Sunday, July 25, 2021

Blog # 132: A NEW REVIEW OF MY FAMILY MEDICAL DRAMA: DINGS

PUBLISHER: AUTHOR REPUTATION PRESS LLC

ISBN: 978-1649612786

GENRE: MEDICAL FICTION

PAGES: 280

REVIEWED BY:  LILY AMANDA HOLLYWOOD BOOK REVIEWS

 

Dings is a moving unabridged tome that chronicles the life of Sandra Golden and that of her family, and a medical diagnosis on her son that takes them all by surprise. Sandra is managing the home while her husband, Sam, is away on active military duty in Iraq. One day, she is summoned by the principal of the school Conner, her son, attends.

The school principal and psychologist suggest that her son goes through a psychoeducational evaluation to uncover any cognitive or emotional problems that were contributing to his difficulties in class. After several tests and sessions with a neurologist, her fears are confirmed. Her son is epileptic. It was easy to feel Sandra's despair and fear.

The work is a fantastic combination of real-life situations of a medical doctor who uses his scientific knowledge to create a medical mystery story. This exudes both great imagination and creativity. The writing style is gentle and even. I could almost hear the neurologist speaking as if he was near. Peppered with medical terms and valuable information, this is a publication which left me wiser and more aware.

 Author Fogan brilliantly blended contemporary drama and helpful information about epilepsy in an articulate manner. Throughout the story, a reader finds it easy to spell out the symptoms of the condition, the medication used, and how to help an epileptic patient. Uniquely, Dings sheds light on the commitments and sacrifices of healthcare givers in the compassion they show within their line of duty. The patience and concern that Conner's neurologist showed, was admirable.

The text seeks to demystify all the misconceptions associated with the condition and its medication. The author is descriptive, a feature which thrusts the reader into the Golden family. The writer brings out the sacrifices Army wives make for their families while their husbands are away on deployment. I loved how the author did a great job capturing the tone and emotions of the protagonist. A lot of times, the strength of the characters is what builds a story. The characters in the book are well-developed and it felt as though I was part of the story and the turmoil engulfing the family as they sought answers. The book further has a spark of Haiku poetry in its plot and provides for an epilepsy glossary and information associated with it. Overall, Dings was a plausible and solid read and by all means worth investing in. Knowledge, as has always been said, is power!

Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is a medical mystery and his first novel. It is a mother’s dramatic family story that teaches epilepsy, now available in eBook, audiobook and soft and hard cover editions.

 

 

Friday, June 25, 2021

Blog #131: MEDICAL MARIJUANA CAN CONTROL SOME SEIZURES

 

Medical marijuana, also called medical cannabis, is derived from the whole cannabis plant. Its effect on epilepsy has recently been summarized.1 Cannabinoids are in cannabis; these chemicals act on the body and on the brain cells. Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two main cannabinoids. THC binds to brain receptors and creates the “high” or psychoactive effect. CBD, however,  does not have this psychoactive effect.

 

Epidiolex, a mostly purified plant-based cannabidiol oil derived from the cannabis plant is a liquid that is administered orally. It was beneficial in treating people with notoriously-difficult-to-control-seizures in Dravet and Lennox-Gastaut Syndromes. The US Food and Drug Administration (FDA) approved it in 2018. In 2020, Epidiolex was also approved to treat seizures in the tuberous sclerosis complex.

 

Marijuana products sold in dispensaries and online, however, are NOT approved or regulated by the FDA because they can vary in quality and contents.

 

How the different compounds in marijuana affect neurologic diseases and epilepsy syndromes is not yet understood. When CBD was added to the benzodiazepine clobazam (Onfi), the combination improved the positive effects on seizures in children and adults with Dravet and Lennox-Gastaut Syndromes. Researchers theorize CBD may slow the sending of messages to the brain, change calcium levels in the brain that affect signals between cells, or it may reduce inflammatory effects in the brain.

 

There can be side effects of this treatment including fatigue, nausea, diarrhea, liver dysfunction and an increase in suicidal thoughts.

 

Seizure frequency in approximately 30% of people with epilepsy is difficult to control, so Epidiolex may be considered in a treatment plan after evaluation by epileptologists and epilepsy centers.

 

Remember that epilepsy-health includes taking your antiseizure medications as prescribed, getting enough rest and sleep, minimizing alcohol and do not take illicit street drugs.

 

1)     A.D.Patel Can medical marijuana help control seizures? Brain and Life.org: p 23; June/July 2021




Lance Fogan, M.. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is a medical mystery and his first novel. It is a mother’s dramatic family story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.

