Rough Nite for Brady

On December 15, 2010 at 11:37 pm, the seizure monster reared it's ugly head and Brady had a grand mal seizure. His last seizure was on August 1st; 136 days, 18 hours and 47 minutes ago. This equals 4.5 months, which is the longest amount of time that he has been seizure free since last year. It is so terribly disappointing to see him have seizure activity after such a wonderful long streak of peacefulness. But at the same time we are extremely thankful that he was able to go for such a long stretch without any episodes. The seizure began at 11:37 pm with convulsions and thrashing and a lot of drool. There was no loss of urine or stool. At 11:40 pm, the thrashing stopped and Brady laid there as still as could be. Jeff was gently massaging his head as I inserted the rectal suppository of valium. By 11:44pm Brady was up on his feet. It seemed that he laid there so calmly and still after the seizure was over a little longer than normal. I remember thinking when is he going to get up?  Once up, he seemed to recover fairly quickly although at the time he was pacing and unsteady on his feet. He was also ravenous. Once I realized that he was okay, I gave him some rescue remedy and also a cup of food. It was really hard for him to settle down afterwards and in about 20 minutes or so, Brady began to whine. We thought that this was possibly due to him needing to go out and potty. Jeff took him out to relieve himself, so, of course, the valium suppository came out as there had not been enough time for it to dissolve. After his potty break, I gave him some plain yogurt with two scoops of di tan tang and one scoop of bu xi xue feng mixed in. These are the two Chinese herbs that he takes each day.
At 12:41 am Brady started to contort his face and clench his teeth together and what looked like another grand mal was beginning. However, thankfully, this was only a focal and did not become a gm. There was no thrashing and it was over within a matter of seconds.
During the next half hour after this focal, it was hard for Brady to settle down so Jeff decided to take him outside and let him walk around on leash for a bit. This seemed to help matters so we tried to doze off, but at 1:19 am another focal started which lasted only a few seconds. Same thing...his teeth were clenching and his jaws were snapping with facial contortions. But again there were no convulsions or thrashing. It seemed to me that every time Brady would dry to doze off, another focal would occur. Another one came on at 1:24 am; Jeff estimated that this one lasted 20 seconds. We were so thankful that these focal seizures were not grand mal seizures, but why wouldn't this cluster of focals end?! I was beginning to be really worried. Things settled down for just a bit, but once again at 2:09 am another focal took place. This one was less than a minute; it had the same characteristics as the others, but seemed a few seconds longer. This made 4 focal in a relatively short amount of time. At 2:18am, my mind was racing. I decided that I should insert another valium suppository. Once this was done, things remained calm and no more seizures occurred. Thank you God!
I assume that the valium suppository broke this series of clusters. I just wish I had thought of it sooner before four focals had occurred. The good thing is that Brady made a quick recovery after each seizure. Once this suppository went in, it seemed that he immediately was able to rest. Everything was peaceful and calm until 7am when the alarm went off to give Brady his morning medication. Brady appeared to be fine and none the worse for wear after the night he had. We couldn't say the same for ourselves. He took his meds, had his breakfast and went out to relieve himself as normal. We didn't go for our daily walk due to the snowfall. Hopefully, it is over and now the clock will start over again.
I phoned Dr. Katherman to inform her of what had occurred overnight. Her initial feeling was that Brady's phenobarbital level has probably dropped due to his liver metabolizing it so fast. Her recommendation was to increase his phenobarbital by a half a pill morning and night. He will be getting 81 mg twice per day for a daily total of 162 mg instead of 64.8 mg twice per day = 129.6 mg daily. He will be getting 16.2 mg more per dose and 32.4 mg more per day.
Brady has an appointment with Dr. Katherman in two weeks on Thursday, December 30th, to check a trough level of phenobarbital to insure that we haven't taken the dose up too high.