Tuesday, May 12, 2009

More seizures

So I increased Rick’s Topamax Thursday to 75 mg bid. He seemed to be fine. Then on Sunday he was having the little starts off and on all day and then again on Monday morning. I called Valerie, Dr. Bell’s nurse, and she said Dr. Bell said to give him 100 mg at his evening dose and keep the 75mg at his am dose. So he got his first 100mg dose about 6:30 pm last night.

I went to Bible Study Fellowship last evening and Debra Riley was here with Rick. She said about 8 pm he had a seizure-ish episode with muscle jerking and being out of it, not unconscious, lasting about 5 minutes. Then he was ok and ate a bowl of ice cream all by himself.

This morning he seemed ok and was easy to get along with. I took him to the Center. About 8:45 am I started getting calls on my cell. I was on a conference call for work and didn’t respond to them. But then my home phone called. So I decided I had better answer it. It was Lynn, RN at the Center, saying Rick had a grand mal seizure there this morning about 8:30 am. He fell forward and bumped his forehead on the floor and got several abrasions on is face from the carpet. So I went to pick him up. I spoke with Dr Bell’s nurse, Valerie, who spoke to Dr Bell and they said to give him a bolus of Topamax today of 50 mg when I got him home and then another 50 mg this afternoon and then his regular dose at supper. She told me that it takes about 7 days for the Topamax level to get up in his system and become effective. So hopefully the bolus will help to bring it up faster.

Rick is home now and sitting in his chair in the living room watching TV.

Rick has been so much more social since he has been down and off the Dilantin. He is more alert, stays awake more, tries to make jokes, says more meaningful things and laughs a lot.

The other evening we were sitting on the couch in front of the living room windows. It had been a beautiful day and I had the window open and the whole house fan on pulling the cool air in from outside. It was getting a little chilly. All of a sudden Rick looked at me and said, “I’m cold.” He does get cold a lot easier than I do. That was a very good statement letting me know what to do for him.

Rick was in the living room in his lounge chair watching TV. I kept checking on him while I did other things. He didn’t seem to fall asleep at all. He just sat there with his head up looking toward the TV. I decided that I should be able to go back to work after lunch, so I emailed Mary Beth, my manager, to let her know this.

Then I proceeded to prepare lunch. I got out some frozen hamburg and put it in the microwave to thaw it. I was going to make sloppy joes. It took me about 30 minutes to get it ready. Just then Rick came walking out to the kitchen. So I sat him down at the table and brought his plate to him. He picked up his fork right away trying to eat it. I hadn’t gotten it cut up for him yet. As I was cutting it, I noticed he was having those little starts every few seconds. I went to get his second dose of Topamax bolus – 50 mg. I gave it to him but he had trouble swallowing it. Those little starts interfered. I was afraid to let him eat much because he might choke on it.

So I decided to call the doctor again. I reached the receptionist and told her that I needed to speak to Dr. Bell or Valerie in person, not just leave a message. She went to get Valerie. Before she got back Rick had a second grand mal. He was sitting in his chair, so didn’t fall. As soon as the jerking was over, about 30 seconds, I pulled him in the roller chair over to the couch to try to lay him down. This was a very difficult task. He was limp, dead weight. Just as I got him on the couch I saw that he was wetting himself…and my couch. I also found blood on his mouth. He must have bit his tongue during this seizure. I hadn’t noticed that at all with the others.

This all happened about 1 pm. I had to email Mary Beth again to let her know that I wasn’t going to be working at all today. Rick slept until 3 pm. He then woke up enough to get to the bathroom. I was able to take off his wet clothes and put his pajamas on. He is in the bed sleeping again now.

Valerie called me back saying that Dr Bell had two options. We can wait to see if the Topamax will take effect, or we can give him a bolus of Dilantin to hold him until he gets regulated on the Topamax. She said Dr. Bell would call me after he got out of his meeting this afternoon. I opted to wait until this afternoon to talk to Dr. Bell. I really hate to put him back on Dilantin, but will if Dr. Bell thinks it is the best thing to do.

4:05 pm. Rick is waking up again, but has just turned over in the bed and is settling down again.

Dr. Bell called me about 5:30. Rick had been sleeping most of the afternoon, only getting up to go to the bathroom a couple of time. We decided to see how he did with this bolus of Topamax instead of going back on the Dilantin.

It is now 6:30 and Rick is starting to get more active. He got up by himself and walked around the end of the bed and then it happened. He had one of those little starts. I said, “Oh, no. You are not going to do that.” As if that would stop them. I put him back in the bed and went to get his supper time pills. There is 100mg of Topamax in that dose. I crushed them and put them in maple syrup and he took them without difficulty. But he keeps having those starts. Even while he is lying still in the bed. I just don’t know what I’m going to do. I hate the violence of the seizures. It hurts me to see him have them. I hope the medicine kicks in soon. It’s 6:40 pm and he has gone to sleep.

7 pm. We just got back up to the bathroom. He didn’t do anything but he had very minimal little starts. I could hardly make them out. He is back in the bed resting. Not asleep, but close to it.

7:07 pm. Rick is asleep. Praise the Lord!
7:14 pm He is awake again. He went back to sleep again and has been sleeping for the last 2 hrs. He would wake up and change positions and then go back to sleep again. I sure hope he will sleep tonight when I’m ready to go to bed.

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