I recall the day I had my first seizure very well. I was walking into the room where a school-wide mass was taking place when suddenly, as the music began, I became very anxious. Everything seemed to be in slow motion – even the music slowed down and I started to shake. I did everything I could to continue standing but the pain was too great. I slowly dropped to the floor. At one point, I thought I was dying (I thought this was the end). I woke up to the comforting smiles of my middle school’s vice-principal and nurse. My body was physically drained. They told me I had a seizure.
What was a seizure? For someone who had no bad medical history, why me? The shock of the diagnosis of Epilepsy was a bit overwhelming in and of itself, but then I had to learn all about it. All of it seemed so surreal. Over the next two years I went through countless seizure-drug combinations, some of which drastically changed my mood. At one point, brain surgery was discussed.
I was already struggling with anxiety but the diagnosis only made things worse. I constantly would wonder “When would my next seizure happen?” I was terrified. Seizures didn’t just affect me physically, they affected me emotionally and socially. During Middle School, I was nervous when I wasn’t around an adult. Also, I felt other students didn’t really understand me, some were even scared to have me around. There was always a sense of guilt and that I just caused ‘extra work’ for everyone; often I just wanted to disappear.
In the 9th grade I starting to become very socially withdrawn and didn’t feel accepted. I began to spend more time composing and engineering music, whether it be in the hospital, my room or a local studio. I caught a break and started working with major songwriters and recording artists, while continuing school. Throughout high school, I only had a few people I could confide in. There aren’t a lot of people who will understand those daily struggles. Most never saw the tears or the endless nights in the hospital.
When I graduated June 2014, my seizures were finally controlled by medication. I recently started college, focusing on graphic design, while continuing on music collaborations. I consider myself extremely blessed to have had great support from family, teachers, doctors and school nurses.
My dream is to create a career in the arts, one that will help inspire other struggling artists to persevere and push beyond the seemingly hopeless circumstances they sometimes face in life.
Epilepsy is difficult to explain, describe and understand. People can only “see” epilepsy when someone is having a seizure. For many people with epilepsy, seizures are unpredictable and, sometimes, undetectable to others. In my case, most of my seizures have been tonic-clonic, or grand-mal, seizures. Tonic-clonic seizures are hard to miss. However, unless I’m having a violent seizure, no one would know I have epilepsy, until I open my mouth. I talk a lot about my epilepsy. Communicating with others about my epilepsy keeps me safe and helps me take control. As a person with epilepsy, I force myself to keep an open and honest dialogue with all of my medical professionals, my peers and my work colleagues.
I was five when first diagnosed with epilepsy after having absence, or petite-mal, seizures. At the time, I did not mind the epilepsy diagnosis because my seizures were not visible to me. Then, I learned I had to take monthly blood tests…with needles! I dreaded blood tests and I did not go softly or quietly into the pathology lab. It was stressful for me; every time I knew I was getting another blood test I would start crying and screaming. Finally, a lab technician took a moment to speak with me. I expressed to him my fear of needles. He offered to take my blood with a smaller needle he called a “butterfly,” and it would not hurt as much. I agreed to cooperate calmly. One conversation changed my entire attitude towards blood tests and my behavior at the lab. The recommended “butterfly” needle might have reduced the physical pain, but in hindsight, it was the technician who calmed me down by communicating with me and addressing my fears. At the age of six, I found power and control by openly communicating with all of my doctors and medical professionals.
My first tonic-clonic, or grand-mal, seizure happened when I was in junior high school. Epilepsy is a difficult thing to openly discuss, especially during those awkward adolescent years. After many in-class seizures, I realized it was difficult and scary for my peers to witness one of my seizures. So, I took responsibility, and talked openly about my epilepsy. There were some students who used my epilepsy as a way to bully and tease me. A few kids called me “seizure girl.” I endured other unpleasant instances of bullying targeted at my epilepsy. Fortunately, I did not care about the opinion of those who bullied me. They did not want to communicate; they wanted to attack.
My seizures were controlled during high school. Although my epilepsy wasn’t visible, my parents and doctors strongly encouraged me to continue to disclose my condition. I often had to explain to friends I did not go to concerts because most concerts have strobe lights, a trigger for seizures. After I turned sixteen, I knew communicating my health issues was a legal and ethical responsibility as a licensed driver. I was becoming an adult and I needed to learn to talk about my epilepsy independently from my parents and pediatric doctors.
