Seizures & Medications

I'm going to be lazy, because I'm over six months pregnant, I worked today, then came home and made dinner and put Simon to bed. In a little bit Malachi's going to go to bed and John and I are going to hang out. I'd rather hang out with John than write a long blog, so...you're going to get pieces of things I've already written.

Written to our D.C. Neurologist on 3/11

Dr. Lastname,

You saw Malachi (last name) (DOB) as a patient in '09 & '10. We've since moved to Costa Rica on orders with the State Department. Malachi was seizure free for almost 18 months. We have a relationship with a Neurologist here, Dr. Firstname Lastname at CIMA, and had been doing check ups with him. Recently Malachi has started seizing again. He had a grand mal on Friday 2/4 and again on Wed 2/9. He was also having partials. An MRI was done on 2/12 and an EEG was done on 2/14 and both came out normal. The Dr. increased his Keppra dosage to 300 mg 2x/day. He continued having partial seizures but the grand mals seemed to have stopped.Because the partials continued the Dr. here upped the dossage to 400 mg 2x/day. Yesterday 3/10 Malachi had another seizure. This time it wasn't a grand mal but one where he blacked out, had his typical postictal period, and then went to sleep. The Dr. told us to keep the Keppra at 400 mg 2x/day and also add Trileptal 250 mg 2x/day at first and then to 300 mg 2x/day until he sees Malachi on 3/22. 

I was able to buy the Trileptal in suspension form here, but there's no Keppra in suspension form in all of San Jose. They only have tablets and it's a different dosage. Here's where this email comes in...

I'll be in the D.C./NOVA area (insert dates) by myself for work and I was wondering if you'd be willing to write a Rx for Malachi for Keppra in suspension form at 400 mg 2x/day so I could buy it while I'm in the States. We have enough to cover ourselves until then. 

If you need any more information, I'll be happy to provide it. I can also provide you with the email address and phone number for Dr. Lastname. 

Thank you,

Sara Lastname

We had a lot of drama with the MED unit (our normal nurse was at a conference in Singapore, we had a substitute) trying to find the Keppra. When our normal nurse got back on Saturday she called and left a message saying that she was back and she wanted to hear about Malachi. We found out on Saturday night that we were much lower on medicine than we thought, and in fact only had 7 1/2 days worth. I called our nurse on Sunday morning and told her our dilemma. She said it would be her top priority on Monday morning. 

On Monday she put in an overnight mail order of three months worth of the Keppra we needed. That wasn't going to get here fast enough though (new Rx's in this system take five to eight days to process, expediting it would mean four to five days, and then it has to be sent from D.C. to Costa Rica). She finally called the Costa Rica Neurologist who said you can find liquid form at this pharmacy, and this other pharmacy. Our nurse called and arranged to have it delivered to the Embassy where I was working yesterday (the Trileptal was delivered to our house last Thursday, I LOVE pharmacy deliveries). We now have enough Keppra to get us to the mail delivery, and beyond I'm sure. 

Since we started the Trileptal on Thursday, we haven't had any full seizures but are still seeing partials (he had 8 on Sunday alone (and all but one was before 8:30 a.m.)), the Neurologist said we need to give the Trileptal 7-10 days to become fully effective. He seems completely unconcerned about the partials though. I'm not noticing any side effects from this new medicine. 

Oh - and btw. Dr. Lastname from D.C. still hasn't gotten back to me. That would never happen here. I don't know that I'm very excited about Medical care in the States anymore.