Tony: An Internist with Epilepsy

 

In September 1984, Tony was a pre-medical student anxiously awaiting the day he would begin medical school at Georgetown University.  While driving along a congested I-95 along the East Coast, the car immediately ahead swerved and crashed into the median while four lanes of traffic eked onward.  Tony, already equipped with the “helper” mindset that he would hone in medical school, stopped his car and ran to help.  The woman in the driver’s seat of the damaged car was suffering from a generalized tonic-clonic, or grand mal, seizure.

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Tony did his best to ensure the driver’s safety while he waited for emergency personnel to arrive.  Although he didn’t know it at the time, Tony’s first patient was suffering from the same illness that would plague him many years later.

Tony’s life preceding and immediately after his first brush with epilepsy on Interstate 95 was relatively worry-free and picture-perfect.  He grew up in the suburbs of Washington D.C. and was an avid tennis player, skier, and straight-A student.  He attended an esteemed private high school and was quickly admitted to an Ivy League college to continue his education.  While in medical school at Georgetown, he met his wife. Together they moved to Michigan to complete their residency training.

Immediately after completing residency, Tony and his wife found jobs in their respective fields and settled into life in the upper Midwest.  Over the ensuing years, they welcomed three beautiful girls to their family.  Tony and his family remained active and carefree until early in the morning on a winter day in November 2006. Although he does not remember all of the details, Tony recalls waking in the middle of the night with his wife hovering over him and asking him repeatedly if he was OK.  There were also two policemen and paramedics in the room, along with a neighbor sitting next to his bed and watching with concern.

Although Tony’s confusion was profound after his first generalized seizure, by the time he was transferred into the ambulance he had reassumed the physician role and gave advice to the emergency personnel.  The ensuing hospitalization and diagnostic testing led to Tony’s diagnosis of “idiopathic epilepsy” and he began to take the antiepileptic drug Dilantin.

Tony dutifully took his medication for the following year and his seizures disappeared as quickly as they came.  When the medication was weaned one year later, Tony hoped that his experience with epilepsy was a thing of the past.  However, slowly but certainly, smaller, partial seizures marched back into Tony’s life.  He had one in front of a patient, another one month later, and soon he was waking monthly in the middle of the night in the midst of a seizure.

As epilepsy reestablished itself in Tony’s life, further testing revealed a small area of atrophy, or injury, to his left anterior temporal lobe.  Tony and his doctors estimated that the injury most likely occurred years previously when his brain bounced like a ping-pong ball inside his skull after a skiing accident or trauma playing soccer.  Once the atrophic area was identified as a source for Tony’s seizures, he began the arduous process of trying to find a way to stop them.

Tony is currently undergoing evaluation to see if he is a candidate for epilepsy surgery.  He is taking two antiepileptic medications but can list the series of medications that he has tried and failed as if he were reciting a grocery list.

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“Carbamazepine didn’t work and caused horrible constipation,” he said.  “I tried oxcarbamazepine for a few days, and felt like I was stoned without the fun.  Zonisamide didn’t work and caused numbness and tingling in my hands and my feet.”

Tony states that he is currently tolerating phenytoin and levetiracetam relatively well although is emotions are more raw than ever before.  “I don’t know if that’s a medication side effect or epilepsy itself,” he mused.  “Recently my daughters saw me cry for the first time in twenty years.” Tony notes that since his seizures have escalated, his grown daughters have visited more, been in contact more, and are acting increasingly protective of their father. Tony’s wife watches him diligently and protectively.  Moments of silence and contemplation or repetitive movements like scratching his nose now warrant questions from his loved ones about a possible seizure.

Through his experiences with seizures, hospitalizations, testing and medications, Tony finds what’s most frustrating about his epilepsy is how it has changed his perspective of himself.

“My disease conflicts with my inherent personality.  Epilepsy has an incredible ability to change how I feel about myself.”

Throughout his career, Tony has enjoyed tremendous success as a physician.  He has been promoted as a physician leader in his health care system.  He repeatedly achieves the highest quality metrics in the care of his patients.  Despite this, his epilepsy undermines his success and makes him fearful for the future.

“The pride in my profession is the brain and our mental ability. Epilepsy is all about how we can hurt our brains. Being a physician with seizures is kind of like telling a football player you can’t bench press anymore.  How do you teach that person who always been the caregiver and first in line to help suddenly say ‘I need help, I need a hug?’ It’s so hard to say that.”

