That wasn’t verbatim.  I can’t remember what I said, but it was along those lines.  To whom? A doctor in the ER dept.

Starting this Depakene/Valproic Acid has been bad.  More than.  “Go To The Hospital Bad?” I’ve made several Anticonvulsant additions, titrations, but I have NEVER become such a train wreck as this! Probably the biggest side effect is that Non-Arsey Neuro is away until Tuesday.  I have no choice other than to hang on until then.  Maybe I simply can’t tolerate Depakene, period?

I sort of figured they may not be able to do anything, but maybe there was something “alarming” going on.  This might have been all that captured their attention, though.

After I was admitted, they put me on a stretcher in the hall.  They called me back to triage, I guess to be moved into an exam room.  I got up and hobbled over with Wonder Cane’s brother.  WHAM! I completely lost my legs in front of about 10-15 people.  I didn’t think I hit my head when I went down, but maybe I did.  Because it started to hurt a bit later.  Maybe it was even an Atonic seizure (although I lose consciousness with those.)  However, I had a Simple partial earlier that afternoon!

It caused quite a stir! They put me back on my stretcher, this time with the rails UP! Good thing PA already went to the bathroom before all of this.  Now PA trapped.  PA cognitively trapped, too.  She brought baby MacBook to write but gave up after only getting out two sentences–after an hour–no, probably more.

Alright.  Beware the Medical!

I really wanted a neuro consult but all I got was a lot of confusing blood work.  Initially, Dr. WAA (What’s An Anticonvulsant) wanted to measure my “Epival” levels.  Dude! Dr. WAA! What decade did you grow up in! Epival? Seriously? No one calls it that anymore except maybe in another country where that IS its name! And this isn’t one of them.

My Depakene levels came back as L 229µg/mL (µg/mL means microgram per milliliter.)  I just had to put that cute character in there because I love it.  You don’t have to care, though.  The most important thing is that labs come back highlighting anything flagged as high or low, so you can get it to a doctor stat.  Mine was simply L 229.  Note the “L.”  Low.

Of course I didn’t have my “Depakene Serum Reference Range” memorized before I arrived.  So, I asked Dr. WAA just what was “the normal” range.”  He told me roughly between 350-700µg/mL.  This is where my non-verbatim, “You want me to…?” thing sprang from my mouth.  He said that I may not have hit the therapeutic range, so I need to take more. Oh, really.  I reminded him that things were getting worse over time and they weren’t stopping. Does Depakene somehow work “backwards?” Well, why not? Nothing’s making any sense in my world now, so anything’s possible!

He wrote me a script and said I could increase it from that, keep taking it and wait for Non-Arsey Neuro, or just stop taking it altogether.  I was agog at his last suggestion.  Even though it hasn’t been long, you never discontinue a med or monkey around without medical supervision!

Now that I’ve had a bit of time to ponder Depakene blood plasma readings, check this out! Exactly my line of thinking!

The relationship of plasma concentration to clinical response has not been established for divalproex. In controlled clinical studies, 79% of patients achieved and tolerated serum valproate concentrations between 50 and 125 µg/mL.

Because, I really wanted to tell Dr. WAA about my other Anticonvulsants and stuff.  You know.  Maybe it was a little important?

Oh, but let’s chat more about my blood work.  Just for fun.  Okay, maybe my fun but not yours.  This is all about my kidneys, even though the vast majority of Depakene goes the liver route to say bye bye.  Or crunch crunch.  Or something.  Nonetheless, kidneys say bye bye to so much, that we really can’t say bye bye to the kidneys for this stuff–EVER.

My creatinine.  This filters, stuff out of my blood, via my kidneys and through my urine.  I’m a bit on the high side.  Just a tiny bit, though.  What’s really more important is to move beyond it, and look at (for one) my GFR (Glomerular Filtration Rate.)  That can ask, “What are my kidneys doing?”

There is an estimate system (won’t bother to explain) so, an eGFR.  Mine was a little on the high side, but again, not too high?

So, although Depakene primarily shoots through my distended, overmedicated liver, it does continue to meander along.  Then, it somehow finds my kidneys that look like broken colanders, where a lot of pasta will never, ever be saved.  But that’s a good thing! I like my pasta al dente, so let’s keep throwing the other garbage out!

Wait a minute.  Just like never saying bye bye to your kidneys, you can never say bye bye to these!

