Saturday, March 29, 2014

Every Little Bit!

We came home yesterday - Friday.  We decided to bring Luke home because we thought he could recover more quickly at home than in the hospital.  He's really tired, irritable and unstable but he's home and doesn't seem to be having any seizures.

I wanted to share some things about this latest episode and what it means for Luke and his epilepsy.  Luke's seizures are called partial complex seizures.  Typically - in most individuals that have them - these seizures last 1-2 minutes.  Luke still has some partial complex that last short amounts of time.  In his past history he would have some small ones, we would increase medication and they would go away.  Then last winter happened...and he had his first status seizure, the 20+ minute seizure. 

At that point we were still on Keppra to control his seizures. It became clear that Keppra wasn't going to work anymore so we switched to Lamictal. Keppra doesn't have any huge major side effects besides major anger issues in some kids.  When the nurse brought up Lamictal the first thing she talked about was the possibility of a severe deadly rash that can occur when you take Lamictal.  When researching it, it comes up as the first information about the drug on most websites.  But we took a deep breath and decided to go ahead because it was what our neurologist felt was best at the time and from our research we did, too.  Well, luckily it didn't cause a deadly rash in our guy but any time he even got a fever we freaked out. 

This past January it became clear that Lamictal wasn't going to cut it anymore.  We were increasing and increasing and his seizures were still popping through.  With another status seizure now in Luke's history, we decided to go ahead and add another medication - Zonegran.  It also comes with a long list of precautions - namely the possibly of kidney stones or decreased kidney function among other bad stuff...but we have to try to stop his seizures.  So we began with a small dose at night because that's the time we really run into seizure trouble. 

We also have two medications at home that are 'rescue medications'.  They are supposed to stop the seizure or stall it long enough to either NOT need medical help or for us to be able to get to the doctor.  When Luke has one or two small ones, the pill we have does seem to work.  But this last seizure - it came fast and strong.  He would only come out of it for seconds.  I gave both rescue meds and it did nothing to pull him out of his seizure.  They were also completely ineffective for the January seizure. 

 A lot of seizure medications also impair cognitive function which scare the crap out of me.  We've avoided them so far but we're starting to fly through medications.  Luke is amazing everyone with how well he is doing given his extensive brain malformation.  I would hate to have to do anything to change his level of success...although continued lengthy seizures could also have the same outcome. 

As I consulted Dr. Google I found out that it is rare for individuals with partial complex seizures to go repeatedly into status seizures.  I also either heard or read that once someone tries 4 different seizure medications the likelihood of being able to control your seizures via medicine drops drastically.  Since Dr. Google isn't always the best doctor to listen to, I was able to ask our doctor while we were in the hospital. 

Dr. Smyser is truly our hero.  He is not a wait and see kind of guy.  He answers our questions fully and is respectful and listens to us.  He is aggressive with Luke's treatment and developmentally I KNOW we owe soooo much to him because he made sure Luke was getting therapy from the moment he was born.  He very patiently and sweetly addressed my Dr. Google questions.

Yes, it's rare for individuals with partial complex seizures to go into status.  However given Luke's extensive brain malformation (PMG) it changes Luke's epilepsy.  A lot of individuals with epilepsy have no reason for their epilepsy - we do.  So that makes Luke's case and treatment tougher.  Also since he has an extremely rare gene mutation (MPPH syndrome) there just isn't enough information or research yet to say why Luke's seizures are amping up at the rate they are and being so resistant to several drugs. 

As far as the medication question - also true.  The more medications someone tries - the trickier it gets to control the seizures.  But he also said that there are more and more medications being developed and we still have some to try that could help.

Right now since we had the whopper Thursday night out of the blue, he wants to be somewhat aggressive with our medicine.  We are going to quickly increase his Zonegran to a much stronger dosage over the next three weeks as long as Luke is tolerating the increase. If that doesn't work, Dr. Smyser is going to refer us to a neurologist that specializes in epilepsy which means we probably won't be seeing him anymore.  He knows I am STRONGLY opposed to not seeing him anymore so he promised to work with us and that we might be able to see two neurologists:)! 

One of our biggest fears is the nighttime.  We have an awesome video monitor that we can watch.  Thursday night I was watching it and I saw Luke opening and closing his eyes.  He wasn't moving. He wasn't fussing. I thought it was weird as I watched.  Then he flopped over and I thought he was going back to sleep.  Then I heard him cough and I knew!  I raced in and grabbed him as he was about to vomit.  It was dumb luck that I happened to see him opening and closing his eyes.  And that was the beginning of a seizure that lasted about an hour and was followed by two more seizures lasting 7 and 5 minutes each - two more seizures that came AFTER he had 4 doses of 'rescue meds'.  Then he was given a drug called Fosphenytoin to finally stop it altogether.  He also required this drug to stop his January seizure.  If he ever has a seizure that he doesn't vomit after....well, that'd be bad. 

All of those medications finally stopped our guys seizure.  But the meds and the awful seizures left him drugged, not feeling well, irritable, unable to walk, slurring his speech, and I'm sure just plain scared.  Today (Saturday) he is walking but he can only walk a few steps without falling.  He is still slurring his speech and extremely irritable. 

I try to keep our blog upbeat.  I try not to overshare the stuff that you probably don't need to or necessarily want to know.  We ARE so happy with Luke's progress.  We ARE proud of how hard he works, how hard we work and how hard our family & friends work to ensure his success.  But these stupid seizures.  Argh.  I hate them. 

So I'm totally going to play dirty here.  We've had such an overwhelming response to our walk page so far.  We are already 32% of the way to our goal in just a few days!!  We've had such a generous response from family, friends and even friends of friends.  We can't tell you what that means to us.  The money isn't for us.  It's for all of the kids and adults affected by epilepsy.  They need better monitors that could help identify when they're having seizures.  They need medications that don't come with red level warnings of possible death side effects.  They need support.  We need support so we can do our best to keep Luke healthy, developing and happy.

There are a lot of great causes out there that touch our hearts and I know Dan and I try to help as many as we can.  Sometimes it might only be $5 or $10.  Every single bit helps.  Every dollar, every share will help with epilepsy research and support.  And we appreciate every single bit that we can get to do our part to help the Epilepsy Foundation of Missouri and Kansas. 

So if you can help, here is the link to our walk page:  Stephen & Luke's Seizure Stoppers!  I've had a few people ask if they should join our team if they were planning on walking - please, please do!  We'd love it!  I know Jaime's family, my family and many, many other families are very thankful for whatever you can do to help. 

The prayers and love the last couple of days, weeks, months & years has definitely been felt by us.  Thank you. 
Our sweet boy sleeping off his seizure/medication hangover
with his keys in hand.  He is *obsessed* with keys.  We usually
 don't let him have them in bed but since I'm sitting with him
 and he's had such a rough few days...we made an exception. 




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