Showing posts with label the mama. Show all posts
Showing posts with label the mama. Show all posts

7.05.2018

Logan's June Neurology Check Up

Last week we took Logan back to the neurologist.  

His doctor wanted to check on him and see how he was adjusting to his new prescription of Lamictal.  Lamictal is the medication that took twelve weeks to slowly titrate him onto.  When he finally hit his goal  of 100mg 2x a day, though, he was still having seizures.  So the doctor upped it to 150mg 2x a day.  This was in addition to the 900mg 2x a day of Trileptal he has been on since his second seizure back in January of 2017.

At the appointment his doctor, who is an amazing deaf woman with the ability to read lips like nobody's business (although I signed throughout the appointment, because it felt rude not to since I have the ability) she patiently answered all my questions and we made some good decisions about Logan's future care.

To sum up what I learned:
Logan has both focal (starts in one place) 
and generalized (starts over the whole brain at once) seizures.  

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His grand mal seizures (the ones where he shakes and falls down, like the one at school and the one in the hallway at home) that first lead to his epilepsy diagnosis back in 3rd grade (fall 2016/winter 2017) are focal (or starting in one place in the brain).   

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His absent seizures (the ones where he has an aura beforehand and stares off into the distance while smacking his lips) could be generalized or focal, and that's why we're having a hard time controlling them.  Watching them more closely, and catching them on video (like I did last Sunday) will help his doctor better diagnose his type of epilepsy and choose the best medication for Logan, should the Lamictal not work. 

The absent seizures that are generalized are more likely to be outgrown whereas the absent seizures that are partial complex seizures are focal and less likely to be outgrown.  During an absent seizure that is focal (starting in one place in the brain) you will have an aura (sense that it is coming) beforehand (which Logan almost always does) but your eyes tend to go to the side, or roll back in your head, which Logan's do not.  He always stares straight ahead during his seizures.
During an absent seizure that is generalized (starts all over the brain at once) you don't usually have an aura beforehand, and your eyes are straight forward (like Logan's always are).  You also tend to come to quickly afterwards.  Needless to say, his symptoms are pretty confusing!

Unfortunately for Logan, I feel pretty confident that his are partial complex seizures because of how strong his auras are, which means he's less likely to outgrow them.  (Josh, my husband, also has epilepsy that he hasn't outgrown, which is another reason I assume Logan has this type of epilepsy.)

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Further hits to the head (in the course of a "normal" ten year old day) will not make his epilepsy worse.  Only Traumatic Brain Injury or brain bleeds will do that. So I can stop freaking out.  As long as I keep him safe while in the water (bathing or swimming); don't let him climb too high (we don't want him having a seizure while he's up twenty feet in a tree); and make sure he always wears a helmet, he should be good to go.  

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Some seizures can be preceded by intense physical activity as it seems Logan's have been.  However, our goal is to reach a medical point where his epilepsy medication controls the seizures so he can do whatever physical activity he wants without restriction.

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We ended the appointment deciding to wean Logan off his Trileptal because it is only for focal, not generalized seizures and in fact, it can increase generalized seizures.  So he's currently down to 600mg 2x a day and next week we will go down to 300mg 2x a day.  By mid July he will be off Trileptal completely.  Our prayer is that we will see his seizures disappear after weaning him off this medication that is no longer appropriate now that his epilepsy has evolved from one type to another.  

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His technical diagnosis is Primary Generalized Epilepsy, which is basically a really general term for what he has, and isn't descriptive at all.  It just says, "this kid has seizures."
His EEG shows broad based sharp waves in the left central region, so that's where his focal slowing (slowing in one area) is.  His generalized slowing occurs both when he hyperventilates and when he is exposed to flashing lights, as well as when he is sleeping.

Because of this, our family has had to skip the new Incredibles movie, which has some really severe flashing scenes that have caused seizures throughout the epilepsy community.  Super sad, but not worth the risk to our boy.

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We left the doctor with instructions to call back in one month and let her know how it's going.  If it's going well, we will continue with just the Lamictal.  But if it's going poorly, we may wean him off the Lamictal and try a different medication for his two types of epilepsy.  Time will tell. 

