The night before ECT treatments I stop eating/drinking at 7 pm due to the anesthesia I’m to be infused with the following day. Something I have eventually grown accustomed to.
That first time and whilst in hospital, I skip attending breakfast, of course, and hang out in my room, reading and just lay about killing time waiting to be called for treatment. The ECT group has several patients to treat, some from my station, Depression, and some from other stations like Schizophrenia, etc. Thus, there’s always a queue of patients to be treated and one simply waits until they’re called in. Same as it was with ketamine infusions, but ketamine treatments always followed ECT patients. Always.
So I wait and am finally called in. It’s always nice when you get called in early because the longer you wait, the hungrier and thirstier you get. This first ECT time, and others to come, are typically around mid-day.
The nurse at my station had already taken my blood pressure and so, we’re ready to roll. He enters my room, along with another nurse, grabs my bed, and we walk down the hall, pushing my bed towards the elevators. As routine, we stop for some medical supplies for the treatment. These, along with my file, are placed on my bed and we continue onto the patient elevators.
The nurses have a special FOB for the patient elevators. The nurse swipes the FOB in front of the key point and calls the elevator. We three wait alongside my bed and then took the elevator to the third floor. During the elevator ride, the nurses looked at me. Of course, we knew each other and happen to be comfortable with each other already. One nurse said, “Are you nervous?” knowing it was my first ECT treatment. “Of course, what do you think? How would you like to do this instead?” I replied. And then we all broke out in laughter. It was wonderfully human and I found this all very comforting.
We roll the bed to the ECT office/space and move it into the waiting area. I’m familiar with the office because it’s the same one as where I had ketamine infusions, recently and also in 2015. I wait, sit on my bed, while the ECT doctor and nurses are busy, closed off in the treatment room with another patient.
At last, the treatment room door opens, the ECT doctor enters, introduces themselves, extends their hand for a shake. We shake hands and I answer basic questions as I sit on the edge of my bed. Ok, we’re ready, I take off my shoes, lift the foot-edge of my mattress and place my shoes between the mattress and frame for safekeeping. I won’t be needing them for the next little while.
We move into the treatment room. I lay on my back. The doctor shifts the bed for the best angle for their work. I relax to allow them to do their job. It’s the ECT doctor, nurse and anesthesiologist (doctor) in the room.
The ECT doctor prepares my skin for electrodes, the nurse attaches the heart rate and brainwave monitor bits, blood pressure cuff to my arm, and inserts the needle for the IV while the anesthesiologist prepares the cocktail to put me out and facilitate muscle relaxation.
The last touch, a second blood pressure monitor cuff, this one gets attached to my foot/ankle. This second one is used for its mechanics only — stopping the flow of muscle relaxant to my foot and allowing the motion of my foot to indicate the seizure activity I am experiencing. Otherwise, the rest of my body is not just under anesthesia but a muscle relaxant, as well, to stop the extreme physical exertion of typical seizures. Thus, this foot cuff, along with the other tools, helps the doctors monitor my seizure experience.
Once the IV is in, the cuff on my ankle, it’s only a minute later an oxygen mask is placed on my face. At this time, I hear, “Ok, we’re going to start”, I agree and then it’s maybe 10 seconds and… I’m out.
Have you heard about your happy place? Sure you have. It’s a silly thing to laugh about until you need one and look forward to it. It’s really the only thing that makes this whole thing work effortlessly. As soon as the anesthesia is injected, I recall the times hanging out with my brother and our close friend D. at the beach in LA during the summer. It’s a vivid memory of us bodysurfing and boogie boarding every single day when I was about 10 years old. Kids in summer, happy, free. How it should be, yeah? Yeah.
I fade comfortably into sleep and awake some 10 minutes later (?) in the next room, still laying as before, on my bed. There’s someone there keeping an eye on me. They see I awake and ask some basic questions: my name, birthdate, location, etc.. I felt very disoriented but was able to answer.
All good, I continue resting under the singular watch of a nurse, the world only a hazy notion to me during this time. I clear my throat continually and, personally, get annoyed by this but it dissipates over time. I guess it’s just a side effect of the anesthesia. Never to worry only to be annoyed.
After some time, maybe 30-40 minutes, nurses from my station come down to pick me up. They roll me out of the ECT office, down the hall and take me back up to my room on the 7th floor. As we cruise down our own hall, some others looked, checked out who the nurses were wheeling about. Depending on the people I passed along the hall, some gave me a thumbs up, some nodded and winked, others were embarrassed — like they shouldn’t have seen me in my bed. The latter were usually some of the psychiatric staff – therapists or assistants. They’d all adjust eventually.
I am carefully returned to my room, comfortably on my bed. I’m fully awake at this stage, just feel wasted. Of course, I have to pee straight away and found I could get myself out of bed and to my bathroom without any problem. Whew…
I returned to bed to rest for several hours. I would have loved to read or draw but had a headache that wouldn’t stop. I tell the nurse, “Ich habe eine stark Kopfschmerzen” (I have a strong headache) and ask for some ibuprofen or paracetamol. I take it and just lay about, waiting for the headache to recede.
Several more ECT treatments would come to pass. More than I could ever have imagined. And I’m still not done.
Every time, it’s the same process, with the same roles involved even if the staff happen to change based on shifts, it all operates like clockwork.
Images included are random sketches made during this time. All rights reserved.