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ketamine

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In a Nutshell: My Week in Review

by Heather Loeb
written by Heather Loeb
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Happy Sunday, everyone. I’m trying to have a good day, but man, this is been a hard week. I’ve been feeling depressed, sad and fatigued. I was going to scheduled some ketamine treatments, but I started feeling better Thursday and Friday. Then we had to put down my favorite cat, Possum, because she was having severe kidney and liver problems. We’ve had her for 10+ years, and it was very hard to say goodbye, but I’m glad she’s no longer hurting. The kids are okay. Isla went with us to say goodbye; Eli declined, saying it was too hard, which I totally understand. He’s already asked for a new cat. Sigh.

I think I will call Monday to set up some ketamine treatments, I don’t want this crappy mood to continue and get out of hand. This coming week is going to be a busy one — my husband has a fundraiser (he’s running for a board position for the community college here) and NAMI GCC is holding a panel discussion for Minority Mental Health Awareness month. I’m pretty excited about that. I think it’s going to be very eye opening. What I’ve learned from doing research on it for my column and our event has shocked me — read my column here. I’m always thinking about my mental health and problems; I didn’t even think about the hurdles that others have to go through to get just a quarter of the quality care I get. It needs to change, for sure.

Oh, I almost forgot! I made it through the first round of voting for the Caller-Times’ Best of the Best. I’m up for Best Columnist. Please vote for me daily. You can vote here.

That’s it for me. I hope you guys are well. As always, stay in the light.

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Ketamine/Spravato

What a Ketamine Treatment is Like

by Heather Loeb
written by Heather Loeb

Last week I did a ketamine treatment, the first in years. Before I was hospitalized at The Menninger Clinic in 2019 for depression and anxiety, I’d done about two or three but never felt better after doing them.

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I tried again last week because it’s easier for me to do ketamine treatments than ECT treatments, which I’ve been doing since 2019. Those are a pain; I have to drive 2.5 hours to San Antonio, undergo the procedure (which includes anesthesia) and then have my husband drive back home while I battled an inevitable migraine. I’m usually out of it for the rest of the day and some of the next.

I haven’t had an ECT in months, the most I’ve ever gone since being hospitalized, but I started recognizing some of the signs that I might need one. Enter ketamine treatment.

I was very nervous when I got there and as they begin to set up the infusion and IV. I was scared that I would feel out of control and that I’d be overwhelmed. I was sweating. The nurse could tell I was nervous so she stayed with me for a few minutes. That’s all it took, really. I started to feel the warm flush feeling of the medicine entering my body and I started to panic. It was just so overwhelming, so I asked the nurse to slow it down, which she did. After that, it was a gradual high and I didn’t feel out of my mind. I started laughing, saying “wow, I’m so fucked up.” She left the room so I could vibe.

Because the infusion was going slower, I was able to realize that I was “high” and able to enjoy it. I did inventory on my emotions and felt hope that this would help improve my mood. I wasn’t sleepy or tired, but I could tell my eyelids were at half mast (plus I took a picture).

I felt a feeling of euphoria and thanked God for all I was thankful for. I relaxed and explored any emotion that came up, which is cool because normally I swallow my emotions, never giving them any time or space.

Finally, as I did become sleepy, time was up. They took the IV out. They let me “come to” after about 10 minutes. I was a little tired for the rest of the day but wasn’t totally useless, which is good. That’s how the ECTs leave me.

I felt like the treatment worked right away but thought that maybe it was just a lingering feeling of euphoria. It has been several days now and I still have that feeling — that I feel good. That I’m thankful. And like it’s going to be okay. I’m so pleased with how it went and I’ll be doing five more treatments to do.

I’m just so thankful that I didn’t have to get an ECT. I hate anesthesia and memory loss. It’s just too much to deal with, so I’m really hoping I can keep up with ketamine treatments instead.

Here’s hoping.

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Ketamine/Spravato

A Horse of a Different Color

by Heather Loeb
written by Heather Loeb

The other day my doctor suggested a couple of Ketamine infusions to do until I can do ECT. I didn’t think much of this because I’ve done several ketamine infusions in the past and they didn’t do much for me, but I learned the clinic that I was going to in Corpus was doing the infusions wrong, or perhaps not in the ideal way. Let’s put it that way.

At the old clinic they were adding benzos (Ativan, Valium) to the ketamine, which actually lowers the efficacy of the ketamine. I didn’t know that until I got to Menninger. Also, the other clinic’s protocol was to give everyone 100mg/hour no matter what. Here, they go by weight. I was skeptical of that at first but now I see why.

When you do 100 mg per hour, rather when I do 100 mg per hour, I feel like I’m in a black hole. There’s a lot of dissociation and I just feel drugged up and then I’m tired for the rest of the day. When I tried ketamine at the clinic, it was almost a religious experience. It was the most calming, most relaxing, therapeutic experience I’ve EVER had. I felt happy – and I haven’t felt happy in a loooong time.

