Thursday, November 16, 2017

All these strands of love

I was writing someone an email, trying to describe and explain how this journey has been, and now I feel the need to share with y'all what I said about you:

The past two (and a bit) years have been the hardest of my life.

I don't believe in a sentient universe, but if I did I would be asking it what the hell I've done to deserve how shitty the last two years have been. My illness, the doctors, tests, hospitals, meds, seizures, feeling shitty ALL the time, exhausted ALL the time, sad ALL the time. and scared.... so afraid.  Never knowing if or when things will get better, if or when I might have a seizure today or in public or at work (again). What it might do to my life over the long term. Not being able to drive. Not being able to work. Not being able to fucking buy groceries. My income dropping off to virtually zero, for months. Getting suicidal (repeatedly). Spending days/weeks in bed, crying. And The Flood, and being displaced, and having to move (twice), and my rent going up right when my income was dropping off and I wasn't working and wasn't driving. More hospital visits, more ambulances, more tests, more meds. I'm the crazy girl crying on public transit and then fixing her make-up in the bathroom at work, trying to hold things together. Then I go from not working to working seven days/week just to get my income back on track, and spinning my wheels because my business is stagnating, and stressing every. fucking. month. about how I'm going to pay my rent. (and this week my car broke down and I can't afford to fix it... so I'm back to transit...)


And in all of that, there are only two things keeping me from going completely off the rails:
- my own inner strength, which is currently at an all time low
- my friends and family. I've lost some in the process. Some of them have blatantly abandoned me. But the rest have been amazing. They have gone with me to the hospital and in the ambulance. They have driven me to the grocery store. They have come when I asked for company. They have had me over for dinner. They have gone with me to the forest. They have comforted me when I'm sad. They've taken me for coffee, and given me business advice. They have helped me financially. They have inspired me. They have followed my blog and given me so much support and walked with me for the past two years and told me that I'm strong and that I can do this. Right now, at this time, it's mostly one-sided. I have nothing to give them right now. I need them to hold me up, and they are doing it, and I'm so incredibly grateful to them. This is all new to me. Before this I was always so independent and strong; I never needed anyone else (I thought). I always took care of myself. I have had to learn how to ask for help, and how to accept it when offered. I've had to learn how to be vulnerable, and my community has wrapped me up and held me together with all of these strands of love. 

Thank you. 

Sunday, November 5, 2017

Victim Mode?

Recently I have been dealing with a situation where another professional has been treating one of my clients poorly and she had asked me to talk to him on her behalf. I spoke with him on the phone last week and he treated me just as poorly, to the point of attempting to bully and intimidate me over the phone; when that did not work, he hung up on me.

I went to my regional manager to discuss it with him and get his insight because he knows the person in question. He let me know that the person has been diagnosed with a terminal illness--and while that does not excuse treating people badly, it may explain some of the behaviours.

I let that sink in for a few minutes, and I felt some of my anger soften. And yet I know that we all choose our response to the things that happen to us. I said, "but I have a chronic illness, and so does [another leader in our company] and we don't take it out on everyone else." He responded, "and that's what makes you good people."

Granted, my illness is chronic, not terminal. It's not going to kill me (not statistically, at least... there is something called SUDEP but that's highly unlikely). 

Regarding our responses to what happens to us:

If anything, my illness has made me more empathetic to the plight of others, not less. I didn't get it before. I didn't understand illness before. I had always been healthy. I didn't know what it was like to always feel shitty and sick and exhausted, and yet still have to find a way to function. I didn't know what it was like feel betrayed by your own body. I didn't know what it was like to live with deep depression. Now people ask me "how are you?" and I never know how to answer them; my standard answer is, "It depends on the day."

And so it mystifies me when I see memes on facebook that pit one illness against another, like the one someone posted yesterday, which created an argument where one person's friends started attacking another because in their minds diabetes deserves public funding but addictions don't. And the vitriol that came out of that thread, and the personal attacks that were completely uncalled for, just like the bullying of the man I talked about before--it might be explained by the shitty situation a person is in, but it can't be justified. Going through a bad situation does not justify treating others around us like shit. My experience with one illness doesn't negate the experience of people with other illnesses.

