u/TravelSeparate3353

I'm posting this since I'll be going into my usual weekday sessions tomorrow (other than July 3rd) so anything folks can suggest that I should bring up to my TMS team and psychiatrist I'd like to hear now. And suggestions in general for this fatigue. I'm not upset it's a thing, I'm just annoyed that it's been going on for this long now. I'm at 120% by the way and that's been the case ever since the 8th or 9th session I believe.

I started my new job on June 15th and it's a full-time career track job where I work from 7 AM to 3:30 PM in the office and have one remote day a week too. Others in my post 8 days ago did mention how starting a new job is stressful, but this has been the opposite given how slow onboarding has gone for me, mostly due to the bureaucratic elements of getting tech requests resolved and a slew of issues with online systems not working on the system side of things properly until this past Friday. Even going into this week, I need to get my office phone number working since I need to legally use it to get information I need from certain hospitals. I've had a ton of unexpected free time as a result given how I'm a step removed at every corner so far it seems.

I also do my TMS sessions at 4 PM after work since that's the latest they could do for me. It doesn't hurt nearly as much as it used to thankfully, even though I slept a ton this weekend and ate meals too. I used to power nap for 30 minutes when I got back from my old job and was in my bedroom around 5:30 PM to 6 PM. However, even when I tried those so I could to bed by 9 PM at the latest, they weren't enough after the intensity reached 120.

Does this mean I'm responding as I should to TMS? What can I do to mitigate this fatigue? I'm going to ask tomorrow if the plan is to go 30 or 36 sessions with me before I'm discharged since they never told me the session maximum they're aiming for here. I was hoping to get it wrapped up at the end of next week since that's when I resume neurological rehabilitation and when I expect my workload to increase too.

After I send this post, I'm going to sleep for a bit because I feel awful even after I had a full lunch about an hour ago. I'm glad I got food in my stomach since it's supposed to help with the side effects, but I felt tired as soon as I got home with my food. I completed my 17th TMS session yesterday and it was my 8th session at the full 120% intensity. I'm going to meet with the psychiatrist overseeing my treatment plan this coming Monday after work. It's worth noting that I do my TMS sessions 30 minutes after work and I started my recent full-time job this past week.

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How long is it until fatigue isn't an issue? I know there likely won't be a universal timeline at all and if there's anything else you all need to know then I'll answer them the best I can.

I'm posting because I have orientation day for my new job on June 15th working for my home state of Ohio. I'm currently on MAGI Medicaid and have previously been concerned about when it'll expire after my first paycheck for this new full-time job given that I'm through pre-approved TMS treatments that are fully covered. If my current MAGI Medicaid expires at the end of July then I'm not worried because my last week of TMS will be the second week of July. I also got my regular PCP appointment done for refills last week so I'm topped off on medications.

I recently learned about the Medicaid Buy-In Plan that Ohio offers those who are about to work full-time and have been on Medicaid prior to starting their new job where they'd normally lose Medicaid. The point of that program is to address the loophole that certain full-time incomes aren't good (usually $40k to $50k a year) because they aren't eligible for Medicaid and will pay full price for certain health plans because their income isn't low enough to qualify even if it still isn't affordable.

My starting income is going to be $30.82 an hour. There will be a 3% pay increase for unionized employees like myself and then after 6 months I'll go up to Step 2. My probationary period is 365 days. It's worth noting that I have multiple neurodivergent conditions (ASD level 1, ADHD-I, and dyspraxia) and many debilitating mental health conditions, albeit not enough to the point I'd qualify for disability. A big part of the Medicaid Buy-In that I'm concerned about other than my income being too high is whether I'm disabled under the SSA's definition since that's a requirement. I also don't need assisted living. Function wise I have what's known as a "spiky profile" where I have exceptional skills in certain areas and debilitating lack of skills or issues in other areas. Mine's emotion control and I'm trying to get a hang of it now even though said issues never affected my professional life at all. Instead, personal and online reputation, which doesn't mean much since it usually never creeps into a profession.

