Had my routine 3-month interval MRI today at Cedars-Sinai. The appointment was at 9:30 AM so of course I left at 5:45AM to beat the SoCal crush up Interstate 405. Surprisingly, I arrived at 7:30 AM which gave me the opportunity to have breakfast.
I decided to check in early about 45 minutes before my scheduled time and was pleasantly surprised to get called in only a few minutes afterwards. The MRI went as normal. The vein at my right elbow even cooperated this time. It has been shy for the past two years, probably because of overuse from my two stays at the hospitals. So all of my IVs and blood samples have been either at the hands or forearms prior to today. As customary, I fell asleep due to the soothing beats generated by the MRI machine.
Since my scan was completed early, I decided to check in early as well for my meeting with Dr. Hu. Again, to my pleasant surprise, I was shown in and didn't have to wait long for Dr. Hu. The first thing he said was that everything is stable to my great relief. We both then went over my scan from about a year ago to days and everything looks the same. After viewing the scans, Dr. Hu mentioned that he'd like to keep me at the 3-month MRI cycle for my next two MRIs and then will likely move me to the 6-month MRI cycle. I am not sure how I feel about this yet. In a way, it's nice to be on a 3-month MRI schedule because there's less anxiety about what could be going on up there in my brain. However, I suppose the 6-month MRI schedule would in a way signify that circumstances are such that I needn't worry too much about things overall.
Showing posts with label Cedars Sinai. Show all posts
Showing posts with label Cedars Sinai. Show all posts
Tuesday, October 22, 2013
Wednesday, August 8, 2012
Meeting with Epileptologst
I met with Dr. Jeffrey Chung at Cedars Sinai this past Monday and his recommendation is to
go forward with the continuous EGG video telemetry (V-EEG). This kind of
testing requires a person to be admitted into a hospital and be
continuously monitored and recorded with a video camera. The advantage
of a V-EEG over a regular EEG is that the continuous monitoring can
greatly increase the likelihood of "catching" an episode. The video will
supplement the EEG readings.
Dr. Chung stated that this is best diagnostic tool to determine whether my episodes are seizures. If my episodes are seizures, the V-EEG can pinpoint and reveal the location and root of the problem. There are certain approaches that can be taken if I do have seizures. One approach is a change in medication that may be better suited in preventing or mitigating the root of my seizures. Apparently there are 20+ anti-seizure meds out there! Another could include surgery, but Dr. Chung said it's too early to start worrying about this therapy and that it is normally reserved for people who have acute gran mal or clonic tonic seizures.
Dr. Chung also stated that my symptoms appear to be somewhat consistent with simple partial seizures (aka, focal seizures). Simple partial seizures do not cause a person to lose consciousness of which I have never had happen to me thankfully. My symptoms that are consistent with this type of seizure include numbness/mushy-like feeling in my limbs, actual weakness of the limbs, rapid heart rate, heightened ringing in my ear, sometimes nausea, and sometimes slight twitching of my limbs.
As I've mentioned and what has been stated to me before by Dr. Lai and reconfirmed by Dr. Chung, is that my episodes may be a combination of seizures, side-effects of the meds, and just result of brain damage from my surgeries and radiation therapy. Simple partial seizures normally lasts no longer than a few minutes, but my episodes normally can last from 30 to 60 minutes. I asked Dr. Chung what if the V-EEG indicates that my episodes aren't seizures and he stated that he didn't want to make too many specific guesses of the next steps until after the V-EEG. He stated that there are just too many possible causes and he didn't want me to worry too much for the moment and that we should take it one step at a time. He was willing to delve into the possibilities, but I agreed about the taking things one step at a time for now. He did add that if my episodes aren't seizures, then I may no longer need to take Keppra and Vimpat. His general approach is, "Why take meds if they don't work?" I completely agree with this.
Of course after my meeting with Dr. Chung, I did some additional research, and apparently V-EEGs are also an effective tool in diagnosing something called non-epileptic pseudo-seizures. As the name suggests, these episodes may seem seizure-like, but are in fact not seizures. The video monitoring is the key here because while a person may be physically displaying a seizure (e.g., stiffened muscles, jerking, etc...), the EEG readings are normal. These types of episodes are also known as psychogenic non-epileptic events and the root of the problem is psychological more than anything physical. Great, just something else to worry about!
Lastly, Dr. Chung recommended that I see a neuropsychologist to have my neurocognitive functions assessed. Neurocognitive functions include memory, mood, higher brain processes, etc...Ideally, I should have had one done back in February last year before my first biopsy to set a baseline, but hindsight is 20/20. Anyway, having a neuropsych evaluation will help in moving forward as it will reveal my neurocognitive strengths and weaknesses and help in the preparation of future possible treatments. It can also help in creating strategies to improve or help my brain to compensate for any deficiencies it might have.
