Have Your Cuttings and/or Scars Ever Bothered You “Physically?”

Some time ago, I wrote this post about showing your scars in public but that is not what I am referring to here. What I am asking is, in terms of a physical feeling, do they ever bother you, irritate you or can you feel anything from them at all? Initially, the feelings will be felt internally but then of course your brain will interpret them as external sensations.

What I have been noticing lately is that I am experiencing this with definitely my most recent cutting/scar that was done in late winter of this year and to a lesser degree, my first that required reconstructive surgery as I severed three quarters of my median nerve. It’s been a running joke (albeit not a very funny one?) that I became a very poor amateur surgeon myself as I only cut the nerve and no major arteries or veins. All of the medical staff at the hospital were in disbelief and even my Hands and Plastics Surgeon was shocked.

Nerves. It’s all about the nerves is what I am going to say.

I am feeling some vague sensations of pain, itching. That’s about it. It reminds me of what I believe I had called Postherpetic Neuralgia. Now don’t misunderstand, here, people. PA doesn’t have “Herpes.” No, Postherpetic Neuralgia is caused when you contract the virus called the Varicella Zoster Virus. That will bring on Chicken Pox in kids and Shingles (aka Herpes Zoster) in adults. The Postherpetic Neuralgia commonly follows the Herpes Zoster. Or at least it did with me?

It was bad, too. My concentrated outbreak of Herpes Zoster was all over my neck and shoulders. It was (and is) very painful. I don’t remember much of it but I was told that I just laid there a lot of the time and cried and cried. I was around 15 years old? I was covered in tonnes and tonnes of blisters and you just had to wait for them to go away. Lots and lots of Calamine was pretty much the only thing to use and some minor painkillers? It’s a virus so no antibiotics.

Afterward, the Postherpetic Neuralgia hit. Similar to now but perhaps worse due to the larger area of my skin affected. A vague pain and itch that you just can’t make “go away!”

So on to the nerves. Well with the first cutting I did, it is quite obvious a nerve (and a damn important one!) was damaged. I am still lacking a bit of feeling in my hand and some fingers but the surgeon told me that it might not be 100%. Fair enough. However, with my most recent cutting, I didn’t go deep enough to hit a major nerve. This is what I think happened, though. I think I may have knocked out some of my C Fibers with my knife.

This is where it gets kind of interesting. C Fibers have free nerve endings called Nocioceptors. If you don’t read the aforementioned link, Nocioceptors are pain sensing receptors that are involved in Neuropathy and/or Neuralgia. You see where I’m going with this?

Within the C Fiber link, it actually states their role briefly in Neuropathic Pain. “Trauma” is listed, so therein fits my cutting? Even more specifically for me because of feeling the pain and itchiness, well basic Nocioceptor, I suppose, and then the “Ultra-Slow Histamine-Receptive C Fiber” for itchiness.

Anybody else think this is neat or am I geeking out too much, here? I kind of thought the Histamine part was interesting. Treatment for Neuropathy and Neuralgia can involve Antidepressants and Anticonvulstants. Hmmm…some Histamine receptor stuff going on?

Now, just to wrap this all up, when I was experiencing the Postherpetic Neuralgia, I was always very stressed and tired. I am extremely stressed and tired now. I was not experiencing these feelings from my cuttings and/or scars prior to losing my job. As you all know (or do now), I am a very strong believer in the mind-body connection. I am reading what seems to be a good book on it now but I have just started. So perhaps a review will be in order later.

So, yes. I am going to take a stance right now–and it really may not be that ridiculous however a lot of the medical community balks at the mind-body connection. Stress is a definite trigger to Neuralgia/Neuropathy. Can anyone else out there relate?

We Now Return You to Your Regular Programming of Lower Level of Insanity

Okay. I’m not sure what happened last night. Did we have another little spin around the Ultradian Cycling Dance Floor? Or did I throw some kind of tantrum like a toddler at the checkout counter when their parents refuse to buy them some candy? Well, I’m not really prone to tantrums and outbursts, that’s for sure. Too much stress got the better of me? Some wacky Bipolar mood shifty-shifty? I’m still feeling a little “spinny” today.

Rather a bit of a posting spree too. I pretty much expected no comments but that is fine. That can tend to happen when I (may) start to go off the deep end. I start to spew forth quite a bit on my blog. Not to worry–no hurt feelings. I think no one knows what on earth to say, really! Other than perhaps in their heads: ‘Oh, here we go! PA’s losing it again!’

Well, it’s a new day. Alright, after some sleep it is. Although, oddly (again, who knows what was going on) when I went outside to listen to the birds before retiring, one seemed to be chirping a little too loudly for my ears. My face got a little twitchy and I started to feel a bit altered. It didn’t last long but I can’t tell you exactly.

Did I have a Simple Partial Seizure? I can’t say for sure but I would only mention anything to neuro if I had another Complex Partial. Or if I started having a whole whack of Simple Partials. That may sound irresponsible but since I’m already on a whole bunch of Anticonvulsants, an isolated Simple Partial in my mind should not merit any major concern–especially if I’m not even sure I had one–which may be indicative that I did? Sounds a little counterintuitive, doesn’t it? However, since the Simple Partials have been managed for so long and the one Complex Partial is obviously more serious, that would be more of an issue? Again, unless I started Simple Partialing all over the place.

I can’t speak for everyone who has Epilepsy or a Seizure Disorder but from those that I have spoken to, they generally tend to handle it in a manner of their choosing. Sort of a comfort zone of their own. They know how it works for them as they have usually lived with it for a while.

A perfect example may be, should a person seize in public and an ambulance be called, if the person is not injured they may just simply want to go home and speak to their neuro about it. Whether they are taken to hospital is another matter. However, if you have a Tonic-clonic you can be pretty damn out of it when you’re Postictal and not be making any sense. You can even be combative so the paramedics may/will (?) just cart you away anyway. Still, the person won’t be admitted as it is a chronic condition and what is the point? They may just remain in hospital until they are a bit more “with it” and then be sent home…and follow up with their neuro as they see fit.

Actually, I had a version of basically Simple Partial Status Epilepticus (well, I believe it was as I rotted away in hospital and I was not dx’d at the time.) But boy does it sure fit the description! And in reading, you can have a Type I which is a non-progressive form. Oh, man! It was nuts.

It started like this and progressed in about…15 to 20 minutes or so: rapid eye blinking, facial twitching, all the way down to my mouth, mouth paralysis–therefore, tongue hanging out of mouth–drooling, due to the paralysis, motor aphasia although consciousness preserved, full on wicked neck and shoulder twitching and jerking–SO painful–and finally, jerking all the way down my right arm to my wrist/hand.

“Status” with any seizure means it’s basically prolonged–way longer than it should be and that is when you need to go to hospital. Especially if it’s a Complex Partial or a bloody Tonic-clonic. The latter? You could die. Even the former is not good either because your consciousness is lost with it as well as a Tonic-clonic. So major medical attention needed! And fast!

