April Update

Well, it’s April, and at the end of June I’ll have had my implant for a year.  The psychiatrist who handles my VNS adjustments keeps telling me that many people see the most noticeable improvements between a year and a year and a half.

I started seeing a difference within a few weeks; now the thing I’m most aware of is that when I get down I don’t feel the need to sleep for 20 hours at a time.  (Seriously.  When I get depressed, I can just SLEEP.)  Though a few times that’s bummed me out, because sleep is an escape for me, overall I’ve been able to stay more active in things I like doing, rather than just becoming kind of comatose.

I need to post new pictures of my scars.  The one on my neck is really hard to see at this point; some days I don’t even bother to cover it with makeup, because you’d never notice it anyhow.  The one on my chest is still pink, but it’s flattened out and I can see that it’s going to start turning white soon.  I can’t tell you how much I appreciate that the doctor who did the surgery did a vertical cut that disappears behind a bra strap.  And it doesn’t bother me even if it does peek out from time to time if I’m wearing a bathing suit or something. 

I’ve really enjoyed reading comments and questions from other people who are considering the implant, or who have gotten one themselves.  I’m curious about what other people’s experiences have been?  If I’m able to collect a few stories, I can post them in a new blog entry.

Status Update

Several things happened to contribute to my worsening depression in October. 

This picture isn't of me, I found it online. But the lightbox looks just like mine.

First, I always struggle when the days get shorter.  I actually use a clinical lightbox and I really recommend one to anyone who feels worse during the winter.  Mine is from Alaska Northern Lights.  They’re expensive — about $250, but it makes a huge difference in the quality of my life.  Without it, I can literally sleep 18-20 hours a day, and I feel drugged when I’m awake; with it, I sleep a normal 8 hours without needing naps.  I carry it back and forth with me to work, and sit in front of it at work for several hours a day.  People jokingly call it my Happy Light.  Everyone wants to know if it really works.  A few people have gotten their own after seeing what a difference it makes for me, especially when I use it regularly, like I’m supposed to. 

Second, there was a lot of upheaval in my family of origin.  My little brother got married, and I felt really inadequate for still being single.  My parents are getting a divorce, and things have been very strained (you can just imagine what the wedding was like, though everyone was pretty civil). 

Third, I’ve been dealing with some dissatisfaction about my own life.  I’m in a job I really enjoy, but I don’t make the money I believed I would when I was younger.  I also know that if I were to go into a different profession I could make a lot more.  It also frustrates me that I have trouble meeting people I’m interested in dating — that also partly has to do with the nature of my work; I don’t meet many people (ok, any people) who are potential dating partners.  I’ve been single for a long time now, and I’m finally tired of it.

Fourth, my meds needed adjusted.  Going up on the Effexor helped a lot, though it does make my hands shake, which I don’t like.  (I can live with it, though.  Anything to feel better…)  I don’t know that the Prozac has done much to help, and since I’m still dragging a bit some days, I might ask if we can go up a little bit on the Abilify.  I don’t know, I’m honestly a little leery of making a lot of changes to my meds during the winter months, because in the spring they just end up needing to be adjusted again with the longer days and better weather.  I seriously just need to move to Florida or SoCal and be done with it. 

I did go back into therapy to deal with the situational things — the parents’ divorce, the feeling bad about my inadequate dating life.  I have also worked hard to pursue interests and not let them fall by the wayside on the days I don’t feel like doing a lot.

Exercise is still a bit of a struggle for me, but I think that’s because I’m out of shape, and when you’re out of shape, your body doesn’t want to exercise.  When you’re in shape, it wants to go to the gym (or for a walk, or whatever).  Your brain may not want you to go, but your body does.   I started to get back into the routine in December, but then the holidays hit and there was a lot going on.  I’ve been sick the last few days (the weather has been all over the place, and I’ve had migraines), but I’m planning to get back into the gym when I get past that and struggle through until I’m back in shape and actually want to work out.

There are also things I do that make me feel better because they make me forget about my depression, even if it’s just for a little while.  For example, I really enjoy taking photographs, and finding good shots keeps my brain too busy to feel bad.  I also got this bee in my bonnet that I was going to learn to sew (which would really crack you up if you knew me — I’m not really very domestic) and I find doing that soothing.

So overall, I’m doing really well for the time of the year it is, especially compared to last year.  I do believe the VNS is a big part of that.  I talked some more to my VNS doctor (I have 3 psychological professionals — my therapist, my psychiatrist — who does my meds, and my VNS doctor — who’s technically a psychiatrist too), and she said that usually as people improve, it’s in steps. 

So maybe their concentration improves a bit, and then their energy levels.  Maybe they don’t need quite as much sleep, or they’re more interested in things.  But the subjective feeling of unhappiness vs. happiness is what changes last, usually.  She said it’s not uncommon for people to say “Yeah, I think it’s helping, but I want more.”  And she can see the improvements, but they don’t feel great, so they feel like it’s not working very well.  She said that somewhere around a year and a half, a lot of people reach the point where their subjective mood finally feels better, too.  Since I’m only at about six months, and I’m doing pretty well overall, I figure it’s gotta be uphill from here.

My scars are looking really good.  I don’t even bother to cover the one on my neck on days I don’t work; another month or so and I may not even need to bother then.  I keep thinking I need to take another picture to post here.

Scars at 3 Months

implantation scars at 3 months

Well, it’s been a little over 3 months since I got the VNS implant. I took a picture so you can see the scars. The one on my neck is increasingly hard to see — soon I won’t need any makeup to cover it.

