epilepsy Archives - Page 61 of 84

To CBD Or Not To CBD

There is no shortage in the news of sensational headlines highlighting the miracles of CBD and medical marijuana as a treatment for epilepsy.

The articles write about children who tried any number of medications that failed to control their hundreds of seizures a day but were all but cured by CBD.

After two years of uncontrolled seizures, we were so desperate for something that could help our son so we brought CBD up with our doctors. At the time, it was illegal in Pennsylvania and our doctors weren’t comfortable talking about it because they had no experience with it. We were unable to get into the CBD trial happening at our hospital so we discussed moving back to Colorado. Our doctors said there was only limited testing on the drug and that it was focused on specific syndromes associated with epilepsy. There was little research on its long-term effects or its interactions with the antiepileptic medications. Another concern we shared with the doctors was the inconsistent quality coming out of many CBD providers. At the time, we made the decision to not try CBD because it wasn’t worth the risk of introducing a drug with so many unknowns. We had seen what a bad reaction to a medicine looks like for our son and we weren’t willing to risk the progress that we had made.

My son was still having seizures every day so we started to make plans for a VNS surgery. I struggled for weeks with the decision and, even after it was made, I agonized over the thought of surgery for my son. Then, in April of 2016, medical marijuana was legalized in Pennsylvania. We again brought up CBD as something to try before we pursued the surgery and we were referred to doctors in Colorado. The waiting list to get an appointment was so long. Even after a trip to Colorado, we were not able to get an appointment. We spoke to one of the doctors from our neurology department that was familiar with CBD and decided to give it a try.

When the bottle of oil arrived, I tried to temper my expectations. We’ve tried and been disappointed by too many medications already and, regardless of the press clippings, I knew that, for every sensational success story, there were countless stories with less than miraculous results. It may not work at all, or my son may have a negative reaction, as he has had from many other treatments.

The dosing to introduce CBD is slow and we were told it could take months before we saw the full effects. As the parent of a child with epilepsy, I’m no stranger to hearing about patience. That practice doesn’t make it any easier, especially watching my son continue to have seizures. But we started the treatment with a hopeful, open mind and as much patience as we could muster.

After a few weeks, we were up to a functional dose but we didn’t notice any difference in my son’s seizure burden. We increased the dosage again and continued to wait. By the third month, we did see a slight decrease in seizures but nothing like the stories in the news and nothing we could directly attribute to the CBD. With the advice of our doctors, we decided to stay at the dose we were on and adjusted one of my son’s other medications. The result was our first few small stretches of seizure-free days.

I was grateful for those days but I was also disappointed. I had hoped that the CBD would be the miracle drug we were looking for. I hoped it would stop his seizures and that we could get off the other medicine and the ketogenic diet. So far, we haven’t been able to reduce any other medications. Ultimately, we’re not quite sure how much CBD is actually helping my son or if it is helping him at all. This is how it goes sometimes with any drug that tries to control something as complex as the brain. You try it, see if anything changes or gets worse, and then decide what to try next.

For us, I think our experiment with CBD will be coming to an end. We’re going to adjust his regimen and, once those changes take hold, we will start weaning off CBD. If anything indicates that it was working, we will reevaluate. I expect, though, that it will be another medicine to add to the list of ones that didn’t work for us.

Planning For An Uncertain Future

I slid my finger up the length of the envelope, tearing it open along the spine. Pushing the sides apart with my thumb and finger, I reached in and pulled out the folded piece of paper. I lifted the top section above the crease to reveal a bold, red logo and the words “To the parents of…” introducing the rest of the text.

The form letter listed one of my son’s prescriptions at the top and used phrases like “convenience and cost-saving” and “long-term prescriptions”. After I finished reading the letter, my eyes retraced their path and scanned the paper, searching for the words that my mind refused to process the first time around: “long-term”.

“Long-term.” I raised my head as I lowered the letter down to my side. “Long-term.” The words echoed in my head. “Long-term.” My mind ran through inflated synonyms. Never-ending. Without end. Constant. Permanent. Forever. My son would be on these medicines for the rest of his life. The letter became impossibly heavy and pulled itself from my fingers. It landed on the floor without a sound.

When my son was two, long before his first seizure, we set up an educational savings account. It’s one of those investment accounts that provides interest-free growth and tax breaks along the way, but the money must be used for college. We’ve been funding the account ever since, even after my son started struggling with memory recall and attention. He still does and, if things get worse or if his condition changes, he may not go to college. I struggle to acknowledge that possibility. I should look at other options that hope for the best but aren’t penalized if things don’t work out, but I feel like I have given into his condition. That his epilepsy would have somehow won and stolen my son’s future.

Looming larger over me is the idea of what would happen to my son if my wife and I passed away or were unable to take care of him. Our parents are at an age where caring for a child isn’t an option. Before he had epilepsy, we had asked friends in Colorado to care for him. But now, I look at how complicated and hard life can be dealing with epilepsy. I imagine the commitment to care for him as a huge burden that I can’t bring myself to ask anyone to bear. I need to write a letter to our friends and ask if they would be willing to care for a beautiful, amazing child that has epilepsy but I can’t. I can’t risk the feeling of rejection, of rejecting my son, if they say “no”. And I can’t face a world where that’s all I hear and where my I feel like I will be leaving my son alone.

