The EEG Result

So, I threw up for the first and only time right before the EEG. It seems like when I went off my meds, my morning sickness got stronger. Interpret as you will.

The tech said he thought it looked fine, but it was up to the doctor. He's seen more of them than she has but hasn't been formerly trained. I felt pretty good about it. Then the phone call cascade comes in. 3 messages later, my neurologist gets a hold of me.

"There is generalized activity throughout the brain and one incidence of an ictal focus at the temporal lobes." She went on to say how I could basically have a seizure at any moment. "Have you had a tonic clonic before?"

...what? Well, yeah, remember? I thought that was why she was so worried. That was an odd question... maybe they just put people on medication if they have interesting EEGs these days.

I haven't felt any activity other than the buzz happening around me about what an idiot I am to not be on my medication. Like I have a lamotrigine deficiency. How about we work to solve the individualized symptom of seizures? Alas, the bulk of the brainwashed population believes that we are powerless to cure anything and certainly couldn't function without medication. Of course, I don't watch TV.

I went to my first OB appointment today. Again, not impressed. It's all about data collection, genetic tracking and, God forbid, someone decides that you're an unfit mother and calls DHS on you. I'm not on medications, I don't even drink caffeine.

"What do take for pain?"

That question was interesting to me because I don't take anything. If I'm having really bad menstrual cramps, I'll take a few shots of cramp bark. If I'm having a tension headache, I'll drink more water and try to relax. If I had migraines, I'd look into food allergies, etc.

"I just ask because if you take anything, it should be Tylenol."

You mean the drug that leads over 26,000 people to the hospital per year, 458 of them not living to tell the tale? Maybe people should think about where their pain is coming from before they nuke their livers. And what about a developing fetus? Doesn't anyone think about what it goes through because you've got a backache and it's uncomfortable?

What a crazy, crazy world we live in. I feel like they've all gone mad, so it's just a matter of time before they discover I'm a nut in their book.

Off the Meds!

"Discontinuing therapy: Decrease dose by ~50% per week, over at least 2 weeks unless safety concerns require a more rapid withdrawal. Discontinuing carbamazepine, phenytoin, phenobarbital, primidone, or rifampin should prolong the half-life of lamotrigine; discontinuing valproic acid should shorten the half-life of lamotrigine"

Well, I've been on 25mg a day for 2 weeks. I think it's time to bid adieu to this little quarter of a pill. I'm not going to attempt to chop it in half again or anything - it's time I let go of the railing. I only had a pinky hold anyway.

I'm going to feel so good not having to think about this anymore. I won't have to think about miscarriage, developmental delays or deformities. I'm lucky because for some reason my neurologists over the years just refilled Lamictal as a monotherapy, no other drugs necessary. And over the years, I learned my triggers and educated myself about the condition I have. What's alarming to me is that people aren't educated about their own health boggles and they have to go discover this on their own - in a sense, go get a medical education.

And graduation from medical school for me, my friends, is the Saturday after next. I'm unimpressed with my 1st neurologist who put me on Dilantin and told me I wouldn't be able to hack it in med school.

Now I feel like I know what's going on in my body and I vow to teach my patients what's going on in theirs.

My New Neurologist

So, I asked the medical assistant at the hospital which doc she'd recommend for a pregnant women with epilepsy who's into natural medicine and wants to not be on drugs. Tall order for a neurologist. So this neuro is new and has advised a patient to take Butterbur for migraines - there's hope.

The MA was disgruntled and shared that she was frustrated with the medical establishment after over a decade of working in it because all they do is hand out pills like solutions.

When the doc came in, I explained that I haven't been on the dose I'm supposed to be on in a long time, I'm sleeping all the time, eating frequently & healthily, cut caffeine and alcohol and my stress level has gone down since I'm about to graduate (kind of over the panic). I've had no myoclonic jerking or symptoms and I rapidly lowered my dose.

She said that it was the American Neurological Association's stance that I should increase my dose by 6 times back up to the dose I was prescribed 6 years ago and stay on that for the course of the development of my fetus. Period.

She then went on to say that I'm putting my baby at risk for death because I would cut of the blood supply during a seizure. She said, "But, it looks like you've already made up your mind"

Darn tootin', Miss. I hadn't had a full-on tonic clonic in 6 years on a low dose of medication that is mostly used to control myoclonis and bipolar depression, but I had 2 on a higher dose of Lamotrigine and 4 on Tegretol. So, for someone who went a year without medication or a seizure (a.k.a. I'm not convulsing all the time and I know my triggers), is it really indicated? Is it worth the risk of damage to the baby?

I don't think her brain was working far beyond the functioning of a parrot. Her physical exam sucked and she nearly forgot to do it. She was mostly worried about giving me the PARQ and charting that she gave me the standard of care so I can't sue her. She couldn't even advise me on how I should come off of it - she just pointed out that I might feel sad because it's for bipolar & that I should consult my general practitioner about the danger of the herbs I'm taking.

Look, I am a general practitioner in a matter of months. I know the biochemistry f the drug I am taking more than most doctors & very few doctors know anything about herbs. They just say they're dangerous and don't work in the same sentence. If the tiny amount of rosemary is contraindicated due to uterine contraction, then so are orgasms. I can feel that red raspberry tea is not good for me right now because I know my body... and it hurts, but it CAN be used throughout pregnancy in some people with great benefit.

