Yesterday as I was driving down the interstate, during my commute home.  I suddenly smelled a very strong odor.  It was the smell of something electrical getting very hot - like it was burning.  This is a type of aura that I sometimes had in the past when I was getting close to having seizures.  That type of aura is known as an olfactory hallucination.  (It's a smell that isn't really there.)  The smell was very strong this time.  I was nervous.  I didn't know why I was experiencing this smell - I had been well-hydrated and had been sleeping well too.  

Then the radio quit working.  What a relief!  It wasn't just in my brain, it was actually something electrical getting very hot.  Brought back memories of seizures, but luckily, this was just the real smell.  I guess I'll have to get used to really smelling things now.

It's more confusing than I had figured, driving to work again.  Riding the bus for so long, I have the route the bus takes and the route my wife takes memorized.  I really don't know how to get to much else around town, since I hadn't driven much in this city.  At work I had to get a parking permit and then figure out where to park and when the shuttles run.  Felt kind of weird figuring out the parking thing, when I wasn't a new employee.  All said, it has gone very smoothly.  It's a great feeling to not be dependent on others for my transportation needs.  Driving home gets me home about half an hour sooner (because the bus is slower and then I had about a half-mile walk), which is nice.  It means more time with my family.

It's been a little over 4 weeks since my right medial temporal lobectomy.  I understand everything went well in surgery.  The nurse practitioner called a few days after the surgery and told me that what they removed was not a neoplasm.  I take that to mean that it was not cancerous at all.  She said the neurosurgeon will explain the results in more detail at my follow-up visit.

I follow up with the neurosurgeon next week and am anxious to get back to normal.  I think I underestimated the amount of fatigue I would have.  The headaches have varied, but are getting less frequent and less intense each day.  In fact, I find that I don't take much of the pain medication I was prescribed.  What is generally worse than the headaches is the pain in the jaw on the side the surgery was done.  For some reason it hurts to open my mouth very wide, which makes eating uncomfortable.  Chewing doesn't hurt very much, just the actual opening of the mouth.

At night I have been staying awake until at least 1am and sometimes 3am.  Granted, I am sleeping in a little later than usual in the mornings, but it still is odd that I have to lay in bed for so many hours before getting tired.

My vision is improving.  I still have some double-vision.  It is most noticeable in the lower one-third of my field of vision.  The upper fields are almost unaffected.  The vision is improving each day it seems.  I do find myself being more careful with how I walk, doing so slowly and deliberately to avoid falling.

My sense of smell and taste I seems to have been effected for the worse, but that is something I think I can learn to live with.

Overall I have been very blessed with so many family, friends and wonderful coworkers thinking and praying for me.  I don't seem to have any problems speaking English or Spanish, as I have been bilingual for about half of my life.  I do have some stuttering, and I am wondering if that is because of the Keppra they put me on to prevent seizures.  I had a stuttering problem at times when I was on Keppra for several years, but never had one growing up.  I am beginning to play the piano and violin again.  I don't really notice any deficit with that either.  It is more difficult than usual to play due to double-vision and just not feeling great in general.  Those of you who play a musical instrument know that your playing is not the best when your body is not running at 100%.  I really think I will regain all of my playing abilities back as I heal and practice a little.

Besides being told that they didn't find cancer, the next best news has been no seizures.  This is a big deal since I usually have at least 15 per month.  I have not had a single seizure since surgery!  The first few days after surgery, and a couple of other times, I felt like I may have a seizure coming on in a while, but never did have one.  I'm really hopeful that I can be seizure free again and come off the small amount of Keppra that I am on.  If all goes well I could be working nights and driving again someday.  For now, I just can't wait to get back to work.  I want to feel like I'm doing something productive

Thanks to everyone for you thoughts and prayers!

My seizures continued without much change for several years.  They had started in 2005.  I was told that one EEG showed left parietal lobe activity.  No other EEG's ever showed seizure activity.  In 2009, following an MRI at the VA Medical Center in Salt Lake City, Utah, I was told that there was a "spot" on my brain they were watching.  Not one that's easily excited or prone to worry about medical problems, I didn't think much of it.  In fact, I didn't even tell my wife.  A doctor had also correctly (as I would later learn) hypothesized that my seizures were temporal lobe in nature, rather than parietal lobe, based on my symptoms.

Two years later, in August 2011, at the VA Medical Center in Kansas City, Missouri I was told that I had an astrocytoma.  I wasn't even sure what an astrocytoma was, just that it must have to do with the brain cells known as astrocytes.  I was told after an EEG that there was some slowing seen in that same area as the astrocytoma, the right medial temporal lobe.  I was told that the astrocytoma hadn't grown in 2 years.  I asked how they knew.  The doctors said they looked at my scan from 2 years earlier and it was the same size.  A little frustrated I told them I was told it was a "spot" that they were watching, not an astrocytoma.  The neurologist sent me to see a neurosurgeon.  

