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Days 1-6 of TMS Therapy

Day One
I drank coffee and saw a sign saying I'm not supposed to! Its decaf only before treatment. Later I learned as long as I regularly drink coffee in the morning, its okay to drink caffeine before treatment. I came in and signed forms and then the technician reviewed them and set up the machine. I went in, we discussed my paperwork and started cortical mapping. They will ask questions about your daily routine every day. Poor sleep can cancel treatment because it lowers motor threshold. You can cancel for medical stuff or emergencies but shouldn't stop TMS for a week or days at a time. The longer you go without treatment the less effective it will be. You can do it with a neck brace, which I have, that's no issue. We adjust stuff with the chair then doc comes in to do brain mapping. There are different machines [neurostar and brainsway] they will make a slight difference. You will usually do a test "train" after they set the angle and strength and you will tell them how it feels. If its good you will start, but can tell them to lower the power if you need. Some places have a TV you can watch. Treatment lasts 20 to 30 min then you're done. It doesn't hurt, and just feels like somebody tapping on your head. If the power is on too high, it will be uncomfortable but will only sting. It doesn't feel too bad. Some providers have earplugs you can use during treatment if you are sensitive to sounds. TMS treatment is usually 30 days, insurance can approve for more. My first time, i had 32 days and this time I have 36 days of TMS approved. 


Day Two
Today was pretty similar. I had to get set up on their HIPPA compliant communication system and then I answered questions, got in the chair with earplugs, then we got started after the tech placed the coil. We discussed if I wanted to up my power of keep it the same to start, and I decided to up my power. The treatment went smoothly and then we stopped to switch to the low frequency cycle set up, which we discussed yesterday. For this the train was a lot slower and had lower power, and only lasted 10 minutes. Low frequency cycles are to treat anxiety, and I'm very excited to try it! 


Day Three
Today I answered questions, got in the chair, and we started at a slightly higher power than before. I'm at 110% and the goal is 120% for high frequency. I mostly chatted with the TMS technician about the show we were watching. We had to stop and adjust the coil because it lost contact a few times. Low frequency cycle went by very fast, then we discussed scheduling an left. 
Day Four
Today was the same other than the fact that i noticed some hand movements at the beginning of treatment. I told my technician and we stopped the train, to change the coil angle. After that the movements stopped. Its not bad or dangerous if you do have hand movements, it just means that the coil could be in a better place to treat your depression more effectively. 
Day Five
Treatment went very smooth today. After I answered questions and got set up, I tried a new show. We tried a few different power settings today, which I didn't mind. We finished with a low frequency cycle and then I thought about the small mood changes I had noticed so far. 
Day Six
Today I was tired but came in ready. We discussed the schedule for next week again and then did the questions. I also filled out the PHQ 9 today. Nothing interrupted high frequency except for one time the coil contact was off. We finished with low frequency and then I left, excited for the weekend. 
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