Taper

I’ve been continuing to taper off of Trileptal and I keep feeling better. I walked during my lunch break three days this week and I’ve gone to the gym three days, too. However, I may be pushing myself a little too hard, at least at this time: I’m so excited to be healthy enough to exercise again that I’m kind of jumping in headfirst. Most of my muscles are sore and I’ve been having trouble sleeping, which has made it hard to be productive at work.

All of this fatigue is just a part of my body getting used to being active again and will pass with time. Plus, I’d rather be tired from too much exercise than because my medication is making me sick.

One thing that hasn’t changed? The severity of my allergies, as I still can’t wear my contacts for more than a few hours at a time. Still, I’d much rather be forced to wear glasses and be able to exercise than have the convenience of contacts again.

Healthy Again

I exercised! Not only that, I did it for two days in a row!

Starting on Depakote while I was still taking Trileptal at full strength was rough and left me feeling weak. Plus, the Trileptal had made it hard for me to exercise with any consistency without getting sick. So it was just another normal day when I went to sleep on Thursday night still feeling kind of sick. But imagine my surprise when I woke up on Friday feeling better than I have in months. I went to the gym that evening after work and walked on a treadmill for an hour.

What happened? Thursday was the first day that I started tapering off of Trileptal, so I guess my body responded positively to the change. With my newfound vigor, I went with Leah to the gym this morning and did a full-body workout. I generally avoid those kinds of workouts, seeing better results from focusing on specific muscle groups, but I wanted to make all of my muscles sore so that I can get over that quickly and back to my normal lifting routine next week. (Plus, it was nice to be able to show off for my bride-to-be.)

I know that my neurologist was skeptical that the Trileptal was having any negative effect on me, but I'm glad I convinced her to make the change, especially now.

PS
The QSG is now online and can be viewed here. It's boring, but I'm really proud of it.

Side Effects

I know that I just wrote about changing the dosage of my medication, but now I'm switching to a completely new medication. Let me explain why.

Remember last summer when I had such bad eczema? That prompted me to change everything in my house to hypoallergenic products: every soap, lotion, shampoo, detergent, and solution was now perfume- and dye-free. With those changes in place, the eczema went away and hasn’t come back.

Around the same time, I started having problems with my contacts. I'd already been using a hypoallergenic cleaning solution for years, but I switched to a preservative-free saline for rinsing, and that seemed to alleviate the problem… at least for a while. Around late January, even with the changes I made, I could only wear my contacts for about four (maybe six) hours before they'd get so itchy that I couldn't stand it anymore. In March, I saw an ophthalmologist who said that my eyes were showing clear signs of experiencing an allergic reaction. I told him all of the changes that I had made and he said that I was taking all of the right steps and gave me some steroidal eye drops to reduce the reaction. I used the drops for a week straight before attempting to wear my contacts again. The next time I wore them, I was able to go the whole day without discomfort, but only for one day. On day two, I was back to being itchy to the point of not being able to keep my eyes open. Since then, I only wear my contacts for short periods.

Even more worrying, since December, I've had something like five sinus infections. I've been on so many rounds of antibiotics that I'm a little worried that I'm going to become resistant. I've also missed four days of work this year. That may not seem like a lot, but I've gotten teased from my coworkers because I never take any time off. Other than for Thanksgiving and Christmas, I just keep to my normal schedule, so taking that many sick days in such a short period was shocking. It was also troubling because I went from being healthy to being unable to exercise on a regular basis, something that I'd come to rely on to keep me sane.

Because of the problems that I had with my contacts, when I got my annual bonus this year, I looked into getting Lasik surgery and even had consultations at two separate locations. I talked about everything with Leah and we decided that I should wait until after the wedding before we plan something so expensive, though I decided to pray about it just to be sure. I felt like I hadn't explored all of my options and I thought that I should look at the side effects of my epilepsy medication.

So I did.

What are the major side effects? Allergic reactions (including rashes) and flu-like symptoms. I thought that match up too well with what I was going through to simply be a coincidence. I called my neurologist about my discovery and she was not convinced. To be fair, I hadn't told her about all of these problems before because I didn't think it was related to my medication. Plus, the fact that I had been on the new medication for a while before the side effects showed up. So she was understandably reluctant to prescribe a new medication, but I cajoled her into trying what is now my third medication.

