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Epilepsy

What you need to know about epilepsy . . . and seizures

I’ll be talking to Jill Krop about epilepsy on her am B.C. talk show on Global’s new BC1 channel, Tuesday March 26th at 9 am.

Here’s the link to the video: http://globalnews.ca/video/431044/ambc-mar-26

On June 28th, 2012, Parliament enacted the Purple Day Act designating every March 26th to be “Purple Day.” Canadians are encouraged to wear the colour, purple to support people with epilepsy and to increase public awareness of this medical condition.

Purple Day was founded in 2008 as a global day of epilepsy awareness by 9-year-old Cassidy Megan and the Epilepsy Association of Nova Scotia.

Those of us confused by the variable dates of Spring Break and Easter holidays should note that Purple Day is not a holiday. Go to work or school, but wear purple and learn more about epilepsy.

Epilepsy is a medical (not a psychological) condition marked by recurrent seizures, which are episodes of recurrent abnormal electrical activity in the brain and manifested by neurological symptoms that may include involuntary movement or sensations.

An estimated 0.5 to 1% of the general population suffers from epilepsy. Seizures themselves are much more common; approximately 1 in 10 people may experience one at some time in their lives. Most people with a single seizure will not be diagnosed with epilepsy.

Seizures can result from a variety of conditions, including pre-eclampsia (a condition associated with high blood pressure in pregnancy); withdrawal from excessive alcohol or from medications, such as sleeping pills; an abnormality of chemicals in the blood, including sodium, oxygen or glucose; or brain disorders, including head trauma and strokes.

Children are much more susceptible to seizures. Very young children may suffer from a febrile seizure. Though this is of course frightening for parents, most of these children will not have recurrent seizures or epilepsy.

Children are also more sensitive to photic or light-induced seizures. In 1997, 685 Japanese children sought medical attention for neurological symptoms while watching an episode of the cartoon, Pokemon. 80% of these children were diagnosed with a seizure induced by a scene involving an explosion of lights.

Absence or petit mal seizures are more common in children and are marked by very brief – perhaps 5 to 15 second – episodes. These children may appear to be staring blankly as if daydreaming.

Complex partial seizures (formerly called temporal lobe epilepsy) are more common in adults, and though individuals appear to be awake they do not respond normally. They may get a variety of psychological or motor symptoms depending on what part of the brain is affected. For example, involvement of the speech centre will impair language whereas involvement of the occipital lobe will affect vision.

Tonic clonic (or grand mal) seizures involve the entire cerebral cortex. The tonic phase involves stiffening of the muscles. This is followed by the clonic phase with repetitive muscle jerking. Because large areas of the brain are involved, the individual is unconscious.

In status epilepticus, seizures are nonstop or prolonged (i.e. over 5 minutes).

Before the onset of a seizure, some individuals experience an aura – neurological symptoms or a feeling of not feeling quite right. After a seizure, individuals may have post-ictal symptoms, including drowsiness, confusion or headaches.

So what should you do when someone is having a seizure?

Remain calm. Ensure the safety of the individual. In a tonic clonic seizure, try to protect the individual (especially his or her head) from harm striking objects around them but avoid restraining them. With complex partial seizures, individuals may need to be gently guided. You should remain with them until they are fully alert and oriented.

You should call 911 for first time seizures, status epilepticus or other undiagnosed neurological symptoms. Individuals may have conditions other than epilepsy or the seizures may indicate other medical conditions requiring prompt treatment.

For appropriate first aid training, I recommend a course with St. John Ambulance (sja.ca), and for more information about epilepsy, check epilepsy.ca, the website of Epilepsy Canada.

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Empowering Healthcare Healthy Living patient-doctor relationship Preventive Health

5 Reasons You Need A Family Doctor . . . And What To Do Until You Get One

On March 14th, Global BC will be launching BC1, the province’s first all-news channel. Jill Krop will host her talk show AM B.C. weekdays at 9 am.

Here’s a clip of my interview with Jill.

https://www.dropbox.com/sh/lhljh6q6q8yeh8s/Ot5gns5D62?m

Top 5 Reasons You Need a Family Doctor:
1. Having a regular family doctor improves health outcomes.
(This has been shown in the international research of Dr. Barbara Starfield and the Canadian studies by Marcus Hollander, that show improved patient outcomes, reduced mortality, decreased hospitalizations and reduced health care costs.)
2. Your family doctor takes the long-view: your lifetime – your history, your family history and your potential future.
3. Your family doctor provides holistic care, treating you (not just disease) in the context of your family, work and other important aspects of your life.
4. Your family doctor treats all your health conditions – acute & chronic, including your emotional  & relationship concerns.
5. The family doctor who knows you well may be the best physician to help you make personal health choices, sorting through information you’ve read on the internet, advice from friends and the opinions of other physicians.