Mine lasted for HOURS. No, it was ridiculous. I had to try and write and communicate with my left hand as I am right handed and I swear, the jerks, twitches, spasms (basically mycolonus as it is called) were incredibly painful. I have never felt such bodily force like that in my life. It is amazing just how violent seizures can be and that was probably nothing compared to some other peoples’ out there.

Anyway, no work up. Just some simple neuro exercises and I was released. But exhausted and a bit loopy, again, being Postictal.

Sorry. Seizure chat diversion… I told you, I’m kind of out of it. Back to “life stuff.”

Ex-partner sent me a text a couple of hours after I fell asleep. I sent her one around midnight as I just needed someone to talk to. Again, she is out of the country on vacation. We went back and forth a bit. I ended it by saying roughly, “…you go back to your vacation and having fun. I’ll text you when the next crisis happens.”

Good lord.

“…my family and friends, are blowing in the wind…” Well, ex-partner is good but she is usually so busy with work.

Filmmaker’s been pretty good, actually. Normally she is so unreliable! Well, has been in the past! Still, she has two kids so that of course keeps her busy! We are still trying to get together but it shall happen.

Speaking of “getting together,” let’s put a wee “it” in the middle, shall we? No more fooling around! I know. How many times have I said that?! No, really. The clock is ticking.

I need to somehow find a balance between not pushing myself too hard so I don’t throw myself over edge and yet I can accomplish all I need to do! How well can all relate to that one, right? So, I’m working at it today. Trying to do all that I can. Trying to climb back up on the horse or a Shetland pony or some animal that will help me along.

I am seeing Merlin #1 tomorrow. Normally I am not all that keen to see him unless we really need to sort out my meds but no…I think I really need to talk to him. That is very rare for me as you all know (or if you don’t) I have great trouble with any kind of “talk therapy.” I feel like I’m slipping and I know I am struggling.

Topamax Brain Blast

So, it’s nice to see you all down there. I always wondered what earth looked like from way up where in I am space right now. It is actually quite realistic from the pictures they show you from the shuttles and all of that. And I’ve finally gotten to experience anti-gravity! I have wanted to do that ever since I was a child! It’s like a dream come true!

*PA laughs*

No, no…I’m just on my bed, typing away on MacBook as you all are thinking. However, I really do feel like I am in outer space or at least in some other…land?

I wanted to post about something else today but shall do that tomorrow–obviously this takes priority as it’s just so…whoa. I mean, Merlin #1 and I? I think we made an interesting decision here!

I took the first 100mg increase of my Topamax/Topiramate last night as I said I would since all of my appointments were done as of yesterday. If memory serves, because my cognitive abilities are extremely screwed right now (will get to that in more detail re: ACs and Topamax) I waited a little bit before taking my Seroquel/Quetiapine before bedtime. Wow, am I glad I made the decision to wait until the weekend!

I didn’t go to bed extremely late last night (did I…?…oh, fucking memory…did I come home and watch a bit of television?) I know I sent off a quick email and that was around 2230hrs. That means I must have gotten home around 2200hrs or so–maybe earlier? The late arrival home was because I called Grocery Man as I thought he would be getting off from work at around the time I would be arriving back in the neighbourhood. I thought it might be nice for a visit. It turned out he was sick with a bit of a cold and had taken the day off but no problem. So we had a visit, listened to some music and had some soup and toast for dinner. It was a rough week so I did get a wee bit tippled on some whisky.

I know. Right on the heels of talking with Prester John (now known as Greybeard) about drinking on Valium. Not to worry, kids. Again, just a bit of relief and relaxation because of all of the stress. However, I will note that initially it did seem to make PA a pretty cheap date. Then it just seemed to move off to…well, who knows? Regular PA drinking? Or maybe there was still some Valium/alcohol combined effect going on? I had taken the 5mg dose early in the morning. *PA shrugs*

So back to the good ol’ Topamax. Indeed, had I taken it the night before last, I don’t even know if I would have been able to make it to my appointment! I have been outside for a tea (not that it’s making a sachet of a difference) and a cigarette and I’ve just been walking around in circles. No, I was almost literally walking around in circles outside! Escher called and knows I’m on another crazy med overhaul and asked if I needed anything as I am obviously incapable of leaving the house right now. I told him that I am fine but might need some milk tomorrow as I am getting low on that. He said to call if so.

You know, speaking of cognitive impairment (I know…I said I’d get there re: the meds…) he’s right fucked. He said he was going back to work and now he’s not and I don’t know! I think he may have forgotten that I loaned him money. It was only sixty bucks/dollars/quid/euros/pounds…whatever you wish. I really don’t care if he pays me back. The funds are now gone from “PA International Mortgage And Loan.” The institution is filing for bankruptcy. Unfortunately, it may turn the world economy into yet another tailspin but that is just how Big Business goes sometimes.

Alright…Topamax and cognitive impairment. I apologize for it taking so long for me to get here but you obviously can understand why?

Now, all meds can come with some generalized side effects based upon their classes which pretty much makes sense–even if we still don’t know exactly how they work on our brains. With ACs, one of the biggies is cognitive impairment (followed by clumsiness!) Why the clumsiness, I’m not sure but the cognitive impairment? Maybe to do with GABA and Glutamic Acid and when it gets turned into Glutamate–a precursor to GABA. GABA is linked to memory? GABA is linked to seizures and the meds are of course Anticonvulsants–originally prescribed for seizures and Epilepsy.

But again, the clumsiness? Maybe if you get so stoopid you bump into things all the time? What bloody neurotransmitter is responsible for being swift and agile?!

Still, they are a very poorly misunderstood class of med and I believe this (at least for one reason) because they are so “multi-purpose.” They are used to treat seizures, Bipolar and migraines! I have always been so interested in possible links between the three–especially since I have them all! Others out there share the comorbidities as well. Maybe not all three but two of them.

I really think that Topamax is the worst in this area–the clumsiness/stoopid business. Some people may disagree. It was probably tied for the hardest hitting side effect for me along with loss of appetite/weight. Then there was the taste perversion (some things just tasted like crap!) and the paraesthesia (I got tingly in my extremeties.) The latter two went away and I did end up gaining a bit more weight and some of my appetite did come back. Also, a little less cognitive impairment but it’s still there (forgetting words: their names, meanings, spellings; I can get lost and turned around so easily, problems with memory…things like that?) Also, I’m on Lamictal/Lamotrigine so what does that have to offer me? I think I am a bit more clumsy now. Maybe a bit more cognitively impaired too? *PA rolls eyes*

Alright, I guess this is long enough. I did manage to write it too instead of just saying, “Hi, the Topamax has done me in. Laters.” And I don’t think there is any need for my Valium today? *laughing* Oh…PA turns into a little puddle on the floor. Unless for some reason I get really anxious about something…

Groin Pulls, Seizures And Exhaustion

Why do I feel like I have a groin pull?