My bicarbonate.  A bit on the low side as well.  My calcium is getting down there.  Pretty close to the basement! Ditto my potassium! My electrolytes are looking like they’re going to need some kind of serious electricity to keep them going!

But, oh my! Look at that phosphorous! L 0.86 mg/dl.  Huh? Normal values are 3.0-4.5 mg/dl.  Go straight to a doctor if you are under 1 mg/dl! Hello! I’m here, doctor WAA!!!

Still, there’s this “thing” called an “Anion Gap.”  It’s an equation to somehow chunk a few of these metabolites/compounds together, and guess what! I’m somehow “perfect.”  My Biochemistry sucks.  I know it does but…?

Isn’t this great! On a final note, going back to the creatinine that got the whole ball rolling in the first place? There is another possible problem with my eGFR–and maybe everything else along with! The production of creatinine is basically due to muscle mass.  Just exactly how wee is wee PA? Just exactly how bad are wee PAs gastro problems? *shakes head*

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  1. ZinfryQuefty

    Haha, Doctor WAA.

    Sure you didn’t get Doctor Quickie in that ER? O.o

    I remember a year ago, he referred me to Thistle, he was like What Is Concerta? He was convinced 18mg was an adult dose.

    ACs are just screwy, from what I’m read. Try going up, down, and sideways to see if it might work? LOL

    Although that research suggests you do need to go down, probably even more likely with all your other meds boosting it up, down, left, right, and SPAZ.

    Oh, and divalproex is Depakote. Depakene is known generically as valproic acid if it’s pills, and sodium valproate for syrup. Wtf, it’s all valproate anyway, and it’s epic in terms of confusion.

    As far as I can tell, Epival is a European name. A lot of places use Epilim and Epival instead of the Depa-names.

    Also, since if I remember right, you’re on clobazam and diazepam, maybe there’s a Depa-benzo thing going on?

    I know if you mix Depas with clonazepam you can get NCSE, which would have you starting all over again. O.o

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  2. I’m seriously worried about you. Please keep us up to date with the insanity of your meds.

    *thinking of you*

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  3. Hi ZinfryQuefty. *laughing* Maybe Quickie got a transfer. Or maybe Quickie and Thistle morphed into WAA, somehow. Ah, well. But 18mg of Concerta as the adult dose? No comment.

    ACs are pretty screwy and yet they’re not, I find. For one, you get your results a lot faster that ADs! That’s Bipolar territory, though. Epilepsy may be a different story. That might take us back to someone who has anything related to Depression and having to run the AD gamut.

    I think it’s a lot harder because you’re comparing two very different things, as well. “Depression” or whatever, isn’t as precise as epilepsy can be.

    A person may actually be restricted to one type of seizure alone! Therefore, based upon past precedent, the best AC for this is x. Give the person x and they luck out! My seizures were just dandy (only Simple partials and almost gone) until I got laid off! Sheesh. I was only on ACs for my freakin’ Bipolar! Then, titration of Lamictal in the summer and pretty much everything quiet but some SPs and Reflexes!

    Yes, the whole “Depa” madness. It really is so stupid. Valproic Acid vs. Sodium Valproate. I’ve looked endlessly for a pretty picture of the molecular structures of each, but just gave up. Who cares? There are much more pretty things to look at in life.

    Because of all these insane side effects, I’m wondering if the sprinkles would be better. I have taken this with food (whenever I CAN!) but it doesn’t make a difference. Since it does so much to me, maybe I could try the sprinkles over ice cream and have a little “Valproate Sundae!” Add in the Topamax ones, too? Nah. KISS Rule. I don’t know if they are available in Canada.

    I think the name Epival may have been used in the past. Well, I don’t really “think.” I know. I just had to remember!

    Way back when I was seeing Dr. Asshole, we talked about trying it. “Way back when…” is quite possibly where a patent hadn’t expired! Yes, it sounds kind of weird to change the name so drastically, right? Well, Big Pharma is totally weird anyway. Case in point: Epival IS still on the market from Abbott in Canada! Just in the IV form!

    And finally, the benzos. The only one that they’ve mentioned is Clonazepam. I took that a few years ago and had some issues anyway.

    There is a noted side effect where it says my Valium might NOT work so well but it seems fine, I think. It’s only the Gravol that’s not cutting it! Feeling barfy is a definite problem.

    Hi katm. Good to see you. Awww, thanks hon. At this point, I’m really wondering if I just can’t handle this med. My body just can’t tolerate it! That feels really weird to me because with ACs, it’s always been so simple. I know the regular pattern of side effects and what to expect. The next factor is either the drug works or not. But this???