(Quick aside: I've been referring to my medications on this blog by their generic names because I like avoiding proprietary eponyms, like calling any kind of lip balm Chapstick or any brand of tissue Kleenex. But whenever I tell doctors or nurses about what medications I'm taking, they ask for me to clarify with the medication brand name. So from now on, I'll refer to my medications by the names everyone recognizes. Levetiracetam, the first medication I took, is Keppra; oxcarbazepine, my last medication, is Trileptal; and divalproex sodium, my new medication, is Depakote.)

Because of how anti-convulsants work, I have to gradually start the Depakote as I gradually stop the Trileptal or risk what the warning labels call "non-stop seizures." For this first week, I'm going back to my old Trileptal routine of one dose in the morning and one in the evening while adding one dose of Depakote in the morning. Next week it'll switch, with two doses of Depakote and one dose of Trileptal in the evening. In two weeks, I'll maintain the two doses of Depakote and reduce my intake of Trileptal to once every other day. After that, I'll stop taking Trileptal completely.

Depakote has its own list of side effects which I'll be on the lookout for. Most prominently is the risk of liver damage, which was also a risk with Trileptal. That means quarterly blood tests to make sure that the medicine that keeps me from seizing doesn't also kill me. The other most common side effects are headaches, nausea, drowsiness, dizziness, vomiting, stomach pain, and (ironically) tremors. There may be other side effects that I'll encounter from the Trileptal and the Depakote interacting, but those will be short lived. So far, I was nauseated for less than ten minutes when I first took the Depakote yesterday, but that was it. I don't want to have the same problem as before where I didn’t connect my ailments to my medication, so any time I have any medical problem, I'm going to check it against the list of side effects.

Managing my epilepsy has not been easy, and I'm still encountering new challenges, but I'm living with it and not letting it get in the way of the rest of my life. Anyone else think I should be on a motivational poster?

Aphasia Strikes Again

On Monday, at about 3:30 in the afternoon, with about ninety minutes left in the work day, I had an aphasic episode. I've had episodes like this plenty of times before, but this time I was medicated and I wasn't in the middle of transitioning to a new medication.

When it hit me, I was listening to a podcast and immediately lost the ability to understand anything that was said (I recognized all the words as English, but I had no idea what any of it meant). I also felt exhausted and struggled to stay awake -- not that it mattered since I wasn't able to read or write while I was in the throws of the episode. After about twenty minutes, I was able understand what I was listening to, but I was still exhausted and couldn't concentrate. After about five minutes of futilely trying to be productive, I stood up and walked over to the desk of my boss, Magda.

She was talking with one of my coworkers, Chelsea, so I waited for a break in the conversation before speaking up. Before I had the chance to interject, Magda looked up and asked what was wrong (apparently, the feeling of extreme exhaustion was all over my face). I explained what happened, describing aphasia as a kind of micro-seizure, and said I needed to go home. She was completely understanding and Chelsea offered to drive me, which I declined -- I've had aphasic episodes while driving before and never blacked out, so I figured I was fine.

As I drove home, I talked to Leah on the phone. She also expressed concern about me driving while in my fatigued state, but I assured her I was fine. Almost on cue, I felt another aphasic episode begin before evaporating (I can feel them just before they hit, though sometimes they pass). She told me I was lucky and that I should have accepted Chelsea's offer for a ride.

The next morning, I woke up and felt sick. It felt like I had the flu and I was physically weak. I worked from home, though I was not terribly productive. Thankfully, I felt better this morning and was able to put in a full day at the office.

After talking about what happened with my neurologist, she recommended increasing my medication dosage. We increased the dosage for a few weeks last year when I first transitioned onto oxcarbazepine and it made me really drowsy. My neurologist thinks that this time I'll handle it better since my body has acclimated to the medication, but if I feel overwhelmingly tired like I did before, she has a supplemental medication in mind that we can try. For now, we're going to wait and see if simply increasing the dosage will be sufficient.