Until I do, we’re sitting in this terrible space where nothing is decided and where everything is at risk. Instead of being brave, of doing what needs to be done, I have been frozen. Being responsible feels like an impossible task when it involves admitting to the cruel condition that my son may live with forever. I’m frustrated not only by my inaction but because I know the worst outcome would be for someone else to make the decision for me. It makes me feel like a terrible parent. It makes me feel like I am letting my son down.

It’s hard to figure out how much hope to have, how much reality to let in, or how much to commit to the possibility that there is an equal chance that things get worse as things getting better. It’s not that I thought my son would be cured. It’s not that I didn’t think that he would be on these medicines for the rest of his life. But I also didn’t actively think that he wouldn’t be cured or that he would have to stay on his medicines for anything longer than today. I didn’t open my mind to either possibility. Instead, I kept my head down and tried to live in the present without looking too far into an uncertain future. Reading the letter reminded me that my son’s epilepsy and his medications will exist beyond today, whether I wanted to face the idea or not.

The reality is that these types of things will continue to weigh me down and keep me feeling stuck until I take action to remedy them. The best thing I can do is to acknowledge that the future is uncertain and to take control of the choices in front of me.

Maybe facing the situation will help. Maybe writing about it will spur me to action. Maybe the new year will renew my strength that last year depleted.

I picked the letter off the floor and put it on the desk in the pile of things that I need to do. It’s time to be brave. I pulled out the chair and sat down in front of the computer and started drafting a letter of my own.

“Dear friends,” it began.

My Little Miracle

When my son was first diagnosed with epilepsy, I didn’t think we needed a miracle. At first, we simply hoped that the seizure he had would be his only one, but it wasn’t. Then we hoped that the medicine they put him on would prevent more seizures, but it didn’t. Still, I believed in the science and the medicine and I thought the doctors would figure out what was causing his seizures and they would consult the great book of diagnoses and prescribe a way to make the seizures stop. But they couldn’t.

The first time I sat next to my son’s bed in the hospital while he was in status epilepticus, I started to lose hope. Or maybe I needed more than hope. I watched the EEG on the screen above his bed spike and flash a constant red alert. The seizure count continued to climb. I thought about racing against the power meter on the side of my grandmother’s house. My cousin and I used to race to see if we could make it around the house before the reading on the meter ticked up to the next number. I was fast in those days, but as I looked up at the counter on the screen, it was moving too fast even for me.

The doctors did the best they could to slow the frequency of the lightning strikes in my son’s brain. A barrage of medicine did more harm than good, leaving him toxic and unable to move. There were a lot of sleepless nights, sitting up on the purple, uncomfortable foam bed as I watched a team of doctors circle around my son’s bed. The wires, many times reattached, that went from my son’s small head to the Great Machine carried signals of coordinated chaos that mirrored the activity by the doctors scrambling to find an answer.

As our time in the hospital continued to accumulate, so did the seizure count on the screen. The technicians reset the system a few times. They said to make sure they were getting good readings, but I wondered if it was to hide how high the seizure count was going. As bad as it is to see the number increasing, it’s probably worse to see the equivalent of an odometer rolling back to zero from too much mileage.

By the second month in the hospital, I started to lose hope. The science and the medicine weren’t finding the answer and my son was still seizing and my sweet boy turned into an unrecognizable, angry creature trapped inside an unstable shell. The child we brought into the hospital was not the one we were taking home. With my hope faltering and no end to my son’s agony in sight, I turned to finding a miracle.

Out of difficulties grow miracles. ~Jean de la Bruyere

I always thought of a miracle as one big thing. I thought a miracle meant that we would wake up one day and my son would be healed. When we sat in the class about the ketogenic diet and heard of miracle stories of children that were seizure free on the diet and were able to wean off their medication, I wanted that miracle. When we were finally able to try CBD, after seeing the stories in the news of the miracles that it had done with children that had hundreds of seizures a day, I wanted that miracle for my son, too. But none of these miracles visited us in the way that I hoped. Or maybe, not in the way that I expected.

Sometimes a miracle is not one big thing but, instead, a lot of little things. While the pills or the diet or the CBD alone did not provide relief for my son, a combination of them slowed and occasionally stopped the rampant storm inside his brain. Dedicated and persistent teams of doctors didn’t give up finding a working dose of medicine and the therapists worked impossibly hard to restore his mind and body. My son is alive, in school and learning, dancing, laughing, and playing. He’s back with us in ways that I began to think were impossible. I was so focused on the lack of one small, discrete defining miracle that I almost missed the larger one that was slowly revealing itself.

It’s easy to give up on miracles when we don’t wake up to find a healed child, a rich bank account, or a clear purpose for our own life. We think we don’t deserve a miracle because of something we did in our past that cannot be forgiven. Or we pray harder or channel our anger at God and the universe when we continue to see someone we love struggle or suffer and they do not intervene. But the secret isn’t praying harder for the miracle that we think we want. The secret is being open to the miracles that happen around us every day.

Miracles are a retelling in small letters of the very same story which is written across the whole world in letters too large for some of us to see. ~C.S. Lewis