I was told by the neurosurgeon that since this spot hadn't grown he thought is wasn't likely to be an astrocytoma, but more likely some type of lesion or scar tissue that I was born with.  He told me that I couldn't drive.  I reminded him that I had never had a grand-mal seizure or loss of consciousness during any of my seizures.  He pointed out that the frequency of my seizures had increased the last several months.  He also said that due to the location of concern in my brain, the seizures could easily spread and become generalized seizures.  In the end I quit my job as I lived 42.5 miles from work and there was not bus route.  We then moved from Kansas to Idaho and later to Salt Lake City, Utah so that I could have a job that I could get to without driving.  An MRI-Spectroscopy was ordered.  I was told that they would know for sure if this was an astrocytoma based on the results of this test.  By the time we got the results, we had already moved.  The doctor called and told my wife that he was very sorry, but I did indeed have an astrocytoma.

I began seeing doctors at the Salt Lake City, Utah VA Medical Center again.  An attempt was made to better control the seizures by changing medications.  They began by adding Topamax (topiramate) to my current regimen of Keppra (levetiracetam) and Trileptal (oxcarbazepine).  At first I was a little less drowsy during the day.  I think this may be due to a small dose of the medication controlling seizures at night.  Eventually I was again at least as drowsy as I had been before.  As they increased the Topamax, I was tapered off of the Keppra.  I experienced neuropathy in my feet, and tingling in my hands and forearms when pushing shopping carts.  My seizures intensified and became more frequent during adjustments of my medication.  I sometimes woke at night with a tingling sensation around my lips, which spread to my nose and left face.  I would then wake every 2-3 hours during the night with seizures.  This was the most frequent they had ever been.  I was referred to the University of Utah in May of 2012.

I saw a neurosurgeon at the University of Utah.  He did not seem to think that I had an astrocytoma, but his office lost the copy of the MRI-Spectroscopy I left for him to review prior to the appointment.  He ordered a long-term video monitoring EEG.  For that test, I spent 8 days in the hospital connected to EEG wires.  My head got sores from the pressure of the wires on my scalp. They tried many tricks to get me to have seizures, including severe sleep deprivation, high amounts of caffeine intake (I usually don't drink any caffeine), reducing and then stopping my medications.  I only had a handful of seizures while in the hospital.  What was worse, they didn't see any seizure activity on the monitors.  Each time I had a seizure I had to press a button.  I sounded about as urgent as a fire alarm and several people would come running in the room.  It's kind of embarrassing, when you are awake for your seizures to have so many people come in as if it's some emergency.  After I got out of the hospital other tests were ordered.

I had another MRI.  They requested another MRI-spectroscopy, but I told them I didn't see the point, since I had one less than a year prior.  They ordered a PET scan.  I read the result of that and it said I had signs of early dementia.  They ordered an MEG scan.  They ordered Neuro-psychological testing.  Tests, tests and more tests.  They wanted me to get video monitoring again with sphenoid electrodes placed nearly on my brain by placing needles in through my temples.  I told them I didn't want to do that.  I'm sure some of the doctors have gotten tired of dealing with me, but I'm tired of just doing tests.

If this really is an Astrocytoma, why is it taking so long to do surgery?  If it isn't then I'm not so sure I want a chunk of my brain removed.  On one hand they have told me that it is very safe.  On the other hand one doctor said she couldn't guarantee the surgery would have no adverse effects since I also play musical instruments and have seen the effects of medication on my playing.  At the current time, I have not gone back on my medications.  I have more seizures than I had in the past, but they are not more intense.  I'm unable to drive, which sometimes makes me feel like a junior high kid again.  I have an appointment with the neurosurgeon again this week and we'll see what that brings.

Not driving was no fun.  I didn't enjoy being the passenger.  A person I worked with lived nearby and so I paid him, and we car pooled.  On the days he wasn't available, my wife dropped me off at work.  When people I worked with asked why I couldn't drive, I joked that I had gotten another DUI.  This was a way for me to break the ice.  They all knew I didn't drink alcohol at all.  It was kind of embarrassing telling people I had seizures.  I was worried they might treat me different.  At the same time I wanted to be safe, so I made sure to tell my managers and other people I was around a lot; such as other Boy Scout volunteers.

Since I don't lose consciousness during my seizures, or fall, they aren't likely to be unsafe for me.  When people would ask me what they should do for me during a seizure, I would ask that there isn't a large crowd gathered around me, as that would make it more embarrassing for me.

