Pre and during ECT
On the night before ECT, my mum's night dosage of Olanzapine was increased from 2.5mg to 5mg, making it a total of 10mg for the whole day (morning 2.5mg, afternoon, 2.5mg). According to the doctor, she managed to sleep quite well that night. My mum disputed that though @@
There were no issues arising on the first day of ECT. They started at a low electrical "energy" level (4%). There was no response (brain's wavelength? something like that). Then tried 8%. Still nothing. Stopped because doing it only twice in a day. They would repeat this on the next odd weekday, after having a team discussion on which energy level to try next.
In the meantime, we were told that when mum was restrained on the bed to prevent her from banging her head on the floor, she knocked her hands' knuckles on the bed frame. The nurses treated the wound, wrapped her hand with towels and lastly a clear plastic. That was the condition she was in when I visited her. Once again, the staff there kindly let us in, one at a time, to visit her.
She spoke less compared to two days before but on the other hand, she ate and drank a little more.
On Saturday, mum was still restrained but hands were no longer wrapped. Looked better. Talked more and clearer. However, she used her hands to knock against her forehead :( Nurse told me that they would resume giving her Alprazolam (asked us to bring her supply back to them) but they yet to know, at that time, the dosage to be given. Doctor wasn't in for me to query.
On Sunday, mum was still restrained but, oh my, she was so much better! Talked as much as a normal person. More coherent. Could even give advice. Ate and drank more. Olanzapine was increased to 5mg three times daily. This medication about to run out. Since the quota for public hospital had already been exhausted for the year, we were asked to get them ourselves. Fortunately, Dr N directed us to a Wellings Pharmacy, that had stock.
Monday: finally, mum's "brain" responded to ECT. Apparently I misunderstood previously: if the first stimulation of the day is successful, the therapy will be stopped and repeated at the next odd weekday. It is only if the first attempt fail that a second one will be attempted. They replaced Alprazolam with Lorazepam 1mg twice daily. When I first arrived, she was drawing at the nurse's counter while 5 nurses were "entertaining" her :) Then we both went beside her bed and conversed while seating on chairs. However, 10mins into our conversation, she stood up and bang her head on the pillar :( A nurse managed to persuade here to "help" them stamp papers, and then advised me to to leave.
Tuesday: there was a grand meeting among the psychiatric doctors and mum's case was one of the cases discussed. Since she tended to get agitated in the morning, they adjusted Olanzapine to 10mg morning, 2.5mg afternoon and 5mg night. She was restrained during visit but managed to converse (and initiated some of them too) with my dad, three relatives from Seremban and me.
Wednesday: doctor said that mum was unrestrained for long period of time after our visit yesterday. There was response to ECT this morning. When doctor explained to her that she couldn't go home yet, she got angry and wanted to bang her head. Staff tried not to restrain her by positioning mum between 2 nurses. Olanzapine was increased again to 10mg morning, 5mg afternoon and 5mg night. During our visit, she was unrestrained but not allowed to go in the visitors' area. Instead, we chatted at the gate. She spoke more, used longer sentences and was coherent.
Thursday: same as yesterday, she was unrestrained but could chat only at the gate. Spoke normally. However, she had stiff neck and giddiness and so she wanted to sleep.
Friday: was restrained when we visited but was untied towards the end when she wanted to go to toilet. She spoke less and a little softer but gave details during conversation. There was response to ECT that morning.
Saturday: there was a noticeable lump on her forehead, which she confirmed it was due to her banging her head (against pillar/floor, I supposed). She could, once again after a long time, go out to the visitor's area. Spoke normally but slow to respond. Smiled once or twice. Less blank look. Could sleep at night. Still had stiff neck and giddiness. She suspected she was down with cold/flu, which she alerted the nurses about.
There were no issues arising on the first day of ECT. They started at a low electrical "energy" level (4%). There was no response (brain's wavelength? something like that). Then tried 8%. Still nothing. Stopped because doing it only twice in a day. They would repeat this on the next odd weekday, after having a team discussion on which energy level to try next.
In the meantime, we were told that when mum was restrained on the bed to prevent her from banging her head on the floor, she knocked her hands' knuckles on the bed frame. The nurses treated the wound, wrapped her hand with towels and lastly a clear plastic. That was the condition she was in when I visited her. Once again, the staff there kindly let us in, one at a time, to visit her.
She spoke less compared to two days before but on the other hand, she ate and drank a little more.
On Saturday, mum was still restrained but hands were no longer wrapped. Looked better. Talked more and clearer. However, she used her hands to knock against her forehead :( Nurse told me that they would resume giving her Alprazolam (asked us to bring her supply back to them) but they yet to know, at that time, the dosage to be given. Doctor wasn't in for me to query.
On Sunday, mum was still restrained but, oh my, she was so much better! Talked as much as a normal person. More coherent. Could even give advice. Ate and drank more. Olanzapine was increased to 5mg three times daily. This medication about to run out. Since the quota for public hospital had already been exhausted for the year, we were asked to get them ourselves. Fortunately, Dr N directed us to a Wellings Pharmacy, that had stock.
Monday: finally, mum's "brain" responded to ECT. Apparently I misunderstood previously: if the first stimulation of the day is successful, the therapy will be stopped and repeated at the next odd weekday. It is only if the first attempt fail that a second one will be attempted. They replaced Alprazolam with Lorazepam 1mg twice daily. When I first arrived, she was drawing at the nurse's counter while 5 nurses were "entertaining" her :) Then we both went beside her bed and conversed while seating on chairs. However, 10mins into our conversation, she stood up and bang her head on the pillar :( A nurse managed to persuade here to "help" them stamp papers, and then advised me to to leave.
Tuesday: there was a grand meeting among the psychiatric doctors and mum's case was one of the cases discussed. Since she tended to get agitated in the morning, they adjusted Olanzapine to 10mg morning, 2.5mg afternoon and 5mg night. She was restrained during visit but managed to converse (and initiated some of them too) with my dad, three relatives from Seremban and me.
Wednesday: doctor said that mum was unrestrained for long period of time after our visit yesterday. There was response to ECT this morning. When doctor explained to her that she couldn't go home yet, she got angry and wanted to bang her head. Staff tried not to restrain her by positioning mum between 2 nurses. Olanzapine was increased again to 10mg morning, 5mg afternoon and 5mg night. During our visit, she was unrestrained but not allowed to go in the visitors' area. Instead, we chatted at the gate. She spoke more, used longer sentences and was coherent.
Thursday: same as yesterday, she was unrestrained but could chat only at the gate. Spoke normally. However, she had stiff neck and giddiness and so she wanted to sleep.
Friday: was restrained when we visited but was untied towards the end when she wanted to go to toilet. She spoke less and a little softer but gave details during conversation. There was response to ECT that morning.
Saturday: there was a noticeable lump on her forehead, which she confirmed it was due to her banging her head (against pillar/floor, I supposed). She could, once again after a long time, go out to the visitor's area. Spoke normally but slow to respond. Smiled once or twice. Less blank look. Could sleep at night. Still had stiff neck and giddiness. She suspected she was down with cold/flu, which she alerted the nurses about.
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