No, PA hasn’t been getting any “action” lately. Unless you count…ah, never mind…

Maybe I’m just really exhausted? Oh, let’s hope I haven’t moved on from the Complex Partial Seizure I had in December to Tonic-Clonics in my sleep! No. I can’t be having crazy-ass (groin?) seizures in my sleep!

I’m just kidding. I’m quite sure I am not seizing in my sleep. Reason being…despite my current state of exhaustion (that does tie into this) I did have a flash of med/seizure insight today…that might relate to my past regarding the psych med bane of my existence EFFEXOR!!!

I apologize for that but Effexor and I DO NOT get along. We never did even though we had a very long and intimate relationship. It just took a while to figure out how difficult and disastrous it was! Sound familiar to a lot of you–even outside the realm of medication?

I updated my Medication List Page today but the actual update is neither here nor there because it was just about Domperidone/Motilium that is really a tummy med. However, I will take for any migraines during the day at work. It can be used for nausea without any drowsiness side effects so I won’t end up passing out at my desk.

So back to the lovely Effexor. This was, hands down, no question, without a doubt the worst medication for me. I probably blogged about it before but because I’m exhausted and my groin pull is bothering me I can’t be bothered to search my archives.

Here’s what it did–and if you don’t already know, I am someone with Bipolar that can not take ADs. Effexor is an AD. So, obviously it made me cycle like hell. In terms of that, the mentalness, I started cutting and made my second suicide attempt. As far as the other stuff…?

Physically, excessive yawning, myoclonus (twitchy, jerky muscle spasms) mostly in my legs (this was also an indication of a lowering of my seizure threshold.) So yes! Effexor is known to do this but at the time, my seizures weren’t dx’d. But they were happening. They’ve happened all my life. But Effexor made them “prettier?”

When I would drink? Oh…myasthenia (muscle weakness) to the extreme so I would be falling down all over. I mean, I almost got a concussion? Sleeping was the absolute worst. Night sweats, horrific nightmares, sleep paralysis, bed wetting (this was pretty much indicative of nocturnal seizures even though unconfirmed as I wasn’t seeing a neuro at the time…still, PA has never wet the bed from drinking!) And the wackiest of all: nocturnal orgasm.

Yes, feel free to chuckle away. Everyone else always did and said, “Hey! Give me some of that drug!” I would always say to them that it really wasn’t that sexy with all of the above shit happening, especially with the nightmares when you’re dreaming of train crashes and bloodied, dead bodies all around you! Yes, charming to get off on those images, don’t you think?

It was also very strange as I could make all of the night time sleep stuff happen if I missed a dose. Now how messed up is that? Forget to take your med for a night (or even two–then I’d really be in trouble?) and that is what happens!

So getting back to the bed wetting, seizures, exhaustion… After all of this stuff would happen and I would wake up, I would be so unbelievably out of it. I would feel like I was hungover but not like being hungover from drinking. No! It was like my entire body had been run over by a truck, my brain was in a complete fog. At times, I could barely speak…well, I could but I really wasn’t that coherent or I had to struggle very hard to be.

And that is when I had my flash of insight today. I never even realized because it was so long ago! If I was having nocturnal seizures, when I woke up, I was probably post-ictal! When some people seize and are post-ictal they can be so fucked up in so many ways. And I wasn’t on any ACs to control the seizures. Effexor lowers the threshold. Incidentally, so does Wellbutrin and I was on both for a period over time too…

Wow. It may be no wonder why I woke up feeling like such a bag of trash those mornings.

EEG Update And Gee…Am I Really Obsessed…An Addict?

So with all the latest talk about being addicts with alcohol (or other substances…) the latter may be tea/caffeine for me? True, it has been said it can be worse than heroin? Oh, my day was hard without it.

Ironically, I woke up much earlier than I normally do…or would. It probably was due to a dream I had. I can’t really share the content with you *laughing* However, if I did I would probably be able to maintain my NC-17 rating? We don’t actually have that in Canada but it is dreaded by all the filmmakers who try to get their work across the border for release and when they get nailed with that naughty, naughty rating! *PA rolls eyes* They get so frustrated!

Go ahead and click the link. It’s one of those “blogthings” quizzes or whatever so if you like to play with those…have at it.

So yes…my saucy dream probably woke me up early.

Okay, jump in the shower and get my hair all squeaky clean for the EEG. Since I was up so early, it was ironic as I would have had time for tea! Bugger. I don’t normally drink it before I leave as I can’t get out of bed to have enough time to sit and enjoy it and really, my commute is kind of long and caffeine is such a diuretic! I checked my email, responded to a blog post and then left.

Alright, my EEG and being obsessed?

Well, oddly enough it was the same tech from a few a years ago! Oh, he is such a nice guy! He was surprised I remembered him. I made my stupid Delta wave joke about it slipping and me becoming brain dead. I asked him how many leads this time and woo hoo! 28!!! Or maybe a couple more as I was counting them as he stuck them on. I laughed and told him I wanted a picture of me taken with me all hooked up and ready to go! I know. I am such a total med geek (but it gets better!)

Oh yes…I mentioned before that apart from my head, they were on my forehead and cheeks. I forgot that they were also placed on my chest and my earlobes! HA!

So, the most exciting thing was how totally spastic my eyes got with the strobe this time around. I did ask the tech beforehand why it was done with my eyes closed. I thought that it was done with your eyes open. He said that no, it was more effective with them closed. Huh, even super-med-geeky PA doesn’t know everything! I’m kidding people…I have an ego that can only be seen under a microscope.

So yes, the strobe. My eyes were twitching all over! Maybe even my face a bit too but that may not matter. I told him after the fact that it was much worse than the last time. He said…really? He’d have to pull the other EEG and compare.

Now, after we were done, he did something techs are never supposed to do! However, since I was yacking to him so much before in my typical geeky fashion about all things med and head and we got along, he said to me, well…let’s take a look and let me show you. Oh, man! Getting a chance to look at my tests and what my head is doing! I had said to him prior, I know you can’t tell me what you saw and all of that…blah, blah, blah…but he gave me a peek anyway re: my eyes.

Admittedly, I really had no clue what I was looking at and since he is not my neurologist, if it actually meant anything, he could not say. At the bottom there was a line indicating the speed ratio of the strobe. Then, the waves of what the hell my eyes were doing! I asked which wave it was and it was Beta. So, he said at this interval it was this and then here this and then…whoa! My spazzy eyes at those points had waves that were so much larger than anything else!

Now, I don’t know what the activity means. Again, I didn’t know what the hell I was looking at *laughing* I should maybe check into what Beta waves with strobes look like with ranges etc… Still, it was pretty neat for stupid PA!

We spoke more and how it would (obviously!) be significant if my body started going haywire after the strobe. Well, no shit! Seizure! I wasn’t twitching body wise. Nonetheless, I am kind of curious as to my eyes really going nuts more this time. Hopefully the tech will pull the last EEG to compare with this one in case my dumbarse neuro doesn’t!

