Well, brains are complicated little things and as I've begun to research I've realized why we make jokes that theme around "brain surgeon". Why, oh why; did I have to have a seizure? Why couldn't my malady just have been a mangling of the metatarsals or something so much simpler? But no, I have been handed lemons and will make lemonade.
Right from the start I knew the new neurologist was, as they say in Hawaiin Pidgin, "da kine". He's this wiry little guy with a big shock of Albert Einstein hair, and his office was plastered with enough diplomas to paper a King Kong sized parakeet's cage (culminating with a PhD from Harvard).
Additionally, although the rest of his garb was professional, he had on this tie that said "I am confident in my self worth and therefore I can wear this ugly tie". You can read your own meaning into that! I loved the guy within 10 minutes. As we reviewed my EEG and MRI, he pointed out to me a little squiggle and said "there's your problem". I looked and it wasn't apparent to me. He gave a little description and pointed out how the other side of my brain was void of the squiggle in the opposite and corresponding section. Suddenly, like when you are watching House or ER or CSI the squiggle emerged and was visible to me. It made sense. He explained how this scar or lesion was smack dab in the place where seizures are triggered. I asked if the scar was a result of, or the cause of seizures. He said it was the cause and he asked if I had ever suffered head trauma. Not that I can recall, and in a subsequent conversation with Mom I asked her if there had ever been an event in my childhood that might have precipated serious trauma, like dropping me as a baby.
She laughed and said "do you think I would tell you?". Love you Mom! Seriously though there was nothing that she could think of. Then, I asked how come the other neurologist passed me with flying colors. He said that it is a matter of interpretation and he could not speak for the other doctor, but to him there was a clear and present cause of the seizures. It made a little sense to me working in the software world - what's FAD (functions as designed) to some may be a defect to others.
Well, truth be told I was very discouraged about finding the cause. Because the Dilantin is working, and I live an absolutely normal life other than a few minor side effects, I had slipped back to a Pollyannish view that I'm OK. But I'm not. I'll have to take drugs for the rest of my life which threw me into a mild depression for a few days. But then, realities pushed their way back into my selfish worldview. I feel great, I'm living the same lifestyle that I was before the seizures. I just have to take pills every day of my life. Many, many people are in far greater daily physical pain and problems than I am.
One thing though I thought of was the impact of Katrina displacing thousands of people in a sudden, irrevocable way. If I were to stop taking my meds cold turkey, it could actually induce a seizure. I now carry a few days supply with me every where I go "just in case" I'm separated from home involunatrily.
Well, as mentioned I have a few minor side effects with Dilantin. Nothing of great importance, but the doctor is switching me from Dilantin to Lamictal. He said it is a much newer and advanced drug than Dilantin and will have less side effects, although he said that if a rash develops I should seek medical treatment immediately as I might die. No kidding, I'm not making that up. Otherwise I should see a marked improvement. Here is a picture of how my brain operates:
It's hard to see but there's a little electrician goes around plugging in various outlets and receptacles the conscious and unconscious workings of my body. Sometimes he goes on a lunch break and the circuits get overloaded and pop a breaker. Dilantin is like a bologna sandwich on Wonder bread to this guy, solid, reliable and dependable - his wife's been packing his lunch with these for 35+ years. Add a few Cheezits and pickles, and he's gonna make it through the day. Lamictal though is like the energy drink RockStar - it's hip, it's sexy and it will give my little electrician a jolt (no pun intended against Jolt cola) that's gonna have him plugging and unplugging and watching those circuit breakers like foam on a latte.
I like the following description of what Lamictal does. I plan to memorize this so I can repeat it at parties and appear to be very smart (remember, appearances are deceiving). I particularly like the part about lightly brushing receptors, it invokes the image of Lamictal being Leonarda Da Vinci, and my brain being Mona Lisa. The master and the canvas, Michael Jordan and a basketball, Lance Armstrong and a bicycle, Dick Cheney and a shotgun - these are the partnerships that make life worth living. This is how Lamictal Works in Your Brain:
Lamictal (lamotrigine) works on binding to voltage sensitive sodium and maybe calcium channels in the brain. The calcium bit is a matter for debate. It also invokes glutamate which is a major excitatory neurotransmitter in the brain which is responsible for sending messages from neuron to neuron in 85% of the brain. It also lightly brushes the 5-HT3 serotonin receptor and the sigma opioid receptors, which probably account for its lovely antidepressant properties. Nothing like a combined serotonin and opiate reaction. As to precisely where in your brain Lamictal does its sodium and calcium channel magic, that's a mystery.
And likewise, my brain is ultimately a mystery to me, although after a hard day at work there's nothing like having my 5-HT3 receptors lightly brushed. 