It was amazing. Now, this infusion lasted just 40 minutes but I’ve already noticed a shift in my behavior. I made some jokes with some of the patients and staff here. I cleaned up my room and generally my mood is a bit better. I still have depression, of course, but it did provide a respite from the constant pain I’m in.

This makes me hopeful. I’m scheduled to have another ketamine treatment Monday and then later in the week, I’m due to start ECT. I’m not expecting my life to change but I’ll take any improvement from my current state. Some days it’s just so hard to breathe and it’s so exhausting to be a wife, mother, daughter, friend, etc. It’s just painful. Everything is painful, so relief is all I want. I want to be there for everyone. I want to smile and laugh – just live in something other than this awful darkness. I know I have to work on my therapy, too, and believe me I am. Everyday here is emotionally draining and I don’t think I’ve gone a day without crying, but that’s okay. I’m just trying to get to the other side.

I hope I see ya’ll there soon.

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See you later, alligator

by Heather Loeb
written by Heather Loeb

So, I’m taking off the next 6 to 8 weeks. I talked it over with my therapist and husband and we all decided I needed to be inpatient at a mental health facility this past week and, lucky for me, the clinic had an opening in the program starting this Monday that I wanted to be in and that was the best fit for me. One that focuses on my treatment-resistant Major Depressive Disorder, generalized anxiety disorder, social anxiety and PMDD, and emotional eating. Even substance abuse, because I’ve abused my anxiety medicine in the past.

The clinic is Menningers in Houston, which is well known in the psychiatric arena. I’ve heard such good things about it and I’m hopeful. I should be – the program cost a damn arm and a leg but now’s the time to get better. Nothing else has worked.

The one thing I’m worried about is ECT is not part of my program and I really want to do it. The program leader said I can meet with the doctor to see if I’m a candidate but I don’t know who else would be a better candidate. I’ve tried multiple medications (Prozac, Wellbutrin, Zoloft, Lamictal, Rexulti, Saphris, Doxepin Lexapro, Cymbalta, Abilify – just to name a few), TMS, ketamine infusions and now Spravato. I’ve been depressed (way) over 5 years, so really how can they turn me down? But they could, so good thoughts please. It’s really my one shot. I wont be able to afford a place like this again and I’m not willing to be away from my children for this long again.

That’s the only thing making me nervous. My babies. I know my husband and mother-in-law (and my mom and dad are helping too) can handle everything, I’ll just miss them so much. I’ll miss my son’s birthday and I’ll miss the first day of school. It’s just hard. But when I come out I’ll hopefully be way better and won’t have to miss anything else, because let’s face it, I’m barely living now.

I won’t have access to internet, other than email., so this is so long for the next 6 to 8 weeks. I will miss blogging but I guess I’ll have some stories when I get back.

Stay well, my friends. See you on the other side.

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Ketamine/Spravato

Spravato: Treatments 1 & 2

by Heather Loeb
written by Heather Loeb

This past week I completed my first two treatments of Spravato. What’s that, you say? It’s a nasal spray with esketamine (very much like ketamine) that helps with depression and a host of other things, such as migraines – at least for me.

imgresMy first treatment did not go well. First of all, I HATE things going up my nose. Second, it gave my a horrible taste in the back of my throat and I got a little nauseated. I also didn’t dissociate, which is one of the biggest side effects of the drug. Under the FDA’s rules I had to stay there for two hours, so I was hoping for a little dissociation, otherwise it’s just boring. So, it had no affect on me besides being a little sick to my stomach and then I was bored for two hours. Plus when I got home, I got a huge migraine and for the next two days and had to see my neurologist to get a Nubain injection for my migraines to go away. Maybe it was just a coincidence but I was annoyed and didn’t want to go for the second treatment. It had been awhile since I’d had a migraine.

But to my delight, the second treatment went well. I got the hang of putting the nasal mist up my nose, got used to the nasty taste in my throat and this time they gave me Zofran for the nausea. I still didn’t dissociate but I was tired enough to take an almost two hour nap, so the visit passed rather quickly. Can’t say the same for my husband who has to stay there the whole time and give me a ride home. FDA rules again. He can’t leave the whole two hours while I’m receiving treatment.

I don’t feel a whole lot better, and since it’s hardly affecting me, my doctor is going to bump me up to the big girl dose next week, which is about 84mg of esketamine. When I go to get the ketamine infusions at the clinic via IV, I’m receiving 100mg, plus they give me a benzo in the IV – I don’t know why they do that. So, maybe the larger dosage will help me more.

