Day 25
Today I was struggling to eat before treatment. My tech had been speaking with others and doing research to make sure it would be safe for me to skip eating or eat less before treatment. It was comforting to know I didn't have to force myself to eat.
Day 26
Today treatment went very smoothly today. We have a nice routine going. I usually come early, heat up my pop tart and eat it while we go through daily questions, then get in the chair and adjust myself. After that we put my favorite show on the TV and do high frequency [20 minutes] and low frequency [8 minutes] of treatment. Before we start there is always a test pulse which calibrates the machine.
Day 27
I did a MT check today, which is usual. They happen about once a week and there are fast or long ones on the neurostar machine. When it comes to the motor threshold you do have to report your daily meds & any med changes. However, only a small group of meds change your MT.
Day 28
What disqualifies you from treatment? I had somebody with frontal lobe damage ask me if they could safely do TMS. I asked my TMS tech and I was told nothing automatically excludes people from treatment except for having metal plates in your head due to the magnet strength these machines use. Receiving TMS therapy with certain types of bipolar may lead to mania, so it's not always reccomend.
People who have higher risk of seizures due to like being on specific meds or medical history can do tms- the TMS technicians just may need to adjust the settings or monitor you more during treatment. My TMS tech said she has even worked with 1 person who had a paralyzed motor cortex. This is a big deal because targeting the motor cortex is an essential part of treatment.
People with pacemakers and other implanted devices may not be able to do treatment safely. However, the manufacturer of your medical device can work with the TMS office to test the device with the machine [in order to determine how safe it is]. This process is called interrogation. If you are concerned about contraindications for TMS, schedule a consult and discuss your concerns with a technician! You can do a telehealth consultation and evaluation. During your evaluation you will be checked out for contraindications of tms.
Day 29
Treatment, which consists of about 3,000 pulses, went well today. We have been able to keep a consistent power level, and I haven't had any side effects or hand movements. My emotion regulation, sleep, mood, and social energy are all much better than before TMS. I have way less panic attacks, thoughts of self harm, and suicide as well.
Day 30
Today we discussed what happens after treatment since I finish in 6 days. On your final day you will fill out the GAD-7 & PHQ-9 again to compare to your other scores. You will also schedule a follow up 2-3 weeks in the future to discuss how TMS has helped. If you wish to do maintenance treatment you will talk to your provider again to get approved.
Day 31
I was very sick and having issues with my stomach today. As I am disabled, this is common. I didn't want it to interfere with treatment but my tech was amazing and let me know we could take a break if I needed to. I did take a small break between high and low frequency, which helped.
Day 32
all you need to know about maintenance tms
Day 33
Today we did a short MT check, continued to watch my show on TV, and did high and low frequency. I only missed low frequency one day. The low frequency cycle is specifically for treating anxiety with the neurostar machine. Most machines have specific treatment for depression or anxiety [and usually the treatment for anxiety helps both depression and anxiety as well] but its nice to have a targeted treatment.
Day 34
Today my tech told me what to expect for the rest of my week: some extra paperwork and then scheduling a follow up on my last day. We did our normal routine except for discussing the schedule for the next week.
I wanted to talk about why honesty with your TMS tech is so important. If you are dishonest about the morning questions it could increase the risk of side effects including seizures, or make the treatment less effective. If you don't tell the tech that the position isn't comfortable, it may take longer to get positioned and be uncomfortable for you. They won't mind helping you out, especially during re-mapping! If you notice hand movements and try to hide it, that would also make the treatment less effective and could cause more side effects. Your technicians aren't there to judge you, just to help you be comfortable and have the most effective and safe treatment!
Day 35: tips for keeping comfortable
Your treatment center may offer earplugs, like where I went, but you can always buy your own. If you struggle to sit still, bring some fidget toys. You may need to have your right hand on the arm rest [to check for hand movements] so make sure you bring something you can hold with your left hand/one hand. My center has a TV but if they don't, music is good. Wear comfortable clothing & make sure you eat and have enough water before your treatment. If you have accessibility needs, talk to your tech or provider.
Day 36: what to expect on your last day of treatment
You will have high frequency treatment and answer daily questions like usual, fill out all your weekly mood & lifestyle paperwork, and schedule a follow up with your provider for 2 or 3 weeks in the future. You can apply again for insurance covered treatment after 60 days or 2 months, or you can speak with your provider about starting maintenance treatment.
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