Ketamine Treatment: D1
Updated: Sep 22
My First Spravato Treatment
Today is the first day of my ketamine treatment.
And I am pretty nervous.
Sadly, I’m also not particularly hopeful that anything is going to change.
I’m exhausted—fatigued, via the parlance—and thirsty, but I’m not supposed to eat or drink anything within two hours before the treatment.
I’ve decided to take my Tascam and set it on record, just in case I blurt out the meaning to life, the universe, and everything while sitting in the “zero gravity” chair.
I think it’s a Barcalounger, but there is a “ZeroGravity” sign on it.
I took the BDI (Beck’s Depression Inventory) that I’m supposed to take before each session, and everything seems to center on the second-to-last answer in each question:
“Things suck, but it could get worse.”
And I have signed my name to about four different other things that I pretended to read, but didn’t
Heading out for the treatment. More after the line separator.
Well, it’s done.
The first treatment, anyway.
I’m still in the treatment room, but, other than fatigue, it feels like the drug is mostly out of me.
I am using Spravato, a brand name for nasally administered esketamine.
The nurse came in and took my blood pressure and checked my blood oxygen levels. They have to be within a specific range or they can’t do the dose.
My BP was a little high, but still within the range, so…
She asked if I wanted a motion-sickness pill.
I am old and no longer ride rollercoasters with names like The Disemboweller, so, yes, please.
I’m assuming that question raised my blood pressure significantly.
While the anti-puke pill melted under my tongue, I had to blow my nose and “wipe it out.”
Then I gave each nostril a little squirt with a nasal spray applicator: 28 mg.
Five minutes later she came in with the second dose for a total of 56 mg for my first go.
There is also an intravenous ketamine treatment option. But my insurance provider doesn’t pay for it because it works better and faster. Go, America!
The Spravato Taste
Okay, the nasal stuff can—will—drip down your throat.
It is as bitter.
It is bitter as the squinty-eyed stare from a rebuffed folksong busker on a Boston sidewalk.
Fortunately, they suggested I bring some sour candy with me to “balance out the bitter.”
It was little like cleaning skunk squirt with gasoline, but it worked.
Once I got over the taste, the experience was actually pleasant.
I think the music choice was pretty key to the experience. So pick your music bliss.
I went with the following and named it my Ketamine Therapy Music:
· Gabriel’s Oboe: Ennio Morricone
· Nuvole Bianche: Ludovico Einaudi
· Death is the Road to Awe: Clint Mansell & Kronos Quartet
· Now We Are Free: Lisa Gerrard
· Une Meeles: Maarja Nuut & Ruum
· Spiegel im Spiegel: Avro Pärt
· Breathe in Me: Liquid Mind
· Concerto for 2 Mandolins: Antonio Vivaldi
· A Meaningful Moment through a Meaning(less) Process: Stars of the Lid
What Does Ketamine Therapy Feel Like?
I’m about an hour and a half in now.
You can see I’m typing.
And thinking.
And writing, so…
I do not need the Tascam to remember the treatment.
Unfortunately, I did not blurt out the meaning to life, the universe, and everything.
The main struggle right now is to stay awake, which is why I started writing this, now.
I also put on my “Motivation” stream from Brain.com. Not a plug, but if they would like to pay me for my words or voice…?
The Biggest Surprise
Alrighty then, the main thing I remember is the feeling of absolute contentment.
I haven’t felt that feeling for quite some time.
The overall feeling was like a nice warm and comfortable drunkeness. Silly and sauced up.
I guess I expected to end up cursing my mother or screaming incoherently about some as yet unkown trauma scratching to get out.
But none of that.
The Post-Treatment Sleepiness Is No Joke
Right now, the struggle to stay awake is MONUMENTAL.
I got the shaky legs.
The sudden jolt to wake up.
It is later in the day, eight hours.
Still a bit fuzzy.
I haven’t driven, but I have done some computer work and have taken a nap.
Not too bad.
What Happens Next?
This is the first day of what they call the Induction Phase of ketamine therapy.
According to Reach Behavioral Health, the goal of the induction phase is to “stabilize mood, jumpstart neuroplastic changes in the brain, and achieve meaningful symptom relief for treatment-resistant depression.”
Tomorrow is off.
A normal day.
The next day I will have a regular treatment with a larger dose.
Two treatments a week for four weeks.
Then one treatment a week for four weeks.
Twelve total for the induction. Then figure out how long I can go between treatments.
I have no idea whether Spravato is going to help me.
My hopes are not, as they say, up.
But I felt pretty darn content for a hour today.
I’ll take that.
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