I am grateful for you all, not only for your love & prayers, but for letting this blog be a safe place for me to work out my feelings as a mama.  It's been a really hard six months with Logan & Wyatt both needing more medically than they ever have before and I'm so thankful that whenever I post anything about Logan's seizures (or Wyatt's asthma), I am met with  nothing but love and support.  You are all amazing and I'm so thankful.

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6.20.2018

Our Days with Epilepsy & Asthma

Two years ago, my three big kids got up in the mornings & brushed their teeth.  
All our bathroom had in it was Children's Tylenol and Minion toothpaste.  

 Now our bathroom shelf looks like this:

And the wall looks like this:

In October of 2016, Logan had a grand mal seizure during lunch at school. He was eight years old.  When a child has one seizure they are highly unlikely to have another, so following a normal EEG, we let it go, hoping it was a one time event.  Then in January of 2017, home during a snow day, he had another grand mal seizure.  Following this second seizure we had an MRI done as well as another EEG.  The MRI showed us that he has a Chiari malformation, but that is unrelated to seizures.  In adulthood it can cause headaches and other symptoms, but it can also be asymptomatic and his is quite minimal.  His EEG, however, was abnormal and showed some waves typical of someone with epilepsy.  He was officially diagnosed and placed on Oxcarbazepine, 450mg, 2x daily.  He was incredibly sleepy at first, but as his body got used to metabolizing the medication, he did better with it.  
Ten months passed with no seizures and we were ecstatic. We figured he had the same kind of epilepsy Josh (his dad) has and that the medication was controlling it.  But then in October 2017 he "passed out" in the bathroom, bashing his face on the counter and scaring the heck out of me.  We assumed it was actually a seizure (not passing out, as he called it), though no one was there to witness it, and increased his meds to 600mg 2x a day.  
Then in December 2017 his seizures began to change.  We were at my sister's house and he had a strange, absent type seizure with some lip smacking.  Then again in February he had two more absent seizures (where his body did not convulse, his eyes were open, but he was not in his right mind & was unable to respond to us.)
Spring of 2017 brought us back to the neurologist for our yearly check up and yet another abnormal EEG.  This one showed both generalized and focal seizures (meaning that Logan has seizures that start in specific areas of the brain, as well as seizures that start in an unknown area and effect the whole brain).  Before he only had focal seizures (seizures that start in specific areas of the brain).  Why his seizures have changed, we may never know.  But they have.  
So his doctor suggested we change his medication.  We started him on Lamotrigine, on a very slow titration schedule.  He started at 25 mg and we watched for any reaction (specifically a really scary rash that can occur) and slowly over 12 weeks we built him up to 100mg.  Throughout May and June we found Logan having many absent seizures after being physically active (jumping on the trampoline, riding bikes, running, riding his scooter).  The good thing is that these new seizures are short (typically less than 30 seconds) and they are almost always preceded by an aura (or sense that they are coming).  Sometimes he gets a telltale headache, other times it's just a bad feeling or pain in his nose that lets him know one is coming on.
Occasionally he can force them away, but only for a short period of time.  Eventually he has to let them come.  He said stress is also sometimes a factor, in addition to being out of breath from physical activity.  Despite being at the full 100mg dose the last two weeks, Logan has continued to have seizures, so his doctor recently suggested we up his dose to 150mg, so this week we are increasing his night dose and next week we will increase his morning dose, in hopes it will stop these seizures.  Once the seizures stop, then we will slowly wean him off the Oxcarbazepine and he will remain on the Lamotrigine alone, as it can control both kinds of seizures, whereas the Oxcarbazepine only controls the focal seizures and could be causing more of these new absence seizures we are seeing.

Logan's AM meds
Logan's PM meds
Everything I need to know about dealing with Epilepsy in Childhood.
This book is amazing & offers so much peace.
I record all Logan's seizures in the back of the Seizures book...
I write dates, details and times for the doctor.
I also include all testing he's done & epilepsy medication he's taken or increased.
Yesterday we went to the water park as a family for the first time this summer and while we were there, Logan had a seizure in the pool.  We had taken into account that seizures would be part of what we'd be dealing with this summer and the twins were prepared to have a little less freedom this summer than last summer because of it.  So Josh was with them when it happened.  Jack was nearest and Logan reached out and put his hands on Jack's shoulders.  Jack knew instinctively what was happening.  Logan started having repetitive mouth movements and Jack used his one free hand (the other was helping keep Logan up) to signal Josh.  I was in the kiddie pool with Carly & Wyatt, but Josh said that this seizure was quite different in that it lasted longer than his previous ones have recently, and also, when it was over, he took much longer to recover.  He could not tell Josh where they were, who his friends were (he had classmates in the pool with him) or what they were doing (swimming).  He was, eventually, able to tell Josh who he was ("umm, dad") after a few seconds thinking.  But he was very pale and suffered a headache most of the afternoon following the seizure.