As we parted, I told him some more information I know about seizures in general…more yackity, yackity, yack.

I know. I.am.such.a.med.geek.

Oh, Tomorrow…Anything For All The Tea In China? My Head’s Going To Get TWO Workouts!

I don’t know if using that idiom is “Politically Incorrect” or not but I am not allowed to have any caffeine after midnight tonight. Not that I drink it that late but, again people, if you do not know already, PA needs her vats of tea to get through the workday!

I am not allowed to have any caffeine because I’m having my EEG done. And of course it’s later on in the afternoon. This means I will have to struggle longer at work without my precious leaves. I should probably try and remember to eat something to get my blood sugar levels up a bit? My last one was first thing in the morning and I am not really a breakfast person but since this is later on…

I wonder how many leads I’ll get this time? I think I had the full on “Royal Treatment” last time with 22 or 24? They were even on my face *laughing* On my forehead and cheeks to be more precise.

Also, it is very important to have clean, unadulterated (i.e. no product in it) hair! I don’t wear any product anyway. It would be rather useless if your hair was all super stylin’ no matter how much you think you might want to ask the EEG tech (or any other passerby in the hospital) out on a date. The leads need to stick with the paste.

Ah, the paste. It’s not that bad, really. In fact, your hair product(s) might be worse? Just wee dabs of it on the electrodes. My tech was really great the last time and cleaned me up really well afterward. I think I brought a baseball cap with me as I had to go to work right after I was done but since he did such a good job, I don’t think I even needed it! I’m taking the afternoon off tomorrow so who cares if I don’t get the same guy or if the same calibre of scrub-a-dub-dub isn’t done.

Just for fun, I found a type of EEG paste to see exactly what was in it. Perhaps you can compare it with your hair product ingredients?

• Polyoxethylene 20 Cetyl Ether
• Water
• Glycerin
• Calcium Carbonate
• 1,2 Propanediol
• Potassium Chloride
• Gelwhite
• Sodium Chloride
• Polyoxythylene 20 Sorbitol
• Methylparaben
• Propylparaben

No doubt some things will not be in your hair care essentials. Maybe all? I mean, it’s not like you’re trying to somehow measure your brain activity with your hair dryer, right? However, that would be kind of cool and save me making a trip to the hospital. Just head down to the drugstore or something and I’d be all set. Oh, I don’t have a printer so maybe a computer store as well.

A DIY EEG! Heh. That was sort of overkill with the acronyms, wasn’t it?

I suspect it (and my MRI that was done about a month ago) will show nothing. Neither of them did when I had them done initially a few years ago. I really don’t believe my brain has now morphed into something that resembles a mushroom made out of Swiss Cheese (that will appear on the MRI scans.)

*PA ponders for a moment*

And the EEG. Well, my EEG should be fine too. Unless this time around my Beta waves stay in a nearly continuous state at around 15-22Hz. This can happen in someone who is awake but if they are comatose it’s called “beta coma.” Definitely a toss up on that one the way my brain works. I’m pretty much in a walking coma most days.

Then there are my Delta waves. If they start slipping below 1Hz and moving straight to zero, PA’s moved well beyond deep, dreamless sleep and is on her way to becoming brain dead.

“Wake Up!” Let’s Start Treating Insomnia Properly!

I apologize as I need to cut and past this entire interview/discussion as only some of you may have access to it? It’s from Medscape on this little microsite, almost. Here’s the link anyway.

It might be a little long but skip over the parts that bore you. Or feel free to skip over this entire post if it bores you. I shall interject with a few comments as always. This article may not be that thrilling, but it interested me somewhat.

The Impact of Insomnia on Sleep: An Expert Interview with Daniel Buysee, MD
By Suma Jacob, MD, PhD

Dr. Jacob is the 2006 American Association for Technology in Psychiatry Fellow, sponsored by GlaxoSmithkline.

Introduction: Daniel Buysse, MD, is Professor of Psychiatry, at Western Psychiatric Institute and Clinic University of Pittsburgh, Pittsburgh, PA. Dr. Buysse is an internationally renowned psychiatrist and sleep expert, who discussed the interaction of depression and insomnia with Suma Jacob, MD, PhD in the Fall of 2006.

Dr. Jacob: Dr. Buysse, in addition to insomnia being a medical disorder, it has often been a prominent symptom or comorbid with other disorders, especially depression and anxiety. How common are these co-occurrences?

Alright, insomnia is a “medical disorder.” Yes. This is true. Can it occur as well with psych stuff?

Dr. Buysse: They are very common. If you looked at people who have chronic insomnia, approximately 50% of those will have comorbid depression. So depending on how you diagnose people, one can easily come to the conclusion that comorbid insomnia, particularly insomnia that is comorbid with depression is the most common type.

Why sure! The first words out of his mouth are “chronic insomnia!” If that doesn’t speak to “medical disorder…?”

50% too. That’s a fair figure as well. I know I sure fall into that number! If I don’t have my meds I can’t sleep at all! I think if you took me off them I might never sleep again! Well I might sleep at some point for brief intervals, but I would still have insomnia.

Dr. Jacob: 2005 National Institute of Health (NIH) Consensus Conference made a point about the concept of comorbidity in insomnia. What are the consequences of considering insomnia to be a symptom as opposed to a disorder?

I’m sorry. I can’t find the NIH Consensus Conference information, but it’s important. They didn’t link to it or anything.

Dr. Buysse: Considering insomnia to be a symptom only could lead to under treatment and it could influence general treatment outcomes. If we consider the specific case of insomnia comorbid with depression, it is a fairly common occurrence that insomnia persists after depression is treated. We know that when insomnia persists it leads to a reduced rate of remission in the depression itself and increased risk for relapse and recurrence of depression. So there are consequences for not treating insomnia.

Oooh. This is getting exciting now. Insomnia as a symptom only. We’re heading back to the issue of perhaps a (chronic) medical condition too? If not (or even if so) the point about “under treatment” is very important here.

Think about it. How many of us with any of our illnesses have “comorbid” insomnia? How much has it messed us up? It is absolutely possible that we might experience a shift in mood, we might feel better, but our sleep is still completely disastrous. Then our moods get completely out of whack again. This guy is making some sense, don’t you think?

Dr. Jacob: Do you believe that there is a common mechanism or pathway in the brain that can explain such a common co-occurrence with depression?

Dr. Buysse: We don’t really know the answer to that. There are data to suggest that the biology of insomnia and the biology of depression are related to one another. One potential key is that both disorders, depression and insomnia, involve dysregulation of the HPA axis and in particular, elevated corticotropin-releasing hormone.

Okay, the “HPA axis” is the “Hypothalamic-pituitary-adrenal axis.” It’s a major hormonal “hub,” if you will, between your brain (the first two parts in the name) and the the adrenals that sit atop your kidneys. Obviously because of that there’s a whole whack of stuff going on.