Where's the empathy? I'm so absolutely, incredibly grateful for the care I've received for my epilepsy; why would I want to deny that care for ANY other illness, just because it's different from mine?

And whether I have a terminal illness or a chronic illness or I am perfectly healthy for the rest of my life, why waste ANY of my energy on this earth in victim mode?

I mean sure, I've had my share of "feel sorry for myself" days. But I can't stay there all the time. It is what it is; eventually I have to accept it and move forward. Taking it out on other people doesn't make anything better, only worse. The best thing I can do is focus on making myself better (as much as possible and realistic) and giving the rest away. I wouldn't deny anyone else the opportunity to do the same.

Monday, October 9, 2017

Adapting...?

It's been a month since we started increasing the Topamax from 200mg to 300mg. It was a 25mg increase each week for 4 weeks, so the increase just finished a little over a week ago. Overall it went well. I didn't feel all loopy and stoned like when I first went on the Topamax back in March. However, I still haven't been feeling well and I'm not really sure whether it's because of the meds or not. I think it must be.

The first few weeks I was really busy with work so I didn't have time to really pay attention to what was going on. It's only in the past two weeks that I've really noticed. Most of the time I feel pretty normal, but then I have these random times (a few hours each day, or just random times each day) where I just feel off. Like I need to go lay down, or I feel like I'm getting sick, or I feel like my partials are coming back, or something just feels wrong and I can't identify it. Last week I had one partial and I had 3 in September, but that's it since increasing the med so that is ok.

The biggest thing has been when I try to go for a run. I will feel ok for a bit and then I'll start to feel woozy/dizzy/off and I'll have to walk for a bit, or I'll feel like I'm going to have a partial so I'll walk until it passes, or I'll feel like I'm going to pass out and have to walk it off until it passes. It's got to be the med because this med is known to mess with body temperature, electrolytes, and make you stop sweating and overheat, etc... you're supposed to be careful with activity while taking it. So I've been paying attention to that while running. I've been making sure that I'm hydrated, paying attention to breathing, sweating, heat, etc. But even so, even with gentle, easy runs, I'm still feeling like crap.

I'm going to keep focusing on hydration and electrolytes and hope that it improves over the next few weeks as I continue to adapt to the new dose... it's still new. If it doesn't get better I'll talk to my neuro about it when I see him next (he's a runner too so that's helpful!).

Thursday, September 7, 2017

Boring Update

Saw my neurologist today:
  • had half a dozen or so partials in June
  • half a dozen or so in August
  • no generalized seizures since March 11, which means I'm 6 months clear on September 11 (four days from now)
  • Which means I'm officially allowed to drive again as of Monday
  • I did not mention to him that I've already started driving again this month (close enough ;)
  • Next appointment in four months
  • I told him I'm happy with the Topamax and since it's working well and we're close to getting rid of the partials I'd like to increase it a little, and he agreed, so we're upping it to 300mg instead of 200mg/day; he mentioned that it can impair cognitive function if we go too high. I said I haven't had any issues with it yet. It does seem to make me somewhat ADHD (lack of focus, inability to sit still, etc) on some days, but not all days. I haven't had trouble with memory or general functionality though, so I'm happy to keep going with it for now, and he said that's good. So we'll increase it and see how it goes. 
  • I told him that I eventually want to decrease and/or discontinue the Keppra since that's the one that makes me depressed. He said that's fine and depending on how the next four months go we may decrease it on the next visit. That would be awesome. I'd rather be ADHD than depressed, any day of the week!

