Today we saw Dr. Sperling, Corey’s seizure specialist.
You may recall our last visit in May. Corey’s cognitive development, awareness and behavior began to spiral downward from February. When we saw Dr. Sperling, his first question after hearing our observations was, “has anything changed”? The only change I could report was the brand drug Tegretol was put on permanent backorder so the pharmacy switched us to generic. Dr. Sperling confidently announced, “Oh, that’s it; she’ll be fine”. We had been watching Corey’s progress regress for four months and I was shocked at his reaction…but that’s why he’s the specialist ~ he insisted we switch her generic Rx to Teva Pharmaceuticals and she’s been back on track cognitively as well as improving behaviorally.
Dr. Sperling’s resident was charged with writing up the clinical history over the last 6 months. She was unaware that Corey was in a car accident. As she proceeded through the interview, she asked more detailed questions about her current physical function. As she administered the standard neurological and physical exam, she was surprised by Corey’s strength and accuracy. She asked me if any Doctors have given a prognosis in regard to the delay of her left side. She was wondering if it could continue to improve. I told her I didn’t have a prognosis but the movement on her left leg began in March and her left arm just began moving within the last four months.
I wish I had a camera to capture this young resident’s facial expression. It would be an understatement to say she was stunned. She looked at me with shock and disbelief as she told me, “Are you aware that if a patient is immobile on one side it’s nearly impossible for them to re-engage their muscles especially after 2 years”. Unaffected by this clinical fact, I assured her “we received a diagnosis but no one could give us a prognosis because, as you know, each brain injury and recovery is different. We push her therapy as if there are no limitations”.
Dr. Sperling joined us for the second half of the exam. The last time he saw Corey her left arm was immobile and she couldn’t speak in sentences. She used her whiteboard to respond to his questions. Today she asked him how he was, commenting that it was good to see him again. He was very pleased to see her progress.
We are considering an ambulatory EEG. Although Corey hasn’t had a grand mal seizure since March (I’m knocking on wood as I write this) she appears to continue to exhibit silent seizures. Rather than admit her to Thomas Jefferson for 2-3 days, we may go in to have her “wired” and bring her home. If we think she’s having a seizure we can press a button which will trigger a notation on the recording. The record will be analyzed and hopefully indicate how many seizures she is having. I’m not sure when this will happen but I’m sure the exercise will be useful.
Happy dreams, xoxo