Veterans and Epilepsy: Basic Training: Surgical Interventions


I WAS IN THE ARMY
FROM 1978 TO 1981. WOMAN: HE WAS A KIND OF
A BIG BIKER GUY. I WAS KIND OF AFRAID OF HIM
WHEN I FIRST MET HIM, AND… HA HA HA! THEN I GOT TO KNOW HIM, AND HE ENDED UP BEING ONE OF
THE NICEST GUYS I’VE EVER MET. HE’S GOT AN AWESOME PERSONALITY. REALLY NICE GUY– OBVIOUSLY, OR I WOULDN’T BE
MARRIED TO HIM FOR 20 YEARS. I DON’T REALLY KNOW
WHAT THEY WERE CAUSED BY. THEY HAD SUGGESTED– THE HOSPITAL IN CHICAGO WHERE HE
HAD HIS SECOND BACK SURGERY SAID THAT MAYBE IT WAS CAUSED
BY THE ANESTHETIC BECAUSE HE WAS UNDER
FOR SO LONG. WE WERE ON I-90 COMING HOME
FROM CHICAGO, AND I HAD TO PULL OFF
OVER TO THE SIDE. WE DIDN’T EVEN KNOW THAT THAT
WAS A SEIZURE AT THAT TIME. WE DIDN’T KNOW WHAT IT WAS. TIM: THE SEIZURES WOULD TAKE ME
FOR A WEEK, AND THEN IT’D TAKE ME
A WEEK OR SO LONGER TO GET OUT FROM BEING DOWN. AND THEN, AFTER A COUPLE
OF WEEKS OF THAT, IT STARTED ALL OVER AGAIN. JOELLEN: AND IT COULD GO ON
FOR A COUPLE DAYS,2 OR 3 A DAY, AND THEN HE’S JUST IN BED. HE CAN’T GET UP.
HE CAN BARELY EAT. HIS WHOLE BODY HURT
FROM THE SEIZURES. IT JUST DEBILITATED HIM. HE WOULD BE IN BED FOR DAYS. AND IT WHUPPED ME, BAD. IT WAS HARD.
IT WAS REALLY HARD. THE KIDS WERE LIVING AT HOME. THEY WERE–THE KIDS WERE SMALL
AT THE TIME. WE JUST–WE JUST DEALT WITH IT. ANYBODY WHO HAS A DIAGNOSIS
OF EPILEPSY FIRST GETS TREATED
WITH MEDICATIONS, AND THEY OFTEN
ARE VERY EFFECTIVE AND WITHOUT SIDE EFFECTS. HOWEVER, SOMETIMES THEY DON’T
WORK, AND ACTUALLY, IN ABOUT A THIRD OF PATIENTS, MEDICATIONS WILL NOT CONTROL
A PERSON’S SEIZURES. WHEN YOU START A NEW MEDICATION, IT TAKES MAYBE
3 WEEKS TO A MONTH TO EVEN GET INTO YOUR SYSTEM TO
EVEN KNOW IF IT’S GONNA WORK, AND THEN IF THAT DOESN’T WORK, YOU’RE BACK TO SQUARE ONE AGAIN,
TRYING SOMETHING NEW. SO IT–IT GOT TO BE FRUSTRATING
FOR EVERYBODY. WHEN A PERSON HAS EPILEPSY
THAT IS MEDICALLY INTRACTABLE, OFTEN WE RECOMMEND
PERFORMING SURGERY TO REDUCE THE AMOUNT OF SEIZURES
THEY ARE HAVING. FOR EXAMPLE, MANY PATIENTS WITH
MEDICALLY INTRACTABLE EPILEPSY HAVE SEIZURES THAT EMANATE
FROM THE TEMPORAL LOBE, WHICH IS A PORTION OF THE BRAIN
BEHIND THE EYES. BY REMOVING EITHER THIS SECTION
OF THE TEMPORAL LOBE OR A SMALLER SECTION OF
THE TEMPORAL LOBE, IT MAY REDUCE OR COMPLETELY
ELIMINATE THE SEIZURES THAT SOMEONE IS HAVING. – HELLO, MR. HOED.
– HOW YOU DOING? RUTECKI: MRS. HOED.
