Seizure-ish?

Rick did some really weird different things last night. I gave him the Depakote at 9:15 pm and we got in bed about 10:15 pm. I didn’t give him any melatonin at bedtime, just to see what the Depakote would do. He was up again at 1 pm at which time I gave him the melatonin, 2 tabs. Then at 2 am he hollered out – I’m not sure if it was a start or not. He didn’t wake up from his sleep. This happened again about 3:30 am. Then he woke up at 6:30. I took him to the bathroom and he was very halting in his walking, very jerky muscles. No starts as such but still seemed seizurish. I got him dressed and then we had breakfast at about 7 am. I got his Keppra and Depakote in right away. He had occasional starts from then until he got on the bus to go to the center.

This morning is his first morning dose of Depakote.

Hopeful answers

I decided to give Rick another Topamax 25 mg this morning so I could be comfortable with putting him on the bus to go to the Center.
Now I have received this reply from Valerie, Dr Boggs’ nurse:
I spoke w/Dr. Boggs and she feels that we may be on to something good with the Depakote and recommends increasing it to 500mg twice daily. She recommended that we could call in something to use as needed for those times when he has a cluster of "starts" that may work better than the Topamax. Topamax is not really designed to be used on as needed basis. She recommended that I call in Tranxene 3.75mg tablets that you can give him one tablet as needed on a day like you had Sat and Sun to settle down the activity. Hopefully it will settle down with an increase in the Depakote.
Now we will see how this works. I will start giving him the Depakote bid tomorrow morning.

Weekend issues - no doctor to talk to!

It seems that if anything is going to happen it happens on the weekend when I don’t have anyone to call.

Saturday we left the house about 11:30 or so and made a couple of stops. Then we went to Tamara’s house because we were going to go to lunch with them. While we were sitting there waiting to go, Rick started having some of his little ‘starts’. They just continued on and on in fairly rapid succession. I was afraid to have him even get up from the couch; much less take him out to a restaurant. I didn’t know what to do, but finally remembered that I still had a Topamax 25 mg in my purse, so I gave that to him. In about an hour he was slowing down and we went out to eat. He was better the rest of the day. That was about 12 noon to 1:30 pm.

Today, Sunday, we got up about 6:00 am. I gave him a shower and got him dressed for church. He sat in a chair while I showered and dressed. We ate breakfast at 8 am, which is when I usually give him his morning meds. We were ready to leave for church at 8:45 am. I got him in the car and he was beginning to have the ‘starts’ again. I decided I didn’t want to wait any longer, so I gave him another 25 mg of Topamax. We got to church and I was afraid to have him walk down the flight of stairs to our Sunday School class room, so drove around to the back which is a ground level entrance. He slowly calmed down during SS. He napped during that time and when it was over at 10:45 am, he was fine. He has been fine the rest of the day.

I need some help knowing what to do. I just used the Topamax because it is what I have on hand and I felt he needed something. I am worried about sending him to the center tomorrow.

Medication Change

Rick had his first dose of Depakote 500mg last night. His last dose of Topamax was yesterday morning. We didn’t get home last night until 10:15 so he didn’t get his Depakote until about 10:30 along with 2 melatonin. HE SLEPT ALL NIGHT!!! I had to wake him up this morning at 6:40 am. What a wonderful night’s sleep.

So I’m not sure if it was the Depakote or the fact that he walked around the church sanctuary for 1.5 hrs before we went home that helped him to sleep so good. But I don’t remember the last time he slept all night. I have felt it was great if he just woke up once in the night.

He did have one small start this morning. I hope that will stop soon. Is depakote cumulative?

From Valerie,RN, with Dr. Boggs, neurologist,
The Depakote will take about 5-7days to fully stabilize in his system but he may be a little groggy the first few days as he becomes accustomed to it--so you may see that he does sleep more soundly as a result.


From Lynn, RN, at TWADC at 1:42 pm
Rick has had a very good day thus far. (I hope I am not sending this prematurely) He has been active and smiling at everyone. He seemed rested and showed no stress in his face this morning. Many people made comments about it. Hopefully, the Depakote is the key. If I see any changes I will let you know. 
Thanks,
Lynn

Second seizure in 4 days

I got a call from Lynn Byrd at the center today about 1:45 saying Rick had a seizure about 1:30. He fell hard and hit his head on something. He has an abraision and and knot on the right side of his head just above his ear. She said he seized for about 4 minutes, this including the jerking, heavy breathing and then some lighter breathing but his eyes weren’t functioning properly. They were able to get him in a recliner and he was sleeping.
At first I thought I would leave him there to sleep it off, but decided that it would be better for me to take my lunch break to go get him. Rather that have to leave later on because they weren’t able to manage him.
He walked out to the car without difficulty and got in well. He slept all the way home. Got out of the car easily. Was rather sluggish about walking up the stairs but did it. I took him to the bathroom and then put him to bed. He is sleeping there now.
I called the neurology department at NCBH twice since this seizure. Valerie has been in a meeting all afternoon. Finally Sandy, another nurse there, called me saying she spoke with Dr Boggs explaining the situation. Dr Boggs says to stop the Topamax altogether and start Depakote 500 mg hs. I asked about lamictal, which is what Dr Bell had said was a good drug. She said she would relay this question to Valerie so she could talk with Dr Boggs about it. Sandy will call Depakote to Gateway pharmacy. I will pick it up tonight.

Seizure, first since February 2010

Rick had a grand mal seizure this morning, Saturday, April 02, 2011. It was at 7:47 am before he had taken his morning medication.
He seized for about 30-60 seconds and then went into a deep snoring sleep for about 15 minutes. Then he would try to get up and then sleep for awhile, repeating. I was finally able to get him in the bed at 8:14. Then he slept pretty good until 9:24 when he got restless and I took him to the bathroom.

I gave him his Keppra and Topamax at about 9:40 am. He chewed them but didn’t swallow them. I was finally able to get him to swallow a little bit. I’m not sure how much he actually got down. Most of it I think. I guess I won’t give him any more until evening.

He’s awake again at 10:18 acting restless.

I really want to work on his medications. I don’t want to keep him on the Topamax. But it looks like he needs something to control his seizures.