Perhaps I was foolish to think that my epilepsy problem was solved since it was under control. Maybe my life will be segmented by periods of being in control, punctuated by times when I have to look for new solutions. While I'd rather not have to worry about my epilepsy, it's under control for now and we have a possible remedy lined up if I start to show symptoms again, so things are still pretty good.

Root Canal

Remember back in May when I had my first dentist appointment in nearly seven years and I got away with just three small cavities?  And then in August how I narrowly missed a root canal?  Turns out, I'm not that fortunate.

Last week, the tooth that the dentist drilled the most started hurting.  My teeth had been sensitive to temperature changes since my appointment, but that was supposed to be normal and would eventually go away.  The pain that I experienced was different.  It was intense and would come out of nowhere.  I would be sitting at my desk at work and suddenly it felt like I was being stabbed in my mouth.  It would last for as long as twenty minutes and it was all I could do to not try to rip my own tooth out.  I made another appointment to see what we needed to do to stop the pain.

Yesterday, the dentist saw me.  After a quick look, he suggested some treatments we could try, including having me use a special prescription toothpaste, but confessed that a root canal was probably in my future.  After looking at a full x-ray of my head, however, he told me a root canal was necessary and asked me if I had time to do it right away.  I decided to go for it, so he numbed me up and started drilling and digging away the deepest part of my tooth.  (And perhaps my experience was different from the norm, but I didn't think it was all that bad.  My jaw got tired holding it open for so long, but it the actual root canal process was no worse than getting a regular filling.)  I got a temporary filling for the tooth that's soft -- and causes me pain if I accidentally eat on that side of my mouth -- and I'm getting a crown added in two weeks.  If all of that wasn't enough, the dentist admitted to me that the tooth is dying and that it will have to be pulled and replaced with a prosthetic some time next year, so I should start saving my money for what insurance won't cover.

Still, the pain stopped.  The dentist gave me a prescription for oxycodone, but I haven't needed it.  And, while the procedure was not cheap, I could still afford it, so I know it could have been much worse.  In fact, the whole experience was pretty good; I had a procedure done that ended my pain and didn't require me to use a credit card.

Lysine to the Rescue

At some point during my childhood, I contracted the herpes simplex 1 virus, or HSV-1.  This virus causes cold sores and fever blisters and once a person contracts it, they have it for life.  These mouth sores are little more than annoying, so the fact that it's incurable is really a non-issue.  Plus, I usually only get fever blisters once every few years, so I haven't really had to worry about it.

Or I didn't, until I had a girlfriend who doesn't have the virus.  And guess what showed up this week?  Two cold sores right next to each other.

I know that increased stress can lower the immune system and that's usually when HSV-1 strikes.  I've been facing a lot of deadlines at work lately, so it makes sense that I've been more stressed than usual.  Still, though, I didn't like the idea of growing a festering wound on my lip, so I looked up remedies.  Holding ice to the sores throughout the day is supposed to help, but that didn't do much for me.  Applying tea tree oil thrice daily is also supposed to speed up the healing process, but I didn't notice a difference.  However, lysine (or rather, a topical ointment with lysine as the active ingredient) worked like a charm.

I first noticed the cold sores coming in on Monday morning and, after trying ice and tea tree oil with no results, I started using the lysine ointment on Wednesday afternoon.  I've been applying the ointment frequently throughout the day (about once an hour) and as of this writing, one sore is gone and very little of the other remains.

If you have HSV-1 and suffer from either cold sores or fever blisters, try lysine.  It worked wonders for me.

Close Call

I returned to the dentist this week so that my teeth could be drilled and filled.  Remember how my three cavities weren't very deep?  Well, for some reason, the x-ray didn't show the severity of the decay in my teeth.  It turns out that my cavities run deep, with one going so deep that I narrowly missed having to have a root canal.  I may still get my chance in the future, but for now it seems to be taken care of.  Even so, the doctor mentioned more than once that he was having to drill deeper than expected on all three teeth.

The take away from this experience?  Don't skip dental visits for seven years or your teeth will fall apart.

Slight Return

My eczema came back.

Kind of.

The eczema returned, but not where it had been before.