However, for the sleep business the CRH mentioned above comes from the Hypothalamus. What gets me more excited, even though it’s not mentioned here, is that Cortisol is also involved! I am always fighting for my Cortisol to get more “press,” and research done with it as far as all of our head crap!

I did find this under the Psychopharmacy section in Wiki that doesn’t get me so excited. Changes in CRH in cerebrospinal fluid have been noted in suicide victims. Better get that insomnia treated! I’m kidding. That’s not funny.

Another way of getting at the similar pathways involved in insomnia and depression is through functional neuroimaging studies during sleep and wake. Similar patterns have been observed in depression and insomnia using positron emission tomography. Both depression and insomnia show a relative persistence of brain activation in the frontal brain regions during non-REM sleep.

Huh. That’s kind of cool too. There’s a bit more on that later.

Dr. Jacob: When both insomnia and depression are present, are there any data that describe which came first?

Dr. Buysse: In the last 5 years or so, a variety of data have suggested that the usual expectation that insomnia is due to depression may actually be the incorrect sequence. There are now several epidemiologic studies that show that having insomnia independent of depression, there is a risk for later developing depression. Insomnia is one of the stronger risk factors identified for development of depression.

In recurrent depression, there are additional data suggesting that insomnia typically appears first and depression appears later. A study by Ohayon and Roth suggests that the particular sequence of insomnia preceding depression is a more common one than insomnia appearing at the same time as depression or depression coming first and insomnia showing up later. Therefore, the data suggests that insomnia commonly precedes depression.

Oh, yes indeedy over here! I know my insomnia hit like a freight train before I became depressed. Shall we take a poll? Who else out there experienced sleepy problems prior to moody problems? Again, let’s “wake up” to this people!

Dr. Jacob: If assessment for sleeping difficulties is a part of a usual mental status exam, why is insomnia often missed?

Dr. Buysse: I am not sure that it is necessarily missed, but rather underplayed. We know that sleep difficulties are part of the diagnostic criteria of depression, anxiety disorders, and bipolar disorder. I think that clinicians are assessing for sleep difficulties. However, when sleep difficulties are present, they are seen as another symptom of a depressive or anxiety disorder and the assumption is that treating the depression or anxiety disorder is sufficient for dealing with insomnia. As we previously discussed, this can lead to under treatment.

Yes, yes…please can we keep hammering it home?

Dr. Jacob: Would sleep patterns present differently with comorbid insomnia and depression (i.e. falling asleep, staying asleep, early morning awakening, and overall length of sleep)?

I can answer this one before Buysse! Completely not! I’m still leaning to my “chronic insomnia”/medical condition presenting along with psych illnesses opinion. See above with his 50% statistic?

Dr. Buysse: In general, people who have comorbid insomnia and depression have more severe difficulties than people who have insomnia alone. The specific type of difficulty is not very different than in people with primary insomnia. Patients with primary and comorbid insomnia have about equal degrees of difficulty falling asleep, difficulty staying asleep or early morning awakening. The usual assumption is that early morning awakening is more of a sign of depression, but there is not really great data supporting that.

Dr. Jacob: Does age play a factor in these two disorders presenting comorbidly?

Dr. Buysse: Younger patients with depression more often have hypersomnia, whereas older adults with depression more often have insomnia. There is evidence from sleep laboratory studies that depression and age interact. That is, older adults have disproportionately worse sleep when they are depressed than younger adults.

This may be true. Although I will say as a caveat that adolescents’ sleep is completely screwed up because of their hormones anyway. It has been proven that they need more sleep–depressed or not. The depression may just exacerbate this, however.

Dr. Jacob: How does anxiety fit into this?

Dr. Buysse: In general, older adults with depression will have more anxiety symptoms than younger adults. Older adults can have a more activated or anxious depression and have greater insomnia symptoms as part of the picture.

Hmmm. Well we all are different. When I was depressed as a kid…well, I was anxious since birth. However, I do know that my anxiety increased with depressive episodes as an adult.

Dr. Jacob: Which disorder would you treat first in comorbid insomnia and depression?

Dr. Buysse: We shouldn’t necessarily think of treating either one first or second, but of treating both conditions adequately. If a patient has significant insomnia as well as depression, he/she should be treated promptly, for both problems. If you look at overall morbidity, there is more danger in not treating for depression than missing the treatment of insomnia. Depression, if untreated, can result in greater negative outcomes. The key is to diagnose and treat both conditions appropriately.

Hallelujah! This is what we need! Treat them both! Don’t just focus on the psych illnesses! Those are important as well, especially if the patient is in imminent danger, but TREAT THE SLEEP PROBLEMS! *laughing*

Dr. Jacob: What impact does insomnia have on quality of life? What impact on quality of life does comorbidity with depression have?

Dr. Buysse: Insomnia, both as a primary disorder and as a comorbid condition, has a negative impact on quality of life. Insomnia has its own independent negative impact on quality of life, even when it occurs with disorders such as arthritis, cardiovascular disorders or cancer.

Perhaps I should have deleted this. It’s a very dumb question.

Dr. Jacob: Are there functional MRI changes seen with patients who have insomnia compared with those who don’t?

Dr. Buysse: I’m not aware of fMRI data. However, using positive emission tomography during sleep and wakefulness, we found that in people with insomnia actually appear different in both sleep and wake time compared with good sleepers. Patients with insomnia have relative brain activation. That is, when they appear to be asleep by polysomnographic criteria, their brains show excessive metabolic rate in the frontal cortex and in the brain arousal structures. During wakefulness, their brain is more metabolically active than good sleepers but insomnia patients have a relative decrease in areas such as the frontal lobe which are important for executive function and higher order cognitive function.

I find this a bit more interesting than the brief mention above about the PET scans, and non-REM sleep. However it doesn’t distinguish between those with primary insomnia, and those who have psych illnesses either with, or without primary insomnia. Maybe it doesn’t matter *PA raises eyebrows*

As far as the latter, there have been many studies done with PET scans, and fMRIs (not mentioned as being done above for insomnia) for those with psych illnesses, and measuring frontal lobe activity. I am not sure, but many seem to have been done regarding Schizophrenia–at least from what I have read. There may be more regarding other illnesses.

So is it illness related that your cognitive, and higher order functions are compromised, or is it because of lack of sleep? At the very worst (or “best” for the scan results) could it be that after building up a massive sleep deficit, your cognitive functions are completely screwed up?

However, I think what is more interesting, is that being measured while the insomniacs are asleep: the fact that they have a higher metabolic activity than the “good sleepers.” So what are we doing when we’re sleeping? Rather, what are our brains doing?

If we go back to the HPA axis, and try look at what Buysse is trying to say about the change in the CRH…well? Release of CRH is moderated in part by my good old friend Cortisol! Also by “stress,” but Cortisol is also known as “the stress hormone.” So it’s all a bit tricky. Circadian cycles get linked in there too…well, gee! That’s just going to screw things up, and not really help right? If you’re already thrown off because of your Circadian Rhythms, you’re probably not sleeping!

