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Days 11-15 of TMS Therapy

Day 11
Since I did not do treatment on Friday, this was my Day 11. I was a little restless during treatment, but fidgeting a little is fine as long as I do not move enough to loose coil contact. If you fidget a lot, moving your hands and legs is fine just do not move your neck/head too much since it could change the coil angle. I always bring my favorite fidget toy to treatment, and also some treatment centers have basic fidgets like stress balls you can use. This weekend I noticed more subtle changes from TMS its easier to stand up for myself and face my fears. 
Day 12
Today I was very tired during treatment. I was curious if anybody ever managed to sleep during treatment and asked my TMS tech. Apparently there are no studies on how/if sleep impacts the TMS treatment so if you fall asleep they will wake you up, and if you are sleep deprived they will cancel treatment [for multiple reasons]. Due to this, if you consistently get less than 5 hours of sleep at night I would suggest you do not do TMS until your insomnia is better controlled. 
Day 13
Today treatment went well and very fast. I've been at full power for a while and at this point I'm very used to the sensation of the train of pulses. I have not had any side effects so far. I discussed the pros and cons of the two main treatments for treatment resistant depression with a friend who has had both today, and wanted to share parts of that discussion.

Ketamine infusions work very quickly — often within hours — to ease depressive symptoms. This is very different from TMS where impacts of treatment can be felt a week or later from treatment. For the average patient, ketamine infusion therapy consists of a series of six infusions spaced out over the course of two or three weeks. This initial treatment is followed by a long-term maintenance phase that includes occasional booster infusions as needed. The time frame of the treatment is slightly shorter, and also you don't have to do in every day like if you are doing TMS therapy. For efficacy, several studies indicate that over half of people with treatment resistant depression achieve significant symptom relief after a single infusion, and many more find relief after the full course of infusions. A ketamine infusion for depression may take as little as 45 minutes, but once your infusion ends, you’ll have time to recover before going home- and you should also avoid driving or strenuous activity for about 48 hours after your infusion. The time frame of a ketamine infusion is slightly longer than an average TMS treatment, not including the recovery time. Ketamine therapy has unique side effects, such as dissasociation. A major difference is that Ketamine Therapy is not covered by insurance, unlike TMS therapy. Check out my longer blog comparing the two treatments. Ketamine vs TMS
Day 14
Today I wanted to explain the different parts of the TMS machine, using the neurostar as an example. While it looks confusing at first, there are a few main parts to the machine: a head support, a small alignment mechanism with a laser, the coil, and the computer which controls the treatment. This is all attached to the chair that looks like a dental chair. Here are two attached color coded photos. The coil is red, the computer is green, the head support is orange, and the alignment arm is yellow. Learn More About TMS
Day 15
Today I had treatment and re-mapping with is a repeat of the cortical mapping you do on your first day. This process also includes an MT check and basically ensures the coil is at optimal power and position for effectiveness and comfort. What is Brain Mapping While during treatment, hand movement is something that shouldn't happen, with Brian mapping hand movements is what they are hoping to stimulate [because they are targeting the motor cortex not other areas of the brain that are targeted during treatment] so don't worry when that occurs. We adjusted my seat and headrest position and got a seat cushion so I don't strain my back, then did the re-mapping which goes through different power levels and coordinates/coil angles to determine the most effective setting for your treatment at this point in time. When we started treatment I had some hand movements, so we adjusted. They persisted, so we did one more adjustment. At first I still had slight hand movements but then they went away on their own, which apparently is normal. I also learned holding your right hand up will accentuate any movements and sometimes cause hand movements when there normally wouldn't be any. So, multiple factors go into hand movements. Also its normal to have slight eye twitches during a pulse, but it may go away throughout treatment [and it isn't painful]
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