HOW ARE YOU ALL DOING? JOELLEN: WHEN THE DOCTOR STARTED
TALKING ABOUT SURGERY, IT WAS PRETTY SCARY. WE DIDN’T SEE THAT THERE
WAS ANY OTHER ALTERNATIVE BECAUSE HE’D ALREADY BEEN
THROUGH ALL THE MEDICATIONS THAT THEY COULD GIVE HIM. TIM, VOICE-OVER: AND I WAS AT
THE POINT WHERE IT DIDN’T MATTER BECAUSE I WAS DOWN
MORE THAN I WAS UP. SO I WAS WILLING TO…
DO ANYTHING AT THE TIME. LAKE: EPILEPSY SURGERY, LIKE ALL
TYPES OF SURGERY, HAS RISK– THE RISK OF STROKE,
THE RISK OF BLEEDING, INFECTION, AND OF COURSE
THERE’S EVEN A RISK OF DEATH. THE ACTUAL RISKS ARE QUITE LOW. THE RISK OF DEATH IS SMALL– WOULD BE VERY SIMILAR
TO ANY SURGICAL PROCEDURE. THERE’S A SMALL RISK
OF INFECTION. AND THOSE RISKS ARE QUITE LOW,
WELL LESS THAN 1%. THE ONLY TIME WE DO EPILEPSY
SURGERY IS IF SOMEONE’S SEIZURES ARE POORLY CONTROLLED
WITH MEDICATION, AND WHEN WE CHOOSE TO DO THAT, WE ACTUALLY FEEL THAT
THE SURGERY IS LESS RISKY THAN NOT HAVING THE SURGERY BECAUSE IF THEY DON’T HAVE
THE SURGERY FOR THEIR EPILEPSY, THEY CONTINUE TO HAVE ONGOING
AND UNCONTROLLED SEIZURES. AND THERE IS AN INHERENT RISK
TO UNCONTROLLED EPILEPSY THAT CAN RESULT IN DEATH. HE REALLY DIDN’T HAVE
ANY ALTERNATIVE OTHER THAN LIFE
THE WAY HE KNEW IT OR LIFE THE WAY, MAYBE,
IT COULD BE AFTERWARDS. THERE WAS A LOT OF TESTING
GOING ON, BUT I GUESS THEY DID
WHAT THEY HAD TO DO. THE EPILEPSY MONITORING UNIT IS
THE SECTION HERE IN THE HOSPITAL WHERE WE CAN BRING PATIENTS IN, GET THEM ALL HOOKED UP
WITH THE EEG LEADS SO THAT WE CAN SEE
THE BRAINWAVES, AND THEN MONITOR THEM
WHEN THEY HAVE A SEIZURE. THAT DATA WILL HELP
THE DOCTORS DECIDE WHERE THE SEIZURE
IS COMING FROM, WHAT PART OF THE BRAIN
IT IS COMING FROM, WHAT KIND OF A SEIZURE IT IS, AND THEREFORE WHAT KIND OF
TREATMENT IS GOING TO WORK BEST. SO OVERALL, WE THINK THAT
EPILEPSY SURGERY AND A TEMPORALOBECTOMY
WOULD BE THE WAY TO GO ON THE LEFT SIDE. CARNCROSS: IF SOMEBODY
IS GONNA HAVE SURGERY AND WE’RE GONNA TAKE OUT
PART OF THEIR BRAIN, THAT NEUROSURGEON WANTS TO KNOW
EXACTLY WHERE TO GO AND EXACTLY WHAT TO TAKE OUT. THE TESTING THAT WE DO
NOT ONLY ALLOWS US TO FIND THE ABNORMAL
AREA OF BRAIN, IT ALSO ALLOWS US TO ASSESS
HOW FUNCTIONAL THAT PORTION OF THE BRAIN IS. I THINK WE SHOULD DO
A LEFT SIDE OF THE INTERIOR
TEMPORALOBECTOMY. HE IS LEFT-HANDED, SO HE DOES SEEM TO HAVE LANGUAGE
FUNCTION ON BOTH SIDES. WHAT WE DON’T WANT TO DO IS
NOT MAKE THE SEIZURES GO AWAY AND THEN HAVE SOMEONE
HAVE A NEW PROBLEM IN ADDITION TO THAT
THAT MAY BE JUST AS DISABLING. LAKE: PATIENTS USUALLY COME IN
FOR SURGERY FIRST THING
IN THE MORNING. THEY’LL UNDERGO SURGERY, WHICH WILL LAST SOMEWHERE
BETWEEN OFTEN 4 TO 6 HOURS. SO IT IS A LONG SURGERY. SO WHEN HE HAD HIS SURGERY,
HE ACTUALLY HAD IT AWAKE, AND WE STIMULATED AREAS
OF THE TEMPORAL LOBE TO SEE WHETHER OR NOT LANGUAGE
LIVED THERE, IF YOU WILL, AND TRIED TO AVOID THOSE AREAS
TO MINIMIZE ANY PROBLEM. THEN THEY WAKE YOU UP, AND… DURING THE SURGERY,
AND IT’S LIKE, IT’S PRETTY WILD
WHEN YOU’RE AWAKE WHEN THEY’RE UP HERE. IT WAS REALLY SCARY,
JUST WAITING AND WORRYING. SOME PATIENTS MAY REPORT
SOME CHANGES IN THEIR SPEECH OR SOME CHANGES IN THEIR MEMORY. OTHER PATIENTS MAY EXPERIENCE
SOME WEAKNESS OR FATIGUE. IN MOST PATIENTS, THIS IMPROVES
WITH A REHABILITATION PROGRAM OR WITH TIME. ARE YOU HAVING ANY PROBLEMS
RIGHT NOW, OR ARE THINGS GOING ALL RIGHT? TIM: THEY’RE GOING ALL RIGHT,
WITH THE SAME OLD. LAKE: IF CAREFULLY SELECTED, EPILEPSY PATIENTS USUALLY
HAVE GOOD OUTCOMES, AND THEY’LL HAVE SOME
IMPROVEMENT IN THEIR SEIZURES, AND SOME PATIENTS WILL HAVE
A COMPLETE ELIMINATION
OF THEIR SEIZURES. BEFORE THE SURGERY,
I WASN’T ABLE TO DO ANYTHING. AND NOW THAT
HE’S HAD THE SURGERY
AND EVERYTHING IS GOOD, WE DO A LOT TOGETHER. WE CAN GO OUT WITH OUR FRIENDS.
WE CAN GO DO WITH THE HORSES. WE WORK IN THE YARD TOGETHER.
WE GO ON HIKES. WE DO A LOT NOW. LAKE: IF EPILEPSY SURGERY
IS SUCCESSFUL, IT CAN PROVIDE A LOT OF REWARDS
TO PATIENTS. THEY’RE HAVING FEWER SEIZURES
OR NO SEIZURES. THEY HAVE GREATER COMFORT
IN THEIR LIFE, GREATER SAFETY. IT’S AN ABSOLUTE GAME CHANGER. THE SURGERY GOT MY LIFE BACK,
SO YES ON THE SURGERY. THE SURGERY CHANGED OUR WHOLE
FAMILY’S LIFE, ABSOLUTELY. IT WORKED. THAT’S ALL I KNOW.

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