11 Apr 11 EPISODES OFTEN MISTAKEN FOR SEIZURES: BREATHHOLDING SPELLS

01 Apr 11 THE CARBOHYDRATE ADDICTION: THE INSULIN CONNECTION

27 Mar 11 COPING WITH SEVERE HANDICAP WITH EPILEPSY

A parent may come to accept the limitations, even the severe limitations, of cerebral palsy or mental retardation, realizing that there is no medicine or surgery that can reverse cerebral palsy or mental retardation. “But if you could only get rid of the seizures,” you may say to us, “life would not be so difficult. I thought you could control seizures with medicine for most children. Why is my child still having seizures?”
Seizures in a child who has other evidence of brain damage may be much more difficult to control. Still, your physician should try new medications, and even if your child is retarded, surgery may not be impossible. You may need to find a physician who is willing to consider new options.
If your child’s damage is primarily in one portion of the brain, removal of that portion could be of benefit. However, most children who are retarded have damage on both sides of the brain; removal of one portion will not be of benefit. Still, even in the child who has bilateral brain damage, section of the corpus callosum can sometimes be of benefit in controlling the atonic seizures that lead to injury, although this surgery, in the severely brain-injured child, has a lower rate of success.
Why do we treat seizures? We treat seizures because they interfere with a child’s function. For the otherwise normal child, occasional seizures that interfere with function require treatment. For the severely handicapped child, however, an occasional seizure may be less handicapping than the toxicity of medications. The risks of treatment and its potential benefits must, therefore, be evaluated carefully in light of your child’s other handicaps. When seizures interfere with your child’s behavior or interfere with placement in otherwise optimal programs in school, every effort reasonable should be made to control them. Schools may be reluctant to accept the responsibility of a child who has seizures. Parents should first try to convince the school that the seizures are not a major problem. It will require persistence, information, and lobbying. If necessary, it may take legal action. The solution will require both strong advocacy and compromise.
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20 Mar 11 SURGERY FOR EPILEPSY

If the spells persist, doctors consider surgery – cutting out the damaged part of the brain. But first they must map the brain to avoid cutting out parts that control vital functions – speech, hearing, sight, writing, muscular movements.
In the past, doctors kept the patient awake during surgery and mapped the brain during the operation by touching or electrically stimulating various parts. For example, if they put a small electric current through the speech area of the brain, the patient would stop talking. But there’s a limit to how long you can keep a patient in the operating room.
Now, doctors map a patient’s brain by putting a network of up to 100 electrodes inside the skull and under the dura, the fibrous tissue that covers the brain. The electrodes may stay in for weeks – patients walk around with them. The scientists record the brain’s electrical activity to spot damaged regions.
Dr. Ronald Lesser, director of Johns Hopkins Epilepsy Center in Baltimore, is one of the proponents of this method.
“In follow-up after surgery, patients do remarkably well,” he says. “You would expect that taking out an area of the brain would create lots of damage afterward, but usually it doesn’t.”
Mrs. Kathleen Fitts of Oakdale, Connecticut, had surgery twice – in 1970 and again in 1989 at Yale-New Haven Medical Center. “The first time, the doctors went in blind,” she says. “They took out tissue they thought was scar tissue. They had left some damaged brain behind.” The second surgery identified all the safe and dangerous areas and removed part of Mrs. Fitts’s brain. She also takes Mysoline and Tegretol. No more seizures.
As many as 16 different drugs a day could not control the blackouts of Marty Downing of Delmar, Maryland. In January 1988, in a 6V2-hour operation, Dr. Sumio Uematsu, a neurosurgeon at Johns Hopkins, took out Mrs. Downing’s right temporal lobe – a quarter of her brain. Afterward, her left thumb and index finger were numb and remained so. But the blackouts are gone.
“I am so much different now,” she says. “I can teach Sunday school again. I ride my bike. I put on a dress for the first time in 14 years. I had to wear pants all the time before, because I kept falling down stairs.”
“It’s not simple. It’s not like getting your tonsils out,” says Dr. Uematsu, “but we do help 75 percent of our patients. The rest are unchanged.”
For Beth Usher of Storrs, Connecticut, surgery was the only way to stop her seizures – up to 100 a day. Surgeons at Johns Hopkins cut out the left brain. Miss Usher went into a coma for 5 weeks. After she regained consciousness, the right side of her body was paralyzed, but she learned to walk again with a limp. She has limited use of her right hand. “But there has not been one seizure since the surgery,” says her mother, Kathy. “Beth gets stronger every day.”
Fewer and fewer people hide having epilepsy now that drugs can control their seizures. Representative Tony Coelho (D. – California) is the first Congressman to announce that he has epilepsy. “When I ran for Congress, my advisers told me not to talk about it,” he recalls. “When I got elected, I decided to go public about it. I had my last seizure in 1982. I ride cutting horses. I am a runner. Nothing slows me down.”
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13 Mar 11 CANCER AND NUTRITION: RIBOFLAVIN (B2)