Despite his setbacks and frustrations, Tony has learned to ask for help and accept his limitations.  He’s recently made the decision to decrease his clinic hours in order to reduce his stress levels.  A former marathoner and triathlete, Tony has also backed off on his training and endurance exercise in the past year.  While he’s made these changes reluctantly, Tony is willing to do whatever it takes.  Like so many of us living with epilepsy, he hopes to once again live without the constant worry of when the next seizure will occur.

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Raising Awareness However I Can

Yesterday I was honored to be a guest on the Joy Cardin Show (listen to the broadcast here) on Wisconsin Public Radio to discuss living with epilepsy and my memoir, The Sacred Disease.  I was surprised by how many people called in to share their experiences with seizures, their hopes for the future, and the subtle ways that epilepsy changed their lives.  I walked away from the broadcast both excited to have participated in another forum to raise awareness and saddened that there are so many people who are touched by seizures in many different ways.

The following is a poem I wrote in effort to describe what it’s like for me to live with epilepsy.  I’m sure those of you who are touched by seizures can relate.  I cope with my uncertainty by writing and speaking out as much as I can.  What helps you?  Please share in the comments below.

Living with epilepsy means that I know the distinctive scent of EEG glue as well as I know the scent of my children.

Living with epilepsy means that I’ve learned how to fall asleep in MRI machines, wait patiently in doctors’ offices, and perform neurological tests without prompting.

Living with epilepsy means that I must not be the “Epileptic Patient” but rather “the patient with epilepsy.” I cannot let the seizures own me.

Living with epilepsy means that even some of my most significant days have been accompanied by seizures: the day I delivered my son, my tenth anniversary, Christmas Day, Thanksgiving.

Living with epilepsy means that when the familiar sensations of a partial seizure appear, I find myself searching for a place to sit away from view in case the simple seizure leads to something more.

Living with epilepsy means hiding my illness under a well-designed shroud, afraid that if others know that I have seizures they will lose their faith and trust in me.

Living with epilepsy means I examine my tongue each morning in the mirror to look for the characteristic bite that’s my sign of a nocturnal seizure.

Living with epilepsy means learning to ignore the staggering fatigue that comes with each new medication trial and medication adjustment.

Living with epilepsy means that I can list almost every anti-seizure medication and its associated side effect profile. I have tried them all.

Living with epilepsy means that I treasure the mundane and hold these things as close as possible, for fear of losing them: driver’s license, health insurance, life insurance.

Living with epilepsy means that I will consent to tests that turn off part of my brain, remain tethered to a wall with an extension cord for up to a week, and consent for removal of my entire temporal lobe in hopes for a cure that still eludes me.

Living with epilepsy means that I have created a handful of euphemisms to describe a seizure: head problem, not right, episode, incident.

Living with epilepsy means I feel compelled to join others like me and look down the long, dark road that I pray may ultimately lead to a cure.

Alex and George: Living a Full Life Despite Seizures

Twin brothers Alex and George share many things.  They share their love for the martial arts.  They both have achieved the level of black belt in tae kwon do.  They also love to ski, both near their home in Wisconsin and on the significantly more challenging slopes of Colorado.

Alex and George also share their diagnoses of epilepsy.

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Alex and George snowshoeing in Colorado

 

 

 

The tale of Alex and George was told to me by their mother, Maureen, who talked with a combination of emotion and pride over the bluetooth phone in her car while she drove her slumbering teenage sons back from vacation in Michigan.  Every so often, a mumbled “hhhmph” of assent or “harrumph” of question emanated from the teenagers in the back of the car.

Maureen started our conversation by making sure that I knew how far her boys had come despite the challenges that they had faced with epilepsy.  “My mother socializes with a large group of women in the Michigan area and she is holding a fundraiser to raise awareness about epilepsy next week,” she said.  “One of the goals of the fundraiser is to show the important and relevant realities of the disease and how it affects the whole family.

“On the invitation to the fundraiser, my mother and I wrote:  Since their diagnoses 10 years ago, George and Alex have taken about as many medications that are available, have had a myriad of tests,  George had intracranial EEG monitoring, and George had brain surgery.

 Despite all that, they are active, funny, engaging teenagers.”