I hate that he is still having the seizures, that the medication has yet to stop them.  But I am determined to make the summer amazing regardless of what his epilepsy throws at us.  If that means Josh and I have to divide and conquer at the pool, then that's what we will do.  Whatever it takes to keep him safe and make sure he's having fun.


He has a follow up appointment with the neurologist next week on Wednesday and I have so many questions for her:
  • Where are Logan's seizures located (the ones that aren't generalized)?
  • Why does he have two kinds of seizures?
  • How many kids go from having tonic clonic (grand mal) seizures to having absence seizures?
  • Should we do another MRI?
  • Are complex partial seizures (absence seizures) more difficult to treat? Why?
  • Do further hits to the head/injuries worsen his epilepsy?
  • His seizures often seem precipitated by physical activity & nose pain.  Should we therefore limit his physical activity? Is this a common thing?
  • Were those the only seizure activities we saw on his EEG from April? How much activity was there?
  • Is generalized epilepsy the same as generalized seizure?
  • Does he need a calcium or magnesium supplement?
  • Is it time to start weaning off of oxcarbazepine?
  • At what point do we give up with Lamotrigine & try another medication?

So that's where we're at with Logan's seizures & epilepsy currently. 
He's had 22 seizures as of yesterday, and I'm just here along for the ride, monitoring what I can, praying a lot and being the best support I can be for him.  Listening a lot, agreeing that it sucks, and being an advocate for him where I can be, fighting for what I think he needs (different tests, med increases, etc.) and making sure he feels heard.  It's been a really  hard few months with his new type of seizures being uncontrolled, but I really do remain hopeful that we will find something that works for him.  We've only tried one medication and there are so many on the market now that we have access to and can try if this one doesn't work out.

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About a year after Logan was diagnosed with epilepsy, Wyatt got really sick after a cold and was having trouble breathing.  He ended up being transferred from our small town to a children's hospital two hours away so he could be cared for in the Pediatric Intensive Care Unit.
Wyatt has always had Reactive Airway Disease (basically he has a hard time with coughs following colds) and has often needed his nebulizer following illnesses.  But this time, he was retractive breathing which was terrifying to witness, and I am so grateful I knew something wasn't right and got him in right away.
Following his five day PICU stay, he was diagnosed with asthma and put on an asthma medication regimen.

In the morning he takes a multivitmin to help boost his immune system, and following his continual illness this spring, he has also been put on loratadine to help with allergies as well as flonase (a nasal spray), in hopes it will take the edge off some of his nasal symptoms that cause his lungs to get full of junk.

He also does his peak flow every morning (and night) to tell me how his lung capacity is.
250-275 is his "normal" and it varies for every person. When he first got home from the hospital, he was only blowing 100.  That tells you how very (very!) sick he was.

These are my Peak Flow Guidelines for Wyatt.
If his peak flow is 125 or lower, I am to take him to the ER.
If his peak flow is 250 or higher, he just takes his regular evening meds.
If it's below 200, he needs his nebulizer with Albuterol & Budesonide for 1 week, and I also need to see the doctor to get him on steroids.

Since he was so sick in April, I have started keeping track of his Peak Flows on a calendar I hang in the bathroom.  I feel like this allows me to see trends and have a better handle on where he's at.  It offers me a lot more peace because I can see if there is a negative or positive trend and I can also write on there what inhalers or meds he is using to help his lungs if necessary.

This week has been particularly stressful as he has been blowing about 210-230 each day and I've been waiting (and praying!) for those numbers to increase so we can avoid steroids, which help his lungs, but decrease his immunity to further illness. 

