Seizures

In the mail on Friday we received an appointment to see the consultant opthamologist at the hospital later this week. Admittedly, this was well timed, as we’re getting increasingly concerned about Evie’s vision, but also slightly strange, because as far as we knew, her eyes were structurally fine and our Paed team hadn’t requested for us to have her eyes checked again.

I rang them, and the registrar who had originally seen Evie wanted his boss to check her over as well. Which, great – only, is he doing this to cover his own arse? Or did he maybe see something and not want to sign off on it himself?

We’ll probably never know. In any case, it works in our favour and Evie is being seen by the head of opthamology this week, when we’ll dump all our issues on their lap. Evie’s vision is sporadic, at best. We don’t know if the seizures are interfering with her visual processing, or if there is something else going on that is causing the seizures and visual problems hand in hand.

We were pretty sure that her eyes were structurally fine, but I guess we can’t be 100% certain if the registrar himself isn’t.

She’s still not interested in our faces, and while she smiles occasionally, it’s at our voices. She can track and follow – sort of – her eye movements are incredibly jerky (I think that’s age normal though), but it’s like she’s looking 6 inches above our heads or to the side in order to “see” us. There is never any eye contact, and she only appears to have peripheral vision. And the standard things, like she doesn’t blink at things moving near her face, not even when Isaac nearly poked her in the eye, or when I click my fingers at her eyes.

If we add that to her sporadic blink reflexes (she can’t seem to concentrate on both seeing and sucking, so if you give her a dummy to suck, she rarely blinks at lights shone at her eyes) and her complete lack of interest in anything visually, then I think we’ve got some big issues going on here.

I guess the main questions are going to be: How visually impaired is our baby currently? Is it treatable? Reversible? What is causing it? Will she grow out of it?

I predict that the answers to all of these questions will be “We don’t know” and “We’ll have to wait and see.”

Heh. I just have so much faith in the system, don’t I?

She’s having seizures as I type this, in her pram next to me. Yesterday was a bad day for them – she went all morning without any and inside I was cheering, and then she seized pretty constantly all afternoon. Twitching and eye rolling and unresponsive. She’d come out of them long enough to scrunch herself up and grumble about it, before slipping into more. At 11pm last night she finally stopped long enough for us all to fall asleep, before waking up at 2am and starting the process again.

Eventually I gave up on sleeping and just sat up and held her until they eased around 5.30am.

It wasn’t my idea of fun, nor was she happy about events.

Through all this, I am thankful for your support. Yes, YOU. For everyone who has reached out to say that this sucks, that they’re thinking of us, that they’re holding Evie in their thoughts and prayers. It’s saving my sanity and I need you to know that.

So, thank you.

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So, we saw Evelyn’s paediatrician

by Veronica on September 27, 2012

in Evelyn, Seizures

And in short, because I’m exhausted mentally and physically:

– Her test results are back and are clear for metabolic diseases. Yay, my baby does not have something fatal!

– We have No Fucking Idea what is causing her seizures.

– We have to wait and see if they affect her development before we trial a new anti-convulsant. Phenobarbital is doing nothing, but they’re not keen to try anything else for a little while yet.

– She can come off the pyridoxine, because her B6 levels are fine and the pyridoxine hasn’t helped. Thank goodness for that, she hates taking it.

– We have no idea what is going to happen next, or how things will manifest themselves. Will she develop normally? Will the seizures magically stop? Will she be developmentally delayed? Can she see properly? It’s like super fucked up lotto for your kid!

– Our Paediatrician and the team at RHH continue to be amazing and supportive. Which is nice, when they’re telling you things you don’t want to hear, like “We’ll just have to wait and see” and “We don’t know how this is going to pan out.”

– I am so mentally and physically exhausted that I think I require a week in bed.

 

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The last thing you want to be doing at 5am is watching your baby while she has a seizure. But there I was, lying down with my head close to hers* while I monitored her breathing and watched her eyes roll and her mouth twitch. After a few minutes, she came out of it and vomited all over her bed.

Not that this worries me, except as a seizure symptom – she sleeps on a spare pillowcase to make middle of the night messes easy to clean up. Five minutes later, she’d seized again, puked again and was tired and unhappy at the current events.

She rarely cries, this baby of mine. She gets sad when she’s tired, or uncomfortable, and she whimpers when she’s hungry, but she does not cry much. I am grateful for this, in the middle of the seizures and the vomiting and everything we’re dealing with, I am so grateful that she also doesn’t scream.

Amy was a screamy baby, crying pretty much non-stop for her first 6 months until she learned to crawl. Then she alternated crawling with trying to kill herself (we lived in a house with steep stairs at that stage – it was … interesting) and refusing to sleep. I can’t remember how I coped, but it wasn’t pretty.

So, Evelyn doesn’t cry. At 5am when she was unhappy, I gave her a dummy, rubbed her head, patted her stomach and she went back to sleep, before seizing again. She stayed asleep that time, but I wasn’t so lucky, as I wiped her pukey mouth and made sure that she was lying on her side to prevent her breathing anything in.

This is my new normal and forgive me if I hate it a little bit.

She laughed for the first time, did you know that? It was in the middle of a seizure though, so it doesn’t count. Just like the sobs while she’s seizing aren’t real sobs and nor are the smiles. They’re just responses to internal stimuli. It’s funny how this works.