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Alex, Maureen, and George at Pope Farm Park in Madison, WI

Maureen’s journey with epilepsy began on a Christmas ski trip in 2003 when 5 year old twins Alex and George were sitting outside having a snack in between runs down the hill.  While sitting quietly in the afternoon sun, George started acting differently and stopped responding to external stimuli.  By the time his parents realized something was wrong, he succumbed to a generalized seizure.  The ski patrol office was right next to where George collapsed, so he was promptly put in an ambulance an taken to the local hospital, where a CT scan and all diagnostic studies were normal.  George was discharged from the hospital the next day and he returned home with his family seemingly unscathed.

But George continued to have seizures.  He established care with the Children’s Epilepsy program at Children’s Hospital of Phillidephia and was started on tegretol.   When George’s family moved to the Milwaukee area, his care was transferred to the Children’s Hospital of Wisconsin, where his neurologist recommended an evaluation for possible resection of the focus of his seizures.  George had surgery for placement of intracranial electrodes and then was monitored in the epilepsy monitoring unit at Children’s Hospital of Wisconsin.  His seizures were found to originate from the left temporoparietal region of his brain, the same portion of the brain that houses, among many other things, the circuitry needed for speech and language.

“I’m a speech pathologist,” Maureen stated.  “When Dr. Zupanc  told me where George’s seizures were coming from, it was a low point in this journey.  I knew that if they resected that region, he would never fully regain his language again.”

Instead of having a resection of a seizure focus, George had a vagus nerve stimulator (VNS) placed, which has been helpful to reduce the number of seizures.  He still has approximately one to two seizures a week, despite taking three anti-epileptic drugs.  George continues to ski in Snowmass with his family with the help of a program called Challenge Snowmass that pairs a skier with disabilities with a ski buddy.  George clips into the chair lift and uses a climbing harness while skiing to keep him safe in case he would have a seizure while skiing.  George has also achieved a black belt in tae kwon do and enjoys swimming with his family at the beach — though never without a life jacket.

When George and Alex were 7, in the midst of George’s evaluation for possible surgical treatment for his epilepsy, Alex began to complain of intermittent periods where he “couldn’t see.”   The visual complaints were determined to be focal seizures and before long, Alex had his first generalized seizure.  With both children undergoing treatment and evaluation for epilepsy, Maureen felt like she was being pushed to her limits.

Alex’s focal seizures didn’t always generalize, but they often did.  He began having about one to two seizures a week, but his seizures didn’t seem to be progressing as quickly as George’s had.  Because she was now struggling with recurrent seizures in two boys, Maureen decided to put both boys on the ketogenic diet when they were eight years old.  “I was bound not to fail for lack of compliance,” she said, “so I measured every morsel of food for one year.  The worst part of it was the daily grind and the limited repertoire of what we could eat.”

Maureen remembers Alex’s last seizure like it was yesterday.  “I took Alex to Michigan in December for a holiday music performance and he had last seizure in the lobby of the Interlochen Music School Auditorium.  After that, we were able to sit down and enjoy the performance.”  Not long after that, Alex stopped the ketogenic diet and was switched to Depakote.  Alex has been on the same dose of Depakote for the past seven years and has not had a seizure since.  His EEG his still active, but his clinical seizures have stopped.

Maureen has realized that raising two boys with epilepsy has not only changed her perspective about seizures, but molded her view of life in general.  For better or for worse, she’s gotten used to watching her sons’ seizures and supporting them through them.  “I’ve seen George have 95% of his seizures.  After the initial panic is over, I’m the one consoling everyone else.  I’ve seen it before and I’m used to it.  George had a seizure on the first day of middle school and the case manager was a wreck.  I was the one that had to calm her down.”

And having Epilepsy as an additional family member has also given Maureen and her family a chance to appreciate the simple things and celebrate the small successes.  She reflected, “It’s pretty easy to get bogged down in the worry about the future.  Every parent gets worried about their kids.  It’s 1000 times worse when you have a child with a medical problem or some sort of special needs.  But, you need to look at every day and the success of each day and see that they accumulate and trust they’ll find their way in the world.”

When I asked Maureen how she’s managed with a life of uncertainty, she replied, “You have to take every day and prepare for the worst, and hope for the best.  It’s a balance between worrying about what’s going to happen and being thankful for every good day that we have.”

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Alex at Cascade Mountain, Wisconsin

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George at the UW arboretum

Lisa, Bear, and a lifetime of miracles

Lisa was accustomed to giving birth to big babies.