Wednesday, August 16, 2017

The Stress Test



Last week I read a book called The Stress Test, by Ian Robertson. It is about the physical effects of stress on the brain and was quite fascinating. It talked about why stress seems to break some people but strengthen others, and went into the neurological reasons for how stress can strengthen us and even make us smarter. Throughout the book I found myself feeling inspired and actually felt my own stress levels decreasing as I read. It was as if the past two years of the chronic stress I’ve been under suddenly have a purpose and I can see it as something good instead of something destructive. It might sound strange to put it that way, but it’s helpful to me and that’s what matters. It was almost funny, because I could feel my body physically relaxing as I was reading this book about stress, and feel my stress level decreasing because I was so inspired by it. All of this that I’ve been going through can make me stronger, smarter, more resilient in the long run. Just have to keep going

It's been awhile since I've given gratitude shout outs, so this week they're going to:

  • Laura, who took me to Superstore after my recent meltdown over not being able to get groceries (seriously, you were the best thing that happened to me that week!)
  • Everyone else who offered support in the wake of that meltdown--there were a lot of you, so thank you!
  • my mom, who I have mentioned before but deserves another mention because she has consistently been my best supporter over the past two years!
  • my mastermind group, which I don't think I've mentioned here before; we meet weekly to work on business and life, and it has been a consistent help and encouragement as I try to balance growing my business and managing my health and somehow holding it all together (they even tolerate me crying once in awhile!). That's my tribe! 

Thursday, August 3, 2017

Mad at the World

I haven't updated in awhile and I guess that's a good thing because it means nothing is really happening.

I haven't had any partials since June and I'm only 5.5 weeks away from being officially allowed to drive again.

When people ask me how I'm doing, my default answer is that it depends on the day and I think the worst is over. My meds seem to be working. Overall I'm better than I was back in Jan/Feb/Mar. The last med change seems to have done the trick.

My main focus right now is getting my business (read: income) back on track because it went completely off the rails when I went off the rails in the fall/winter/spring.

Getting my business and income back on track, however, has been an utterly exhausting task. When you lose all your momentum, it's incredibly difficult to get that back, especially when you're not feeling 100%. I go from work to bed with not much else--very little social, very little running, few days off. I'm feeling pretty burned out most of the time, but plugging on, because what else can I do?

Case in point: I have no food in my house. Why? Because I wasn't getting paid for awhile. But this week I got paid, so I should go get some groceries. But when? And how? I can't drive my car. I could take the bus. Not only is lugging groceries on the bus a giant pain and time consuming, but just the thought of it when I'm already exhausted, mentally and physically, caused me to cry for twenty minutes last night. I literally sat in front of my computer crying because I had no food and couldn't bear the thought of going out on the bus to get some. I could walk to the store down the street but then I'm stuck with what I can fit in my backpack, which is what I pretty much do on a weekly basis. Still exhausting. I could ask a friend to drive me, and even that frustrates me, and I come back to being angry. Remember the days when I was healthy and could do whatever I wanted? Oh right, those days are gone. So last night I ate leftover pizza and watched netflix and went to bed with an empty fridge again. This morning I walked over to the store down the street and filled my backpack and my fridge is still empty and I'm still angry.

5.5 more weeks until I can drive again. Hopefully this time it lasts longer than 10 days.

Also, I'm going to ask my doctor to reduce the Levetiracetam and increase the Topiramate. Even though I've been feeling better overall, my mood is still affected (obvious, if you've read this blog post). I assume he'll be ok with that. My next appointment isn't until September though.

Saturday, June 10, 2017

Grandma med boxes

Not much to tell these days, which is good news. My meds seem to be working. I'm feeling a LOT better than I was a few months ago. I've been on my current med mix since March (full dosage only about 6 weeks). Since the med change I've only had one partial and I'm feeling good. My energy levels are increasing, side effects decreasing. I still have days where I feel like I have ADHD (side effect of the Topiramate). And still many days where I just need to rest but that is also partially because I've been working my tail off to get my business back on track now that I'm feeling better.

Given all of that, I think I will probably stay on this med mix for awhile, as it's working better than any of the previous ones so far. As long as it keeps the partials away and I continue to feel good, I'll stay on it. It's still a bit early to say for sure, but so far so good.

For someone who always considered herself extremely healthy, I sometimes have to laugh at the cocktail of vitamins and medications I now take, and I thought I'd share:


The green pill box is for morning, and the purple is for evening. Here's the breakdown:

Morning -
2 x 500mg Levetiracetam (the long yellow pills buried in the bottom of the box)
1 x 100mg Topiramate
1 x B6
1 x B12
Progesterone cream (only at certain times of my cycle)
Palafer CF (only twice a week)
CBD oil (the second syringe) if I remember

Evening -
2 x 500mg Levetiracetam
1 x 100mg Topiramate
1 x Magnesium
CBD if I remember

Two years ago all I took was the Magneisum. How things have changed!

