Today was a pretty stress free and straight forward day. I got up, headed to Bethesda NNMC on the metro and saw my Oncologist for my 1130 appointment. It was a fairly easy visit. He had a resident there learning today so I got the help teach strength, balance and memory testing. They do this every few visits just to gauge my level and see if there any differences from last time. I think my strength gets better each time, but the memory stuff stays the same. I'm not getting any younger!
After that, I grabbed a quick bite and then headed to my Neurology appointment. We discussed my last seizure and also talked about the strange twitches going on around my right big toe and the side of my foot. For about two months before the seizure, the activity was so pronounced that I would lay in bed and could feel it. Sometimes it would keep me awake for a while. Then, after I had the seizure, they seem to have slowed down quite a bit. He was interested by this and seemed fairly certain that these were, in fact, tiny focal seizures occurring throughout the day. I thought it was just my brain confused and healing doing that, but that is basically a type of seizure, I guess.
We did more strength testing and he also seemed satisfied with my improvement, but wanted to control the seizures. I am at the maximum dosage for Keppra at 2,000mg per day. He also told me that Keppra is good at controlling generalized seizures, but not so good at focal seizures. I tend to have focal seizures that progress to a generalized seizure. So, he waded through the list of additional medications that he could add and finally ended up at one called Tegretol. I’ll be taking 400mg per day to start. I took my first 200mg tonight and feel okay – a little drowsy – which is a side effect. He said that it also might make my stomach feel upset for the first few days, but it should pass. It’s feeling pretty good so far. The only issue with the Tegretol is that it can increase liver enzymes, so he’ll need to draw levels to make sure that I’m getting enough of the medication into my system and that my liver enzymes don’t increase to a dangerous level. He also wants to do an EEG on Tuesday, just to see what kind of activity by brain is creating. He mentioned that there may be some scar tissue or something else in my brain that is irritating it and causing these seizures. It is apparent that something in the part of my brain that controls my right foot around my big toe is irritated. He said that if I was interested, they might be able to pinpoint it in time, and possibly go back in to remove the irritation. Hmm… we’ll cross that bridge when we get to it. He was also happy that I had an MRI scheduled for later in the afternoon and would use the data from the EEG and MRI to compile the NARSUM for my MEB. He said that he’d have a better idea of what to include in the NARSUM, but was not going to do it until I was stable. That means that next week, WRAMC will only transfer me into their system, I’ll have to move there and then will have ongoing appointments until the doctors think my condition is stable enough to begin the board process. In addition, my doctors don’t want to see me moved to a different location – they would prefer that I stay close to them for my care during the MEB process. My Neurologist said, “Why start you over again with a new doctor? That’s just stupid.” I agree. I hope WRAMC agrees.
After the visit with him, I went down to MRI, and after a short delay due to an emergency MRI, I had my time in the machine and actually fell asleep inside the magnet again. I didn’t have a chance to get a CD of the images because it was after 1800 when I finished, but my Oncologist is going to call me Saturday morning with the results. I’ll pick up a CD on Tuesday when I’m there for the EEG and will try to share them with you.
After the MRI, I high tailed it back to Clarendon and joined up with Amanda, Buddy, Ryan, Zach (John’s brother) and Tamra for dinner to celebrate Tamra’s getting out the Army. We went to The Cheesecake Factory and ate a lot of food and of course, dessert too. Buddy and Amanda gave me a ride home and hung out for a while with me. All in all – another good day. I’m looking forward to a weekend of rest and beautiful weather here in DC. I’ll let you know what my Oncologist says about the scan results tomorrow.