Like everything else in the big, wide, wonderful world of (brain) science, we require some more research here.

Dr. Jacob: What are potential consequences of not treating a patient who suffers from insomnia?

Dr. Buysse: Not treating insomnia results in poor quality of life and poor functional outcomes. Evidence suggests an increased risk for subsequent depression and anxiety disorders and there is some evidence for cardiovascular and other health outcomes as well.

Again, apologies. Dumb question. Of course there are other consequences as well. We can all think of some.

Dr. Jacob: How can we create better awareness about insomnia among physicians and patients? Do you believe that the new NIH Consensus Statement will help change clinical practice? If so, how?

Dr. Buysse: The NIH State of the Science Conference may help change medical practice. It really comes down to education and awareness. The practicing physician had very little sleep education during medical school or in post-graduate education. There is a great need to educate physicians about insomnia.

Hallelujah Part II!!! Are you listening doctors???

Dr. Jacob: How extensive is the economic burden of insomnia? Direct and Indirect?

Dr. Buysse: Insomnia is associated with decreased productivity and increased costs for individuals, employers and society. The financial impact is difficult to estimate but one study suggests that in the United States, the costs of insomnia are $77 billion to $92 billion annually, including lost productivity and accidents. The direct and indirect costs of depression are equally costly and estimated to be at least $44 billion annually for the US economy.

Stats, stats…bottom line you don’t perform when you can’t sleep, indeed work productivity plummets, people screw up, and it’s bad, bad, bad!

Dr. Jacob: Dr. Buysse, thank you for your time, I’ve enjoyed our discussion today!

Hopefully you’ll thank PA for her post and her time–and you won’t think this sucks *laughing*

Neuro Update: Here We Go Again!

I went to go see my neurologist this afternoon. We had a lot to catch up on. Since I had been fine for the last couple of years or so, we have only been seeing each other maybe every six months for brief consults. Knowing that, I felt I would have to be really on top and try to cram things in. Of course, I made notes. But, bugger! He’s such an “absent-minded professor type.” As we went on…I mentioned earlier that I needed a script refill.

We both forgot. Because I’m an absent-minded professor type too. I’ll have to get him to call it in, I guess, and pay a bit of money. Ironically, he gave me a script for some anti-nauseants as he said the OTC stuff I was taking (Gravol/Dimenhydrinate) was crap. I get really nauseous when I get migraines.

So, we did a med update. The only thing that I figured was new was the Biphentin. Thank bloody Zeus he didn’t bat an eyelash at that! There is some contraindication with stims and people who have Epilepsy/Seizure Disorders. I swear, had he told me I had to go off my dear Biphentin, I would have gone completely spaztastic or even had a seizure right there and then in his office! No, no…the Biphentin is doing good things…don’t take it away!

Okay, so we talked about the bizarre migraine business where I had three in the fall within the span of about two months. That’s completely ridiculous for me. I’ve never had them like that. “Normally…” I am quite lucky compared to a lot of people. I get them a few times a year. My only trigger that I can figure is seasonal changes, weather etc… That’s why the few times a year. However, fall here was really weird weather wise.

After that…on to the biggie. For the people that have been following along, I had a Complex Partial Seizure in early December. If you don’t know what that’s all about or didn’t know, you can read about what happened here. The post is a bit long as the beginning involves this friend I know but you can skip past that to get to the seizure business. Within that is also a link to the only other types of seizures that I have had: Simple Partial Seizures. They are not as serious. In a nutshell, with Simple Partials, you do not lose consciousness (it may be slightly altered) but with Complex Partials, you do. And I did.

So, the “here we go again” part is I get to go for my jolly EEG and MRI again. I knew he would make this decision. Of course!

The EEG is nothing. All wired up, electrodes all over my head and even a few on my face. What happened before? I can’t remember it was so long ago but I know the hyperventilation trick is to test for absence seizures. And the strobe. Ah… Photic? I think there was some breathing business too. I could look up all the procedures but I have to post this before the Blog365 deadline *laughing*

The MRI? AHHH! Oh, going through that again… I was in that damn “tube” for about 45 minutes or so trying not to move with it hammering and banging away. Sure, they give you ear plugs but it’s still so loud!

They do cushion your head pretty decently though. I just closed my eyes through the whole thing, mostly. Occasionally, I’d open them and look at the light/s in the “tube.” Then, I’d just close them again and keep breathing and try to stay relaxed. They actually give benzos to people if they’re really freaked out beforehand. Maybe I should ask for some this time around *laughing again*

They cushioned my legs really nicely too, actually. They raised them and then padded them underneath and in between so I was more relaxed while lying down. They also gave me lots of blankets. I was so cold! Yes, I had to completely emphasize that. My MRI was at 2300hrs. It’s because they do all of the inpatient MRIs during the day, then take as many outpatient ones after that and then schedule the rest of the outpatient MRIs around the clock.

So, who knows when my MRI will be this time. My EEG will be during “regular” hours. It’s at a different hospital than where my MRI is. Same routine as before.

Both times around (with my first EEG and MRI) my techs were so wonderful! Wow…just so fantastic. In fact, all of my techs have been great over the few years or so with all of my tests (head/tummy.)

As for neuro’s thoughts? Well, I rattled off everything I researched as succinctly as I could. He really is a total arse but I do know him. And not to be totally arsey myself but I know at least..something…myself? So, even if we weren’t “necessarily” collaborating, I knew where he would go and I already knew…well, what I knew or thought.

Psychogenic was ruled out because as “articles” have said: “It’s In The Eyes.” If you have no idea what that means, and you didn’t click on the above link, there are certain types of seizures that may occur, but they differ in that they are not a result from any abnormal electrical discharge in the brain. It doesn’t mean that they don’t exist, however. It just means that the person experiencing them does not have Epilepsy. The “In The Eyes,” thing comes from studies (or at least one that I read) that have been done. The way to distinguish Psychogenic Seizures from Epileptic Seizures is that people with Epileptic Seizures have their eyes open–Psychogenic? Closed. In fact, the numbers are so high it’s amazing!

My eyes were open, and always have been for my Simple Partials.

Neuro seemed to think that it was a Migraine-induced seizure. I did look into that before but I didn’t find anything that correlated–or seemed to. I should go back and do some more digging, I guess. Perhaps, there is a connection between the fall migraines and then the CPS in early December. I mean, the last migraine did occur in late November and the CPS occurred in early December. Neuro said that my migraines can just totally screw with my cortex and make it incidentally go haywire (i.e. a random Complex Partial.) I haven’t had any before and I haven’t had any after.

Hmmm.

Treatment? He’s thinking of increasing my Lamictal/Lamotrigine up to 200mg from my existing 150mg. If so, he would also order it b.i.d. as I take it all in the morning and he thinks it might be better if it was spread out. Well, 200mg? Yes, that probably should be b.i.d. but perhaps some people could take it…well, whatever. He also might consider toying with the Clobazam/Frisium. I’m not sure. We spoke about the first option but he wanted to do blood draws to check the levels of both today so, again, if he wants to make any med changes with either…I have no clue.