Her first child was a robust 9# 5 oz at the time of delivery.  Her second child was a strapping 11# 8 oz by the time she met the world.  But when her third child, Bear, was born, he weighed 12# 11 ounces just prior to his descent down the birth canal.  Because Bear was such a big baby, a relatively common but potentially dangerous complication occured during his delivery that would affect his life forever.  His fleshy shoulder became lodged against his mother’s pelvic bone.  Although Bear’s infant circulation separated from his mother’s as the birthing process happened, his body could not get out to receive his first life-giving breaths.

When Lisa’s obstetrician determined that a vaginal delivery was not possible, the pair was rushed to Cesaerean section.  Within moments, Bear was extracted from his mother’s womb — limp, blue, and already showing evidence of seizure activity.  The neonatal team present in the delivery room performed CPR, administered medications, and resuscitated Bear for twenty minutes.  Lisa, a nurse in the neonatal intensive care unit herself, remembers that at one point the neonatalogist who was guiding Bear’s resuscitation consisdered “calling it,” and letting Bear slip away.  Yet, with the determination and strength that Bear would display throughout his life, the pediatrics team was able to regain a steady heart beat after 20 minutes of resuscitation.  This was the first of a lifetime of miracles.

Although Bear was safely outside of his mother, his neurologic prognosis was grim.  After his birth, Bear was placed in a drug-induced coma to quell further seizures.  As the medications were lifted, he was noted to have low muscle tone, decreased reflexes, and absence of a suck/swallow reflex.  A tube was placed in his stomach to provide nutrition and later he had a more permanent gastrostomy tube placed.  Bear was hospitalized for the first six weeks of his life.  He left with a diagnosis of “severe hypoxic ischemic encephalopathy” related to birth trauma and a future that was uncertain.

“Bear became everyone’s baby,” Lisa remembers.  Her father, a surgeon, and her mother, a nurse, babysat frequently and helped care for him when needed.  Other family members and friends helped pitch in to give rides to the doctor or hospital if needed.  Everyone cheered when Bear met each of his developmental milestones — although later than typically developing children — one by one.

When Bear was three, he had his first generalized seizure.  Because the seizure was prolonged, Bear had an evaluation for infection in the emergency room after the seizure.  He was not officially diagnosed with epilepsy, however, until after he had another generalized seizure approximately a year later.  Bear was started on Tegretol for control of his seizures.

Soon after Bear’s official diagnosis of epilepsy, he started participating in school.  The aide that was assigned to work one-on-one with him noted other subtle seizure activity throughout the day.  Repetitive chewing on a sleeve, staring off into space, and smacking of lips were determined to be seizures.  Keppra was added and Bear’s seizure activity decreased.

Since Bear’s diagnosis with epilepsy, Lisa has learned to identify the triggers for his seizures.  She’s recognized that sickness is a trigger, fatigue is a trigger, and abrupt changes in schedule are a trigger.  She also realizes that Bear is constantly at risk, since he attends schools where viral illnesses are a constant reality.  As a result, Lisa reports that she is “constantly checking on him” to make sure that Bear is OK and “someone is always with him.”  Lisa states that Bear was invited to some friends’ houses in the past for play dates after school.  Once she explained to the other parents Bear’s history of seizures, he wasn’t invited back.

 

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In many ways, Bear is the living example of a miracle.  He has gone from a small infant who almost didn’t survive neonatal resuscitation to a strapping young man who likes to bike, run, and play with his siblings.  He evolved from a baby without a suck/swallow reflex to a toddler with a G-tube to a boy who eats everything in sight.  Yet Bear is still susceptible to a multitude of seizures that can ruin a day, a week, a lifetime.  In so many ways, Bear is miraculous, yet a cure for seizures sometimes even alludes those who have obtained the unobtainable.

In Lisa’s words, “epilepsy is like an intruder in our house with a gun.  You never know when it’s going to go off, and you never know how it’s going to affect you.”

Please pass it on.

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Guest Post: A Wilderness for Aidan

Not long ago, I received an email from a father of a little boy with epilepsy that caught my eye:

 I just discovered your blog. As father of a young boy fighting devastating epilepsy and a brother of an adult sister who has spent her entire life fighting seizures, thank you. I would be interested in writing a blog about taking our son on his first backpacking trip in the Montana wilderness, in spite of his intractable seizure disorder.