In other news, I'm also three months without alcohol..... :(

Thursday, May 25, 2017

Epileptosaur

This is the most difficult post to write so far. Some of you have commented on my previous posts that you appreciate how candid and honest I am about how I feel, but this one cuts deep. Last night I was relating this story to a friend and I was embarrassed even to say the words out loud. Earlier in the day I couldn't say them without crying. But first, some background:

Over the past year and a half I have been getting to know other people with temporal lobe epilepsy through a facebook group. Some of them have talked about how they have faced discrimination from peers, employers, and even family members because of their epilepsy. For some of them, their illness has been a lifelong battle. Seizures in childhood can cause learning disabilities and developmental disabilities, which of course can then lead to social difficulties and anxieties. There is often bullying involved and social isolation. Like other disabilities, people with severe epilepsy may not be able to keep jobs or finish school, and they often face discrimination.

In that way I've been very lucky, because mine started late in life, was caught and treated early, and has been mild. I never had any learning problems growing up and even though I'm still building my business, I'm established in my life. Aside from being temporarily unable to drive and having to take some down time from work, this illness hasn't interfered too dramatically with my life. I haven't really thought of it as a "disability", though technically I could.

And then on Tuesday, something happened that dramatically shifted something inside of me.

Someone who had witnessed one of my generalized seizures, months ago, was angry at me on Tuesday morning.

I won't go into details, but he was angry and feeling powerless. And (as a witness wisely observed) because he was angry at me and feeling powerless, he picked on a moment in which I had been literally powerless--the moment when I had had a seizure in front of him--and turned it against me. He started calling me names ("Epileptosaur") and saying things like "keep me out of the splash zone next time".

I think I kept my composure in the moment (did I?) but I was completely shocked. Not only because I did not expect this kind of behaviour from this person, but also because it was the first time my epilepsy has been used against me. It's the first time in my life that I have been at the receiving end of that kind of treatment. I mean, I've been insulted a million times--I've been a youth worker for years--but this was different.

And wow, that hurt like hell. I don't know how else to say it.

This is why we teach kids not to go around making fun of people for things they can't control. This is why we model empathy and kindness and patience and love.

So today:

Be kind, for everyone you meet is fighting a hard battle.
Ian MacLaren


Monday, May 1, 2017

General Update

It's been 7 weeks since my med change, though it took a whole month to slowly increase the one and decrease the other (I ended up doing it much more gradually than the VGH neuro originally told me to, because of how loopy the Topiramate made me!) so I have only been on the current regular dosages for a couple of weeks.

Overall, I'm feeling about a million times better than I was a couple of months ago. Mentally and emotionally I'm feeling a lot better. I'm not depressed and moody anymore, and I have a lot more energy. I don't feel sick and sluggish all the time, though I do still feel tired sometimes and still need naps on many days. There are days when I hit mid-afternoon and get woozy and need to lay down for a bit, but overall I'm much improved. I haven't had any partials since March 14 (though a few weeks after that I had some extremely mild activity.... it was so mild that I did not count it, but just barely there... I can't even describe it and two years ago I would not have even noticed it).

My hands and feet are still tingly, but not nearly as badly as in the beginning, and improving. I still seem to be losing a bunch of hair every time I wash it, but that will hopefully improve. Not having memory or focus issues like I was when I started this one. And still some coughing/sneezing/breathing issues but those are also easing up. So overall I think the current mix is a massive improvement over the former one.