My seizures continued from the fall of 2005 without improvement, even on Keppra (Levetiracetam).  They all started the same - with a deja vu feeling.  Their intensity varied.  Most often I was aware it was a seizure the entire time.  Only rarely did I have one with jamais vu, the opposite of deja vu.  Often during my seizures I had various hallucinations.  Some of these were gustatory or olfactory, meaning I tasted or smelled things that weren't really there.  Sometimes I even saw things that weren't there.  This was generally people, who might even talk.  These hallucinations weren't of such intensity as to seem normal or real.  It was more like a person, or group of people had just flashed through the scene and maybe said something when they were there.  I could still recall their faces during the seizure, but afterwards couldn't remember what they looked like.  During the seizure I sometimes felt like it was the same faces I would see each time.  I'm not sure if it really was, or if that was just the deja vu feeling.

I insisted my neurologist discover the reason for my seizures.  Each time he insisted it didn't matter what was causing them, but that we get them under control.  I understood the need to control them, but felt if we knew the cause that might be easier to do.  I continually argued with my neurologist and gastroenterologist about the Asacol I was taking for ulcerative colitis.  I strongly felt that it was the cause of my seizures.  They continually reassured me that such was not the case.

By January my neurologist had wanted me to take a second medication for some time.  I was reluctant to do so. I felt that one medication, Asacol, had caused my seizures and was fearful of side effects.  He finally got me to agree to add another medication if a new EEG showed seizure activity.  An EEG was scheduled in about a week and a half.  I went home and stopped taking the Asacol.  Within a few days my head felt better.  The tingling feeling was gone.  I could estimate what time it was.  I remembered people I met throughout the day.  I had the EEG.  No seizure activity was detected.  

When the neurologist reviewed the findings of the latest EEG I told him how I felt and that I had stopped taking Asacol.  He was finally convinced.  He agreed I should never take that medicine again.  My seizures decreased after stopping the Asacol, but never went away.  The intensity of my seizures also changed.  I no longer had visual hallucinations with them.  I never had the jamais vu feeling.  In addition to the Keppra, I was eventually given Trileptal (Oxcarbazepine) for seizures as well.  I immediately noticed that I felt more tired from the Trileptal.  Each time the dose was increased, I felt more tired for several days.  If I lay down I could quickly fall asleep.  After about 8.5 months of no driving, I was finally allowed to drive.

The gastroenterologist was not amused that I had stopped taking the Asacol.  He tried me on another mesalamine medication, Colazal.  After about a week my head started feeling like it had on the Asacol.  I stopped taking it and was reassured by my neurologist that that was the right thing to do.

As far as my seizure activity, not much changed the next several years.  On average I had seizures every 2-3 weeks.  I would have a few of them over about a 2 day period each time.  After I had my colon removed (see the colitis blog) I had a seizure the same day or the following day.  Then I did not have any seizures for over a month.  That was probably the largest single break in my seizure activity.

The next day was Saturday.  As I was in the bathroom getting ready for the day, I experienced the same things I had the day before.  As it was at work, I didn't recognize anything or anybody (even my wife) during the episode.  After the episode was over however, I remembered how it started as well as the episode itself.  I was standing and never lost consciousness.  It seemed to last 5 or 10 seconds to me, but my wife stated it was a couple of minutes.  I realized after this episode that I had awoken a couple of times during the night, a few days earlier, with a similar sensation.  I considered it to be some sort of dream-like state and thought nothing of it until now.  The night before I had promised to go to the doctor if it happened again, so to the doctor we went.

We went to an urgent care facility.  It was Saturday and I didn't really have a regular doctor.  After all, I enjoyed being healthy.  Up until my colitis symptoms started I had been jogging 3-6 miles per day 3-6 times per week.  I felt old waiting to see yet another doctor.  My body seemed to be falling apart.  The Physician's Assistant we saw explained that this was likely a seizure and that he would like to refer me to a neurologist.  He then stepped out to check with the doc really quick.  When he came back in he said it could also have been a panic attack.  I had seen panic attacks before and was sure that was not the case.  I was however, unfamiliar with seizures like the ones I had.  I had only been aware of grand-mal seizures and the type known as starring spells.  He gave me some medicine to try for panic attacks.

We returned home where I threw the medicine away.  A few days later I visited the neurologist I had been referred to.  He asked many questions about the episodes and explained that they were complex-partial seizures.  He considered them to be complex-partial instead of simple-partial because I lost track of time during them and therefore had an 'altered level of consciousness'.  He asked if I had a pilot's license or CDL.  I had neither.  He told me I likely would never be able to get those as I now had been diagnosed with epilepsy.  He told me I couldn't drive until my seizures were under control for 6 months.  I had come to the office myself so I drove home.  I cried on the way, feeling sorry for myself.  I wondered how this could happen to me when so many people who don't seem to take care of themselves don't have these problems.  After arriving home I started what felt like being grounded from driving.