I replied to Mr. Long’s email and very soon after received the most touching description of what it’s like to parent a child with epilepsy that I’ve ever read.  I hope you will enjoy the following post as much as I did.

A Wilderness for Aidan

By Ben Long

Growing up in Montana should mean growing up out of doors. Instead, too much of our young son’s life has been spent inside, looking out the sealed windows of hospitals.

In 2004, my wife, Karen, and I had a boy, our first child. We took him camping trip at four months. A challenge in those days was changing a diaper by flashlight in a tent when it was below freezing.

Aidan grew up smart and curious and fun loving, with no sign of health problems beyond the hay fever he inherited from me.  We camped, hiked, skied and canoed because, in our family, being outdoors is what we do.

I particularly love hiking overnight into the backcountry. When I was growing up, my dad took me backpacking every summer. Even before Aidan was born I started planning his first overnight hike.

Stanton Evening reflection low rez

But those plans were shattered on Oct. 28, 2008, when Aidan was 4. Aidan tipped off a kitchen stool and slammed into the floor, his lips blue and a trickle of blood from the corner of his mouth. I thought he had choked on something and called 911, but the ER doctor said Aidan had suffered a seizure.

It was the first of many seizures, and many hospitalizations. There are no pediatric neurologists, let alone epileptologists, in Montana. So in search of answers we traveled to Seattle, then to specialists at Denver, Cleveland and Chicago.

Aidan’s epilepsy defies labels as it defies treatments. We’ve failed a dozen medications, have spent three years on the ketogenic diet, and invested in several nontraditional treatments. The disorder seems particularly cruel in that Aidan thrived so in his early years. His smart little brain seems at war with itself.

Aidan has several forms of seizures. They come at different times, different severities, seemingly without pattern.  Aidan is also prone to bouts of ‘non-convulsive status epilepticus’ – which essentially means non-stop seizures that are invisible but render him immobile for days, even weeks at a time.

Because of these status events, Aidan has been life-flighted from our Montana town to urban hospitals five times between age 4 and 7. Aidan has spent month after month in intensive care units, scalp wired to EEG electrodes and receiving drugs and fluids intravenously through a PICC line in his armpit.

In one of the last extended hospital stays, the doctors tried to get control of the seizures by dropping Aidan into a medically induced coma. This went poorly. Aidan’s muscles shriveled before our eyes as he lay motionless day after day, fed through a tube up his nose, breathing with hose down his throat. Finally, when he had pneumonia in all four lobes of the lungs, the doctors called the brutal experiment to an end. Seizures, if anything, were worse than ever, as was our sense of helplessness.

The hospital sent us home with the phone number of the local hospice and a pamphlet on “letting go.”  We wheeled Aidan out of the hospital in a borrowed wheelchair, and took him home to learn to walk and talk again.

That was two years ago.

The seizures come in waves and have taken a tremendous toll on Aidan, yet he is still the same, remarkable child as a young boy as he was as a toddler. He still loves to listen to books and then act out the parts. He loves Legos, building castles and spaceships. But the seizures and drugs leave him exhausted, blunted, battered and frustrated.

We have lost a tremendous amount, but to me, the worst loss is the sparkle in Aidan’s eyes. That sparkle was once a part of every waking moment; now it’s only there on his better days.

One evening during one of Aidan’s better periods, Karen and I spoke of things we still wanted to do. I said I still wanted to take Aidan backpacking. She insisted we do so.

 KMN and Aidan Stanton Lake low rez

It was the shortest hike we’ve done, but also carefully planned. We wanted to get away into true wilderness – no cars, machines, cell phones — just a million acres of pristine nature. Yet we had to be cautious. If disaster struck, I wanted to be able to throw Aidan over my shoulder and carry him back to the truck.

We picked a lake two miles from the road in the Great Bear Wilderness. As it turned out, it was in the shadow of Great Northern Mountain, a peak Karen and I had climbed on our first hike together exactly 20 years before.

We pulled our gear out of storage, shook out the dust and stuffed our backpacks full.  The night before we departed, I lay awake wondering if the entire idea was a vain, dangerous mistake.

Would the hike stress Aidan’s physiology?  Would excitement or lack of sleep trigger another bout of status?

In the morning, we decided to go for it. We loaded our packs (Aidan carrying his lunch, some water and his favorite stuffed monkey) and hiked into the forest.