Let me start over.  As I previously related, I treated the eczema with steroids, both oral and topical.  The medication worked and my skin healed.  However, once the treatment ended, the rash started showing up in new places: instead of my upper arms, the rash was on my lower arms; instead of my torso, it was on my legs; etc.  So, the treatment worked, but I need to treat everything.  Thankfully, I was able to get back in to see my dermatologist on Monday and get a new round of 'roids.  She agreed with my assessment -- that the treatment took, just not thoroughly -- and was reasonably confident that this would be the end of the eczema (her estimation is that there's a 25% chance of it returning; not bad odds, considering).

So, I should soon be rash-free.

Again.

Full Weekend

I know that it's a cliche that Mondays are so hard because they destroy our weekends, but I think Mondays are one of my favorite days of the workweek: everyone's coming back from the weekend, so expectations are lower compared to other days and it's the beginning of the week, so you aren't burned out from the corporate grind yet.  It's a nice balance.  And occasionally, it's nice to come back to work after a long, busy weekend.  The latter is what I experienced today.

What happened that wore me out?

• On Friday after work, I drove to DC for a joint-ward baptismal temple trip; afterwards, I went and got food with some girls from my ward, plus Jenn (the girl I met at the temple a couple of weeks ago -- we've decided to be friends, so it was nice to see her again)
• On Saturday, I went to the Post Office right as it opened in order to pick up a package (a new Kitchenaid stand mixer that my mom sent me -- thanks, Mom!) and then went to the church to help clean: I was the only representative from the Elder's Quorum (and I was late)
• Also on Saturday, I laid out by my apartment complex's pool; at my dermatology appointment last week, I was diagnosed with vitiligo and the doctor recommended that I get more sun exposure, so I figured that I might as well try to get a tan on my torso as well (yes, I'm sunburned, but only mildly so)
• In preparation for Sunday, I used my new mixer to make some double chocolate cookies
• On Sunday, I taught Sunday School -- it's not a new calling, I was just filling in for the regular teach who was on vacation; I incorporated the cookies into my lesson and then passed them out (and then I made sure the leftovers were passed around in Relief Society)
• My lesson apparently made an impact because after priesthood meeting, the bishop called me aside to tell me that he had gotten some positive feedback from some of those who attended the lesson (and he didn't even mention the cookies) -- I guess word travels fast
• After church, I asked if anyone wanted to go to a fireside at the DC Temple Visitor's Center that evening, saying that I would be happy to drive, I just didn't want to go alone
• I thought it was a YSA fireside; it wasn't
• My passengers were a sister who was baptized about about ten months ago and a brother who had just moved in the Friday before; I think they both got more out of the fireside that I did (I don't regret going, I was just really annoyed at myself for misunderstanding the nature of the meeting)
• After dropping people off, it was nearly 10 PM by the time I got home (for those keeping score at home, that's two trips to DC and back in three days)

As you can see, I had a valid reason for looking forward to starting work again today: I needed a regular work day just to take a break.

Cumbersome Clothes

I've had a rough week.  I had a big long drive on Monday to and from Annapolis for my dermatology appointment.  Then, in the evening, I attended Family Home Evening with the Singles' Ward, which meant a twenty-five minute drive each way to the chapel.  On Tuesday, I had a big long day working with the video production team, which saw me take a late lunch and not leave the office until after 7 PM.  Then this morning, I got to work just after 7 AM because my apartment complex sent out a notice demanding that all residents vacate their cars by 7 so that they could repave the parking lots and I figured I might as well go in to the office early.

All of this really wore me out.  When I was at work, I described how I felt to one of my coworkers as feeling like I was wearing a suit made out of mattresses.  It sounds silly, but all of my limbs felt overly large and heavy.  It took me until about 3:30 to figure out that I actually had a fever, but once I did, I got permission to go home (only find that my lot hadn't even been paved).  Hopefully, all I need is rest in order to recuperate because I'm tired of wearing my phantom mattress suit.

Mutation? UPDATED

For the past few weeks, I've been developing a rash on the inside of both of my upper arms.  I don't know what's causing it, but it continues to get worse.  In addition to the rash, I have bumps growing on both of my hands.  They don't itch and they aren't very pronounced, but they still bother me.  And the latest change happened this evening.  I rinsed my contacts in saline solution and put them back on, only for my left eye to sting and become red and swollen.

