yesterday’s session wasn’t nearly as long as the first one. They plugged in the settings, adjusted the arms and chair to the appropriate numbers (it reminded me of gym equipment), and fired up the flux capacitor.

I had brought a book to read during, but my technician was feeling chatty and so rather than read I had a conversation. I’m wondering if it matters what you do during the session. If you read, speak, or write does it stimulate those parts of the brain along with the targetted magnet area? Now, I want to grow up and be a mad scientist.

Image result for robot chicken mad scientist

It’s highly likely that the tension headache that shared my headspace for most of yesterday is contributing to that hairdo.

Sleep: How’d I sleep? How many hours? Quality?

My sleep was instantaneous. It feels like when your body is so exhausted that you’re asleep before your head hits the pillow. I don’t feel unrested either it feels like it was a very deep sleep. However, I don’t have any recollection of dreams or any indicators that I was getting deep good quality REM sleep.

Appetite: How’d I feel about eating? What did I eat?

I didn’t really feel like eating. My appetite was actually pretty low and what I did eat was very minimal quantities. New diet? Patent pending.

Physical Activity: What did I feel capable of doing? What did I ultimately do? How did I feel after?

I really didn’t even want to move or make dinner. I ended up going out to eat and nibbling on my food while not wanting to have left my sanctum.

Motivation: How much proactive motivation did I have? What motivated me? What were my goals? Did I hit them?

My motivation was pretty good at least during work hours. I managed to clean up a lot of to-do and other items while performing the role of a happy, friendly, completely not-depressed smart guy.

Baseline Mood: What am I feeling as a baseline.

Pretty low. I had a brief period of feeling lighter and happier during the day. I think I was just having a good morning/early afternoon. The evening was pretty much low to the end.

Happenings: What’s happened today that may impact my baseline?

Tired, headache, otherwise it was a very uneventful day.

Reactions: What were my reactions to the happenings?

Boredom, lethargy, grumpy lows.

Learnings: What did I learn, observe, etc?

The second day of treatment the pain was so intense that I almost couldn’t take another pulse and then it gave me the break. There’s a beep right before the pulse that makes my muscles tense which I’m pretty sure is making the pain worse.

This is tough, it feels like a bit of torture, it’s not getting easier. But, I won’t know for 3-4 weeks whether or not it’s working. Ah, blind faith. My mortal enemy.

Transcranial Magnetic Stimulation (TMS) Post #1 (better late than never)

Technically, yesterday was Day 1 but I spent the majority of the day asleep and then took a long drive.

The first day also included measurements and a test for my “motor threshold.” What that means is the doctor was basically testing for the point at which firing a magnet at my motor neurons causes my hand to jerk like a reflex. Apparently, this tells them how high to crank it up. I really wanted an “11” but apparently that’s not how it works.

Once they zeroed in on the strength, provided me some earplugs, and readied the machine the doctor moved the magnet to the position for treatment and kicked it on. They started out at about 80% of the power and gradually increased it over the 19 minutes of treatment as my comfort level allowed.

Don’t let anyone kid you. This initially hurts, you feel a pretty awful tension headache as the magnet fires 40 times over 10 seconds and then it allows you to rest for 26 seconds before firing again. The intensity of the pain rises with each pulse and right when you’re like I can’t do this anymore the 10 seconds is over and you get a break. This repeats over and over until the treatment is over. I wonder how many people were tortured to figure out that threshold.

Sleep: How’d I sleep? How many hours? Quality?

As I mentioned, I spent too much of the day asleep. Not all at once, but every time I tried to read a book or watch a show I more or less vanished from consciousness instantly. Apparently, this is a pretty common side effect after the first treatment.

When I finally put away the world for the night. I slept pretty soundly until about 5 am. One of my chief complaints about sleep is that I don’t sleep. I tend to do a very short 3-5hour nap and then start my day all over. I’m hoping the treatment fixes that but it could just be a circadian rhythm thing.

Appetite: How’d I feel about eating? What did I eat?

I didn’t really feel all that hungry throughout the day. When I did eat, it wasn’t very much, and it wasn’t really that exciting to eat. I’m hoping it was just a case of trying something new at a new restaurant. I’d ordered Bibimbap at a fairly classy place (that wasn’t Korean so take from that what you might). I think I mostly felt a little queasy.