The packs were heavy and my muscles unused to carrying a load up a mountain trail. But the lake was beautiful and we enjoyed it in solitude, loafing, fishing and watching the shadows give shape and form to Great Northern.

“Dad?” Aidan asked as I pitched the tent, “can I watch Netflix on the iPad?”

“Sorry buddy. I didn’t pack it and it wouldn’t work here anyway.”

Instead, we piled up rocks on shore and caught and released little trout. The evening was long and mild. In the morning, after sleeping snuggled in the little pup tent, Aidan danced the happy camper dance around the campsite.

Aidan tent 2 copy low rez

Part of what I like about backpacking is the physical challenge. It teaches one to endure burden, to walk through pain. The strain can be great, but at the end of the trail you shed the heavy pack and feel lighter than air as you enjoy your destination.

Epilepsy, for our family, isn’t like that.  We are learning to bear pain, to carry a burden of broken dreams. But the destination is so far beyond our reach.  The best we can do is reach out to family and friends to share the burden, share the rugged path Aidan is on.

We still believe in a day when children like Aidan and families like ours can leave this burden behind and more fully enjoy the beauty of the world around us.

That’s why we support Citizens United for Research in Epilepsy and the Doose Syndrome Epilepsy Alliance.  We hope you will too.

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morning camp dance

Please pass it on.

Brent, a Notebook, and the Power of Family

I was supposed to meet Brent for lunch last week so he could share his story about living with epilepsy for the One in Twenty Six blog.  We were both looking forward to meeting at 1:00 in the afternoon.  Then, at 11:49, Brent sent me this email:

I have I Kristin I now no to that no now that no no hard not met need new

Confused, I sat at the spot where I was working at my kitchen table and wondered.  Brent was normally articulate and brief in his email exchanges.  Was this a new creative spam email or some type of virus?  Or was Brent playing a joke on me?  Worse yet, was something wrong?

I got my answer a few minutes later.  In an email that I later learned was written by a co-worker, Brent explained his previous scattered message:

I have to cancel our meeting today at 1pm – just had a seizure and am going home.

My heart sank.  I knew that Brent continued to struggle with partial seizures and grand mal seizures despite taking several different anti epilepsy medications.  He had had a grand mal seizure at his office, where he works in internet marketing at a telecommunications company.  Unfortunately, events like this were not unusual for him.

When Brent and I were finally able to meet this week, he brought two notebooks with him.  One notebook was filled with notes detailing his experiences with epilepsy, the other notebook was filled with lists and notes that Brent’s wife and family members used to help re-train his memory and teach him to speak again after his left temporal lobe surgery in 2009.  The second notebook sent a chill up my spine.  I could see Brent cringe and his eyes well with tears and he flipped through the pages filled with notes from a different era.

Words were written in big, block letters with just a trace of feminine curvature in crisp blue ink on page after page.  One of the early pages was titled “YOUR FAMILY –>”  and followed by a list of the family members and animals that lived in Brent’s home.  Another page was adorned with a life-sized sketch of a human hand and labels pointing to different parts of the hand.  Arrows pointed out “Knuckles.”  “Fingernail.”  “Palm.”  Another page of Brent’s notebook strayed from the business-like block letter approach and was decorated with a thick bubble-letter message from a devoted wife.  “Julie loves you.  Brent is awesome.”

wife-and-no-skull

Brent showed me one of the last pages of his notebook with averted eyes and said, “you can read this.  I can’t read it or I’ll get upset.  It’s a promise I made to myself when I was in the hospital after my brain surgery.”

Touched that he would share this with me, I read a message written in shaky handwriting.

Brent, you’re f****ed up.  You’re sick now but you’re going to get better.  

One day soon you’re going to get out of this place and you’ll be able to ride a motorcycle again!!!

I looked at Brent after I finished reading and felt the disappointment brewing deep from within.

“This upsets me because I still haven’t fulfilled my promise,” he said.  “But I still hope I will some day.”  Because of his persistent seizures, Brent’s primary mode of transportation around town has been via bicycle or with his wife, parents or other family members who live nearby.  Brent is quick to point out that he is lucky to have parents, a sister, a wife, and friends who help him with transportation and help him when epilepsy strikes, but he longs for the day that independence will be his again.