Don’t get me wrong, it wasn’t a complete failure. I do feel better after the second one but I’m still dealing with symptoms of depression. But I don’t feel as blah as I have been.

I’m supposed to go three times to the clinic next week to get the larger dose, so we’ll see how that goes.

As far as my weight loss and journey to get healthy, I haven’t even been on the scale. I’ve been eating poorly and drinking Diet Coke again. My depression just hit hard this week and the week before. I think. I can’t remember last week. I’ll get back on track and keep you guys updated. Thanks for the support.

Stay well, my friends.

 

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Week 2 Fasting: I’ll Take It

by Heather Loeb
written by Heather Loeb

Week 2 
Starting Weight: 187
Current Weight: 179

So, I lost 2lbs this week, which is great, but after last week’s 6 I was expecting more. But 2lbs gets me out of the 180s and I’m grateful for that. It means I’m that much closer to my goal weight in the 160s. I sound obsessed with the scale but I know when my clothes fit the best based on my weight. Plus, I’m obsessed with the scale. Which you shouldn’t be by the way – you should have non-scale goals, too.

As far as the Intermittent Fasting (IF), I did go most days without eating past 2 p.m. but this was a crazy week with end of the school year parties and Teachers’ Appreciation Week, so I had to eat dinner a couple nights. I still ate healthily.

I’m VERY happy to announce that I had NO Diet Coke this week. Not one sip. Last week I had a few sips here and there – nothing close to a whole can. Now I can say I went the whole week. I’m so proud of myself. I’ve been drinking Diet Coke for almost 20 years (yes, I’m old) and for the past 10 years my doctor has been begging me to stop*. He will give me a gold star for sure. Right after he jams my B12 shot into my arm.

Speaking being B12 deficient, my depression has been better since I started fasting and losing weight. I don’t know if it’s my diet or the ketamine infusions I’ve been getting – I received one three weeks ago and one last week. Even though sometimes anxiety and depression start biting at my ankles it’s not enough to bring me down. This allows me to keep eating healthy, drink water, make healthy decisions for myself and not sabotage my progress. My depression would not allow any of this to happen.

Getting back to the subject, I know I can’t lose 6lbs every week, like the first week – it’s unrealistic – so I know I need to exercise to speed up my weight loss. (As I’m writing this, I’m saying to myself 2lbs is good and I need to chill.) But exercise is good anyway. I’m still too nervous to go to the gym, I don’t know why, so I’m going to try my husband’s stationary bike. I hope after a few days I’ll get bored enough to go back to the gym to my favorite treadmill and eventually lift weights again. Maybe I’ll just woman up and go to the gym, lol.

This week I will be positive and continue doing IF as best I can. What healthy decisions are you making this week, friends?

 

*Diet soda has links to weight gain and metabolic syndrome, which can make diabetes worse or increase the risk of it developing. Some sweeteners in diet soda even cause insulin spikes in the blood which worsens insulin sensitivity over time and can eventually raise blood sugar levels, according to MedicalNewsToday.com

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When I Hit Rock Bottom

by Heather Loeb
written by Heather Loeb

About two years ago, I felt great. I was taking two HIIT (high intensity interval training) classes a week and when I wasn’t doing that I was training to run a 5K, a feat for me because I hate running. I felt so strong, so energetic and proud of myself. I was doing hard things, things I didn’t think I could do. I was a role model to my kids.

In June 2017 I ran the 5K. I was happy. A couple weeks later I started to feel bad. I wasn’t sick but I started to lose momentum with my workouts. Things that were once easy or doable became hard. Waking up in the morning was hard. I didn’t know what was going on. I knew I had depression but I was doing so well. It had been well over a year since I had Eli, it couldn’t be postpartum depression – I was over that.

I took whatever energy I could muster and put it toward the kids, which meant I suffered more. Showers seemed near impossible. I stopped working out. I just wasn’t myself.

In October, I hit rock bottom. I had suicidal thoughts. I was crying at every little thing. I felt anxious all the time and my marriage was suffering. Thankfully, my mother in law was helping with the kids.

During a school break, we took the kids up to my parents’ house. I had also made an appointment with a new psychiatrist who specialized in women’s mental health in Southlake. My then current pyschiatrist wasn’t cutting it. While my parents’ and the kids were at my parents’ lake house, my husband and I got into a huge fight and I just lost it. I was sobbing uncontrollably and suicidal. This next part is hard – I knew where some hydocodone was and I had a plan to take some but I didn’t want my mom to find my body. I called my best friend and she urged me to go to the ER.

I waiting for hours at the ER for them to transfer me to a psychiatric hospital. Around midnight, hours after I’d arrived, I was taken by ambulance to a psych ward at another hospital. I was there two and a half days. The psychiatrist there was a total dick. He wouldn’t release me until he “talked to my husband about my illness” and didn’t listen to anything I said. Because I had an appointment with the psychiatrist in Southlake, he ended up letting me go after talking to my husband of course.