Okay, I was going to stream a song that might have worked with this but I am running out of time and need to go to bed! Tomorrow?

Ice Cream And Anime For Breakfast…No, The Carbs Don’t Mean I’m Depressed

I know. Could I be acting anymore like a child this weekend? First, throwing out my dirty dishes and now this? Well, being a “grown up” and living on your own does have its benefits. I mean, I can finally buy my lovely Nutella as I was so jealous of all the kids in Europe that could eat it for breakfast. I asked my parents and they said, “What? Chocolate for breakfast?! No way!”

Now, before I move on to the ice cream (and more crazy eating) here’s some Cowboy Bebop that I immersed myself in all morning and actually the better part of the afternoon. I had to tear myself away from it to make this post. And I really should be doing some more things today.

Ironically, it has to do with eating too. It’s pretty funny. The characters accidentally eat magic mushrooms *laughing*

So, why on earth was I eating ice cream for breakfast? A couple of reasons. I’m ovulating (my stomach’s giving me pain and it does that with hormone fluctuations–great…what’s up with that again) so that can mean an increase in appetite and possible cravings. But I usually don’t crave things during changes in my cycle. Probably because my appetite has sunken into the basement over the last year and half or however long it’s been. No, it was perhaps more because of the pain and dairy soothes it–and I’m running low on milk which is the fastest option.

Which means, by extension, I seem to be over my little dairy problem?

Cravings, however. This time around, something crazy did seem to happen. I woke up in the middle of the night in a frenzy for salt, chocolate…wow, just about everything! That was pretty funny so off to the kitchen I went and ravenously ate whatever I could as quickly as I could and then went back to sleep.

An interesting fact–or pattern, perhaps, about moods (depression in particular) and food cravings–chocolate and carbs specifically. My ex-doctor (Ding Dong, Asshole…etc…) asked me prior to my Bipolar diagnosis if I ever craved chocolate in the middle of the night! Surprisingly, I did! And it was at all times, nothing to do with hormones or anything like that–or at least my menstrual ones?

He said it was a sign of Atypical Depression. How odd as he may have had something. Even though the Wiki link doesn’t reference chocolate specifically, have a look at this. It really was the most interesting thing that I could find out there in terms of “study” material other than some abstracts–even though the title is kind of amusing. And it appears that it’s possibly/only been looked into by some folks done in Oz at The Black Dog Institute. I have no clue who they are and what they are about but the information was published in the British Journal of Psychiatry at least?

This was done in 2007 and I was seeing my ex-GP long before that. But in a way, it’s really not rocket science. Eating these things act on your brain and they make you feel good. A lot of “comfort food eating” is done with SAD and other forms of Depression as well? But I suppose, it’s also the combined somnolence factor of both the “Atypical,” perhaps and SAD? Or maybe not so much SAD–it just might be coincidental. The Atypical form gets into a lot of mood reactivity issues.

Now at the time of discussion with my ex-GP, I fluctuated between the DSM-IV characteristics of the “Atypical.” Somnolence/hypersomnia, heavy, leaden limbs, and mood reactivity but hardly over-eating! No, if anything, I lost my appetite completely. And as far as the above three, they really didn’t linger as much, as insomnia was more of a problem. My limbs? Shit, I was Bipolar–heavy limbs didn’t last that long! Mood reactivity? Again, Bipolar! Including ADD that can make you sensitive and wing you out. Plus all of the things that aren’t head related–my past and how I grew up, what I’ve experienced. Not everything is about our brain chemistry.

Anyway, I just thought I’d toss that all out there. I do know that a fair number of people do seek out “comfort foods” and eat more than they normally do when depressed. It may not have anything to do with “Atypical Depression” as a diagnosis. However, since I have still have on occasion woken up in the night when I’ve been feeling a bit lower craving chocolate, it does make me wonder.

Christmas Came Early: “Shocks” And Surprises

I went to see Escher the other night as he wanted to give me his Christmas presents he bought for me. Did I neglect to tell you that I loathe Christmas? Nothing but unpleasant memories.

I knew he went overboard so I suppose that wasn’t too much of a “surprise.” The first gift was a footie jersey. Yes, PA likes footie. Fine. The second? A bloody stereo with a USB port for my iPod! Oh, god! Now, that is way too much!

He’s pretty much a luddite (although he does have a cellphone) but he likes audio equipment. This system isn’t extremely high end (thank goodness!) but it is quite nice in appearance. It’s a micro system (i.e. not full rack–thank goodness, again.) My flat is ridiculously small, he knows this and a full rack system with all the components would never have fit and would have been beyond obscene in price! It’s all black and silver which suits me as I like simple design and really, not wood grain speakers. And the USB port! He knows that I am basically permanently attached to my iPod. That is so awesome.

I don’t own a proper stereo which is kind of ironic since I am pretty much an audiophile, as well. I’ve managed along with a portable stereo that’s lasted for 15 years! It’s made by Panasonic which has been my staple brand ever since I’ve had it. Excluding the Sennheiser headphones I bought a while back. Panasonic also manufactures Technics products if you didn’t know.

I didn’t think I ever needed anything larger as a stereo since I’ve always lived in flats and it has provided me with enough sound. So yes, I expected him going overboard but not with that much gift giving! *sigh* And he had been being a good boy lately. He had been giving me some space and not calling as much. I’m still not quite sure what to do with him. He is a good friend and we do have fun together but he can still be so draining. And I do quite question his mental stability a lot of the time.

Now here’s the really unexpected–the “shocking” part if you can excuse that, perhaps, terrible reference…

I seized when I was there. And yes, I’m climbing the seizure ladder; I’ve moved up a rung. I think. That’s why it has taken me so long to write this–and post this. I have been researching and researching to try and figure out what happened that night for hours. I’m not sure at this point. Probably up to about four or five hours of research? And I’m still looking at/for things to provide me with something. Do you know what I’ve found in terms of an answer?

I. Have. No. Clue.

At first, I thought it was just another one of my Simple Partials, albeit a different and rather strange one. But Simple Partials are weird. I have had incredible ones. And I guess am still capable of having such an array of them–even though my meds have been controlling them? A lot of “sensory weirdness,” basically. You can read about my Simple Partial history here. You do not have to read this post but if you haven’t already, I suggest that you do as it may help you differentiate between what I normally experience and what happened the other night.

The term “partial,” means that basically the electrical misfiring in your brain is localized or happening in only certain parts of it. This is in opposition to “generalized” seizures where the neuronal misfiring is everywhere and you will always lose total consciousness (e.g. a Tonic-Clonic seizure.)