So, I'm alone. I still hate going to the doctor and the hospital, so we'll see how this birthing experience goes. A mom can't be nervous - it makes the whole thing take longer and be more painful because stress and birthing don't mix.

Neurologist Fail.

Probiotics and inflammation in the brain

"Dose-Dependent Immunomodulation of Human Dendritic Cells by the Probiotic Lactobacillus rhamnosus Lcr35."

I'm working on my report for a urinary tract & vaginal infection we treated with probiotics, (among other things), and stumbled upon this. Basically, this certain strain of bug you can take in a capsule these days produces signaling molecules that are healthy for the brain cells via a anti-inflammatory mechanism. A great studies on probiotics and babies - the PANDA study - showed significant decreased allergies and skin reactions in newborns as a result of probiotics. I always think of allergies, skin and the brain as related because they are embryologically and things that tend to show up on the skin may have already had an impact on the brain - like increased histamine in the springtime due to allergies. There's no arguing against the brain fog there.

Thought it was interesting. I'll have to check if it's in the probiotic blend I'm currently taking. It's good to rotate probiotics clinically, so that would go along with the dose dependent nature of this study.

25mg qd still o.k.

Things are going well on the 25mg - just a note. Grand Rounds on Monday is going to be a hurdle because I have to sign in by 7:30am, which means I have to leave by 6:30 to drive for an hour. Not necessarily safe. I can't miss any, so I am at the crossroads of deciding if I will have one of my friends unethically sign me in OR throw myself at the mercy of the administration who may, for all I know, get their panties in a bunch and call the DMV to alert them I'm changing my meds. Who knows?

That scenario is pretty possible because, as doctors, they don't realize that the DMV doesn't want to hear about it until absolutely necessary - like if I have a seizure. When I got my license I asked the DMV worker if I had to provide anything extra because I have epilepsy. Her eyes darted from side to side and she quickly said if I hadn't had a seizure in the last 6 months, it didn't matter. So, it's never been on my record. Of course, I've had less than 15 tonic clonic seizures in my lifetime and they've all been in the morning after I've stayed up too late or was stressed out.

I can watch the grand rounds videos later in the morning to maintain my education, but I'm uncertain if I want to blow the whistle on myself. How ridiculous.

Feeling fine so far, but I've been eating and sleeping whenever I want today. I woke up at 3:30, stayed in bed until 4:30am and finally decided to get up this morning. Could have been the pills of the flux of hormones. Then I crashed at 7:30 for a few hours. I trust that my brain will shut off if it needs to when I have those mornings. Maybe that will happen Monday & I'll be sleeping through grand rounds.

Reckless

O.k., this is reckless even by my standards... but I am now taking 25mg once a day. I feel strange and last night I could tell that my levels had dropped and my brain was tired. I had that light headed feeling and was borderline twitchy for a brief period of time. My only want is that if I have a seizure, I not do it in a bad place.

My baby's neural tube is developing right... now.

Granted, I'm not taking a cocktail of drugs and I'm no longer on dilantin - lamotrigine seems pretty harmless in comparison, but I'm not chancing it.

I made an appointment for a neurologist next week. I'm hoping to tell her that Ive successfully come off of my meds nearly entirely by then (25mg left). That way, she won't have to worry about me suing her or the additional liability. I know that game. Sometimes I'm really happy when patients slowly take themselves off their meds as I treat them when I don't feel like the benefit outweighs the risks. If she's not so happy about it, maybe it will prove that I don't need to be on them... because I'll go off of them with or without her approval - I'm nearly a doctor myself and we can be the most annoying patients.

The tincture I'm taking for brain nourishment:

• Bacopa Monnieri (also used to prevent miscarriage - bonus)
• Centella asiatica
• Ginko biloba
• Hypericum perforatum (great for enhancing serotonin as I come off lamotrigine, which is also used for bipolar and could give me a little mood change)
• Rosemary - this is something I had in the tincture before I knew I was pregnant. Rosemary in high amounts causes uterine contractions and can theoretically cause miscarriage. It's an herb that got a totally bad rap for this and now women get all frightened to even eat it. I estimate that I get 6 drops of concentrated rosemary every time I take a dose, which isn't much. I seriously doubt my body will give up a baby even if it causes increased tone. The carnosic acid in Rosemary will shield my brain from free radicals that may be developing with the stress and abnormal brain activity I felt last night.

I'm taking the tincture 60 drops twice a day with a straight bacopa tincture 30 drops in the middle of the day. Nearly every herb is contraindicated in pregnancy by default in America, but I really think that's poor logic. Just because it's a plant doesn't mean it can't cause harm, but I'm doing my best to support my brain as I come off the meds that I KNOW cause harm. People have been taking herbs as medicine for thousands of years & my research hasn't found solid evidence to not take them.

Avoiding sugar and eating real food is going well. Gluten, not so much. Let me graduate first. I don't eat a lot of bread products, but eliminating small amounts of gluten found in everything from powerbars to the glue in tea bags is going to take some time.

Staying focused and getting things done to graduate... not going all that great...