When I met with Dr. Johnson, I saw the light at the end of the tunnel. She diagnosed me with Major Depressive Disorder, PMDD, generalized anxiety disorder and social anxiety. My old doctors just said I was depressed and never spent more than 15 minutes with me. Dr. Johnson spent more than an hour talking to me. She put me on medications I had never heard of, that my doctors never mentioned, and I left the office crying tears of happiness.

I did get better, I’m better than I was that awful October but I’m treatment resistant, so medication can only go so far for me. That’s why I try alternative treatments like TMS, ketamine infusions and soon the ketamine nasal spray. Right now, I’m definitely not suicidal but I have to struggle though days, some more than others.

If you’re suicidal, please go to the nearest ER or tell your doctor – any doctor. There is help and it does get better. You can also call the suicide hotline at 1-800-273-8255. Someone is there 24 hours a day to help you.

Thanks for listening. This blog was a hard one to write.

 

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Oops

by Heather Loeb
written by Heather Loeb

Oh, hey. It’s been since September since I last blogged. My apologies. It’s been a hard few months since. First, I was busy with the holidays and since the beginning of the year I’ve been depressed and haven’t felt like talking despite everyone’s urging to do so.

That’s the thing about depression, even when you need to talk the most you feel like you just can’t do it. I can say that I’ve been going to therapy on a regular basis but my meds have stayed the same despite me feeling like crap. Because I’m treatment resistant, there’s really nowhere to go from here medicine wise. My psychiatrist has suggested ECT but I’m just not ready for that. Yet.

I have been getting ketamine infusions which helps with my moods. It doesn’t last very long but thankfully we have the money to get them. I don’t know what I would do if we couldn’t afford it. If you’re poor and have MDD, you’re screwed. My medicine alone costs hundreds of dollars. So wrong.

IMG_2079My therapist and I started Dialectical Behavior Therapy. Basically, you identify your negative behaviors and teach yourself positive behaviors. Seems like common sense but it’s really helpful when all you’ve been doing your whole life is practicing negative coping skills. So far, so good. I’m working in a workbook, which I would recommend to anyone.

I’m also going to try the new ketamine-based nasal spray, Spravato. It was approved by the FDA in March. The doc that did my TMS treatments called and wants me to be her first patient. You have to be in the office and monitored for two hours after receiving the spray and I think you go twice a week for six weeks at first. I hate stuff going up my nose so we’ll see how this goes down. Waiting on insurance to clear my first, of course. It’s always insurance.

That’s my update for now. I’ll try to be more consistent with everything and I’ll definitely keep you updated on the Spravato.

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Migrainepalooza

by Heather Loeb
written by Heather Loeb

Remember when I said my migraines were nearly non-existent a couple of blogs ago? Well, this week they came back with a vengeance. Usually I would go get a ketamine infusion, which keeps them at bay, but guess what? The ketamine clinic here – the only one in town – has closed. The closest clinic is two hours away.

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Photo by Public Domain Pictures on Pexels.com

Now what exacerbates my migraines is really anything but since I’m doing TMS and it feels like a woodpecker pecking the shit out of my head, it tends to make things worse. Good times.

This week I had to go to my neurologist for two injections. When my migraines get very bad and my abortive meds aren’t working I go to my doc and he gives me an injection of Nubain and some nausea meds. It worked for a little bit Tuesday but then the migraine was back in full force Thursday. I also had a less intense one on Friday but didn’t end up going back to the doc.

During the week I missed a board meeting, play date, didn’t get any chores done, barely saw my kids because they were either at after care at school or with my mother-in-law. And of course that all depressed me because 1. I felt like crap and 2. I felt useless because all I could do was lie down and take a massive amount of drugs that didn’t help.

My husband, who has picked up the slack for me this week, has decided to drive me to San Antonio for a ketamine infusion. Maybe he realized my job was too hard on top of his because I suggested getting an infusion before I started TMS to avoid this whole situation. Men, they never listen.

Last week I also talked about how good I was feeling and then I went a little downhill but with migraines three to four days a week it cant help but depress you. Chronic pain will do that to you, like I discussed in this blog.

I’ve now completed 10 TMS treatments and they say you’re supposed to feel a real difference by treatment 14 or so. I’m really hoping the ketamine will help my migraines, the TMS will start working better and then I can get my ass in gear. I do have two 5Ks coming up in the next four months and I haven’t exactly been running, unless it’s to the fridge for a Diet Coke (I needed the caffeine this week)….which I’m supposed to quit.

I’ll blog after my ketamine treatment and give an update on my TMS treatments next week. Wish my luck.

For more information on ketamine for chronic pain, go here.

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