02 June 2010

I Can't Keep My Eyes Off You

I keep telling myself, It could be worse. And then sometimes, when I'm looking at her and she's having one of her episodes, my heart sinks.

I can't remember when I started noticing them (at least since April), but it was one of those things that happen again and again until it intrudes on your conscious mind that something's not right. It's more than just staring off into space. It's the same movement of her head, the way it kind of rigidly drags down to her chest, sometimes including her shoulders and upper arms. It's the particularly vacant focusing of the eyes straight ahead. It's the absence for approximately 1-3 seconds, no response when her name is called. It's the snapping back, usually unsure about what came before, but not aware that there's anything missing: no distress, no apparent suffering.

I was first able to describe this more than three weeks ago to our First Steps PT, who told me she thought they were seizures. I was alarmed to say the least. She suggested I monitor and document for a week and then call the pediatric specialist we'd seen in March – after two days, I'd seen enough and called. In the meantime, Drew and I'd been reading up on the internet and between us, our best guess was that Z had absence seizures, or petit mal. Dr Hoffman's nurse was skeptical at first, but as I described episode after episode, esp one in particular in which Z stopped mid-laugh, the nurse suddenly became concerned and contacted the doc who was out-of-town. Within half an hour, she'd called back to say that Dr H had ordered an EEG – labeled "urgent" only because of her age – and within a week of that, we had an appt to see the neurologist (yesterday) and scheduled a first-available EEG in mid-July. Then it was off to the pediatrician's to inform her what was going on, and the best parting advice she gave me, "Get it on video". Thinking back, I'm thankful to have had all these great resources built up waiting for this moment: I hope the "bottom" of Z's development issues.


The neurologist at Children's Mercy was amazing brisk. Forty-five minutes after the start of our appt, in which I whisked out my camera and Dr Allaboun declared in his Jordanian accent, "I love video!" and in which a second doc, Dr Le Pichon, was consulted and they decided to make special arrangements to have Z's EEG in the afternoon, partially because of the frequency of her seizures, we were back out on the street trying to decide whether or not Drew should go back to the office to take his final exam. Once it was decided that he would come back for us, Z and I walked to what probably amounted to the other side of the hospital campus for lunch in the cafeteria; we walked back and then outside to the playground, where we marveled over the walking piano and played on the slides (above) in the rain; and finally to an entirely different part of the hospital to the EEG clinic. They said to have her good and tired, but I think Z was easily classified as a wreck: she fell asleep during the prep, which is 26 probes individually marked and glued on. Though they weren't able to catch a seizure during the waking portion of the test, Dr A was gratified in seeing seizure activity while Z was asleep. (I didn't know it, but he had been monitoring the results from elsewhere and had already talked with Drew about medication.) The diagnosis: atonic seizure.