Sorry for the weird angle.

I have an appointment with my doctor next week to talk to him about what's happening, because I'm starting to feel like my body's attacking itself.

UPDATE
Here's a picture of the bumps on my hands:

Seriously, what's happening to me?

My Happy Place

Today was frustrating.  I won't going into the specifics, just know that someone I needed information from chose today to be a terrible communicator.  It really got under my skin, to the point that I was really distracted for the last part of my workday.

Once I was out of the office, I contemplated doing what I would have done when I was still on levetiracetam and depressed: binge on takeout food.  But I reminded myself that I've made a lot of progress (I've lost nearly twenty pounds in a little under three months) and that I didn't want to bring back destructive habits -- I actually have a personal rule in place where I'm not allowed to go to a restaurant by myself.  But in my agitated state, I still wanted something new (or at least unusual) for dinner.  So, I googled a recipe and went shopping.

Once I got home with everything I needed for garlic butter shrimp pasta, I started cooking.  I don't know when it happened, but suddenly, I wasn't upset anymore.  I was too busy enjoying the aromas of the spices and the feel of the ingredients as I added them to the pan -- I also liked the music I was playing to set the mood (I was making Italian food, so probably should have played Sinatra or Guaraldi, but I played prog metal bands Sea in the Sky and Scale the Summit).  And to top it off, the meal was delicious.

It's good to know that when other people get me down, I can just cook my blues away.

A Real Pain in the Neck

I don't know what I did, but I have a knot in my lower neck.  More specifically, it's in the middle head of my trapezius or maybe in the upper part of my rhomboid major.  I've had it for a few weeks, but it was barely noticeable before.  Starting yesterday, it really intensified.  I've used a foam roller, I've stretched, and I've popped my back a few times, but nothing has brought me real relief.  It's getting to the point that I'm having trouble turning my head to check my blind spots when I'm driving -- I still do it, I've just added a cry of pain to the movement.  I had a massage a couple of weeks ago while it was still just annoying; it helped a little, but the masseuse didn't speak enough English for me to communicate where the pain was and she just massaged everything.  I'm looking into chiropractors, but my mobility is severely limited right now.

(Also, summer is officially here because I found the first wolf spider of the year.  This one was about as big as the last one, but I handled it much better than last time: I smashed it in one whack with the underside of a frying pan.)

Better Than Expected

I went to the dentist today.  That wouldn't be noteworthy except for the fact that this is the first time I've been examined or had a cleaning since late summer, 2009.

I don't get nervous about going to the dentist (it's a common source of anxiety for people), there have just been other factor preventing me from going.  First, I was uninsured for years, so dentistry was a financial burden that simply didn't seem worth it.  Once I finally had insurance, I was either trying to figure out what was causing such bad allergic reactions or I was dealing with my newly diagnosed epilepsy.  Then I was uninsured again.  Once I was finally insured, I was busy working at the most stressful job I've ever had, so a healthy mouth was the least of my concerns.  Finally, I got my job at Danfoss and things settled down... until I needed to start work on getting divorced.  After that, I simply didn't think about it for a while.

So, how does a mouth look after nearly seven years of not being professionally cleaned?  According to the dental assistant who cleaned my teeth: "not as bad as [she] thought."  Don't get me wrong, she had to spend a lot of time scraping away plaque, to the point that my mouth got tired from having to hold it open for so long, but apparently she expected it to be much worse.  My secret?  I brush too hard.  I go through a toothbrush in about a month and they're pretty much destroyed by the time I replace them.  However, brushing so hard has made my gums excessively recede.  The doctor recommended that I invest in an electric toothbrush with a pressure sensor that shuts off if I press too hard.  I may have to do that because the only way to get my gums back is with painful surgery, so keeping what I have is really important.  What I currently have is livable, just less than ideal.

But I know the real question on your mind; how many cavities do I have?  Again, fewer than expected based on how long it's been since my last visit: I have three cavities, but none of them are very deep.  I have another appointment scheduled for drilling and filling, though not until August; my doctor is the highest customer-rated dentist in the area, so he's pretty popular.

I was expecting a root canal after so much time, so a few minor cavities sounds like a good deal to me.