In my early twenties, I started having seizures, again. I was new to the New York City workforce and I knew little about how to talk about my disorder in the workplace. I never knew when to disclose my condition or who to disclose my condition to. As an adult, communicating about epilepsy, or any disability, in the workplace can be a grey area. I did not know if I should mention my epilepsy before or after I interviewed for a new job. Most companies do not encourage people to ask others their health issues, due to privacy laws. At twenty-seven, my epilepsy was uncontrollable and I needed to change my medications (AEDs). At the time, I was having seizures at work and felt devalued as an employee, even though I had a better attendance record than many of my colleagues. In fact, I had a superior criticize me via email for not drinking and socializing at an after-hours company event. I realized the people I was working with did not want to communicate openly and honestly about my epilepsy. Like the bullies in junior high, I stopped communicating with them. Instead, I communicated with my doctors and a lawyer. I filed for the Family Medical Leave Act. This provided me some short-term job protection. It also gave me a chance to stand up for myself against employers and colleagues who tried to exploit my condition as a weakness. My epilepsy is a neurological disorder, not a weakness.
I am still figuring out the best way to live and work openly as a person living with epilepsy. Luckily, I have connected with the Epilepsy Foundation of Metropolitan New York to learn more. The EFMNY provides tools to help facilitate communication and understanding about epilepsy. It provides New York City’s only specialized job development and vocational services program for people with epilepsy. Few people understand epilepsy and epilepsy’s far-reaching effects on a person’s life. So, as a person with epilepsy, I find it easier to tell others about my condition. People are sometimes afraid to ask questions about a disability or condition out of fear of being offensive or sounding stupid. So, I try to beat them to the punch and talk about my epilepsy first. It is important to help educate, explain and remove the stigma. I will never have complete control over my epilepsy, but I have complete control over my conversations about epilepsy.
-Alexandra DeBourcy, Mrs. Gotham City
My name is Alexandra DeBourcy and my epilepsy is a part of my life, my history and my future.
I was diagnosed with epilepsy at the age of five, when my parents noticed I was having “head tics.” Shortly after starting my epilepsy medication, I stopped experiencing myoclonic tics. As a 5 year-old, I did not understand the full extent of my diagnosis, but I recognized a change in my lifestyle. At that very young age, I had to swallow non-chewable prescription medication, undergo many boring diagnostic tests and take monthly blood tests. The blood tests were the worst. Even at five, I knew my epilepsy diagnosis was changing my life.
Despite years of living seizure-free, one day during class when I was in the 7th grade, I had my first ever grand-mal seizure. When I awoke, I was still in school, surrounded by working paramedics, as well as teachers and school administrators whose faces were filled with panic and fear. It took me a while to understand I had just had a seizure. At the time, I could only think about how my peers, who also witnessed my seizure, would judge me. Prior to returning to school, I called some of the students in class. It was easier to explain my epilepsy on a one-on-one basis. It helped. I don’t know if my phone calls helped any of my classmates, but it I do know it helped me. It gave me strength to face my schoolmates. I had more grand mal seizures in school during my adolescence, but I continued to open up and discuss my epilepsy with classmates and adults.
Luckily, I remained seizure free during high school and most of college, but my epilepsy was still a part of me. My parents and doctors reinforced the need for me to communicate my disorder to my friends, teachers and professors. No matter how long I went without a seizure, I had a different lifestyle than my peers. I was approaching the age where my actions, especially as a driver, had a greater effect on the lives of others. So, I continued to use communication, and levity, to introduce my epilepsy to other people.
After graduating from Syracuse University, I started having grand-mal seizures, again. This added additional considerations, as I was about to begin my career search. My epilepsy stabilized, and I moved to New York City. I loved New York City, and it had a public transportation system I could depend on. I was able to find work at an ad agency with an insurance plan. Since I had been denied a private insurance due to my pre-existing condition.
Unfortunately, I continued to experience seizures through out my twenties. I also experienced the Great Recession, the election of our first Black President, and falling in love with my husband. Eventually, my doctors and I decided to change medications. I had seizures at work. Some of my colleagues were empathetic; others were not. I sometimes felt stigmatized in my work environment. Due to privacy laws, it was hard for employers and colleagues to talk openly with me about my epilepsy.