I saw my neuro this morning for my scheduled appointment, first one since December. This is significant since I have been trying to get in since my seizure at the end of December, when I was extremely depressed and realized my meds weren't working. Between December and March I called the office multiple times and even though he had told me that if it was urgent I could call and see him sooner, whenever I called the receptionist told me I could not get in sooner (hence the visit to VGH in March instead). So I told him this today, and he was not happy to hear it. He had no idea that any of this had happened, that I had had two seizures since he saw me last, that I had been to the hospital, that I had been calling and asking for appointments. The receptionist had not passed on any messages to him or made any notes in my file. He told me that he's not ok with that and would be speaking with her about it because with those kinds of mood-altering meds he wants his patients to be able to access him, and it's up to him to decide whether to see the patients sooner, not up to the receptionist (!). He was not pleased and I was reassured that he will deal with it for the future. Thankfully I'm able and willing to articulate these things... not all patients can or will, so hopefully there will be changes made so that others won't have the same problem. Can you imagine being in crisis and being screened out by your doctor's receptionist? Not cool. So I was glad to hear him say that he will deal with it.

I also asked him about long term effects of the medication vs long term effects of the seizures, because both have been a concern to me. He said that the medications I'm on have been around for a long time and are both quite safe, much safer than uncontrolled seizures. He said that leaving the seizures untreated would be much, much worse for my brain than being on the meds, over the long run. So I am trusting him on that one.

In the meantime, working on getting some momentum back in my business since I had let it lapse for the months when I was feeling so awful that I wasn't working much; now that I'm starting to feel better I am working again and need to get back on track!

Monday, March 20, 2017

Topiramate, Week 1 Thoughts

  • The worst seems to be over
  • Still tingly: tingly lips, fingers, toes, feet, all the time
  • Possibly losing hair (luckily I have lots)
  • Change in sense of taste (this is common)
  • Brain function improving; I'm not feeling so scattered and slow as I was in the first few days

I definitely will NOT be doubling the dose all at once like the doctor told me to. I will be gradually increasing it over a few weeks. Why would I double it to 200mg when the initial 100mg knocked me on my ass for a week? I basically took the entire week off and won't be doing that again when instead I can increase in 25mg increments. I felt like I was stoned and dozy for 6 days.

I'm concerned about long-term effects. I've heard and read that memory loss becomes an issue over the long term, both with this med and with others. At the same time, memory loss is an issue with ongoing seizures. Which is worse for my brain--ongoing seizures over the years, or ongoing medication over the years? How do I protect my brain from deterioration? This is something I'm going to ask my neuro the next time I see him.

Something else I'm going to ask him: why is it that although HE tells me I can get in to see him sooner if I need to, his receptionist won't let me? There is clearly a disconnect between what he is telling me and what she is telling me. This needs to be resolved because he has given me the expectation that if I need to see him urgently I can, but when I call she tells me I can't see him sooner.

Other miscellaneous thoughts:

Friday: On Friday I was feeling pretty hopeless. This is my life now. I'm going to go through this cycle over and over again... try a new med, hope it's working, think I'm ok for awhile, and then BAM the seizures come back. From talking to other people I've learned that you never really know if you're in the clear, and it can come back at any time. There is the odd person who gets it managed for good, but they seem to be in the minority. Most people struggle with it for life. So, I could be battling this for the rest of my life. Try a new med, be ok for a little while, hope that maybe this time I'll be ok for a few months instead of a few weeks, or maybe I'll luck out and be ok for a few years instead of a few months or a few weeks, and then BAM it will hit again and I'm back to 0 days seizure free. Meanwhile my body and brain are being hammered by the physical impacts of the seizures and the medications. Basically, it sucks. Like other chronic illnesses, it's not going to go away, and the best I can hope for is management. And it frustrates the hell out of me that I may lose my memory and cognitive ability because without those I will not want to live. On Friday, when I was feeling all of this, I had texted a friend for company. He couldn't see me because he was out of town but he suggested that I go for a hike because that always makes me feel better. I said, "not today. Today I would wander off a cliff and not come back." There may come a day when that is actually the case. Some reading this may think that over dramatic, but only if you don't understand me: I would rather die where my heart is happy than live for decades without my mind, or my ability to enjoy life.