Physical Activity: What did I feel capable of doing? What did I ultimately do? How did I feel after?

Not much, not from a depressed not wanting to move standpoint, it was just that I was so tired that I didn’t really ever do anything physical. I finally got tired of repeatedly napping and went for a drive in the northwest portion of Massachusetts. Beautiful drive and it was refreshing.

Motivation: How much proactive motivation did I have? What motivated me? What were my goals? Did I hit them?

I did not feel motivated at all. I’ve been fairly low and depressed leading up to the start of treatment. It took an excess of energy to even write the first post announcing what I was going to be doing with these a couple of days ago.

Baseline Mood: What am I feeling as a baseline.

I was just south of the middle of happy/sad.

Happenings: What’s happened today that may impact my baseline?

Today was mostly about the first treatment, the headache after, hearing about a friend who had also recently started TMS and the difficulties they were having, and fatigue.

Reactions: What were my reactions to the happenings?

A little worried after hearing about my friend. Tired of being tired by the end of the day. I think in the end – I just wanted results now. By the way, it’s usually 3-4 weeks before the treatment starts showing signs of improvement. There’s a long way to go.

Learnings: What did I learn, observe, etc?

I learned that the only thing they could really tell me about how the whole thing actually works is that it works better if you’re conscious. You’d have to be a sleeping professional to be able to sleep through this treatment.

Cancer and Depression: Transcranial Magnetic Stimulation (TMS) blog series announcement

Later this year, in May, I’ll pass through a milestone of 7 years since my cancer diagnosis, treatment, eventual remission and the fight that followed. That fight is still being waged today against a body that never fully recovered. As a result of chemotherapy and the various related maladies that befell me. I now suffer from chronic fatigue, major depression disorder (MDD), pernicious anemia, decreased nutrient absorption (even more so than bariatric surgery causes), Hashimoto’s Thyroiditis, not to mention relationship and career issues, etc.

I started to reconsider having typed all that information especially given my intention to post this as a blog series. My initial thoughts of privacy are overshadowed by a desire to ensure that knowledge of the aftershocks of cancer treatment are known. There have been many advances in treatment options in the last 7 years – I’d hope, right? One of the biggest developments I’ve noticed is that realization by the overall medical community and the general public that cancer and the aftereffects doesn’t end with remission or a clean scan.

The reality is that for many cancer survivors some of the impacts on your life can feel almost as bad as the treatment and the diagnosis. We suffer silently because after a while your doctors tell you that these after cancer symptoms are just “your new normal” and there’s nothing they can do besides prescribe anti-depressants and additional medications that potentially leave you feeling worse.

I’ve grown tired of this repetitive silence and cyclic attempt to feel better. I’m trying something new this week. I’ve been doing some research into TMS (Transcranial Magnetic Stimulation).

https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625

The results seem promising but as with many treatment options, the depth of knowledge isn’t there. The article I linked to even notes: “Though the biology of why TMS works isn’t completely understood, the stimulation appears to impact how the brain is working, which in turn seems to ease depression symptoms and improve mood.”

I’m not advocating for this treatment currently. I do not yet know if it will have positive effects. I begin treatment on Wednesday, January 22, 2020, and I wanted to start this blog series as an effort to catalog any changes that may occur as a result. To that end, I’m defining the following parameters for the 36 posts to measure perceived changes and document how I’m feeling.

Each entry will include (at minimum):

  • Sleep: How’d I sleep? How many hours? Quality?
  • Appetite: How’d I feel about eating? What did I eat?
  • Physical Activity: What did I feel capable of doing? What did I ultimately do? How did I feel after?
  • Motivation: How much proactive motivation did I have? What motivated me? What were my goals? Did I hit them?
  • Baseline Mood: What am I feeling as a baseline.
  • Happenings: What’s happened today that may impact my baseline?
  • Reactions: What were my reactions to the happenings?
  • Learnings: What did I learn, observe, etc?

I hope this post series will feel helpful to anyone considering the TMS treatment option and look forward to the opportunity to connect with anyone who may have thoughts or questions about the experience. I’d also love to hear from survivors who have had success with other treatments and methods.

Best of luck to us all

~Don