Eventually, I left advertising. It was not the best career environment for my epilepsy. I decided to change careers and become a gemologist. My change in careers has allowed me to work in an environment more suitable for my epilepsy. I also work very happily with diamonds, gems and beautiful jewelry. It also has provided me with more time to devote to helping others with epilepsy. I now have the chance to represent the Epilepsy Foundation of Metropolitan New York as Mrs. Gotham City in the upcoming Mrs. New York America pageant.
I have had to accommodate my epilepsy throughout my entire life and, many times, I have resented my epilepsy. However, the happiest times in my life occurred when I worked with my epilepsy without shame. It is embarrassing to have a seizure in school or at work. It is awkward to tell peers about a personal neurological disorder. Furthermore, it is difficult to disguise EEG electrodes for three days straight. So, as an epileptic, I know I can empower myself by starting the conversation on my epilepsy. I want to continue and expand the conversation with others living and affected by epilepsy. It is the best way I know to keep myself safe and happy. We need to discuss new treatments, gather community support and take the stigma away from epilepsy.
“It was such a privilege to gather with New York & New Jersey families in NYC in support of the #CARERSAct legislation sponsored by Senator Kirsten Gillibrand, Senator Cory Booker, and Senator Rand Paul, which aims to reschedule cannabis to facilitate epilepsy research. The CARERS Act Bill will provide access to research, enabling families and their physicians to chose treatment options without fear of being in violation of federal law. It provides hope in the battle against seizures and we are deeply grateful to the bills sponsors.”
-Statement from Executive Director Pamela Conford of the Epilepsy Foundation of Metropolitan New York (EFMNY)
For full information on epilepsy and the CARERS Act, please read our blog post: http://epilepsynyc.com/2015/03/epilepsy-carers-act-reschedule-cannabis-marijuana-explained/
NEXT UP: Our 1st Community Spotlight featuring Team Gabriella & The Epilepsy Road Warriors
The team at EFMNY would like to thank you for your questions! After each post, we’ll post answers from our experts to the most frequently asked questions we receive. Please note that these Q&A post, like our provider articles, should not be taken as medical advice. Each patient is unique. For medical advice regarding your specific condition, please consult your doctor.
Q&A with Patricia McGoldrick, NP, MPA, MSN:
1. I just found out that one of the medications I’ve taken for years is available in generic form. If it’s only one of the two medications I take, is there less risk in trying the generic?
This is difficult to answer without knowing which medications you are taking. Some of the medications in generic form are made by the same companies that make the brand name medications and so are consistent. The answer depends on the medications, the doses, how long you have been seizure free and a host of other issues. Please ask your provider, as he or she knows you best!
2. My daughter had surgery earlier this year. We were hoping that she would be medication free. However, she is still on meds. Is this typical for kids who have had epilepsy surgery?
The type of surgery, the medications, the length of time after the surgery and the cause of the epilepsy must all be taken into consideration, as well as the EEG findings and the post-operative MRI findings. Typically, medications are considered for some period of time after the surgery. Again, this is a great question for your provider! (more…)
How soon should medications be changed?
The typical rule of thumb is that medications should be switched if they are ineffective. Once a person has been on the appropriate medication for their type of seizures, and has reached the appropriate or maximum dose and is still having seizures, the medication should be changed. Usually a second medication is added and then “titrated up” (that is adjusted in a step-wise progression) until seizure control is reached or the maximum dose of the second medication is achieved. If seizures are under control, consideration should be given to weaning the first medication. Having said that, there are often instances when seizure control is reached with two medications used in combination and the person with epilepsy remains on two medications. The risk of seizures and injury must be weighed against the risk of side effects.
Should medications be changed if there are side effects?
The important thing to remember about side effects is that they MAY occur, not that they will! Medications are tested in clinical trials in large groups of persons. Every event that occurs during the time of the trial is reported as a side effect, even if the event occurs only in one or two persons and is not conclusively determined to be a direct effect of the medication.
Often side effects occur when the medication is first initiated and may lessen or resolve over time as the person’s body “becomes used to the medication.” A prime example is the side effect of drowsiness that occurs with oxcarbazepine and usually resolves within a week or two. Another is the abdominal upset that can occur with ethosuximide and is managed by eating before the medication is taken. On the other hand, intolerable side effects should result in changes of medications. (more…)