Riboflavin is important because it is involved in so many chemical processes and functions in the body. Dietary riboflavin must first be converted into an active form in the body before it can be used. Several drugs and diseases interfere with this conversion and hence will cause riboflavin deficiency.
Consider the following facts about this important vitamin:
Riboflavin deficiency results in a decrease in lymphocytes and an increased susceptibility to certain infections. With T cells decreased, a person could also be more susceptible to cancer development.
It is essential for building and maintaining body tissues including the brain, blood, and skin.
It helps to transform proteins, fats, and carbohydrates into energy.
Riboflavin protects the body from skin disorders as well as cataracts and other corneal disorders.
Its deficiency can result from a low-protein diet and can cause lip, mouth, and tongue soreness and burning.
Excess thyroid hormone can use up riboflavin quicker than normal.
Boric acid, which is a part of some mouthwashes, suppositories, and some important foods, helps riboflavin to be secreted into the urine and thereby causes partial riboflavin deficiency.
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20 Feb 11 WHAT’S HAPPENING TO OUR LITTLE GIRLS? (JULIANNE) PART 6

Therefore, I fed her formula. Unfortunately there aren’t any organic formulas on the market. My real suspicion has to do with estrogenic influences in the formula and diet from the endocrine-disrupting compounds that contaminate the food supply. As a nutritionist, I had made sure that Sarah ate the healthiest diet. The thing that made me think that it had something to do with her formula is that she loves it so much. She used to drink a big cup of it every night right up to five years of age. Of course, I stopped that right after her diagnosis. But it’s not provable at this time.
We are now two years down the track and Sarah seems to be tolerating the treatments well. This has become a medical reality in our family and one that we have come to live with. We still don’t know what the outcome will be for my daughter. It’s hard enough trying to keep little girls, as “little girls”, these days. The “tweenie” teenybopper fascination with such sexy symbols as Britney Spears has little girls trying to act much older than they are. If baring the belly button in sexy midriff tops doesn’t cause great consternation to parents, the growing phenomenon of budding breasts and pubic hair certainly does. Discovering your little girl has breast buds or pubic hair is a tragic shock to parents.”
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13 Feb 11 FACING HERPES

Herpes is a general term for a family of infections characterized by sores or eruptions on the skin. Herpes infections range from mildly uncomfortable to extremely serious. One subcategory, herpes simplex, is caused by a virus. Herpes simplex virus type 1 (HSV-1) causes the cold sores and fever blisters that most of us have been afflicted with at one time or another. Although figures are difficult to come by, it is believed that four out of five adult Americans have herpes simplex type 1 (also called orofacial herpes) and that one out of six has genital herpes.
Genital herpes, a highly contagious sexually transmitted infection – for which no cure is currently available – is characterized by recurring cycles of painful blisters on the genitalia.
Genital herpes is an infection caused by the herpes simplex virus (HSV). There are two types of HSV, and both can cause genital herpes. However, historically, the herpes simplex type 2 virus was considered the primary culprit in genital herpes, and the herpes simplex virus type 1 was thought to affect the area of the lips and other body areas. We now know that both HSV type 1 and HSV type 2 can infect any area of the body, producing lesions (sores) in and around the vaginal area, on the penis, around the anal opening, and on the buttocks or thighs. Occasionally, sores appear on other parts of other parts of the body. HSV remains in certain nerve cells for life and can flare up, or cause symptoms, when the body’s ability to maintain itself is weakened.
Once herpes invades, the victim will experience the prodomal (precursor) phase of the infection, characterized by a burning sensation and redness at the site of infection. This is often the time period when prescription medicines will work in keeping the disease from spreading. However, this phase of the disease is quickly followed by the second phase, in which a blister filled with a clear fluid containing the virus is present. If you pick at this blister or otherwise touch the site and spread this clear fluid with fingers, lipstick, lip balm, or other products, you may be autoinoculating other body parts. Particularly dangerous is the possibility of spreading the infection to the eyes in this manner, for a herpes lesion on the eye may cause blindness.
Over a period of days, the unsightly blister will crust over, dry up and disappear, and the virus will travel to the base of an affected nerve supplying the area and become dormant. Only when the victim becomes overly stressed, when diet is inadequate and sleep is inadequate, when the immune system is overworked, or when excessive exposure to sunlight or other stressors occurs will the virus become reactivated (at the same site every time) and begin the blistering cycle all over again. These sores cast off (shed) viruses that can be highly infectious. It is important to note that sometimes, however, a person can have an outbreak and have no visible sores at all. People often get genital herpes by having sexual contact with others who don’t know they are infected or who are having outbreaks of herpes without any sores. A person with genital herpes can also infect a sexual partner during oral sex. The virus is spread, only rarely, if at all, by touching objects such as a toilet seat or hot tub seat. In fact, if you are seated on a toilet seat properly, the only contact with your genitals should be air, and thus, the likelihood of contact exposure would be exceedingly rare!
Genital herpes is especially serious in pregnant women because of the danger of infecting the baby as it passes through the vagina during birth. For this reason, many physicians recommend cesarean deliveries for infected women. Additionally, women who have a history of genital herpes also appear to have a greater risk of developing cervical cancer.
The many myths and misconceptions surrounding this infection have greatly contributed to the stigma associated with it. Herpes is not only embarrassing, painful, and ugly, but it may also cause social ostracism based on a misunderstanding of the infection.
First, herpes is not a form of plague. It is a communicable infection for which no cure presently exists, but it is not transmissible all of the time. In fact, the only time that sexual partners should refrain from contact is when active lesions are present. At other times, the risk of infection appears to be quite small, although viral shedding is possible.
Second, it is often just as necessary to treat the psychological problems of the herpes victim as it is to treat the physical symptoms. People with this infection often experience fear, frustration, depression, and a feeling that they have been dealt a “dirty blow” by someone. Counseling and support groups for herpes victims and their intimate partners have proved very effective.
Finally, although there is no cure for herpes at present, certain drugs have shown some success in reducing symptoms. Unfortunately, they seem to work only if the infection is confirmed during the first few hours after contact. As you may guess, this is rather rare. The effectiveness of other treatments, such as L-lysine, is largely unsubstantiated to date. Although lip balms and cold-sore medications may provide temporary anesthetic relief, it is useful to remember that rubbing anything on a herpes blister may spread herpes-laden fluids to other tissues or, via the hands, to other body parts.
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06 Feb 11 DECIDING TO COME OFF DRUGS: ASKING FOR HELP AND TAKE THE HELP OFFERED

