The Uber dropped me off a half hour early for the appointment for my first ketamine infusion yesterday. My destination was an old medical building on Van Ness in San Francisco. Jittery, standing outside, I recalled I had had an abortion here over 40 years ago. I was worried about where my stepdaughter would park when she came to pick me up in two hours. I imagined her, driving around looking for a parking spot, me being too out of it to reach her by phone. Chaos. Reminded me of one of the reasons I was here today, to put an end to my constant catastrophizing.
At 9:30, I entered the 4th-floor office, filled out some paperwork, and was escorted inside by a lovely blonde technician, who began by offering me the choice between two rooms for my treatment. One had windows, the other was on the inside of the corridor. I chose the latter. It felt safer, more like a cocoon. I actually resonated with the room, as if there was something intimate about it. A place I would get to know well.
The room was dominated by a huge black leather recliner in the far corner. A blood pressure machine was set up alongside it. A smaller chair for the psychiatrist was opposite. On the table to the side, the technician pointed out, there were ginger candies to help with nausea and snacks for when I woke up to help elevate my blood sugar levels. She gave me a blanket, a neck pillow, an eye pillow, headphones, and an iPod. Showed me how to navigate through the assorted selections I could chose for the session. Each was an hour long. I was worried about using the iPod. I’ve never had one before. She was patient.
The psychiatrist came in almost immediately and we spent about ten minutes talking about my concerns and what I could expect. I was honest about how terrified I was about having a negative experience. I could control this, he said, by setting some positive intentions and returning to them each time I found myself drifting into an unsafe space. Remembering to take deep breaths. He also said the blood pressure machine would be measuring my heart every 10 minutes and that the sound and the pressure on my arm would ground me. Most people, he said, experience a huge sense of relaxation. Some people, he said, experience bliss. I would be dissociated from my body and there would be sensations of space moving around me. I would lose all sense of time. He wanted me to know that I was in a very safe place, that there was a camera on me the entire time, and that there was a button for me to push for help if I started having a frightening experience. Then he left the room, saying he’d see me after the treatment.
The technician came in, bearing a tray with the IV, some medication for nausea, and the ketamine. It took her about five minutes to set everything up. She covered me with the blanket, adjusted my eye cover, and tilted the chair back into a reclining position.
“Have fun,” she said, closing the door behind her and leaving me alone.
Fun, I thought! This isn’t exactly about having fun!
How to describe the next hour? The treatment itself lasts for 40 minutes but it takes about 20 minutes more for you to feel yourself return. Throughout the entire time, you are not aware of your body. I would occasionally flex my feet to gain a sense of connection. I have no recollection of when the ketamine started having an impact but when it did I totally understood why they don’t stay in the room with you because you wouldn’t be able to talk; you are so lost in this ‘other space’ of assorted colors and geometric shapes. The colors I saw were mustard yellows, browns, and blacks. No wild psychedelics. However, the music they select for you to listen to was really trippy. I chose the first track. I can’t imagine how I would have been able to change tracks during the session!
I was really busy moving between the different spaces behind my eyes and trying to orchestrate a safe place. It’s not as if the panorama was frightening in itself. It was actually quite neutral. However, my mind would try to pull me into some frightening reality and I would have to repeat to myself “I don’t want to be afraid anymore. I want to be happy.” I was aware going into the experience that the reality I live in every day, the one shaped by fears of apocalyptic economic and environmental collapse, has come to define how I see myself in the world. I thought it would define the experience for me because it was a truth beyond my own sense of self. I didn’t know if I would be able to escape that enormous rabbit hole but I willed myself out of it each time it started to form from an image on my brain’s screen. And somehow just by my willing this, the landscape in my mind shifted to a safer potential area of exploration. The colors changed, I moved back up from melding with a dark color to the mid-screen of my mind and was able to shift direction. I can remember once or twice feeling as if I was being sucked down into this blob of darkness and succeeding in pulling myself away. It kind of felt to me as if I was perhaps actually watching what was happening inside my brain, although apparently it was actually visual hallucinations.
The experience for me wasn’t exactly peaceful yet at the same time it was exquisitely meaningful. I didn’t experience any bliss but I did experience how the constructs which constitute who I am are not infallible. They are not hard-wired. I do have some power over changing them. That’s really exciting. I wish I’d seen some brighter colors. Maybe I will with time, as my brain changes.
The doctor came in as I was snacking on some cheese nips. I asked him about getting off my medications. I am scheduled for seven treatments in the next month and as ketamine is supposed to invoke neurogenesis in your brain, I was eager to find out when we could start weaning off my medications. He said he wanted to wait until the ketamine started working before we began work on the meds. He wanted me to be feeling good when I started the process. Made sense to me. We are already doing some dramatic work on my brain. Why add withdrawals to it?
My stepdaughter was in the waiting room. She’d found a parking spot just up the hill on Jackson. I was a little shakey on my feet as we left the building and my brain felt like congealed pudding. Still, we went out to lunch and came home and watched the Netflix documentary on Cleopatra. Throughout the afternoon, people checked in on me to see how I was doing. A friend came by to take Aggie on her afternoon walk (my stepdaughter took her out again before she left after dinner).
Side effects were a headache (I was really dehydrated!) and feeling kind of out of it, like I wanted to take a nap but I was afraid to because the doctor had said I might have some difficulties sleeping that night. Slept for 8 ½ hours. Woke up still feeling a little groggy but that passed as the hours went by.
I go back in tomorrow for my second treatment.
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