Wednesday, April 24, 2013

Epilepsy, Electricity and Complementary Medicine

My dear wife of 34 years, Chana,  has been suffering from seizures for 23 of them. I believe that each
seizure is the body's attempt to discharge electricity, often, unsuccessfully.  Imagine if you will, a seizure every 25 days or so, followed within the next few days, by 5-8 post-ictal seizures, for more than 20 years. Do the math, and you will realize that the number of seizures that she has endured numbers well over 1000! Besides the obvious damage they have done, one other consequence has been a rawness, and an inability to concentrate. How could you expect someone who harbors and is distracted by so much electricity, to be able to focus, concentrate or engage in any relaxation technique? The cumulative sequelae of the seizures have just been too overwhelming for her to engage in any active relaxation--at least until recently.

I am pleased to report, though, that now, for the first time over an extended period of time, the seizures are becoming less frequent, and I am very hopeful that slowly and gradually she will be able to discharge the electricity and  heal.

Anecdotally, I will tell you that some years ago, she was seen by late Dr. John Upledger, the developer of CranioSacral therapy. An interesting therapy that Dr. Upledger suggested was she daily, for an hour,  connect a copper wire to her leg, and attach it to a ground, to discharge excess electricity. It was yet another interesting idea, but had little effect in her case.

Let me digress for a moment and share with you how I think as a practitioner:

I feel that there are three critical aspects to be considered as a starting point with each patient:

1.   Thoughtfully determine the pathogenesis of the patient's condition. Trace backward step by step with the patient, to a time before he or she was sick, and then consider how to  reset events differently.
(We traveled around the country and around the world considering so many options and causes eliminating one after the other, until we came to our present conclusion as to what caused the seizures to occur).

2.  Determine the differential diagnosis. The great sage and medical genius Rebbe Nachman of Breslov teaches that internationally, inter-personally and internally, there can only be conflict or harmony.  As with people or nations, illness is a lack of internal harmony in the organ systems, and  the practitioner's task should be to encourage and promote that internal harmony.
(Every three days, I review Chana's symptoms, check her signs and take her pulses, adjusting and adapting her protocol accordingly)

3.  Meet the patient where he or she is. Never have an agenda or prejudge.  Always relate to the patient with pleasantness, being sensitive  and adapting to whom the patient is.  For example, not every patient is an appropriate candidate  for acupuncture or Chinese herbs.
(In Chana's case.  we tried over the years many different methods and approaches to acupuncture, and not only were they not beneficial, as every acupuncture protocol accelerated the onset of seizures in her case, but she has expressed that she feels she is being tortured when she is given acupuncture. In such a case,  I must honor her and respect her boundaries.)

The next goal is to consider the whole person: emotionally, intellectually, spiritually and physically as well as considering possible contributing factors.  Though they are magnificent therapeutic tools, I don't believe  that Acupuncture and  Chinese medicine alone can resolve all conditions. My experience has taught me that sometimes, a condition can manifest as a mineral or vitamin deficiency. Consider, for example, peripheral neuropathy is a common symptom of diabetes, but it can also result from a deficiency of Thiamine or B12, or even from Guillain-Barre Syndrome; Muscle spasms, insomnia, bone spurs, kidney and gall stones, and osteoporosis can all result from  magnesium deficiency;  Hypothyroidism, mental retardation, fibrocystic breast disease, and breast cancer can all result from iodine deficiency; Diabetes, Alzheimer's, Obesity, hypertension, depression, chronic fatigue, psoriasis and fibromyalgia can all result from a deficiency of Vitamin D3 (never take D2 which is known to cause toxicity and side effects); Bromhidrosis (body odor), Anosmia (poor sense of smell), Ageusia (poor sense of taste), hair loss, anorexia, and dermatitis all can result from zinc deficiency!  Though some of these conditions might be successfully treated by acupuncture, moxa, herbs, diet, Qi gong or tuina, in my opinion the wise practitioner must always consider a biochemical component as well.  (As a result, in Chana's case, with each dose of herbs she also takes a number of nutraceuticals based upon her signs and symptoms, but never without a clear indication of their benefit, leaving little to chance).

Let me add, as an aside, that neither Chana, nor any of my patient take multi-vitamins, to the best of my knowledge, for as importantly as it is to fill a deficiency, it is equally important to not toxify with an excess.

The third goal is to carefully consider six aspects of the patient's lifestyle: What and how they eat, proper hydration, thoughtful breathing, gentle stretching and walking, appropriate and adequate sleep, and nourishing the spirit and making oneself happy. In short, the patient must always be related to as a living and vibrant human being, and not a biomedical machine.

Which brings me to my wife, Chana. Western Biomedicine was not only unsuccessful in treating her, as she was not able to tolerate western pharmaceuticals, and almost died from a reaction to Lamictal. On the other hand, Chinese medicine was helpful in ameliorating some of her major accompanying symptoms, (such as constipation, urinary incontinence,  less intense muscle spasms, and insomnia), and nourished her greatly between seizures, but  was completely unsuccessful in stopping the seizures.  . In addition,  she has had 5 MRIs in as well as  CTscans, PETscans and EEGs. No evidence of hot foci or scars( though the PETscan did pick up a cold focus) were seen, as usually is present with seizure disorders. A lumbar puncture (LP) was performed to rule out the presence of bacteria, virus or fungus in the cerebral spinal fluid. Negative.

But, after the LP 4 years ago,  our neurologist suggested that we try a new anti-convulsant, Keppra (Levetiracetam), and though indeed there have been side-effects, such as greater irritability and weakness, and less focus,  its benefits have been life-changing, and now, with the Chinese herbal decoction that she takes three times daily, the three cups of freshly made green smoothie, (see the article on my blog which speaks of green smoothies)  and the regimen of nutraceuticals, seizures over the last couple of years have occurred between 40 and 110 days apart, often without any post-icatal aftershocks!  Dosing has been very important, not just with the Keppra, but with every aspect of her regimen, and I constantly change the herbs in her decoctions based upon my readings of her pulses and other signs and symptoms. I am very hopeful that the long struggle is close to being over.

As I mentioned previously, all along, I considered all the various factors that could have contributed to her condition, in order to determine the pathogenesis and  I am now absolutely convinced the seizure are iatrogenic (physician caused) in nature, resulting from a trauma suffered more than 50 years ago, and leaving  a microscopic lesion, probably in her temporal lobe, which no scan has been able to pick up, and which set in motion the electrical imbalance that eventually caused the seizures. It seems to me,  that such an intense unnatural trauma can only be counteracted by a Western pharmaceutical.

One other important point to always consider, based upon the principles of Jewish medicine is to both carefully avoid negative stimulation and gently and positively nourish.  To that end, we have recently revisited the ketogenic diet (high fat, low carbs and moderate protein).  Back in the early 90s we tried it with little success, which validated research which seemed to show it only effective in cases of pediatric epilepsy.  I find it significant, though, that often Chana's seizures have occurred on the weekends.  How do we eat differently then?  Well, as orthodox Jews, we specifically eat delicious organic and whole grain home baked challah (bread) for all three meal on the Jewish Sabbath: Friday night, Saturday lunch and Saturday afternoon, as well as having a little grape juice mixed with wine.   Could the higher ingestion of carbohydrates be precipitating greater electro-stimulation to her brain?  We'll see, and I'll report my finding to you. 

It is my hope that with time, as the seizure become less frequent,  her accompanying tremors, spasms and irritability will dissipate, as the electricity is slowly discharged.  As this happens, Chinese medicine and the other accompanying therapies will become, with G-d's help, even more effective, but even more than as medicines, as nutrients.   But it will take time and patience.