Anyway, for now, his office will try to set up the V-EEG in the next few weeks or so. The testing will require admission to Cedars. Since the EEG will only be effective if it catches one of my episodes, steps will be taken, if necessary, to induce one. The typical protocol to induce an episode includes tapering of my anti-seizure meds and sleep deprivation for a couple of nights. As the video camera will be fixed on my bed, I will for the most part be restricted to my bed. I can use my laptop, but will not be able to charge it near me as it can interfere with the EEG reading. Overall, I will be monitored for 3 to 5 days depending on how it goes. Some have only needed a day, it just all depends. Since my next MRI will be coming up in a couple of weeks, Dr. Chung's office will be contacting Dr. Hu's office to ensure that the MRI includes a few items needed for his purpose. Also, Dr. Chung will contact me regarding setting an appointment to meet with a neuropsychologist.
Dr. Chung stated that this is best diagnostic tool to determine whether my episodes are seizures. If my episodes are seizures, the V-EEG can pinpoint and reveal the location and root of the problem. There are certain approaches that can be taken if I do have seizures. One approach is a change in medication that may be better suited in preventing or mitigating the root of my seizures. Apparently there are 20+ anti-seizure meds out there! Another could include surgery, but Dr. Chung said it's too early to start worrying about this therapy and that it is normally reserved for people who have acute gran mal or clonic tonic seizures.
Dr. Chung also stated that my symptoms appear to be somewhat consistent with simple partial seizures (aka, focal seizures). Simple partial seizures do not cause a person to lose consciousness of which I have never had happen to me thankfully. My symptoms that are consistent with this type of seizure include numbness/mushy-like feeling in my limbs, actual weakness of the limbs, rapid heart rate, heightened ringing in my ear, sometimes nausea, and sometimes slight twitching of my limbs.
As I've mentioned and what has been stated to me before by Dr. Lai and reconfirmed by Dr. Chung, is that my episodes may be a combination of seizures, side-effects of the meds, and just result of brain damage from my surgeries and radiation therapy. Simple partial seizures normally lasts no longer than a few minutes, but my episodes normally can last from 30 to 60 minutes. I asked Dr. Chung what if the V-EEG indicates that my episodes aren't seizures and he stated that he didn't want to make too many specific guesses of the next steps until after the V-EEG. He stated that there are just too many possible causes and he didn't want me to worry too much for the moment and that we should take it one step at a time. He was willing to delve into the possibilities, but I agreed about the taking things one step at a time for now. He did add that if my episodes aren't seizures, then I may no longer need to take Keppra and Vimpat. His general approach is, "Why take meds if they don't work?" I completely agree with this.
Of course after my meeting with Dr. Chung, I did some additional research, and apparently V-EEGs are also an effective tool in diagnosing something called non-epileptic pseudo-seizures. As the name suggests, these episodes may seem seizure-like, but are in fact not seizures. The video monitoring is the key here because while a person may be physically displaying a seizure (e.g., stiffened muscles, jerking, etc...), the EEG readings are normal. These types of episodes are also known as psychogenic non-epileptic events and the root of the problem is psychological more than anything physical. Great, just something else to worry about!
Lastly, Dr. Chung recommended that I see a neuropsychologist to have my neurocognitive functions assessed. Neurocognitive functions include memory, mood, higher brain processes, etc...Ideally, I should have had one done back in February last year before my first biopsy to set a baseline, but hindsight is 20/20. Anyway, having a neuropsych evaluation will help in moving forward as it will reveal my neurocognitive strengths and weaknesses and help in the preparation of future possible treatments. It can also help in creating strategies to improve or help my brain to compensate for any deficiencies it might have.
Anyway, for now, his office will try to set up the V-EEG in the next few weeks or so. The testing will require admission to Cedars. Since the EEG will only be effective if it catches one of my episodes, steps will be taken, if necessary, to induce one. The typical protocol to induce an episode includes tapering of my anti-seizure meds and sleep deprivation for a couple of nights. As the video camera will be fixed on my bed, I will for the most part be restricted to my bed. I can use my laptop, but will not be able to charge it near me as it can interfere with the EEG reading. Overall, I will be monitored for 3 to 5 days depending on how it goes. Some have only needed a day, it just all depends. Since my next MRI will be coming up in a couple of weeks, Dr. Chung's office will be contacting Dr. Hu's office to ensure that the MRI includes a few items needed for his purpose. Also, Dr. Chung will contact me regarding setting an appointment to meet with a neuropsychologist.
Subscribe to:
Posts (Atom)