The Glade 4.0

The "concentration" SPECT scan is done. The "resting" scan will be done tomorrow. No sign of mutations yet. I'll make a more complete response/trip report when I get home from work.

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Sail forth! steer for the deep waters only!
Reckless, O soul, exploring, I with thee, and thou with me;
For we are bound where mariner has not yet dared to go,
And we will risk the ship, ourselves and all.

Ok, so...I guess there's really not a whole lot to say about the procedure itself. Gallium goes in, gamma rays come out. On the whole, it's very similar to getting an MRI, only without all the clanging, and only your head is in the tube -- well, more like a rotating triangle in this case. I swear there was only a few millimeters clearance between the end of my nose and the plane of the "camera", though. I couldn't help wondering what they do if they have a patient with a larger nose/head.

To clarify what I said earlier, I do talk to my therapist about all of this; I probably didn't phrase that very well. He knows what my symptoms are at the moment -- ex. that I have what they, in the business, call "dark thoughts" -- I just haven't spelled those out in complete detail.

As far as my family goes, it's true that I maintain more of an "arm's length" with them. Partly that's for their own sake. My mother, in particular, worries about me ... well, more than I worry about myself probably. I just don't think it would be a good idea to validate those fears. I don't think she could handle that. But more to the point, I'm not that noble; it's just as much about me not being able to handle her being completely freaked out on top of everything else. There are some things I just don't think she needs to know about because it wouldn't do either of us any good.

Anyway, at the moment I'm actually doing relatively okay. Certainly better than last week or two weeks ago. I've had a bad bout of insomnia the last few weeks, which is unusual even for me. It does happen sometimes, but I tend more towards the hypersomnia end of the sleep disturbance spectrum in general. This has not made things better at all. On my best days, I'm chronically fatigued. Add continuous sleep deprivation to the mix and things get particularly ugly. Thankfully I finally managed to actually get one whole day off last weekend, so I was able to get some damn rest at last.

I'm just really run ragged. With a handful of exceptions, I've been working 7 days a week for about a year now. And not just that, I mean brutal, back-breaking labor on the weekend and, often enough, 12+ hour days at the office at a job that just ... **** everything about it. Yeah, 1st world problems, eh? I know. But it's killing me all the same. Every part of my life is basically owned by someone else. All that belongs to me are a few hours, the leftover dregs of days, when I'm too utterly exhausted to do anything. And that might not even be so unbearable if ... well, as Andrew Solomon wrote in "The Noonday Demon":



In other news, I'm thinking about appropriating my father's old road bike. No promises, but I'm going to try to get more exercise. Which is to say, > 0. I'm damn sure not going to take up jogging, but I did take up cycling a bit some 12 years ago and found it at least tolerable.

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Sail forth! steer for the deep waters only!
Reckless, O soul, exploring, I with thee, and thou with me;
For we are bound where mariner has not yet dared to go,
And we will risk the ship, ourselves and all.

Dude, no wonder you're at the end of your rope. *hugs* Sounds like you need a vacation...preferably on a beach somewhere. You seriously need to rest and destress.

So how do you feel after the treatment? And what exactly is it supposed to do? (I'm going to go back and re-read your initial post and do some googling too.)

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"Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own." Jesus of Nazareth

This is just diagnostic. You don't feel anything other than getting jabbed by the IV. Conceptually, it's pretty similar to a functional MRI (FMRI). Basically it provides 3D imaging of blood flow in the brain. Generally speaking, blood flow and neuron activity tend to correlate well, so it basically provides a map of brain activity.

This particular procedure involves two scans. One is done with the brain in a relaxed state (20 minutes in a dark room...meditating or something. I don't know what, exactly. I'll find out tomorrow). The other is a "concentration" scan. That's what I did today. This scan follows immediately after a 20 minute "test" (basically, just an activity that requires continuous concentration).

To get more specific, you're injected with a radioisotope of some kind. I said gallium earlier, but apparently what they actually used in my case was something called "Ceretec". In any case, it emits gamma rays. This flows everywhere, but since your brain uses a very considerable portion of your blood supply, most of this winds up in your head. The more active a region of your brain is, the more blood flow it has, and thus the more gamma rays it will emit. The cameras are arranged in an equilateral triangle around your head and, if the name is accurate, they are sensitive enough to detect single-photon emissions. The sensitivity keeps the overall radiation dose fairly small (about the same as a conventional chest x-ray, but obviously more concentrated on the brain, so that's not really apples-to-apples)

They also take a detailed patient history, which I also did today, after the concentration scan.

All of the above is analyzed, and they come back to you with a treatment plan ostensibly based on the specific (over/lack of) brain activity, or more particularly, the differences between the resting and concentration state as that may apply to a lot of things like ADD, memory problems, etc. (some of which are probably applicable in my case).

As I said, I'm not totally "sold" on this, but then, it can't be any worse than just randomly drawing meds out of a hat, which is honestly pretty much how depression psychiatry tends to work.

_________________
Sail forth! steer for the deep waters only!
Reckless, O soul, exploring, I with thee, and thou with me;
For we are bound where mariner has not yet dared to go,
And we will risk the ship, ourselves and all.

I dunno, that sounds pretty impressive. And yes, the random drug thing is not very effective...I've tried every anti-depressant on the market over the past 16 years and nothing has worked.
I'm very intrigued by this and can't wait to see what they say. I bet it's something awesome and they come up with a real solution for you, Stathol.

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"Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own." Jesus of Nazareth

Have you noticed any kind of superpowers yet?

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Holy shitsnacks!