 Every evening he takes probiotics and Singulair, which helps with asthma, and we do his Peak Flow again, and check his oxygen levels with this Children's Oxygen Saturation Monitor we got from Amazon for less than $30.  His oxygen is usually between 96-98.  If his oxygen gets below 92 I should be watching really carefully, and if it gets to 90, we should be in the ER, no question.  

When his numbers are questionable (as they are now) we introduce the Flovent inhaler (seen here- it's orange) for about a week, until the numbers improve.  He does the inhaler for two puffs twice a day (morning & night).  It's a steroid preventative inhaler, meant to strengthen his lungs and help give them a boost.  It has kept him from needing the nebulizer or steroids this time around, so I'm very grateful for it!

 When he does dip below the 200 mark on his peak flow meter, then he has to start doing the nebulizer, using two different medications in it- Albuterol & Budesonide.  The Albuterol is a rescue medication that immediately helps him breathe better, while the Budesonide is a steroid meant to strengthen his lungs so they can get better.  The treatments are loud and long, and Wyatt hates them.  But honestly, he's a pretty good sport about it.  What sucks, though, is that once he starts them, he usually has to do them morning and night for about three weeks.  So it's a long haul.

And finally, this is his albuterol inhaler, which we take with us EVERYWHERE in case he goes into respiratory distress.  He can take two puffs and feel instant relief.  When we're at home, I have him use the nebulizer to get Albuterol because the delivery is more efficient, but when we're on the go, this is far more convenient.

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In all, it's stressful some days to have two children whose health I have to constantly monitor... but I feel like six months in, it's finally "normal" and I'm able to breathe deep, even though they aren't always well.  I have to work hard some days to not be bitter that I have to deal with all that I have to deal with while other people have healthy children.  But there are other days when I think how lucky I am that my kids only have epilepsy and asthma.



My silver lining is that Logan's epilepsy & Wyatt's asthma make me super grateful for Jack & Carly's good health.  They also remind me to trust God for the things I can't control.  

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3.23.2018

Around Here: Week Twelve {2018}














Reading... The Immortalists and finishing Station ElevenStation Eleven was so good.  It was intriguing and I could not stop listening.  I had my head phones on constantly, just to listen for ten more minutes here, ten more minutes there.  The way the story was woven together, all the characters eventually linking to each other, was like magic.  The Immortalists is also really intriguing, although, I will warn you that I was surprised by the colorful descriptions of one of the characters sexual exploits in part one. Despite the very graphic nature of some parts of those chapters, the book is just so well written.  I am constantly highlighting beautiful lines that make me stop and take a deep breath.  I can't wait to keep reading and see what comes of these four siblings.

Feeling... really tense.  As I keep eating healthier, I am turning to food less as a means of dealing with my emotions.  But the negative side of that is that I am finding myself more tense in my body since my old way of dealing with stress is no longer working. (Goodbye cookies & ice cream.  Farewell stacks of Ritz crackers.)  I am making goals for April and they include working out each day, which I am hoping will help tackle the tension that is building in my body each day as I parent and deal with life's stresses.

Managing... four sick kids who were home on rotation, and one day all together (what the actual heck!?!) this week.  Runny noses and coughs, even a little vomiting from Wyatt who ended up with (another) ear infection.  He was a wreck!  Every time he sneezes, he just bursts into tears. It hurts so bad. I am praying the antibiotics start working quick so he can have some relief, poor buddy.  Even Carly got sick with a little runny nose, and she is just the cutest ever wiping her own nose with a kleenex.

Back to...  no yelling, with only two days this month where I've lost my temper. It feels good to be back on track.

Enjoying... Josh's parentings visiting this weekend.  They hung out Friday night and then took the three boys all day Saturday out to their land.  Josh and I enjoyed the break, Josh working in the garage and me in the house with Carly toddling around and me reading to my heart's content.  It was a blissful break and one I didn't realize I desperately needed.  (Thank you, Carol!)

Eating... all the crab I wanted at the crab feed Saturday night.  My girlfriends from book club (along with their significant others) went to a crab feed fundraiser here in town (one of them bought our tickets in kindness!) and oh my goodness did we have a good time!  So much laughter and good food.  Thanks for the laughs, as always, ladies.  I'm so glad you're in my life!