When Brent describes his history with epilepsy, he always begins with the year before the seizures began.  “The period from 2006 – 2007 was the best time of my life,” he proclaims, as a smile dances across his lips and his eyes glaze over with pleasant memories.  “I married my wonderful wife, Julie, in 2006 and in 2007 and I won a national award for online journalism in the Outstanding Use of Digital Media.  In 2007, Julie and I bought a 1988 van and put a futon in the back and drove to Yellowstone National Park for our honeymoon.  We had a fantastic time.

“On New Year’s Eve 2007, Julie and I were in Florida and we were planning on going to the Outback Bowl the following day.  Out of the blue, I felt horrible — no, worse than horrible.  I sat with my head in my hands the whole time at the Outback Bowl because I felt so bad.”

Brent and Julie flew back to Wisconsin and later that week Brent saw his doctor and he was diagnosed with the “stomach flu.”  Several days later, Brent and Julie were at home when Julie heard a thump and found Brent splayed out on the floor having a tonic clonic seizure.  When Brent was taken to the hospital that night, he had recurrent generalized seizures with almost no break in between. A spinal tap confirmed the diagnosis of viral encephalitis.  “I felt like I was dying that night,”  he remembers.  Although the details of that long night are murky in Brent’s memory, he remembers waking up in between every seizure, looking his wife in the eyes and telling her that he was dying but he loved her.

Brent states that the infectious disease physician on call that evening told his wife that he had a 50% chance of living through the illness.

Despite the dire predictions, Brent was discharged from the hospital three days later.  On the way home from the hospital, Brent convinced his wife and his friend that he’d like to stop for food.  Not long after they sat down to enjoy some chicken pot pie (“which will forever be known in my family as seizure-pot-pie,” Brent states with a smirk) he succumbed to a seizure and was promptly brought back to the hospital.  And so began the litany of hospitalizations and emergency room visits, medication trials and switches, and a life pock-marked by epilepsy.

As a way to cope with uncertainty, Brent has developed a healthy sense of humor about epilepsy.  At the end of our time together, Brent listed his “best seizures” by finding something memorable in some of the most fearful moments of our lives:

  • “Once I had a grand mal seizure at a movie theater just before my wife and I were able to go to the movie.  We got our money back.  I thought that was pretty awesome.”
  • “I had a seizure at a furniture store and ended up buying the couch that I fell on.  As I woke up, the salesman was blessing me as if I had demons.”
  • “One time I had a generalized seizure at Brat Fest in Madison (a big festival where thousands of people come and eat bratwurst.)  My friends were with me and formed a protective circle around me so no one would see or could get near me and waited for the seizure to end.  I was pretty touched by that.”
  • “I had a seizure at PDQ once and someone stole my phone when I was unconscious.  That still makes me mad to this day.”

Through his frustration, Brent continues to find a positive spin on his life with epilepsy.  “It’s made Julie and I grow closer, it’s given me perspective about the things that really matter.  I don’t get worked up about the little things any more.  I  have tremendous support from my wife, my family, my employer, and friends.  I couldn’t have done this without them.”

Brent sent me one last email last night that I think sums his perspective up perfectly:

” I always want to tell all the others out there with epilepsy or any other challenges, as much as you think your future has failed it hasn’t. People will surprise you and I don’t think things happen randomly for a reason but I do believe things do happen for a reason.”

I believe Brent will keep his promise to himself and ride a motorcycle again some day.

All in good time.

Please pass it on.

brain-cake

Brent’s co-workers made him a brain cake before his brain surgery

brent-julie-dog-day

Brent and Julie have established a dog wash and fundraiser for CURE called “Dog Days” that has raised over $8000 for epilepsy research!

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Brent’s first day walking around Madison after a long period of depression and despair after epilepsy surgery felt like he was “coming out of the darkness.”

Christine

I have known Christine for what feels like a long time.  Our children, who are now eight years old, used to attend preschool together.  I saw Christine at various birthday parties, classroom celebrations, and milestone events over the course of three years when my son and her daughter spent their days at the bright, angular school with halls filled with the music of children that buzzed with laughter and joy.

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Even though I’ve had countless conversations with Christine at parties and preschool events, it wasn’t until I posted the first entry to One In Twenty Six revealing “My Story” that I heard about her history of seizures.  Christine posted a comment on the blog and wrote, “. . .while I have not had a seizure in over 15 years, my middle-, high school, and early college years were plagued by them. Monitoring sleep, food intake, and stress levels are just second nature now, but auras are always scary reminders that there’s a sleeping electrical storm that could break at any time.”  Christine states that the week she saw the post, she was drawn to reading the blog because she recently had an interaction with her colleagues at the University of Wisconsin, where she teaches technical writing.