Apparently I've gained the power to attract malware infections. I've had to clean two different peoples' computers today :/

_________________
Sail forth! steer for the deep waters only!
Reckless, O soul, exploring, I with thee, and thou with me;
For we are bound where mariner has not yet dared to go,
And we will risk the ship, ourselves and all.

I did the resting scan this morning. I won't have any findings/treatment plan until the follow-up appointment next Tuesday. I'm glad the scans are done. Typical small-bore in-the-muscle injections for vaccines, etc. don't bother me at all. But I don't much care for the larger bore IV injections. I wouldn't make a good heroine addict. This was actually not even as large bore as you'd typically use for, say, a blood draw or giving blood. But even so, I'm already a bit tired of getting jabbed, particularly in my dominant arm.

I actually commented to the tech that I was wondering what they do if the patient has a slightly longer nose, since the scanning head passed just millimeters past the tip of mine. He said (and I quote), "yeah, the objective is to get the scanning heads as close to your brain as we can. Sometimes we get people with big old pumpkin heads. I can move the scanning heads further back when that happens."

Today, Mr. technician, we salute you.

Other things I have learned from this experience:

It's not just my imagination -- our office building (or at least the common "cube farm" part of it) is entirely too cold. It's actually far colder than the SPECT scanning room which 1) is kept deliberately cold for technical reasons, and 2) is apparently cold enough that they feel it necessary to offer you a blanket.

I'm not sure whose fault this is.

_________________
Sail forth! steer for the deep waters only!
Reckless, O soul, exploring, I with thee, and thou with me;
For we are bound where mariner has not yet dared to go,
And we will risk the ship, ourselves and all.

Thanks for the chuckle with the blanket observation, Stathol. I'm with you on getting jabbed with needles.

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"Aaaah! Emotions are weird!" - Amdee
"... Mirrorshades prevent the forces of normalcy from realizing that one is crazed and possibly dangerous. They are the symbol of the sun-staring visionary, the biker, the rocker, the policeman, and similar outlaws." - Bruce Sterling, preface to Mirrorshades

We in the medical field like to use highly technical terms, it's part of the "secret" club we have choosen to be a part of.

I am appalled that the Tech divulged one of those to you, Stathol...

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Dream as if you'll live forever...
...Live as if you'll die tomorrow

Vivere Senza Rimpianti

I had the follow-up appointment today. The technical findings in brief:

1. Diffused (i.e. bilateral) increased activity in the deep limbic system/thalamus.

2. Decreased activity, both at rest and during concentration (but more markedly during concentration) in the left anterior lateral and left mid lateral prefrontal cortex.

The first is a common pattern for consistent depression. For cyclical uni-polar depression (cyclodysthemia) or bi-polar disorders, you often see the same thing except that it tends to be "focal" instead (i.e. it favors one side or the other).

The second is also associated with depression (chiefly with respect to low motivation) but is also associated with ADD, particularly when it is more pronounced during concentration. As well, my performance on the concentration test itself was "mid-range for ADD", as he put it. Overall the pattern is consistent with someone who has both chronic depression and ADD, which is also consistent with past diagnoses.

They'll be mailing me a full report later this week or next, which I imagine will go into more detail. In the meanwhile he's outlined a treatment plan. In no particular order:

Meds:
Cymbalta @ 40mg/day
Vyvanse @ 20mg/day

Supplements:
Multivitamin
Neurolink (taurine, tyosine, glutamine, GABA, 5-HTP)
Although he didn't mention it in our meeting, some the literature he gave me also suggested a high-quality fish oil (namely for omega-3).

Therapy:
He wants me to continue with my current therapist, of course, but in particular he feels it's important to tackle the isolation.

Diet:
He suggests an increased protein diet -- that is, on the order of 30% of your calories from protein.

Exercise:
Intense cardio 30 minutes, at least 4 times a week


I haven't really had time to process and research everything yet, but overall it seems reasonable enough. I'm kind of skeptical of all dietary suggestions -- my policy is and always has been a varied diet that isn't high or low in anything -- but 30% protein isn't too crazy. If I'm going to take up cycling for the cardio, and particularly if I also throw in some weight training for the hell of it, I'm probably going to want that anyway. In any case, my one dietary vice is a penchant for skipping breakfast, so at the very least, it's not going to kill me to fill that in with an omelette or something.

I'll follow up with him again in a month and ... we'll see. I did find out that they do sometimes perform follow-up scans to compare before-and-after brain activity, but this would typically be done 6-12 months later (and presumably only if things are improving).

In other news, today I learned that Chrome doesn't know how to spell "omelette".

_________________
Sail forth! steer for the deep waters only!
Reckless, O soul, exploring, I with thee, and thou with me;
For we are bound where mariner has not yet dared to go,
And we will risk the ship, ourselves and all.

Well, at least it's good to have a roadmap so you're not wandering alone. Good luck, man.

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"Dress cops up as soldiers, give them military equipment, train them in military tactics, tell them they’re fighting a ‘war,’ and the consequences are predictable." —Radley Balko

Dude, wish you the best with your treatment.

I have nothing much to offer, other than the cardio sounds like a good idea. Of course I find plain manual labor of some sort a very good device to keep me in a better state of mind. I work in my yard a lot during the Summer, mowing, weeding, etc. I always feel much better (mentally) after I spend time working up a sweat. It also gives me a slight boost in knowing I did something productive and seeing the results right away.

As Andre Agassi said in an interview about the best advice he was ever given (from his father) "There's a lot of good on the other side of tired". I'd agree.

For the Omega 3, I've been told that this:
http://www.google.com/products/catalog? ... H8Q8wIwAw#

Is one of the best out there.

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Holy shitsnacks!

If your insurance will cover it, get your doctor to write you a prescription for Lovaza for the Omega 3.