While I've got some nice progress to share, the last few days/nights have been a bit rough for me. 

The good news is, I'm down to my last 50 mgs of Dilantin per day.  To recap......Soon after my VEEG in late February of 2007, the move to switch from Dilantin to a different AED began. As a result of 40 years of 400mgs Dilantin per day, I was dealing with peripheral neuropathy, osteoarthritis, osteopenia, hyperplastic gingivitis and bone loss in jaw.  My doctor and I agreed that the risks posed by my medication were now outweighing the benefits, even though tonic-clonics were under control. Once my VEEG showed activity in left temporal lobe, it was decided that Keppra would be the drug of choice to switch to. Before any Dilantin reduction would occur, I would start introducing Keppra into my system.

BAM.

Where did that train come from ????

Adding a new drug onto a medication which had already contributed to years of lethargy and fatigue hit me pretty hard.  The first month on Keppra was awful in many ways.  It truly was an effort to accomplish much of anything. I found I had to save all my energy for teaching for I couldn't risk letting professional obligations being unmet. Upon returning home each day, I would resign myself to the couch in the family room, totally "shot". Family fended for themselves much of this time , as the already busy "hubb-bub" of family life seemed to be disordered and out of my control.  However, what was far worse, was that for some reason, the peripheral neuropathy in my legs began to truly torture me. What was once a mere tingling in the toes or numbness alternating with electrical shocks to the feet and lower legs, was now such intense pain that it would wake me from a sound sleep. The neuropathy, in turn, impacted upon osteoarthritic symptoms. Walking became painful and next to impossible without a cane.  Was the reduction of Dilantin or the introduction of Keppra aggrivating the PN? Was it both? No one seemed to be able to tell me.  Friends in the chatroom were wonderfully supportive. If it hadn't been for Tim encouraging me to stick with it, I think I would have told my physician I wanted "off" Keppra.  Thankfully, he was correct. My body did indeed adjust and symptoms lightened. 

Throughout this time, I tried to keep our objective in mind: To switch medications without experiencing a seizure event.  My epileptologist would slightly reduce Dilantin one week, and then, several weeks later increase the Keppra dose. Several weeks after that we'd alternate again, reducing Dilantin once more, and so on. Only every now and then would both medicines be adjusted at the same time. It's proved to be an effective strategy. While I've experienced several simple partials, understandably due to shifts in dosages, I've not had any tonic clonic seizures.  

Mobility was still an issue in late September (See "Apples" blog entry).  After reading the advice of one exercise guru, who succinctly stated, "....Move or die....", and reading about the benefits of rowing as a low impact exercise that combats osteoporosis, I decided to give rowing a try.  I tried rowing regularly at the gym during October, and in early November purchased an indoor rowing erg for home,so that I'd have no excuses during the winter months about not getting to the gym.

I've not used my cane since late October. I was using it at the beginning of "La Boheme" rehearsals. By our last performance, my cane was packed away. 

 All was well till about 2 weeks ago.  As we're approaching the end of this med switch, my medince changes have involed simultaneous reductions of Dilantin alongside increases of Keppra. In roughly the last 6 weeks my Keppra has been increased 3 times.

My legs are screaming at me again. I'm resisting the cane. The past few nights I've woken to horrible leg pains and this is affecting my sleep, which is my big seizure trigger.  I would not have written about any of this, had I not "heard" a yound man, new to the chatroom last night, explain that he had terrrible ataxia and leg pain when Keppra doses were increased for him.  Upon having the doses lowered, his symptoms subsided.  I'm also feeling very weepy. I don't know why and I wonder if the med changes are involved.

I'm just going to hang in there and hope the pain subsides. My next med changes won't happen until I see Dr. L on January 16th.

Please forgive my long winded mouthful of verbiage ......

Ciao per addesso,

Anna