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The ECT Suite

The ECT Suite

I've had about 17 treatments. The first three were bilateral and were part of a series of eight. I've had maintenance ECT at varying intervals for a little over a year and a half. The treatment itself is given around 7:00 am. Preparation for the treatment starts the night before, around 7:00 pm, when I turn to my boyfriend and wail "I can't do this again".

Thus begins an ECT treatment. I cry and whine and complain about how afraid I am, how much it hurts, how I fear dying due to cardiac complications, how I loathe general anesthesia, how there's got to be a better way - and so on and so forth until about 11:00 pm. He reminds me of how beneficial it has been in relieving symptoms of bipolar disorder that just would not respond to conventional treatment, how safe it appears to be, how it is administered in a hospital, and - when he gets tired - suggests I chant the doctor's name over and over followed by "he's the man, he's the man", perhaps hoping I'll become enlightened. I then take a sedative and go to sleep.

We're up at 4:45 in the morning, and at the hospital by 6:00 am. The first order of business is a brief conversation with the nurse/hostess at the ECT suite, informing her that the boyfriend will be waiting in the lobby. I get a hug, hang up my coat, and take a seat in one of eight recliners - four in a row facing each other - in the recovery room.

"Have you had anything to eat or drink since midnight ?", the nurse always asks.

"No", I say before she finishes the question.

"How are you doing, Kathryn ?", is the next question...

which always makes me laugh. I don't go to the ECT suite because I feel great.

The nurse brings two johnnies and explains how to put them on. The first must open in the front, the second must open in the back. She brings a privacy panel around, and I take off my shirt. "Leave your bra on", she always reminds me. She sticks a yellow sticky on my shirt to mark it as mine, and puts it on the coat rack.

Next she takes a temperature and blood pressure. Usually the room is filling up pretty rapidly by this point. No one talks except for the staff.

Next I used to get a shot to dry up mucous secretions. That was stopped after I had a full-blown panic attack on the ECT table. Almost every patient gets the shot, though. After all the shots are given, we're lead down the hall into the waiting room.

There is nothing - I mean nothing - more bizarre than watching Good Morning America while the staff is making ready the ECT room. The ECT machine produces a distinctive odor. The cardiac monitor and anesthesia equipment have their own peculiar noises. Staff, primarily nurses, are attending to hanging IV bags and counting various pieces of medical equipment. Two nurses come into the waiting room and start inserting IV lines in our veins. About the time they finish with the outpatient insertions, the inpatients are brought down from the units. We sit and wait. A mental health worker is assigned to sit with us. No one says anything, no one makes eye contact, no one watches Good Morning America.

The anesthetist arrives a few minutes before the ECT doctor. When the entire crew is assembled, one of the nurses comes and calls my name.

I walk through the doorway into the middle room: the procedure room that divides the recovery room where I started from the waiting room where I've been sitting. She pulls out a small step stool so I can get up on the table. I lay down, take off my glasses and hand them to her. She pulls aside my top Johnnie and sticks cardiac monitor thingies all over my chest. The other nurse is behind me, handling the IV bags: she inserts the correct one into the IV line prepared on my arm.

As the anesthetic starts working I get very cold. I grab the hand of one of the nurses and tell her how scared I am, and ask her to squeeze my hand really hard until I'm "out". My body goes to sleep. There is a fraction of a second when my body stops breathing but I am still awake. I hate this.

I wake up in the recovery room, back where I started my morning in the ECT suite. If they put me back in the same line of recliners from which I started, I ask "is it my turn soon ?"

If I'm facing the opposite way I ask "can I go home now ?"

Two blood pressures later they give me my shirt to put on. A mental health worker arrives with a wheelchair and I am wheeled into the elevator and downstairs, out through the front door. The boyfriend is allowed to park right in the driveway. I get in the van.

My head hurts for days, but the ride home is the worst. My jaw always hurts from clenching during the seizure that's induced. The hospital calls late in the morning that day, while I am asleep, to ask if I'm okay. When I've told them how badly I feel, they say to take tylenol.

I laugh and wish for morphine.

I do very little for the next few days. Rest, sleep... my head hurts. As soon as I'm able I do an inventory of my memories: do I remember that I have children, a boyfriend, parents, friends who love me...phone numbers, people, places things - they're all vulnerable and I've lost quite a bit of my memory in this process. Something always turns up "missing" during the inventory; in a matter of hours or weeks I find that some cherished memory is misfiled in my cranial filing system, and it needs to be looked for so I can feel whole.

After a rest and some distance from what I experience as a very difficult procedure, I get to live a life that pays very close attention to fluctuating energy levels. Then the effects start wearing off and I have to work harder for a while to keep my energy balanced. Then the pendulum swings one way or the other and I know it's time to go back in. And I find myself back in the ECT suite one more time.

 

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