The one on my chest is a lot easier to see, and raised.  It doesn’t bother me at all, though (well, other than itching from time to time) and it disappears right under even a thin bra strap since it’s vertical.

(If you’re reading this because you’re considering having this done and you’re worried about scarring, totally ask your doctor if s/he’ll do it this way.  It’s the best way to go!)

To the left of the scar (your left), you can see what might look like a bruise on my skin but is actually the curve of the implant.  I’m fairly thin compared to most people (but definitely not skinny) and they do tell you ahead of time that people with small frames and who are thin may be able to see a bit of the outline of the implant.  This doesn’t bother me at all.

Last of all, the picture is (probably obviously) life-size, so you can see how big the scars really are.

In terms of me being back on the downward spiral, I figured out that it seems to be psychological.  Major family upheaval, so I’m going to go back and see my therapist to talk about it.  I really believe that will help, but I’ll be sure to let you know for sure!

Relapse & Frustration

Well, I’ve fallen back into the hole.  Between some family upheaval and hormones, I went down and just can’t seem to pull myself back up.  I really, genuinely don’t think what I was getting before was a placebo effect, but I am frustrated by how down I am.

I went to see my psychiatrist, and she adjusted my meds, so now I am at 300mg Effexor, and we’re going to add 10mg of Prozac and remove the Lexapro.  Eventually we’ll go up to 20mg of Prozac.

I have noticed it is much harder to exercise since I got the implant.  I feel winded much more easily.  Not just when the stimulation is on, either; across the board.  That’s also frustrating.

Supposed to see the dr who manages the VNS next week (moved from this week due to conflicts on her end).  I definitely want to go up some more, and my psychiatrist agreed.  So hopefully 1.25 will help me feel better again…

Bored = Better?!

I’m doing really well on this thing.  There’s enough of a difference that I think it’s downright criminal that insurance companies are refusing to pay for the surgery for depression.  For someone like me, for whom treatment as usual (ie medications and therapy) weren’t providing much in the way of improvements anymore, it’s life changing.

I know I said before that I was bored, and I am.  But I’m realizing more and more how profoundly that means that I’m doing better.  Before I was using so much energy just to function like a semi-normal human being.  Everything was a chore, and I dreaded anytime something was required of me.  Just pretending to be normal was using up at least half of my energy. And I’ve been doing it for so long I didn’t even realize just how much energy it was requiring.

An example.  I’m driving a 10-year-old car that isn’t “me.”  I’ve been thinking for about three years that I need to get into a new car, but it’s been overwhelming to think about dealing with car salesmen.  So it was a chore I was going to have to do…eventually.

Well, now I’m going to go drive some of the cars I’m interested in just to do it.  (I’ll let you know how it goes.)

I’m also noticing that I’m more interested in having music playing while I’m doing things.  Usually I find it distracting, but now I’m finding that I’m enjoying it in the background while I’m working on other things.  (See?  I have lots of brain energy freed up.  I can even sing along.)  I’ve been totally enjoying Disturbed’s new album, Indestructible.  I’m sure my neighbors are ready for me to stop enjoying it and listen to something else…anytime now…

1.0

1.0

On Tuesday I got turned up to 1.0.

1.0 what, I’m not sure exactly, but I’m at a therapeutic “dose” now.  We are going to stay here for a month and see what happens.

When she turned it up this time I started coughing.  When the VNS turns on, it feels like someone pressing on my voice box, and the pressure felt like it increased quite a bit.  I can feel it down my neck into my chest now, as if someone is pressing there, too.  It’s uncomfortable and a little painful, but I expect that to get better over time.

I have found that exercising with it can be difficult.  Before I got it turned up to 1, I was doing fine when I just walked, but had trouble breathing when I jogged (without using the magnet).  Now I have to work harder to breathe even when I’m trying to walk (or even when I try to talk, even at a normal volume), and I feel like I’m suffocating if I try to jog while it’s going.  I keep thinking my lungs will get stronger if I just keep pushing myself, but I’m definitely going to start taking my magnet when I work out, and use it if I’m trying to jog.

The Missing Magnet

I lost a magnet already.  I had put it on my purse strap with velcro to get it home after work on a Wednesday, but completely forgot about it until the following Tuesday.  When I went to check my purse strap, it was gone.  It wasn’t anyplace else I looked, either, and of course the Cyberonics website was of no help whatsoever.  Not knowing who else to call, I called the guy at Cyberonics who helped set up my surgery, and lo and behold, he said it would be no problem to get out another set of magnets to my doctor.

This is what a cow magnet looks like.

So then that night I found my magnet.  *facepalm*

I kind of wanted some extra ones anyways.  Especially when your livelihood depends on your ability to speak clearly, and when your VNS is impairing that ability, you want to make sure you have magnets on hand so you can do your job.

I have read that you can use cow magnets, too, but of course Cyberonics says you should only use their magnets.  Since the Cyberonics magnets are easy to attach to velcro, I’m sticking with them for now.

But it’s helping already.  Now I notice that I’m bored.  Suddenly I’m not feeling so overwhelmed; suddenly I’m feeling like DOING things with other people (a miracle in and of itself, believe me), and my friends are all in different places in their lives than me, so I don’t have anybody to hang out with, really.  My friends are dealing with unhappy marriages and young kids and trying to get pregnant (those are all different people); I’d really just kill for a date with someone I was actually attracted to.

I wish the friend I mentioned in the last post lived closer.  Especially because I’m attracted to him.  Of course, his life is complicated, too, with divorce and children and guilt over how the divorce will affect the children.