I want to post this today as tomorrow we have our appointment with the reflections midwife at our hospital so it seems important that I get this up beforehand.
On our journeys with epilepsy we meet so many professionals all of who have some impact upon the way we view our own condition. Not all those meetings will be positive and that's why it's so important to reflect on each contact.
In February I was lucky enough to get an appointment with the only specialist epilepsy midwife in the country! I met here through some of the campaigning I have done with Epilepsy Action. All I can say is she is amazing - her knowledge is incredible and her calm yet competent approach has given us some of the confidence we so greatly need. The appointment has changed my expectations of pregnancy and labour and helped me feel empowered to do the best for me and baby.
Here's a brief summary of what we talked about:
Keppra and birth defects
Although it's still early days as far as the statistics for birth defects with Keppra are concerned the numbers are getting to be statistically significant and it's looking like it could be a safer drug than Lamotrigine. Barely increasing the risk above base line. Also there is no one birth defect which is showing as being linked to it - another thing which helped put our mind at rest.
Could it have been post traumatic stress?
So a major part of our appointment was reflecting on what happened during labour last time. Rich and me both ended up in tears and it was really hard talking about what happened. We'd always felt our experience of labour hadn't been great - but hearing it from someone so specialist brought with it mixed feelings - relief that our fears aren't unjustified and hope that things could be different this time around. Looking back I went through quite a lot and it's not surprising by the time I got home I was exhausted and traumatised. Those first few months were so tough - I found it so hard to bond - could it have been partly post traumatic stress, hearing that gives me hope things could be better this time round.
Different this time around
I think that is the most important thing I am taking from the appointment - things could be so different this time around - I know now I want things to be as natural as possible. No IV, no clobazam, no epidural. As the midwife said I did most of the work at home on my own with a TENS machine last time. I want as few hospital appointments as possible - I'm not going to be stupid about it but at the same time I don't want my pregnancy to become medical. I want to go home as soon after having Riley as possible and if not I want Rich there with me. All this is supported by the midwife and she's going to write it all down so I really feel like this could happen.
Monitoring drug levels
I have also learnt that there is mixed research behind monitoring medication blood levels. That's not to say it's not worth it but they are not sure whether just because Keppra levels drop in the blood stream they necessarily drop in the brain - so if I don't have any big seizures why put my med dose up? It's good to know if they are dropping especially if they go out of therapeutic range completely but has definitely opened up my mind to the pros and cons of it.
So all I can say is I left that appointment feeling empowered - like I do have a choice. Things may well change, I might start having more seizures or something completely non-epilepsy related might go wrong but at least I know that it might be possible to have a natural labour and that for me is a good base line to work to.
Thank you to this amazing lady for helping turn this experience around for me - I went into the appointment so frightened and came out feeling empowered with a plan.