My weekend job: Some reading this know that I still have a weekend job. I don't always talk about it because it's kind of lame that a financial advisor has a weekend job. There's this impression that I shouldn't need it, right? The reality is that when you're building a business you need an extra income until the business income stabilizes, and that can sometimes take years, so I have kept an extra income on the side. When this most recent seizure happened, it happened at my weekend job. In fact, that was a good place for it to happen because all the staff there are trained in emergency situations and CPR and took great care of me. And there's another factor to this that had not occurred to me until yesterday. The past year and a half has been utter chaos for me--one challenge after another, between my health and the flood and my unstable income and moving and everything else... my weekend job is actually one of the very few, very stable things in my life. It's always there, and it's like another home, no matter what else is going on for me. So even though I keep saying I'm going to leave it, I never do. Will hang on to it for awhile longer, until everything else settles down enough that I don't need that stability anymore.

Levetiracetam: Once the new med has had a couple of weeks to build up in my system, I'm supposed to reduce (not eliminate) my old med. I'm currently on 3000mg, which is the max allowed. The doctor said to reduce it to 2000mg and then evaluate with my neuro when I see him in may. So I will be doing that over the next few weeks. While part of me is really glad to be reducing this med because it's the one that makes me exhausted and depressed, and it's clearly not working anyway, I also had a moment of anxiety this morning when I was thinking about reducing it. Where did that come from? It's not working and I don't like it, so why am I anxious about reducing it?

Tuesday, March 14, 2017

Topiramate, Day 1

After my frustrated post and seemingly unprovoked seizure on the weekend, I decided I needed to talk to my neuro sooner than May. Called the office (again... third time since December...) and they again told me they cannot get me in any sooner, and that I'm still on the cancellation list. I said that I'm not going to make it until May, my meds are not working, and I need something now. I asked if I should go to the hospital and see a neuro there; the receptionist said yes, if I can't wait, to go to the hospital.

Given that VGH is the best hospital in town and that they have (had?) an epilepsy clinic on site, I figured if I was going to go to an ER, it may as well be that one. So I took a book and my phone charger and headed for VGH. Sat in the outer waiting room, then the inner waiting room, then was moved in to a bed with a curtain, and waited... finally a doctor came to talk to me. I told him why I was there... that my meds aren't working, I'm still having seizures, I'm still getting severe depression, and that my own neuro won't see me any sooner than May. He said that usually if you have a neurologist then the ER ones won't see you, but he agreed that it sounded like a legit case, so he'd call over. I waited some more. Finally a neurologist came to see me (a woman!). She was really nice and was the first neurologist I've met who was actually curious about my experiences with my partials and generalized seizures. She asked lots of questions about what they feel like, my triggers, my meds, etc. She ran through the regular neuro tests, checked my eyes (said I have "beautiful pupils"). She asked me more questions in that one visit than my own neuro has EVER asked me. She agreed that it was good that I came in, and said she would check with her supervisor about changing my meds. Then she disappeared for so long that I thought she had forgotten about me. I waited and waited, and finally she returned... with three other neurologists! One was clearly the boss, and the others seemed to be in training. He ran through a lot of the same questions again.

Then he started talking about adding another medication to the Levetiracetam that I'm already taking. At first he suggested Valproic Acid, which is a well-established med and I've heard of it, but it can cause weight gain. I said yes, so does the one I'm on. I asked about the one that causes weight loss. I said that I know that is a stupid reason to choose one over the other, but I've already gained 30lb since this started and since we're just doing trial and error anyway, can I try the loss one instead? He said that's not a problem at all. This one is called Topiramate, and the reason it causes weight loss is that it apparently suppresses appetite. Of course it has a whole slough of other side effects too, but all the seizure meds do so that's neither here nor there. It's a crap shoot no matter which one I take.

He told me to start it right away at a half dose for a week, then a full dose, then decrease the levetiracetam (but I'll stay on both). So I started it last night.

And today I felt like shit all day.

The best word is woozy. Buzzed. Literally buzzing... like my body is vibrating. And my brain isn't quite functioning. But that's supposed to get better over time.

If I am sitting/laying down, I feel better, but if I'm up and about I feel worse. So I postponed my afternoon client meeting and hopefully will be ok for tomorrow's meetings. Have also had two very intense partials today (and three yesterday) so clearly that part hasn't been affected yet (but it takes time for the meds to start working, apparently).

Anyway.... I'm now into the combo-meds stage of the experimentation. This is more common than you'd think. And while the Topiramate has a whack of side effects, it does also get good ratings for efficacy, so I'm hopeful it will do the trick.  Wish me luck!