What To Do Until You Find a Family Doctor (when seeing a doctor for episodic care at a walk-in clinic or in the ER):
1. Know your personal medical history (past illnesses, chronic conditions, family history, operations & allergies).
2. Keep a list of all your medications (prescription and non-prescription, including dosages).
3. For any treatment, investigation or prescription, ask three things:
(a) What is it for?
(b) What are the risks or side effects? (both the common and the serious)
(c) What are the alternatives?
4. Keep a record of all test results.
5. Ask this question, “Given my age and family history, what tests should I be doing?” (e.g. mammograms, pap smears, diabetes screening, prostate exams).

Categories
Empowering Healthcare Healthy Living Preventive Health

Using Your Family History to Empower You

In my last post, I wrote of the value of knowing your family medical history and discussing with your physician your personal health risks.

Again having a bad family history does not condemn you to suffer the same fate. Your possible genetic predispositions may serve as early warnings to be more vigilant and to consult early and regularly with your physician. Early detection or intervention can change the course of a disease. Many are curable at earlier stages.

The standard screening for colon cancer begins at age 50 with either an annual stool test for occult or hidden blood or a colonoscopy every 10 years. The latter is much more expensive and not available for most of us through the publically funded system.

However, if you had a significant family history of colon cancer, the appropriate screen would be a colonoscopy every 5 years beginning 10 years before the age of your youngest affected relative.

With this system of screening, benign polyps are often removed before they become cancerous. If we had waited for the appearance of symptoms such as narrowing of the stools, severe constipation and progressive weight loss, we would catch colon cancer at a stage more difficult to treat.

If you have a family history of heart disease, stroke or sudden death at a young age, you should be screened for possible modifiable risk factors such as high cholesterol, high blood pressure, abnormal heart rhythms, valvular heart disease and diabetes. Early intervention with medication and lifestyle changes in many cases may prevent premature death or disability.

We usually start checking healthy males for prostate cancer at the age of 50. However, if a man’s father or brother has been diagnosed with prostate cancer, we would normally recommend screening at an earlier age.

Likewise, if a woman has a family history of breast cancer in her sister or mother or across generations, she should discuss with her physician how much earlier than age 40 she should be screened with mammograms. She may also be eligible for the testing of the BRCA genes that predict a high likelihood for breast cancer.

Elevated cholesterol, diabetes and high blood pressure are common inherited conditions that are greatly modified by lifestyle measures including healthy eating and exercise. In many cases, these actions are combined with medications to prevent the health consequences, including premature strokes, peripheral vascular disease, heart disease, vision loss and kidney failure.

So your family history gives you and your physician invaluable information that can enable you to remain healthy and achieve your potential in life.

Categories
Empowering Healthcare Preventive Health

The Value of Your Family History

Confederation Park, Burnaby
Confederation Park, Burnaby

Though some illnesses are random and many caused by the way you live your life, your family history can reveal your predisposition to certain conditions.

Some people take this to the extreme. If a parent died at a young age, they don’t expect to live beyond that age . . . and they do nothing at all to change how they live. Some people have a false sense of security when their family history is good. Most women diagnosed with breast cancer have no family history. People can have strokes, diabetes, heart attacks and other cancers before others in their families.

Others don’t think about their family history at all, don’t do the screening tests they should or take proactive and preventive measures to remain healthy.

Those who don’t learn from their family history may be destined to repeat it.

Consider Scrooge in Dickens’ “A Christmas Carol.” The ghost of Christmas Future gave him a glimpse of his future if he kept on behaving the way he had. Yet he was able to avoid that bleak future and create a more positive one by adopting new attitudes and actions.

Few of us will awaken completely transformed after one night with three bad dreams, but how we live our lives day by day and work periodically with our physicians can foster our potential for longer, healthier lives.

There are a few basic things you should know about family history. Genetically your closest relations (assuming you do not have a twin or clone) are your first degree relatives who each share half of your genes. They include your parents, siblings and children.

A grandparent, grandchild, niece, nephew, aunt, uncle or half-sibling is a second degree relative who shares only a quarter of your genes.

Your first cousins, great grandparents and great-grandchildren are your third degree relatives. They each share only an eighth of your genes.

So obviously you are much more likely to share inherited health conditions with your first degree relatives. That is why doctors are most interested in the histories of your immediate family members.

However, if a condition has been diagnosed in multiple relatives across multiple generations, your odds of having the same condition are much greater. An example is colon cancer diagnosed in a maternal grandparent, maternal aunts or uncles, their children and your own mother.

Your risk is even greater if an inherited condition arises at a relatively young age. An example for a woman would be breast cancer diagnosed in her mother before menopause; for a man, prostate cancer in his father under age 50.

A family history of a sudden death, stroke or heart attack under the age of 50 strongly suggests a genetic factor you should know about.

Again having a family history of these conditions does not condemn you to suffer the same fate. They serve as an early warning to be more vigilant and to consult early and regularly with your physician. Early detection or intervention can change the course of a disease. Many are curable at earlier stages.

Next: Family history and your risks for cancer, strokes and heart disease.