We are home now. Spring Break is over. My husband is home. ::Happy dancing:: Life is feeling normal again except that my husband looks really happy when he takes out the trash. Gratitude and good sex will do that to a person. I know I’m looking rather thrilled when he’s taking out the trash.
Grace saw Dr. Awesome today for her monthly check-up. Grace is experiencing a new symptom. She is smelling odors that aren’t there–olfactory hallucinations. She also has a history of hearing music that isn’t playing–auditory hallucinations. Combine these two symptoms, however, and psychiatrists get very nervous because this creeps into a neurologist’s territory. Temporal Lobe Epilepsy (TLE) runs in our family. I have TLE, and as a child I frequently experienced auditory, visual, and olfactory hallucinations but usually on the cusp of sleep. I had no idea that I was experiencing seizures. I only knew that whatever it was, it was terrifying, and it always ended with my wetting the bed. I never told a soul. I sensed that it would end badly so I hid it and secretly washed my bedding during the day when no one was home. I experienced seizures for years and was officially diagnosed with TLE when I was in my late twenties during my second pregnancy.
Grace has already had two MRIs and three EEGs all of which were clean. EEGs are notoriously tricky because they only record what the brain is doing during a specific time. If the brain doesn’t seize during that time, then nothing is documented. It can be very frustrating for the patient and the physician as well, but there are other ways to diagnose a seizure disorder like abnormal posturing (i.e. dystonia in the hands, lower and upper arms) which was how I was finally diagnosed in the end.
Dr. Awesome is deeply troubled by Grace’s olfactory hallucinations as olfactory hallucinations are very specific to TLE. Grace has also had what appears to be absence episodes in the past. Grace gets crippling migraine-like headaches, and she struggles with a generalized anxiety disorder which is only getting worse over time in addition to her schizophrenia. She is also developing hypoglycemia. This is new, and this is not good because diabetes is a side effect of her drugs. Hypoglycemia means that her pancreas is struggling. I have to work very hard to get her to eat, and she is experiencing hypoglycemic episodes almost daily. She becomes extremely labile, sad, and terribly intractable. It requires a herculean effort on my part to get that kid to eat or drink a thing. Dr. Awesome turned her chair around and took a firm but gentle tone with Grace, her East Indian accent emphasizing her seriousness:
Grace, listen to me. You must obey your mother and eat a variety of foods. If you do not, you will become a Bonsai of a person! Do you know what a Bonsai is? They are very small plants that a person feeds only what is required to keep alive so they never grow. They just stay small. I don’t want that for you. I want you to grow up to be strong and tall. If you don’t eat well and often, you will be a Bonsai child, and this will do no one any good. Do you understand this?
Grace’s eyes were wide, and she looked very serious trying to understand what it might mean to become a Bonsai child. She somberly nodded her head and promised to obey me and eat. I thanked Dr. Awesome for her third-party credibility, and we ended our meeting with the important question of what to do with the emergence of the olfactory symptoms.
“What do you say about increasing the Neurontin?”
I was thoughtful. “Well, if she’s having seizures it might address that. I took Neurontin for seizure control, and it worked well. It will address her anxiety possibly. It will continue to treat her Restless Leg Syndrome, and Neurontin is used to treat headaches so it might help get those headaches under control, too. I’m all for increasing it.”
She smiled and nodded. “Yes, let’s increase this to 600 mg then. I want to see her in May.”
I am seriously thinking of making an appointment with a nutritionist. I think a one-hour consultation with a certified dietician would do a world of good for Grace. I want her to feel empowered and in control of the things that she actually can control, and when and what she eats are two of those things. If she is truly developing hypoglycemia, then we can do something about that with sound education. It just so happens that a dietician lives directly across the street from me. I might just knock on her door this week. Oddly, her cats are the fattest on the block. Go figure…