We see her Paediatric team tomorrow at the hospital, to let them know that neither the pyridoxine (B6 supplement) nor the phenobarbital (anti-convulsant) have made any difference to our baby. We’ll point out the new symptoms we’ve noticed and hope that they either mean nothing, or that they are benign. We’ll discuss the fact that her test results aren’t back yet, and aren’t expected for another 10 days or so. I’ll mention that her vision is still very sporadic, and that some days she hardly sees at all, but other days she will fix and follow beautifully (today is a good vision day – yesterday was not).

And then we’ll hopefully get new meds to add to her current regime and more time at home while I try not to google “inborn errors of metabolism” and associated things.

You know, because Google is apparently bad for your health.

Dear Evelyn: I’m sorry for taking your photo mid yawn.

*Yes, we’re practically co-sleeping. Evelyn has a three sided cot that fits in next to our bed, so that we can co-sleep on separate matresses. This is the sole reason that the Paed was happy to send us home the second time, because she’s not sleeping alone, or far away from me.

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I think we have a plan.

by Veronica on September 20, 2012

in Evelyn, Seizures

As far as plans go, it’s not a great plan (a great plan being “magically stop my baby having seizures”) but it’s a plan and it will do while we wait for Evie’s metabolic tests to come back.

She started phenobarbital Tuesday morning and has been having regular doses of what I am terming “baby drugs” (different from “kiddy crack”, in that “kiddy crack” is actually chocolate milk) and so far, aside from a sedative effect, there hasn’t really been any impact on the episodes.

From here, we’re hoping to be discharged today, to continue giving her the phenobarb at home, while monitoring the seizure activity and following up in the clinic early next week.

Side note: I am all for gazing adoringly at my tiny baby, but do you know how exhausting it is to watch the baby constantly, to the exclusion of nearly everything else? Exhausting. It’s a good thing she’s so pretty.

If the phenobarb doesn’t work, we’ll try another medication. This we’ll continue doing either until something works, or she naturally grows out of the episodes, or the metabolic tests come back and tell us something.

The problem with Evie’s seizure episodes is that she’s not presenting like a newborn. Normal newborn seizures (usually benign, I should add) are different to Evie’s. Evie is presenting with seizure activity that is similar to something that shows up in 4-5 month olds.

She’s very advanced, obviously.

This is, of course , the reason we’ve done all of these tests, because she’s not presenting in a textbook fashion for the benign seizure disorders that show up in babies. Typical child.

Today when I see the doctors I will mention yet again the probability of Evie having Ehlers Danlos Syndrome (which, SURPRISE! can also be linked to a relatively rare metabolic condition] and see what they have to say.

But really, until tests come back, we can’t do anything except try and control the seizures.

(Or, seizure type episodes, as the doctors insist on mentioning, at which point I say that anything that alters my baby’s consciousness and causes her to have involuntary movements and limited to no responses during, is not normal, and I don’t care what we call them, can we just get on with fixing it? Also, EEG’s are great, but they’re not perfect and how do we KNOW that they’re not just originating from deeper in the brain? Where an EEG can’t pick up? I am probably too well researched for my own good here.)

So, that’s it Internet. An interim plan.

(Also, please let us get home today. This recliner is crap for sleeping.)

Update: HOME! We’re HOME.

That is all.

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I would just like to point out that I haven’t stabbed anyone today. Nor have I shouted (except once, when Amy was incessantly pulling on my pants to get my attention instead of USING HER WORDS and that, my friends, is justified shouting), or thrown any crockery, or had a tantrum.

I mean, considering the circumstances, I am being VERY CONTROLLED in the face of extreme stress.

If you’ve guessed that today is the day for Getting Shit Organised, you’d be right. Unfortunately it seems that Evie’s medical teams are all busy with other patients and emergencies and yada yada and so far, no one has returned my calls.

My twitching, it knows no bounds. Neither does Evie’s twitching, but hers is entirely different.

On top of her regular seizures, it has come to my attention that I just don’t think she can see anymore. Except for bright lights – I know she can see bright lights, they are the only thing she responds to visually.

The last time she smiled at me, properly, was a few days before we noticed her seizures. No smiles since. She doesn’t look at my face, she doesn’t track with her eyes, she doesn’t follow our movement around the house. All things that she was doing prior to the seizure activity. Now, nothing. She also doesn’t blink if you snap your fingers in her face, or flick your fingers at her eyes.

Nor did she blink when Isaac nearly poked her in the eye.

I sat down in front of her yesterday and tried to catch her gaze. It wasn’t until I spoke to her that she responded, by jumping out of her skin and looking offended.

There is something called Cortical Visual Impairment which can go hand in hand with seizures.

(And something even more terrifying that causes seizures and CVI together, along with a few other markers Evie has that we’re waiting on the test results for, but we’re not thinking about that possibility.)

I need my medical teams to call me back so that I can announce to them that Evie isn’t seeing things anymore. So that we can get things moving.

Instead I am wandering around the house, unable to settle, waiting for phone calls.

[I know my medical team is very busy with an entire ward of paediatric patients, so I’m not terribly grumpy that they haven’t called yet. I’ll ring again in a few hours and see if I can catch them them. Our main Paed (working hand in hand with the hospital) has a full list of patients this morning too, so he’s busy as well. I’m just impatient and grumpy. Also, worried.]

 

UPDATE: Spoke to our Paed. We’ve been told to take Evelyn back to Emergency. Wish us luck.

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