It’s not enough to know you need help. You, yourself, have got to ask for it.
And the sooner you make that vital move, the better. For chemical dependence is a subtle and cunning disease. It will try to lure you into false optimism, and give you all kinds of reasons for not doing what will get you well.
If you are an addict whose partner or family has not yet given up hope, you may well already have had offers of help. They may have told you about clinics which can help you, or offered to go with you for expert help.
Or maybe among your friends is an addict who has successfully given up drugs and is living a new life. Or maybe you know an alcoholic who is leading a life without booze. Perhaps they told you about it and offered their help.
Take the help offered-Maybe at the time it was offered, you indignantly refused. Maybe you feel embarrassed, or even angry, at the thought of having to change your mind and tell them you need help after all.
Don’t let shame or guilt or false pride stop your chances of recovery. If you know where help is available, grab it with both hands.
The best kind of care is from other recovering addicts or alcoholics. They know what it is to stop using drugs or drink, and they have learned how to live life without them. You will find these in Narcotics Anonymous and in Alcoholics Anonymous.

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25 Jan 11 FOR THE ADDICT AND THE ALCOHOLIC: THE NEED TO CHANGE

Addicts also have to change themselves. They need to change their feelings, their attitudes and their lifestyle. This inward and outward change is what protects them against going back on drugs. It sounds tough. But this is a killer disease, and half measures get you nowhere. You don’t even get half well from half measures. You stay wholly ill.
The golden rule about recovering from chemical dependence is that half measures don’t work.
In the long run, offering an easy answer for chemical dependence is not being kind to addicts. Some people treat addicts by giving them legally prescribed drugs in the place of illegal drugs because they think this is kinder.
It isn’t. Take the example of Mary, a young addict who was trying to get off heroin. The doctor treating her gave her prescriptions for DF118 (dihydrocodeine tartrate) and tranquillisers. For weeks at a time she took these pills instead of illegal drugs. And that way she did not learn to live without drugs. Eventually, weeks later, she had to be weaned off the prescription drugs, and suffered the much more painful withdrawals that occur after tranquilliser dependence. Her recovery was delayed and made more painful.
The only kindness to a suffering addict is to help them get properly well, not to enable them to stay sick.

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18 Jan 11 MEDICAL TREATMENT OF SEIZURES: BLOOD LEVELS OF ANTICONVULSANTS AND THE THERAPEUTIC RANGE – WHAT IS THE CORRECT BLOOD LEVEL FOR YOUR CHILD?

What is the correct blood level for your child? The correct blood level is the amount of the drug that controls the seizures. It is not a specific amount. The optimal level is the lowest level that works without causing toxicity. It will vary from one child to another.
This brings us to the concept of “the therapeutic range,” a concept often misunderstood. It may be useful to understand how the therapeutic ranges for these drugs have been established. A small number of adults (or children) were carefully studied using a single drug. The lower end of the therapeutic range was then determined by the level at which seizures begin to be controlled in a majority of these individuals. The upper end of the range was the point at which some individuals began to show signs of toxicity. Thus, the “therapeutic range” is the drug level at which most individuals are likely to be controlled without toxicity. Your child is not an average but an individual. Thus he or she may require a more-than-average level, or a less-than-average level to control the seizures. He may be able to tolerate more or less than average levels before showing signs of toxicity. Therefore, finding the correct dose of a given drug for your child requires a trial to determine what is “enough” and what is “too much” for your child.
The therapeutic range is commonly believed to be the “gold standard” that will guarantee seizure control and avoid toxicity and side effects. It does neither. Yet many physicians misinterpret the therapeutic range as the range where they should keep the blood level, decreasing the dose of the medicine if the blood level is above the range and increasing it if the level is below the range.
To repeat, the correct blood level for your child is enough—enough to control the seizures and not enough to cause toxicity. The therapeutic range is a guide, nothing more.
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