A Worrying Series of Events

I've been on my new medication, oxcarbazepine, for nearly a month.  For the most part, I feel great.  It's the other times that have me worried.

While my depression has mostly dissipated, my anxiety has taken the opportunity to rear its ugly head again.  I don't know if my anxiety was always there and I just didn't notice it because of the depression or if only one can be experienced at a time, but whatever the case, I'm forced to maintain behaviors that will help me control my anxiety.  Thankfully, many of the same behaviors that work against depression also work against anxiety.  Also of benefit, while my anxiety has returned, I don't believe it's any stronger than it was before I started taking levetiracetam.  As far as my emotional health goes, I'm happy with the change.

Unfortunately, that's not the only issue.  Yesterday while I was at work, I experienced aphasia.  It was relatively mild, but it has me worried.  While I can chalk up the seizure I had two weeks ago to the transition, can I do the same with the aphasiatic episode?  I called my neurologist, but I haven't heard back from her yet (she works out of the local hospital and they suck at delivering messages).  Maybe the episode was due to something we can fix (maybe my dosage is too low or I have stop eating cheese or something), but it definitely has me worried.

My concern lies not only with the fact that aphasia may be a precursor for seizures, but also that I may have to switch back to levetiracetam and return to struggling to live my life.  Hopefully, I'll hear back from the doctor soon and we'll be able to solve the problem in a way that doesn't require me to switch back.

So That's What the Floor Looks Like ...

One of the worst things about depression is that it takes away your motivation to do even essential things.  Like when the weekends came and if I didn't have plans to meet anyone, I would stay inside, desperately in need of a shower.  Well, the same thing happened with my apartment.  In fact, I can't remember the last time I even vacuumed was.

Until Sunday.  You see, now that I'm off of levetiracetam, I'm cleaning my home again!  Even in my depressed state, I kept my kitchen clean, but the rest of the place went to pot.  I made a big step in correcting that this past Sunday.  After I got home from Church, I started doing laundry.  Instead of throwing everything in a "clean pile" when it was done, I folded and put it all away.  I cleaned up my living room enough that if I have impromptu guests, they'll have a place to sit.  I even vacuumed.  Not only does everything look nicer now that it's all clean, I've noticed that I'm able to feel the spirit more.

Now, I'm not done cleaning.  I have a lot of piled-up junk mail to throw out and I need to toss some grocery bags, but at least I've gotten started.  It feels good to be productive again.

Number Four (Maybe)

I think I had another seizure.  I was asleep at the time and I didn't bite my lip or tear any muscles this time, but I woke up around 3 in morning on Monday feeling, well, feeling like I had just had a seizure.  One thing that was different about this time compared to the previous seizures is that I was medicated when it happened.

So, what caused it?  I think this time it was caused by low blood-sugar.  On Friday, I was still dealing with the worsened depression that came on when I started transitioning to the oxcarbazepine and I ordered a pizza and ate the whole thing.  I felt awful (a bit emotionally, but mostly physically), so I decided to try doing a juice cleanse to help pass the excess food.  In doing so, I was starving most of the weekend (I broke from the diet and got a vegetarian burrito on Saturday).  It was the worst on Sunday, but I drank my last portion of juice right before bed with the hope that I would be okay.  I wasn't.

After I woke up, I couldn't sleep for about an hour or two (when I'm recovering from a seizure, my brain becomes more alert while simultaneously becoming exhausted -- it's not fun).  I emailed my boss and told her what happened, adding that I would need some time to recover.  Even though she approved my absence, I made it into the office after lunch.  I had fitfully slept the rest of the morning (after making sure to eat some cereal and fruit to bring my blood-sugar to a safe level) and I was still pretty of out of it, but I'm glad I made it for the second half of the day.

While I think I was at risk because of the transition, I will watch my blood-sugar moving forward.  And in case you're wondering, the juice cleanse didn't even work.

Transitional Period

I started my new medication on Monday.  Instead of levetiracetam, I'm switching to oxcarbazepine.  Because of how anti-convulsants work, I have to ease off the old medication while starting the new one.  For this first week, I take the oxcarbazepine every morning and evening while I take only levetiracetam in the evening.  Next week, I'll take oxcarbazepine just as frequently, but I'll take levetiracetam only every other evening.  The week after, the transition will be complete and I'll only be taking oxcarbazepine.

