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Obsessing over drug blood-levels can lead to sad consequences. For example, if blood-level happens to fall within suggested range of numbers printed on lab slip, patient and doctor might conclude that everything humanly possible is already being done. But if patient is still having seizures, more work is still needed.
It is also unfortunate when patient and doctor assume that a blood-level outside "normal range" is bad. Some patients might actually do best on a blood-level that is higher than printed range, or, alternatively, do just fine on a blood-level below range. The printed range is just a rough guideline.
6. Keep regular hours.
I know that you are an exciting, vibrant human being. But sometimes it's in your best interest to behave as if you are a dull person, waking up at same hour every morning and retiring at same hour every night. Disruptions in sleep-cycle can lower threshold for having seizures. As an example, one man in my practice never achieved perfect seizure control while working swing-shifts, but became perfectly seizure-free when he went on straight day-shifts.
7. Keep records.
In process of medication adjustment leading to perfect seizure-control, an accurate tally of numbers of seizures per span of time is an essential tool in judging whether or not you are on right track. Women should also chart their menstrual periods. Sometimes there is a correlation between seizures and menstrual cycle.
8. Communicate with your doctor.
The smartest doctors in world can't fix problems they don't know about. If you're still having seizures or experiencing side-effects from seizure medication, chances are that your doctor would appreciate a phone call about it. The advice you receive will allow you to make better use of your time than if you wait until next appointment to report problems.
9. Talk to your doctor about pregnancy.
If you're planning on becoming pregnant, then time to mention this to your doctor is before you become pregnant. Your medication might need to change in order to optimize your outcome. Once you are pregnant, this option is less available. In any case, you and every other woman of child-bearing potential should take at least 800 micrograms (0.8 milligrams) of folic acid (also known as folate) daily in order to minimize chance of fetal malformation. Once you discover you are pregnant, you might already be past time at which folic acid was most needed. Taking it regularly is safest course of action.
10. The goal is zero seizures and zero side-effects.
Yes, I know I'm repeating myself, but it's just that important!
(C) 2005 by Gary Cordingley
Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher. For more health-related articles see his website at: http://www.cordingleyneurology.com