NOTE: Obviously, this experience is different for everybody, but this is how the entire outpatient procedure, from checking in to recovery, is for me. I want to make this short, but I don’t know if I can. If nothing else, I’ll try to be succinct. Also, as stated on my About page, I don’t advocate for or against using ECT. I’m just sharing my experience.
The photo shows me pre- and post-treatment, at the hospital and then at home. The picture was taken in 2014.
The last time I underwent outpatient ECT treatment was in February and March 2017. I’ve had ECT at 2 different hospitals, but I’m only going to describe what it’s like at the one I’ve been going to for the past 5 years or so, and which I will call ECT Hospital.
First I check in at the Outpatient Surgery area, where they process my insurance information, have me sign a consent form, and other administrative stuff. Then I sit in the waiting room until 6:30 AM, which is when an assistant gathers the ECT patients and leads us to the ECT unit. I can tell who the “regulars” are because most of us return with our re-usable oxygen masks and that balloon-type thing attached to it, as requested.
The ECT unit has 5 stalls numbered #16 – 20 against a wall, each of which has curtains on 3 sides, for privacy. There are 2 or 3 other stalls along a perpendicular wall for inpatients having ECT. I enter a stall, and because I’m female, the ECT nurse asks for a urine sample to be used for a pregnancy test. I return to the stall, shut the curtain and change into the hospital gown and the packaged slipper socks they provide. There’s a garment bag to store my street clothes. I think up to 2 guests (it’s only ever my husband, for me) are allowed into the stall. They are asked to leave when the team is ready to begin the treatments.
Once I’m “dressed,” I open the front curtain and then climb into the hospital bed. One of the ECT nurses enters my stall and begins preparing me: attaching a blood pressure cuff and electrodes connected to the heart monitor. I’m not sure if there are other monitors, but these are what I’m familiar with. An IV is inserted, usually into the left arm, unless you’re a “hard stick” like me, where the best vein — yes, just one, really — is on my right arm. The nurse then stands at the computer and goes through what meds I’m currently on, the dosages, and when the last time was that I took them. Oh, and I’m supposed to fast (no food or water) after midnight. They also ask for my weight (I’m pretty sure this is so the anesthesia team knows how much anesthetic to use). Once all this is done, they offer me a warm blanket.
During this process, one of 3 ECT doctors (whichever psychiatrist is on rotation to administer the treatment) will chat with me about how my mood has been. An anesthesiologist stops by to introduce him- or herself and asks if I’ve had problems with anesthesia in the past. I have a history of my blood pressure rising during the procedure, so a nurse anesthetist injects premeds for that through my IV. I believe they also inject a muscle relaxer so my body doesn’t flop around when they induce the seizure (the ECT treatment) and I don’t hurt myself.
When they’re ready to begin, a group of nurses rolls my bed and my monitor into one of 2 ECT treatment rooms. These aren’t much wider than the bed, and it’s crowded because there are at least 2 nurse anesthetists (I don’t know why so many), one of whom sits in front of a computer monitor, and another by my head; the ECT doctor; and the anesthesiologist. The ECT doctor attaches electrodes to my temples, that are connected to the ECT machine, which is about the size of a large radio. A nurse gives me a mouthguard so I don’t bite my tongue or break any teeth during the procedure. Then a nurse anesthetist stands at the head of the bed and places the oxygen mask and balloon-type thing over my mouth. The anesthesiologist informs me when s/he is injecting the anesthetic, and the next thing I know, I’m back in my stall with the lights dimmed and the mouthguard removed.
The ECT nurse has me wait for about 10 minutes to make sure everything is ok, probably in terms of the anesthesia. Then they call someone from Transportation who wheels me, still in my bed, into one of the rooms or stalls in the Recovery Area. A Recovery nurse takes my temperature and blood pressure, and offers me juice and crackers. Once I’m dressed, they call my guest (my husband). He meets me in the Recovery Area, and brings me home, where I sleep off the anesthesia well into the afternoon. After waking from my long nap, it doesn’t feel as though I had the procedure.
Photo provided by author