 

 

 

Monday, May 24, 2021

Blog #130: “DINGS”, My Family Medical Drama, Got a Favorable Review by U. S. Review of Books


May 20, 2021

 

Dings
by Lance Fogan
Author Reputation Press

 

book review by Boze Herrington

 

"I was suffering and, oddly, it was a shameful feeling... Illness had come to my family. It was going to be up to me to be strong and support my son."

Sandra Golden's life is upended one evening when her son, Conner, suffers a mysterious convulsion. Conner has been behaving strangely at school, blacking out and neglecting to finish his assignments. Sandra and her husband, Sam, are distraught when they learn that Conner could be suffering from epilepsy, a medical condition afflicting three million Americans. Between this and Sam's burgeoning alcoholism—fueled by the post-traumatic stress he suffers as a combat veteran—Sandra begins to fear that her marriage and household are unraveling. When searching the internet for symptoms fails to provide any clarity, she turns to a specialist who offers hope.

Fogan's narrative is tautly written and moves at a brisk pace, never allowing the author's impressive understanding of neurology to obstruct the book's more dramatic elements. However, parts of the book are presented in non-chronological order, flashing back to a few months before the convulsion, which changes the flow somewhat. The exposition is delivered in an accessible and compelling fashion as the reader is pulled forward by the mystery of Conner's condition and growing concern for his fate and that of this family. Although the drama is mostly small-scale, tension is maintained throughout. The description is sparing but evocative, and the plight of the characters is genuinely affecting. The reader is left with the feeling that one has gone on an emotional journey with the family. At times, some of the dialogue comes across as less than realistic, and the characters' reactions, especially at the beginning, can feel somewhat melodramatic. Overall, though, Fogan's novel is a gripping portrayal of one woman's descent into a domestic nightmare.

 ©2021 All Rights Reserved • The US Review of Books

 

This review was written by a professional book reviewer with no guarantee that it would receive a positive rating. Some authors pay a small fee to have a book reviewed, while others do not. All reviews are approximately half summary and half criticism. The US Review of Books is dedicated to providing fair and honest coverage to all books.

 

 

 

Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic family story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.

 

Sunday, April 25, 2021

Blog #129: IS YOUR SEIZURE FREQUENCY PREDICTABLE?

 

The longest seizure study yet finds daily, weekly, monthly, and yearly seizure repeating cycles based on continuous intracranial EEG data collected from 2004 to 2018. Patients often tell their doctors that their seizures come in cycles. Skeptical physicians may now acknowledge their patients’ reports and approach their patients with more effective treatment adjustments. 1

Blog #41, December 24, 2013, appearing on LanceFogan.com describes an implantable neurostimulator approved by the FDA in November 2013. The device is called the Responsive Neurostimulation System (RNS NeuroPace, Inc.). It is surgically implanted into the skull bone—not under the bone—close to the brain location where the seizures are determined to originate. Two small holes are drilled into the bone through which two lead wire electrodes are placed on the brain, or within it, close to a seizure focus. The battery-powered stimulator positioned outside the brain on the skull monitors brain activity. When the onset of seizure activity is detected the electrodes deliver stimuli that short-circuit the abnormal brain activity and normalize it before a seizure manifests. The RNS System activates only when it detects seizure activity. It aborts many seizures from manifesting even before the person is aware of the imminent seizure.

The NeuroPace stimulator detects circadian cycle data in epilepsy. Circadian rhythm is a natural internal process that regulates sleep-wake cycles and other processes in an organism. It repeats roughly every 24 hours. In some people with epilepsy, seizures occur in predictable cycles. Have you noted some of your seizures are predictable?

Circadian seizure cycles showed five peaks of epileptiform activity: morning, mid-afternoon, evening, early night and late night. If these findings pan out on further research, perhaps augmenting anti-seizure medications at predictable times may prevent some of your seizures. Knowledge of when seizures can be expected should empower patients. This knowledge can boost self-confidence. Driving ability, employment, social disablement all impact the lives of people with epilepsy; this predictable-seizure knowledge can return confidence and independence. 

This new approach to assessing seizure-frequency by constant EEG recording with the NeuroPace device shows many individuals’ seizures occur every seven, 15, 20 or 30 days. Epilepsy researchers were surprised at this predictable cyclic information and are considering whether seizure forecasting over long time periods can be done. A seven-day cycle is often not precisely 7 days; it might be 6.5 or 7.5 days. As patient’s known cycles, i.e., weekly or 15 or 20 or 30 days or longer approaches patients may predict their seizure and take safeguarding action. Researchers are excited to follow up these findings.

 

1)      Neurology Today: Longest6 seizure study yet finds daily, weekly, monthly and yearly cycles. Reviewed by Dan Hurley in the March 18, 2021 issue, page 10-11.

 

 

Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is a medical mystery and his first novel. It is a mother’s dramatic family story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.