Even having had Simple Partials all of my life, I didn’t even know what they were. It wasn’t until I started to take Anticonvulsants for Bipolar and when I read how they were used to treat Epilepsy that I realized…wow! I was shocked (oh dear…I’m using that word again…) When I read about SPs, it was like a total laundry list of signs and symptoms for me. Now, with all seizure activity, there are chances of them getting worse (hence my mention of moving up a rung on the ladder) but since mine never did all of my life, I never cared about having them looked into. It was ex-partner that was really insistent about it.

So Escher and I were just sitting and talking (and having some beer but I wasn’t drunk and alcohol has never made me seize, bar with evil Effexor and that was unconfirmed but presumed.) Anyway, all of the sudden, I stop. And then a few seconds later, Escher hands me a paper towel to wipe the drool from my mouth. If you didn’t read the link above, I have a bit of a “drooling history” with a couple of my seizures. The two gelastic ones I have had and the time when I believed I had epilepsia partialis continua. That is basically one long ass Simple Partial or “going status” or “status epilepticus.” If you read about “epc” that I mentioned above, it sounds more serious but it can happen for other reasons. If you go status with a Generalized Seizure of even a Complex Partial–you pretty much need emergency medical intervention as your consciousness is more impaired if not gone altogether (i.e. a Complex Partial.) I did go to hospital for this but rotted away until someone saw me. It was hours later and had pretty much resolved itself–about six to seven hours it took in total.

Now, for what really happened with Escher. Since I thought it rather odd as it wasn’t like my previous Simple Partials where my mind and consciousness is always in tact, something didn’t seem right with this one. There was a brief “blackout” of sorts. My neurologist always told me it was extremely valuable that if someone ever witnessed me having a seizure, get their account because if your consciousness is impaired in any way, you may not be able to or can not provide an accurate description of what occurred.

I called Escher and asked him what went on. Whoa. Not at all as I “remembered?” And after this, I worked my brain hard to go over it…is there…was there anything else I can remember about it?

Apparently, I only remembered the beginning and the ending of it and even that is very vague and fuzzy. When it started (and this I had to work to recall later) my vision changed. This is very difficult to describe but I found a near perfect description on an Epilepsy website. Everything went kind of “swirly” and became distorted. Things darkened and then blackness. My vision was just gone. And so was I.

I couldn’t move. I couldn’t speak. My eyes were blank and I was just staring off into space. And yes, I was drooling. Escher was speaking to me but I was non-responsive. He said he gently touched my legs just above the knee but I was non-responsive to tactile stimuli as well. I asked him if I was doing any “automatisms.” These are basically, any repetitive movements that generally don’t serve any purpose and some can be downright bizarre. They are very common with Complex Partial Seizures. He said that I wasn’t. Alright. So, apparently when it was “all over,” I asked him for something to wipe my mouth with. I do not remember this. Again, all I remember is him giving it to me and saying, “Here.” I also don’t remember any kind of a post-ictal state (your ictal state being the seizure itself.) I’ve looked into that and memory loss can happen there too.

And here’s the kicker. It lasted, he said, about two to three minutes. That’s spot on for a Complex Partial.

During a Simple Partial Seizure, you can always talk to me and I can always talk back to you. My consciousness may be just the tiniest bit altered but not even so much that I have tried to time my seizures. In my estimation, they have never lasted past 45 seconds.

So basically, the impaired/loss of consciousness, the inability to respond to any stimuli, the complete memory loss and the time duration all fit for a Complex Partial.

A lot of the literature out there really pushes the automatisms of which I had none. However, I did find a study where several of the research participants had none. Plus they had decreased postural tone so they may have gotten a bit floppy or couldn’t move like me. Also, many of them reported having no “aura” as is what a Simple Partial can be or is also know as. It can serve as a warning sign that a “bigger” seizure is coming. I do not know if the visual changes I experienced was an aura or part of the seizure itself. It could have been one or the other?

Good grief, I even found a study where photic seizures (seizures induced by light/s) can induce a vegetative Simple Partial! But it didn’t go into detail. How long? And photic seizures have never been confirmed with me. During the strobe with my EEG–nothing. But EEGs are notoriously unreliable. They can be consistently negative even in people with intractable Epilepsy.

Another thing that I looked into is if this could be a “Psychogenic Seizure.” Some people refer to these as “Pseudoseizures.” Most people do not like this term as it sounds like they are not “real” or that they may be faking them. The “pseudo” part probably comes from the fact that they do not occur due to electrical discharges in the brain. They are caused by stress and psychological factors. Did Escher stress me out so much I had a seizure?

Well, I suppose I can’t rule anything out at this point. However, some problems with this? It is estimated that between 10-50 per cent of people with Epilepsy can have Psychogenic Seizures as well. I see. They can resemble just about any type of seizure (considering anyone with Epilepsy can have them) but they are generally known to have very specific types of characteristics–none of which I exhibited. However, again…I think it’s safe to say at this point, there are no absolutes in the brain department?

Let’s move on to Migraines! It has long been thought that there are connections between Migraines and seizures. They can look like them, possibly cause them? I looked into that as well and nope. Nothing fit. And I wasn’t even near Migraine territory that night. In fact, daily painy-head seems to be getting better? I don’t feel as bad as before. Either that or I’m just getting used to having small headaches all the time? I think it might be the former? I’m not sure but I’m still monitoring. Maybe I just needed a good Complex Partial to shake my brain up to get rid of the headaches *laughing*

So, I guess I need to talk to my neuro about this. I don’t want to. I have very good reason for that. I don’t want to blog about the reason. I have very good reason for that as well. If it was just another transient, isolated Simple Partial, I wouldn’t bother. But since this is something different, I feel I would be remiss if I didn’t say something.

Complex Partials are really something you shouldn’t play around with. Just because I was sitting down and immobile doesn’t mean if I have another one, it would be the same. When other people have them, they can be walking around, doing all sorts of things… If you lose consciousness, you are in danger. It is also very much believed that once you start having Complex Partials, that is now your course. They will re-occur if you continue to seize. It may not mean that you will not have (or I will not have) Simple Partials but they may be auras to the Complex or they may be “stand alones” as they were before. Or like that study–you may not get an aura and–bang! Plus, Complex Partials of course can then take you on to Tonic-Clonic Seizures.

Indeed, the aim would be to control it all with medication and I have been seizure free for quite a while. I’m still just wondering what on earth happened. And I’m still researching. I should just stop. But in a lot of cases I have a one track mind and that track is long and straight. The freighter just keeps barrelling along at top speed and even if the track curved there would be no one there to work the switch.

The majority of the things above I already knew…I was just (and still am?) looking for something that described exactly what I went through. But one thing I didn’t know that really surprised me was this. I found it in published research and on a lot of Epilepsy websites as well. The way to distinguish an Epileptic Seizure from a Psychogenic Seizure is if the person’s eyes are open. If they’re not; it’s Psychogenic.

Mine were open the other night and always have been with each and every Simple Partial.

Well, congratulations if you got through all of this. I’ll be sure to let everyone know how it goes when I see my neuro at the end of January…or if I seize again?