Saturday, March 11, 2017

Frustration.

I've just started the second cycle of progresterone cream.

When I started it a month ago, I noticed a difference almost immediately--within a few days I was feeling better... more energy, better moods, and no symptoms. No partials since end of January (the week I had 14 partials over 5 days). I thought I was good to go.

Today I was sitting on a couch watching tv, and felt as though a mild partial was coming on. I woke up an hour later. I thought I had just fallen asleep on the couch... I didn't realize I had had a seizure but the people I was with witnessed it and told me (thankfully they didn't call the ambulance! Note to friends and family... don't call the ambulance unless I'm either injured or the seizure lasts more than a few minutes).

So... now what. That was only three months between generalized seizures (the previous ones were 6 months apart). And I had NO symptoms until it happened. No warning, have been feeling fine, until today.

And now I feel fine, apart from a slight headache. Not foggy and wiped out like I did with the previous ones. I actually think it was milder than the other ones because it didn't take hours for my brain to clear this time.

So.... wtf?!

And I still can't see the neuro until May.

Friday, February 3, 2017

Revisiting the Hormone Connection

Last week was the worst week I've had in over a year.

I had 14 partials over a 5 day period, leaving me completely exhausted. I was also very depressed for most of the month of January. Worst month since starting the meds. I seem to be getting worse, not better, which says to me that the meds aren't working. In any case, they're making me miserable so something needs to change. But my neuro won't see me until May (I am on a cancellation list, but no promises...).

There is a massive amount of frustration with knowing that the meds aren't working, they're making me miserable, and there's nothing I can do until May.

So I've been reading a ton. I had a stack of epilepsy books out of the library, and the thing that comes up over and over again is the hormonal connection. I had considered it before but the pattern didn't seem to be consistent and my neuro didn't care to talk about it, so I had left it alone. But one of the books from the library had an entire chapter about hormones and hormone therapy, and now I'm revisiting this.

When a woman's seizures are connected to her cycle, it's called catamenial epilepsy. Catamenial epilepsy is most common with temporal lobe epilepsy (which is what I have). In a nutshell, estrogen excites the temporal lobe and progesterone calms it. So if you have too much estrogen, not enough progesterone, or both, the estrogen will trigger more seizures. As well, the seizures themselves can fuck up your hormone production, creating a vicious cycle of seizures and hormone imbalance.  It can also create problems with fertility, ovulation, etc. A lot of women with catamenial epilepsy will supplement their progesterone, which helps balance things back out.

Given that (I think) I'm in peri-menopause, and my seizures started during peri-menopause, there's a strong possibility that my hormones are contributing. I also have a number of the symptoms of low progesterone, though most of those could be attributed to other factors.

My hormones were tested in November 2015, just after the seizures started, and my levels were within range at that time. But of course those numbers change throughout the cycle and can definitely have changed since then, so it's not necessarily accurate.

So I went to my GP. He is much more open to talking about possibilities than my neuro tends to be. I told him my frustration and what I've been reading, and that I want to explore this connection. I told him that I'm not going to make it until May, suffering and waiting for months and unable to do anything. I cried. He responded by prescribing me a progesterone cream to try for a few months. It may or may not help, but it won't hurt me and allows me to feel like I'm trying something while I wait for the neuro.

Today I spent some time plotting out my seizure log with my period log, to see if there is a correlation.

My seizures are relatively spread out over the 4 week cycle, but there is a definite rise in weeks 2-3 (around/during ovulation). According to my reading, this would be because of the estrogen surge around ovulation. Week 3 is when estrogen is highest.

I have recorded 95 seizures during weeks 2 and 3, and 50 during weeks 1 and 4. So that's a pretty big difference, almost twice as many during mid-cycle. Also all of my generalized seizures have happened smack dab in the middle of my cycle.

I was hoping to find a pattern that is really clear-cut, but it's not entirely. That may be because there are so many competing factors (changes in my meds, going on and off the pill, stress, peri-menopause, etc.).

I'm going to keep tracking it, and I'm going to start the progesterone cream this month.

I have to do something, in any case. :(