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t m c » p u l s e | a p r i l 2 0 1 7 13 "It's not one single thing ECT does that is helping psychiatric patients," Livingston said. "It is a combination of all of these things, and that is why it is our gold standard for neurostimulation treatments." The ECT program at Ben Taub performs dozens of treatments every week—on Mondays, Wednesdays and Fridays. Prior to a treatment, patients are given a muscle relaxant and general anesthesia. Once the patient arrives in the operating room, the care team ensures the patient is comfortable and sedated before initiating the shock. The shock results in two seizures—one in the brain and one in the body. The seizure produced in the body is only visible in the patient's left foot, where it is monitored by the doctor. The procedure itself does not take that long, but due to the use of general anesthesia, patients require time before and after to recover. "I'm normal now" While ECT is an effective treatment for patients suffering from treatment- resistant depression, it does not work for everyone and it cannot be adminis- tered to patients without their informed consent. In Texas, a patient must give their own consent for each ECT treatment they receive. Family members, guard- ians and doctors cannot give consent for the patient. "Texas has some of the strictest laws regarding ECT in the nation," Livingston said. "ECT has had proven success in patients suffering from severe depression, and I believe it could help many patients with bipolar disorder and schizophrenia. This can be a barrier if a person is not capable of giving their consent." Livingston is well aware of the neg- ative stigma attached to ECT, mostly The Thymatron System IV records the brain's reaction to ECT treatment. because of its depiction in films like One Flew Over the Cuckoo's Nest. "For a long time, ECT was seen as a very cruel treatment," Livingston said. "When it came out in the 1930s and '40s, there was no anesthesia, so people's bones would break from the jolt. But that is not the case now. It is very safe and effective." Today, because of the success of her ECT treatments, Rodriguez said she is enjoying life for the first time. "I'm normal now," she said. "I walk my dogs every morning. I get up and make breakfast, see my grandkids—I'm just active all day. I make friendship bracelets for my nieces, teach my grandson how to do art. Last fall, I took my first flight to Chicago for a family reunion and I was a little scared, but I made it and it was okay." Rodriguez receives maintenance ECT treatments once every six weeks. She also sees her therapist once a month, in addition to taking antidepressants. "I recommend ECT to people that are in really bad shape, because it really helps," Rodriguez said. "I tell them it's a choice they have to make themselves, and they really need to see a therapist and a psychologist to really decide what they need to do. But I recommend it to anyone that is really trying to feel bet- ter. … It's a life-changing experience." For a long time, ECT was seen as a very cruel treatment. When it came out in the 1930s and '40s, there was no anesthesia, so people's bones would break from the jolt. But that is not the case now. It is very safe and eective. — ROBIN LIVINGSTON, M.D. Medical director of electroconvulsive therapy services at Ben Taub Hospital