Grateful... my sister was willing to drive an hour and a half both ways to watch the kids so Josh and I could enjoy that date with my book club friends.  We don't get out often, so it was super special to go on a real date.  And it was a double bonus that he got to meet my friends!

Coaching... a few of my new friends as they navigate the interview the process with VIPkid.  It's a lengthy process (an application, followed by an interview followed by a Mock Class) with lots of questions, but I'm more than happy to help you along if you're struggling.  Click here if you'd like to apply, and please reach out if you have any questions about teaching with VIPkid. (Before, after or during the process!)

Helping... Wyatt process some emotions as he played "ambulance" with Carly's Paw Patrol firetruck, pretending the bunny on the "stretcher" couldn't breathe and needed to be taken to Spokane to a different hospital.  I just happened to be at the picnic table as he played, listening to the scenario play out.  Later we talked about how he felt when he was in the ER and then transferred to the PICU at the children's hospital an hour and a half away.  Funny enough, he says he had no fear. He felt excited to go in an ambulance and calm because he really liked the EMT's (so did I) and he thought it was a longer drive than I said it was because he slept so good.  It was nice to talk it through with him and hear that although the ordeal was, honestly, traumatizing for me, he was far less concerned.

Ordering... a new summer swimsuit while dreaming of days spent poolside with my kiddos!

Gearing up... for baseball season for our three boys.  Josh is helping coach the twins, while Carly and I will shuttle Wyatt back and forth to his practices and games.  Here's hoping it all goes smooth and that somehow we can still get family dinners on the table!

Eye appointments... for four of us this week (the three boys and me) and hearing good news for all three boys! The twins eyes in particular have improved from this time last year, but even Wyatt's are better than they were. (His prescription is the smallest, barely necessary.)  It was nice to hear that!  It was also nice to choose all new glasses, and to be able to find glasses that fit their growing faces.  We also opted to get transition lenses for the twins because they often take off their prescription lenses to wear sunglasses, and that's really not safe (especially for Logan, whose prescription is over 5.0) Plus they spend so much time outdoors!

Feeling... not quite like myself after an exhausting week worrying about my kids.  I thought maybe I was starting to get depressed, or that anxiety was digging her claws into me, but a good talk with my mom and a look back at the week I had and I realized I am just wiped out.  I think a relaxing weekend with some down time (I took Saturday night off from teaching) and some extra sleep will help get me back to feeling like myself.

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8.29.2017

Nanny's House: Part 1 (Cousins & Family)

We spent nearly a week at my parents' house in Vancouver this month.  I was brave (!!!) and drove all four kids by myself.  There we were met by my sister and her two sons, who were also staying with my mom mid-move, as well as my mom's three dogs & my dog-nephew (He's the cute scottie you sill see below!)
We made so many memories, that I will share the pictures & adventures in multiple parts.

Fun in Nanny's backyard:
Dodger
Carly
Milo
Logan
Wyatt
Jack
Logan & Jack
Ferris
Basil
He's just so cute!
Sadie



Carly & Nanny


A couple nights while we were there, we let the boys stay up late and go outside to tell "spooky stories" (which, with two 9yo's, a 7yo, a 6yo & a 5yo boy, just means a chance to use a flashlight and tell stories about poop & farts) before bed and the boys loved every minute of it. Hahah!





I stayed up way too late every night, but we packed each day with so much fun, that I honestly hardly noticed the exhaustion (except on the days it lead to migraines. frowny face)!



While we were there, my parents had a BBQ that both my brothers and grown nephew were able to attend, in addition to my sister & her kids.  It was one of the highlights of my trip, seeing those brothers, and getting the chance to take a few pictures of us all together.  They are both in really happy places in their lives and it makes me so glad for them. (I believe the amazing women they're dating have a lot to do with their happiness! Sweet girls!)

Nanny & Papa
+ all the grandkids!




At the end of our time, my sister's house closed, her husband got keys, and it was time for her to say goodbye to Vancouver (and my mom) and leave for a new adventure with her family.  It was heart wrenching watching her and my mom say farewell.  

I am sad for my mom that Roxanne isn't there anymore, but elated because she and her husband moved closer to me (!)-- only an hour and a half away.  And those cousins? They are stoked about that!






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