Friday, October 31, 2008
Thursday, October 30, 2008
Zachary saw his doctor yesterday (Wednesday) (she doesn't work in that clinic on Mondays and Tuesdays). She's great, by the way. She listened to everything I had to say and asked questions. She didn't dismiss anything, but didn't jump to conclusions either. After looking at the lab results from the blood work on Saturday, she wants to make sure Zachary isn't having trouble with his sodium levels. So they took more blood samples and a urine sample. Again, Zachary did very well while they drew blood. He didn't like it, but he didn't scream and cry. The urine sample was a little more difficult. Since he's not potty trained, how do you get a urine sample from a baby? Well, you attach a bag not unlike a vacuum cleaner bag. Then you put the diaper back on and hope he fills the bag. Without going into too much detail, it took all day and three bags to get the urine sample.
Later today, the doctor called me and told me that all the lab results came back normal. She still wants to go ahead with the EEG and neurology appointments though. As Curtis explained, she's looking for one single cause that might point to an underlying condition. It's a situation where we're all relieved as long as we don't know what caused the seizure! If we can't find a smoking gun, then it was probably due to a combination of factors that are highly unlikely to be repeated, meaning that he'll probably never have another one. By the way, I read that 2% of the population will experience a seizure event in their life. That's a higher number than I would have thought!
Tuesday, October 28, 2008
Last Saturday, Zachary had a non-epileptic seizure. He's perfectly okay and back to normal. Seizures, though extremely scary, are harmless (unless someone has one that doesn't stop.)
We were in Gatlinburg with my folks. Zachary had thrown up earlier in the day, but we don't know why. The morning had been spent in a driving tour of Cade's Cove. After the driving tour we were at a restaurant for lunch and Zachary was enjoying exploring the deck. He got to crawling a little too fast and tripped over his hands and bumped his mouth. He looked up and decided that it did indeed hurt and starting crying. I walked over and picked him up. He did that thing that kids do when they're crying where they breathe all the way out and then you wait and wait and wait and then they finally breathe in. (If you aren't around kids much you may not know what I'm talking about). (When I told the doctor about this later, she called it apnea.) Then I realized something was wrong. He went stiff and then started shaking. I kept repeating, "He's not right, something's wrong." Mom came over and took him from me. I stood rooted to the spot, trying not to cry. We didn't know what was wrong and all we could think about was whether he was breathing. People starting pouring out of the restaurant, all wanting to know if he was choking. He hadn't been eating anything, so that wasn't the problem. Someone handed me the phone with a 911 operator on the line. She was wonderfully calm, but irritated at all the people. She wanted everyone to leave us alone and at one point she asked me to tell some lady talking to me to be quiet. She had me take Zachary back from my mom and stayed on the line with me until help arrived.
The first people to arrive were two paramedics in a fire truck. They were very calm and didn't seem worried. At this point, Zachary had become very lethargic, was still non-responsive, and his eyes, although no longer rolled back, were not straight (the right one was turned in a bit while the left one wasn't). We answered the guys' questions and Curtis told me later it wasn't until he heard my explanation to the paramedics that he realized Zachary had had a seizure. They asked if I wanted Zachary to go the hospital to get checked out. I said I did. I was sitting on the ground and realized that more people had arrived. The first guy I had been talking to was relaying my descriptions to someone else. He said that I had described a tonic-clonic seizure and Zachary was now displaying postictal symptoms. I'll explain all that in a little bit.
It turned out that the second pair of people were the ambulance personnel. They had me get on a gurney with Zachary on my lap and loaded us into the ambulance. Mom was invited to sit in the front of the ambulance. Once Zachary and I were inside, they spent a little bit of time getting Zachary attached to some sensors and an oxygen mask. They also checked his blood pressure. I don't know what normal is for a 13-month old, but they said it was really low at 78 over 20. While they were doing all this, Curtis and Dad pulled up behind us. The guy in the back of the ambulance with Zachary and me said that the hospital was about 20 minutes away and we'd be taking back roads or we'd never get there! (we had already discovered how bad the traffic in Gatlinburg can be.) Unfortunately, the gurney faced the back of the ambulance. Althought this meant that I could see Curtis and Dad following, it is the very worst direction to face for someone prone to motion sickness! I spent most of the ride with my head back and my eyes closed. I did have to open my eyes to help the guy as he tried to insert an IV into Zachary's hand. Up until that point, Zachary had been sleeping. The guy said that after a seizure, even adults will sleep and that it was nothing to worry about. When he inserted that needle, however, Zachary woke up and wasn't happy. On the bright side, when he saw me, he recognized me and calmed down a little bit. The guy wasn't able to find the vein, so he eventually gave up on the IV. He took a finger prick and tested Zachary's blood sugar. He said it was within normal, but it was low. Shortly after, we arrived at the hospital.
By now, Zachary was quite awake and very fussy. The nurse asked us some questions and took Zachary's temperature (rectally, of course. He did not like that.) After a little bit the doctor came in and talked to us. He examined Zachary briefly and gave us some information on seizures. Dad and Curtis ran to Taco Bell. While they were gone, two technicians came in and took some blood samples. Zachary had never had blood drawn from his arm, so that was a new experience. He handled it relatively well. It wasn't as bad as getting four vaccinations in his thighs. The results didn't show anything conclusive, though his sodium was a little low. He had had some cheerios before they drew blood, so the results didn't show low blood sugar. The doctor decided it wasn't necessary to do a CAT scan, since they'd have to sedate Zachary to do it. So they sent us home with instructions to follow up with Zachary's doctor on Monday.
We spent Sunday at home, getting Zachary back into his routine. I spent a lot of time online, reading about seizures. There are many different types of seizures, the two main categories being provoked and non-provoked. Non-provoked seizures are associated with epilepsy. Zachary had a provoked seizure, probably brought on by metabolic disturbances, such as hypoglycaemia (low blood sugar), hyponatremia (low sodium levels) or hypoxia (oxygen deprivation). According to one article, everyone has a genetically determined seizure threshold, which can be altered by fatigue, malnutrition, lack of sleep or rest, hypertension, stress, diabetes, the presence of neon or laser flashes or lights, rapid motion or flight, blood sugar imbalances, anxiety and other factors. Zachary's threshold had probably been lowered by one or more of these things as we explored Gatlinburg, and then apnea while crying was the straw that broke the camel's back. From different descriptions I read, Zachary experienced a tonic-clonic seizure, which is a full body seizure that consists of two stages. In the tonic stage, the body goes stiff and the arms and legs are either pulled into the body or stretched out straight. In the clonic stage, the body goes into convulsions. After the seizure ended, Zachary was lethargic and non-responsive, which is consistent with a postictal state.
For follow-up posts, click on the "Seizure" category