Why the transition?  While I don't know the mechanics behind it, one thing that all anti-convulsants have in common is that if you stop cold turkey, you risk having non-stop seizures (which is why the two seizures I've had since I was diagnosed with epilepsy were when I didn't get my prescription filled in time).  In fact, I made the mistake of taking the levetiracetam in the morning on Wednesday (I've gotten used to taking my medication in the morning and I wasn't thinking and kept up the habit), so I had to go longer without a dose -- while still taking oxcarbazepine regularly. Thursday afternoon at work, I started to have a minor aphasiatic episode.  Thankfully, nothing happened: I just felt it coming on before it dissipated (similar to how migraines are often preceded by halos).  I made sure I took both meds on Thursday evening.

So far, I can't say that I notice a difference.  I haven't had any seizures, but I still feel tired in the afternoon.  As for my depression, I won't be able to say if there's a difference until the weekend.  Hopefully, I'll be more motivated than I have been the last several months.

And Now We Meet Around the Board Game

Last night was game night at Mike's house.  I met Mike and Rob, along with two of Mike's coworkers, Joe and Jason.  Mike, Joe, and Jason are all salesmen for Vivint Solar and Rob is a professor that trains new professors how to teach.  An interesting group, but I was able to find things on which we related, so there was always something about which to talk.

The game that Mike chose was Chicago Express, a game about buying stock in railroad companies and building track to Chicago.  Because there are multiple stocks per company, the dynamic of the game was constantly changing: a rival could sudden become a teammate if they buy a share of stock in your company.  I didn't win, but I still had fun.

I usually try to go to the gym during the week to help keep my spirits up, but I'm glad I took a night off and had some fun with some friends.

Imbalance

I saw a new neurologist on Thursday.  This was the first time I'd seen a brain doctor since I was first diagnosed with epilepsy back in December of 2013, so it was nice to get a second opinion.  My doctor said that based on my history, that my current medication (levetiracetam) appears to be working well and that as long as I don't miss a dose, everything should be fine.

Since the meeting, however, I've been thinking more and more about the side effects of my medication.  The most common one is drowsiness and/or sleeplessness, which I definitely deal with, though I don't know how much of that is due to the meds -- I have a sleep study scheduled for a week from today, so maybe with the right kind of CPAP machine, I'll be fine.

The next most common side effects are increased levels of anxiety and/or depression.  This is the one that has me the most concerned.  Right after I started taking levetiracetam (or Keppra, if you want to use the brand name), I went through the worst depression of my life.  The problem, however, is that the circumstances of my life were pretty depressing: I had just been diagnosed with epilepsy, I had lost my job, and my estranged wife refused to communicate with me when I turned to her for emotional support.  It was a tough time in my life.  Since then, I've gotten a much stronger grip on my life and my emotions.

But I still struggle with anxiety and depression on a regular basis.  I even picked up a new hobby as a way to combat these negative feelings (which has helped quite a bit).  Even so, I was unable to find the motivation to leave my apartment on Saturday and when I went to bed, I had a panic attack for a couple of hours.  This resulted in me sleeping through my alarm and missing church the next day.  I wasn't scheduled to teach, so at least I wasn't shirking any responsibility, beyond that of keeping my basic covenants.

Since I couldn't sleep anyway, I looked up how often people deal with these sorts of side effects and I found the answer: around 0.8% of users.  Less than one percent of people using levetiracetam feel anything other than fine.  And even if I'm one of the unlucky few that got more than he bargained for, other anti-convulsants have their own risks (many of which include possible liver damage).  One big problem is that I don't know if the meds are exacerbating a problem that already exists or if I'm just not handling my brain chemistry properly.

The first step is to follow up with my neurologist.  I have an appointment to see her again in July, but I'll send her an email later today (I'd have done it already, but I left her business card in my desk at work).  Maybe she has a go-to medication that can take the edge off the side effects.  Maybe she'll ask me to see a psychiatrist, which I may want to do anyway.  Maybe she'll ask for more test to be conducted.  All I know is that I've been dealing with these problems for a while now and I just want my life back.