I have seizures. Seizure activity. Seizures.
Like usual, no one could decide at one point what to call it.
But now, the "episodes" extend well into partial seizure territory.
When one becomes incapacitated, that is usually an actual seizure.
[So says the neuro.]
I also get migraines.
I also have bipolar disorder.
I also have sleep issues- which may or may not have anything to do directly with any of the above.
These all interplay to produce a nice clusterfuck every once in a while.
For the past 10 days, maybe two weeks at this point, I've been having a lot of headaches and had a few migraines. I can only guess that all the sunlight [which I tend to be reactive to], the crappy sleep, the slowly declining effectiveness of the topiramate I am taking- are all starting to catch up to me.
Oh, and my allergies. Can't forget my allergies- which range from pollen to "what's behind door number three".
If you do not get migraines, I will attempt to explain some things about them at this point:
Migraines, like pretty much anything else in the medical realm, even more particularly in neurology- are pretty variable.
They can involve pain, or just an aura, or both.
The typical course of a migraine involves a prodromal period [leading up to the migraine], an aura [sensations and symptoms which are part of the migraine process], the actual "migraine", and postdromal period [after the migraine].
The prodrome can involve many things: mood, cognition, energy levels, even cravings for certain things or libido.
...along with mild to moderate mood effects, mild cognitive effects- like inattentiveness, "general weirdness" [which I can only really describe as being "uncomfortable"], I tend to have an elevated body temperature. Everything else is neither here nor there- it can come and go, and is not terribly reliable as a tell for knowing that I am going to have a migraine. Body temperature, I have found, is a pretty accurate predictor for me almost every time. But it almost never happens before I have a seizure.
When I was in a car accident I had pretty brutal hits to the head- I thought for a long time I was hit in the temporal lobe and the occipital lobe- which is possible- but given that I had migraines get worse afterward and developed the temperature thing after that [in association with the migraines], I'm starting to suspect I sustained some kind of injury to the parietal lobe.
[But ya know it doesn't really matter, crazy amateur neurologist, and all...]
I rarely have any kind of aura, though when I do it often presents as extreme and sudden nausea.
The headache can be variable.
What I call a migraine is pretty painful, though. I do, admittedly, have a fairly high pain tolerance [and likely threshold as well]. Pretty much anything beneath "jackhammer to my brain" I tend to brush off as just a headache and so I try to carry on as though things are normal.
Though because the pain intensity can be variable, even if I'm not in agony I am likely technically experiencing a migraine at that time as well.
My migraines tend to last somewhere around 6-8ish hours, though I have had them last about 30-35.
That would be the time that I discovered that "Hey! My seizures are not photosensitive [...I don't think], but my migraines certainly are! Fucking NEAT!"
The postdrome often consists of a lot of tired and cranky and sorting out my brain.
Sleep, if I can get it.
And if I am having them fairly often, all semblance of productivity and most concepts of time go out the window.
I'm not going to go into the seizures here, but they are temporal lobe seizures. For the most part simple partial [occasionally possibly complex partial], so there's that.
All these things have a tendency to play off of one another.
If I don't get enough sleep- it's more likely I'll have migraines or seizures, which messes with my moods, which makes it more likely I could edge into some kind of actual mood episode.
...and all kinds of variations on that.
The issue I am facing now is that it is quite apparent that the topiramate [the only anti-convulsant I am taking at this time] is no longer anywhere near as effective as it once was or needs to be.
I am beyond maxed out in the dosage, having breakthrough neurological "weirdness" [...totally a technical term...] and clearly having lots of headaches and some migraines.
I could stand to raise my lithium, but there are problems with this.
Lithium, even more than wellbutrin [which I am also on], is actually considered proconvulsant. Lucky me.
Unfortunately, it has been the most effective mood stabilizer I have ever been on. There is a reason it has been known as The Gold Standard for bipolar.
I'm at the point where I take depo provera [the birth control known as "the shot"] primarily for control of mania, not actually for birth control... I don't have a lot of effective mood stabilizer options waiting in the wings.
But I mean if we were to go with meds according to how they affect my seizure threshold, pretty much all I would be able to take would be AEDs or ACs ro fucking benzodiazepines or such things. Which is not necessarily the most effective protocol for a person with "refractory" bipolar and moderate to at-times-severe OCD.
Going back to the lithium though, what is the point if it is at a subtherapeutic dosage?
Meanwhile topiramate- at well over the maximum dosage- can't keep up with my brain, and also LOWERS the serum level of lithium.
This all looks like I have to completely overhaul all my meds. This does not make me happy. Actually this kind of scares me.
I have had some pretty brutal, even life-threatening [quite literally] reactions to meds before. I also don't like being stupid. The couple of ACs/mood stabilizers that are next in line are quite likely to make me stupid and cause all sorts of other problems.
Then again, I'm on an anti-convulsant right now that is running my kidneys ragged and only kind-of-sort-of working, while reducing the effectiveness of my mood stabilizer, yet I want to insist I stay on it for some reason.
Likely mild fear.
So that kind of looks like I'm already pretty stupid.
So yes I'm frustrated. I'm also a bit scared, a little sad.
Feel like I'm kind of screwed no matter what.
Though to explain all this shit to anyone takes forever [obviously], so much of the time I don't bother to enlighten anyone on why I'm not a "productive member of society" right now.
I think it's easier a lot of the time if people just make the assumption I am stupid and/or lazy.
Saves explanation that they won't accept anyway.