Day 5: Tuesday’s treatment was okay. I was able to read but the pain was so intense that I had to keep closing my eyes to endure the pain. I’m writing this post on Wednesday in the wake of one of my lowest days in months and easily my worst day since starting TMS. This will not be a verbose post.

Pain: How badly did the treatment hurt? Headaches after? Other issues?

4.5/5 –Very Intense, but bearable. Rough.

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

3/5 – I slept.

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

3/5 – Soup and pizza were groovy.

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

2/5 – I initially felt like I wasn’t able to do anything and yet rose to the occasion. It served me well.

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

2/5 – I wasn’t ultra motivated.

Baseline Mood: What am I feeling as a baseline.

2/5 – Depressed. Bouts of Happy. Depressed again. A healthy dose of Meh.

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

A rough daytime, a great dinner with friendly folks, and a decent bedtime.

Reactions: What were my reactions to the happenings?

Depression
Exhaustion
Pleasurable Happiness

Learnings: What did I learn, observe, etc?

I learned that potentially writing these posts the day after is actually opening me up to misrepresenting a good day (yesterday) by my mood today. I will likely adjust this in the coming posts.

Day 4: The treatments are only conducted on business days and so I had the weekend off to recover from the first three rounds. It wasn’t long enough. I’ve noticed that I exert a great deal of energy keeping the headache at bay. The more tired I am at the end of the day the worse it hurts because it seems like I don’t have the energy to fight it off.

It’s not all bad. There have been several days that I honestly feel some changes. I don’t know if it’s just a series of good days as far as mood goes but I have had some very positive feelings and experiences over the past week. There’s a certain lightness in my mood that I haven’t felt in a while. I don’t want to discount the possibility that it’s simply positive feelings related to attempting to do something about my depression.

Just prior to starting TMS, I began focusing on practicing mindfulness. This was done in conjunction with therapy, a focus by Salesforce (my company) on mindfulness and mental well-being, and some personal reading on how to incorporate mindfulness into your daily life. This enhanced focus allows me to reflect on how I’m feeling in the space of the treatment.

Pain: How badly did the treatment hurt? Headaches after? Other issues?

4.5/5 –Very Intense, but bearable. Rough.

The magnitude of the electromagnetic pulse was increased again to 110. This increase came with an intense amount of pain during the pulses. As in previous days, the tension releases immediately after the last pulse. However, I can feel the muscles in my head tensing across my jaw and the base of my skull. Ultimately, it feels this tension is contributing to the headaches I feel later in the day. The base of my skull being the root of all evil as the pain takes hold.

Last evening, I attempted to take ibuprofen and eventually even tried a THC edible to relieve the pain. Legality note: I live in Massachusetts. Neither was effective. It constantly feels like the weakest migraine I’ve ever had with a strong sense of pressure behind my eyes and near the base of my skull.

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

3/5 – I slept. It wasn’t the best sleep ever.

I slept for about 7 hours. I felt groggy and grumpy when I woke up. I think I slept poorly and would very much like a nap.

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

4/5 – My friend Edmund invited me to lunch at a Korean/Japanese fusion restaurant for Bulgogi and sushi. My appetite for this food was ravenous. However, the rest of the day’s appetite was pretty blase.

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

2/5 – I wasn’t motivated to conduct any physical activity but I wasn’t unmotivated either. This weather is dark and oppressive and makes it difficult to desire any interaction with the elements.

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

2/5 – I ultimately took the day off of work due to the level of headache. I was very unmotivated and the only time I left the house was when my friend took me to eat lunch.

Baseline Mood: What am I feeling as a baseline.

2/5 – Depressed. Anxious. There’s a number of problems with my daily life and there are many considerations about the future. Today, these items were at the forefront of the mind. This drove a large portion of my mood.

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

A rough day with headaches. A gentle reprieve from work. It was otherwise uneventful.

Reactions: What were my reactions to the happenings?

Depression
Exhaustion

Learnings: What did I learn, observe, etc?

Doing nothing is actually worse than doing everything you’re supposed to be doing. I don’t like standing still and doing so contributes greatly to the decrease of mood.

Day 3: I was dreading the treatment on Friday morning. I arrived, headache already well in hand, and hopped into the chair. It was just as bad as I imagined it would be. The pulses started hitting and it was quickly too much. Fortunately, this coincided with the 26-second breaks between pulse barrages. I also believe they had moved the power setting up because they wanted to get me to the prescribed level dictated by my motor threshold gauging earlier in the week.

I also decided to add an arbitrary rating system to my categories below. To get a sense of improvement over time. I’ve also decided to add Pain as a category all it’s own.

Lastly, I experienced something very strange and unusual. I offer the fact that I discussed blueberries with someone I encountered throughout the day. I remember thinking that blueberries sounded delicious and I’d have to find a muffin, pancake, or a yogurt bowl sometime in the near future. Later in the evening, shortly before attempting to sleep I had an olfactory hallucination of the freshest blueberries as if I were chewing them in my mouth. The smell was unmistakable and so potent and fresh as if I were literally eating a bowl of blueberries. I don’t know what that means or if it’s even a common side effect. But, I think, it’s worth noting.

Pain: How badly did the treatment hurt? Headaches after? Other issues?

4/5 – Intense, but bearable. Barely.

The treatment itself was intense and painful. The following hours treated me to a migraine of the light-sensitive variety. Two rounds of Advil and some caffeinated tea later I managed to break it down to a pretty awful tension headache. This headache became my constant companion for the rest of the day.

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

2/5 – I slept, but it wasn’t particularly restful.

I managed to sleep for about 2-3 hours. Unlike previous nights I was barely asleep and it felt like I woke up hundreds of times. It was very unpleasant to go with a crappy headache.

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

3/5 – I had no desire to eat at mealtime but once I ate some things it was pretty easy to eat a much smaller amount of food than I normally do. There’s definitely something up with my appetite and willingness to eat. I feel like I’m just picking at food instead of really eating it as I would normally.

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

1/5 – I didn’t want to do anything. I forced myself out into the world and had a decent time with what I did but really just wasn’t feeling it. My head kept hovering somewhere in between a migraine and complete exhaustion from trying to filter the pain out.

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

2/5 – I’m not sure if it was more determination not to stay locked in my head or motivation but I did get out and about for a while. It was refreshing but quickly depleted what little energy I had.

Baseline Mood: What am I feeling as a baseline.

2/5 – Low, enjoyed the evening but fighting the headache kept bringing me back to a place of ungrateful preoccupation with the pressure behind my eyes.

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

A decent day of work, read a book of poetry by Margaret Atwood, roamed a thrift shop, got a little sad about not owning a house yet, imagined what I’d build into my future home office.

Reactions: What were my reactions to the happenings?

Depression
Exhaustion
Hope

Learnings: What did I learn, observe, etc?

Imagination seems to be waking up. I was able to conjure up smells of blueberries and ideas for a future office. It was fascinating because my imagination has been quiet and almost non-existant since chemotherapy. It was this moment, this thought, an indulgence of imagination that gave me one little blast of hope at the end of the day.

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.

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.

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.