So, am I potentially eligible? Is there anything that would affect my eligibility that I can address?

I'm going through TMS right now and completed a session earlier this morning after my mapping session on May 20th. If we count that mapping session it's the 8th one as of now. I realize that not everyone will be able to answer all of them but answers to some of them would be helpful.

1.) I've unfortunately relapsed into taking a lot of caffeine tablets again the week before TMS started for me. It wasn't due to the anxiety about it, but that I got a new job offer and I was up early in the day finishing a lot of the paperwork side of things and tried to get used to getting up earlier given that 7 AM to 3 PM is an option for a range of hours I can work when my new job starts on June 15th (this will be important later). I take about 800 mg at most each day and stop there once I can feel myself trembling a bit. I've read mixed findings on caffeine affecting TMS effectiveness. Is this true?

2.) I got up to 110 as of today. I read that 120 is the ideal number and that it'll be what comes out over the last couple of weeks of TMS (until the end of the first week of July since I'm going through a full course). It still feels like I'm getting stabbed behind my left eyeball but it's becoming less and less painful and feeling like fullness the more it goes on. How should I mitigate the fatigue going forward? If I can get a 7 AM to 3 PM schedule at the start of my new job then I'll schedule a 4 PM session so I can rest off the fatigue then.

Mood swings as well? The latter was sadly responsible for me swearing at my mother (I've had lifelong emotion control issues) and a discussion about moving out at some point, which isn't any time soon thankfully. This leads into the third point.

3.) I will get new health insurance from this new job that will kick in on July 1st. However, my state has a Medicaid Buy-In option and I submitted a form about an hour ago to see if I qualify at all and what's involved in the process since there aren't many specifics online. I'm trying to look into disabled housing in particular as I'm AuDHD among my other disabilities, mental health conditions (e.g., PTSD), etc. I'll probably be well over the 250% of the poverty line for monthly income but I felt I'd give it a shot.

If I manage to keep my Medicaid going into July via the Buy-In, will that mean Medicaid will still cover my last 5 sessions in July? That's a big one for me.

I'm going through TMS right now and completed a session earlier this morning after my mapping session on May 20th. If we count that mapping session it's the 8th one as of now. I realize that not everyone will be able to answer all of them but answers to some of them would be helpful.

1.) I've unfortunately relapsed into taking a lot of caffeine tablets again the week before TMS started for me. It wasn't due to the anxiety about it, but that I got a new job offer and I was up early in the day finishing a lot of the paperwork side of things and tried to get used to getting up earlier given that 7 AM to 3 PM is an option for a range of hours I can work when my new job starts on June 15th (this will be important later). I take about 800 mg at most each day and stop there once I can feel myself trembling a bit. I've read mixed findings on caffeine affecting TMS effectiveness. Is this true?

2.) I got up to 110 as of today. I read that 120 is the ideal number and that it'll be what comes out over the last couple of weeks of TMS (until the end of the first week of July since I'm going through a full course). It still feels like I'm getting stabbed behind my left eyeball but it's becoming less and less painful and feeling like fullness the more it goes on. How should I mitigate the fatigue going forward? If I can get a 7 AM to 3 PM schedule at the start of my new job then I'll schedule a 4 PM session so I can rest off the fatigue then.

Mood swings as well? The latter was sadly responsible for me swearing at my mother (I've had lifelong emotion control issues) and a discussion about moving out at some point, which isn't any time soon thankfully. This leads into the third point.

3.) I will get new health insurance from this new job that will kick in on July 1st. However, my state has a Medicaid Buy-In option and I submitted a form about an hour ago to see if I qualify at all and what's involved in the process since there aren't many specifics online. I'm trying to look into disabled housing in particular as I'm AuDHD among my other disabilities, mental health conditions (e.g., PTSD), etc. I'll probably be well over the 250% of the poverty line for monthly income but I felt I'd give it a shot.

If I manage to keep my Medicaid going into July via the Buy-In, will that mean Medicaid will still cover my last 5 sessions in July? That's a big one for me.