    I know you’re on my feed of something (I think?) as you just seem to come by at random moments and say the “right” things. If so, you probably know why this has been prescribed and its huge significance. If you, or others, out there don’t know, it’s Typical Absence Status Epilepticus.”

    It leaves me in bed for 12 days every month, unable to leave the house. Obviously, that presents a bit of a problem. However, I have now been sitting feeling even sicker, unable to leave the house, for taking a drug to try and remedy this. Yes, I know. We won’t know for some time, but please!

    I managed to find just the itty-bittiest amount of energy yesterday, so I really wanted to put it to good use! I had a shower and did sort of 1/2 laundry. What is 1/2 laundry?

    I put a load in the washer and then when done, put it in the dryer. Then I just left it. It’s still sitting there. I decided to stop when doing a risk-benefit analysis of “Laundry vs. Life.” I had to hobble down an awkward stairwell with a fair amount of weight.

    But absolutely katm, I will keep you informed! I promise.

    Also, how’s your bed situation? *laughing* Mine has completely reverted to the bed/office/closet/pharmacy! I knew THAT wouldn’t take too long! However, I have sheets, pillow cases, and my duvet cover still in tact. Although, my duvet looks like some kind of jumbled mixture of a small meteor, charcoal and jello.

    Speaking of linens and stuff, better go get that laundry. Don’t worry! I’ll be safe!

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  4. :-)

    My bed. I actually put a clean sheet on the other day in a fit of energy. And, get this, it actually fits. I was having to remake my bed every other day because I was using a double sheet on a twin bed. Now I have a proper twin sheet.

    *sob*

    I miss my double bed. Me and two cats are a bit crowded in this little bed. And you know they must lay horizontally across the bed. They leave me pressed up against the wall.

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  5. Hi katm. Indeed, a fit of energy required. I was forced to (re-)make everything because I actually got bed bugs! Can you believe that? Bed bugs!

    I was having so many “fits of energy” I cleaned my entire flat from top to bottom! Well, as best I could. Thankfully, I got rid of them. However, it did require several bed linen changes!

    Oh, twin beds are not good. I have a Queen (Double in other countries?) and I loooove it. Wee PA in a big bed!

    I’m not surprised by the feline, sleeping, behavioural patterns at all, either. They don’t just own the bed in your living space, they own your entire living space–you included!

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  6. I am only their servant.

    And bed bugs? *shudder*

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  7. Hey katm. They only “sound” icky. They’re more of a pain in the arse. You can’t see them as they’re nocturnal. It’s only when you wake up and find yourself with little, itchy bumps.

    At first, I only had a couple and I know you can get spider bites in your sleep, so I didn’t worry. Then, I started to get them in larger patches.

    I thought I had hives but I’d never had hives before. However, stress can bring them on and I was under extreme stress at the time (when J. was going through all of that that crap, his sister came over from Paris etc…)

    I went to see a doctor and this is kind of funny in its own right. Aspie literal thinking or just me being stupid. He asked me if I had a computer. I thought for a second, ‘My computer is giving me hives?’ *laughing*

    No, he printed off the first page of one of our city’s Ministry of Health, blah, blah about BEDBUGS!!! When I got home and online, I could not believe what I read. They have this entire “task force” and program and hotline number. If you need it, they’ll have someone come by and assess your place to see if it needs fumigation. I was stunned.

    Because, you see, there has been an incredible increase in infestation where I am, in New York, another city too, I think. No one knows why, either. I think we reached 2009’s total amount of infestations by the first 3-4 months of 2010!

    It can happen anywhere, as well. A lot of people think you get bedbugs because you live like a disgusting, filth pig. Not at all. The doc was telling me he and his wife went on vacation and they stayed in this uber-chic hotel. She got nailed!

    Apparently, I was really lucky. I got rid of them all on my own. That’s probably because I was freaking out so much, I cleaned virtually non-stop for a week! I’m not joking. I laundered every single thing possible. Vacuumed and swept everywhere (no carpet) threw out six bags of garbage, vacuumed my bed several times as I had to sleep on it, then had to re-wash my clothes and back and forth. That was kind of interesting as I don’t have a hose attachment.

    Anyway, the most important thing is they’re gone! I’m not entirely sure how they got in here in the first place! The other two tenants didn’t have them. I think I pulled something old out of storage and maybe that was it?

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