Letter to Valerie, Dr. Bell's nurse
Dear Valerie,
As far as seizures go, Rick is doing fine. But there are some other things that are concerning to me and I wonder if they could be side effects of Topamax.
I think maybe he is having some hallucinations. It is hard to tell since he can’t talk. But he gets very anxious, maybe frightened, at times, saying, “Ohh..oh no.” Once he even slapped his leg like something hadn’t gone the way he thought it should. Sometimes he has said , “I’m sorry.” He wakes up at night at least once each night with a start, jumping up in the bed and trying to get out of it, very anxious. I can calm him down in just a minute or two and he goes back to sleep. Then usually sleeps the rest of the night without incident. May get up once to go to the bathroom.
He seems to be a little more agitated this week also. Friday was a great day. I can’t remember when he started getting this way. But most of this week he has been more agitated, rubbing his hands together. Not staying focused on his eating. Not sitting still in his chair. Looking worried. More resistant to my direction. Hard to get him to sit on the toilet and chairs. He pulls his hand away when I try to lead him somewhere. Sometimes he doesn’t want to move his feet.
These things have happened in the past but I felt they were medicine induced. Especially since he has been so good about all of this with the Dilantin gone.
Do you think that his Topamax is too high? I just started with the generic yesterday and these symptoms have been going on all week.
Valerie's response:
Dr.Bell says to try staying at current dosages of Topamax and Keppra for now---give it another week to see if these symptoms resolve. If not, then he says we can try reducing the Topamax by 25mg to see if that will help with side effects but keep seizure control.. He feels like if we give it a little more time, that he will become more accustomed to the medication and the symptoms will fade away.
My comment:
I didn't think about the fact that these symptoms might be part of the adjustment to the medicine and may go away in a little bit. I will keep observing.
As far as seizures go, Rick is doing fine. But there are some other things that are concerning to me and I wonder if they could be side effects of Topamax.
I think maybe he is having some hallucinations. It is hard to tell since he can’t talk. But he gets very anxious, maybe frightened, at times, saying, “Ohh..oh no.” Once he even slapped his leg like something hadn’t gone the way he thought it should. Sometimes he has said , “I’m sorry.” He wakes up at night at least once each night with a start, jumping up in the bed and trying to get out of it, very anxious. I can calm him down in just a minute or two and he goes back to sleep. Then usually sleeps the rest of the night without incident. May get up once to go to the bathroom.
He seems to be a little more agitated this week also. Friday was a great day. I can’t remember when he started getting this way. But most of this week he has been more agitated, rubbing his hands together. Not staying focused on his eating. Not sitting still in his chair. Looking worried. More resistant to my direction. Hard to get him to sit on the toilet and chairs. He pulls his hand away when I try to lead him somewhere. Sometimes he doesn’t want to move his feet.
These things have happened in the past but I felt they were medicine induced. Especially since he has been so good about all of this with the Dilantin gone.
Do you think that his Topamax is too high? I just started with the generic yesterday and these symptoms have been going on all week.
Valerie's response:
Dr.Bell says to try staying at current dosages of Topamax and Keppra for now---give it another week to see if these symptoms resolve. If not, then he says we can try reducing the Topamax by 25mg to see if that will help with side effects but keep seizure control.. He feels like if we give it a little more time, that he will become more accustomed to the medication and the symptoms will fade away.
My comment:
I didn't think about the fact that these symptoms might be part of the adjustment to the medicine and may go away in a little bit. I will keep observing.
posted by Unknown at 11:33:00 AM
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