After hearing a colleague recount a story where he suddenly lost consciousness and fell off his bicycle, Christine suggested that he should be evaluated for possible seizures.  When the colleague scoffed, Christine pressed on, adding that she had an intimate knowledge of how unpredictable and variable seizures can be, since she had lived with epilepsy for many of her adolescent and adult years.

Christine shared her story with me while we had breakfast on a grey Monday morning that promised only more cold, slush, and snow. “After I told the group about my history of epilepsy, the room suddenly became silent,” Christine remembered, the irritation visible in the smoldering fire of her dilating pupil.  “No one knew what to say. The stigma associated with seizures is still very much there,” she said.  ” Something’s got to change.”

Christine’s journey with epilepsy began when she was an active middle school student at a parochial school in northern Michigan.  Never one to be idle, she was involved in a myriad activities and pushed her body to the limit.  Christine first noticed events where she felt an overwhelming sense of sleepiness that she couldn’t shake even if she was able to get adequate rest.  Then she started to notice paroxysms of involuntary movement of her right hand, evidenced by sudden streaks of irregular writing across her papers at school where her hand jerked out of voluntary control and was suddenly guided by the brewing electrical currents within.  Eventually, when Christine was working her hardest to help prepare for the middle school graduation ceremony, she succumbed to a grand mal seizure.  Her diagnosis of epilepsy ensued and she began treatment with Tegretol.

Christine reports that once she started and increased the dose of her antiepileptic medication, she went from being a straight-A student to “sleeping through a year of high school.”  She was no longer able to participate in a variety of activities because the medication side-effects were too great.  Her grades suffered significantly as well.

After muddling through a sleepy 18 months on Tegretol, Christine was switched to Depakote, which allowed for fewer side effects and better seizure control.  She noticed that she had to exercise almost all the time to avoid gaining weight while taking Depakote. Early in the initiation of Depakote therapy, Christine was warned by her physician that while she was on antiepileptic medication, the risks of potential birth defects would likely preclude her from ever having children.  Too young to worry about it too much at the time, Christine took her medication every morning with hope in her heart that her seizures would one day be a part of the past.

In some ways, Christine got her wish. When she went years without seizures or auras in college, she talked to her neurologist about weaning off Depakote.  She was able to become free of medications before she became pregnant and delivered her first child.  Emmy was perfect, with sandy blond hair, chocolate brown eyes and an expressive smile that could light up the darkest room.  Her daughter’s life seemed unmarred by her mother’s history of seizures.

Then when Emmy was three, Christine and Emmy were walking out of the library together one spring afternoon.  They were smiling at the warming sun and looking forward to the day they would enjoy together.  Suddenly, Emmy’s hand slipped out of Christine’s hand.  Christine turned around and found her daughter spread out, quaking, unconscious, and helpless on the sidewalk.  Knowing that she needed help, Christine had no choice but to leave her daughter alone for a moment while she ran inside to call for an ambulance.

Emmy’s seizure was not associated with a fever or an illness or any of the typical culprits that may lead to benign seizures in children.  In discussion with Emmy’s physicians about use of possible antiepileptic medications to prevent future seizures, Christine states that she was “appalled to find that many of medications that we use in children today are very same with the debilitating side effects that were used for me twenty years ago.”  Currently, Emmy is not on any medications and is doing well, but Christine reports she lives in fear of the day that things may change for both of them.

Christine describes her experience as having a “brush with epilepsy” and states that she has been fortunate to not have seizures and medications affect her everyday life.  Still, while the grey changed to silver outside on a Wisconsin Monday morning, I could see slivers of how a history of seizures and years of mind-numbing medication can haunt you like a ghost forever.  Christine admits that she still monitors her sleep and stress levels diligently.  While she used to be “on the path where she needed to be in control of everything,” now she has learned to let things slide.  She also admits that she dreads the hormonal changes in life more than most women.  Where puberty and menopause are headaches to some, they may mean resurgence of seizures to women like Christine and Emmy.

Christine looks forward to the day when she can talk about epilepsy in a room full of colleagues and not be met with awkward silence.  The more we talk, the more we understand.  Please pass it on.

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Photo source: http://the-second-half-of-my-life.com/2010/09/16/mothers-daughters-9/