 

 

 

Thursday, March 25, 2021

Blog #128: A FAMILY DEALS WITH UNRECOGNIZED EPILPESY: Excerpted from Dr. Lance Fogan’s novel, DINGS Chapter 24, Part 2

 In the Neurologist’s office—making the diagnosis

 

The doctor looked at me. “Mom, can you tell me what happened?”

I described that evening: Conner sneezing and coughing in his sleep, his high temperature, hearing the strange noises coming from his bedroom, finding him jerking all over the bed, the wet sheet and blanket, all that blood in his mouth…

“My tongue got bit. It still hurts!” Conner blurted. He opened his mouth. “Thee?” He lisped as he protruded his tongue.

We all looked at the almost-healed blue laceration.

I heaved a sigh to slow my breathing. I put my cold fingers under my thighs to warm my hands. “Then there was that rush to the hospital and Dr. Choy.”

Dr. O’Rourke glanced again at the hospital notes in front of him on his desk. The neurologist smiled and drew a deep breath.

Before he could continue I sat forward and interjected, “Doctor, I, uh, we were hoping”—I flashed a glance at Sam’s querulous face—“Uh, we were hoping to stop the Dilantin as soon as possible. Do you think that we can?”

“We’ll see, Mrs. Golden. Dr. Choy did a thorough job screening Conner for causes of that seizure. I see that he put Conner on Dilantin. That medication may not be necessary. Your boy is a bit old for his convulsion to be secondary to just a fever, though. Let me find out a bit more. I need more information.”

I beamed at Sam and squeezed his hand. Yes! He was confirming what I had learned from the Internet. The neurologist just said what I had been praying for. I leaned back in my chair.

But, he said that he would investigate further. That was when I pictured a detective with a baying hound that scurried right and left over the ground smelling out prey. So there it was again. Something wasn’t right for these doctors. Dr. Choy had said something like that about the convulsion and Conner’s older age, too. What wasn’t Dr. O’Rourke telling us? I got the feeling that he was taking care not to terrify my already-shaken family. I don’t exactly know why—I felt some ominous undertone.

Dr. O’Rourke asked, “Has Conner ever passed out or fainted in the past?”

“No. But, you know, I wanted to ask you: Sam’s brother had something similar when he was an infant. He had a fever then, too. That was the only time it happened though. Right, Sam?” Sam nodded. “I’ve heard that seizures can run in families. Is that true? God, I hope not…” My voice trailed off.

“They can.”

I clasped my hands and leaned forward. Then I sat on my fingers again.

Dr. O’Rourke turned and addressed his patient. “Conner, have you ever blanked out when you’re thinking about something?”

“Uh, like…what?”

I looked at Conner. Sam did, too. Why did Conner say that? I got this uneasy feeling that Conner somehow understood what the doctor was hinting at. Sam’s mouth dropped open. He looked at me; his eyes narrowed.

The neurologist cleared his throat and leaned forward over his desk. “I mean, let’s say that you’re thinking about something, or watching a movie or a TV program, or someone is talking to you. Does it ever seem as though you suddenly missed what was happening? Like your mind went blank all of a sudden. I don’t mean daydreaming; everybody does that. When you daydream, your mind is still thinking of something—like you zone out—but you know it. Let’s say something is important to you and you are really paying attention.”

Dr. O’Rourke stole a quick glance at Sam and me. Then he looked back at Conner and continued, “And then, all of a sudden, the scene in the movie or on the TV screen has changed, and—” He clapped his hands once. “Suddenly you don’t know what happened, even though you were following the story really closely. Has that ever happened to you?”

Conner leaned forward in his chair and dug his fingers hard into the edge of the doctor’s desk. I saw white at their tips. “Well, um, sometimes I get these, uh…you know, I get this funny, this ding feeling. I don’t know, I—I—and then something else has happened and I don’t know what.”

What? Sam and I looked at each other. My jaw dropped. My body tightened and my voice was loud. “What do you mean, Conner? What ding feeling? What are you saying? When does this happen?”

He turned toward me. “A lot. When it happens at school Mrs. Dorsey gets mad at me.”

“Mrs. Dorsey gets mad at you? What do you mean? Why? What happens?” I grabbed his arm.

I looked at Dr. O’Rourke. He sucked in his cheeks and his lips pursed as he slowly nodded his head one time. His eyes moved down to my hand that gripped Conner’s arm. Otherwise, he maintained a placid expression as he watched us.

“She asks me if I…um…if, uh…I need more time to do my tests. Like that spelling test. She said I needed more time…um…to finish.”

“Did you finish? Did you need more time? Which was it?”

“I—I don’t know. I don’t know!” Conner’s chin quivered.

Dr. O’Rourke picked up his pencil and held it poised over his notepad. “What you’re telling us is very helpful, Conner.”

I released Conner’s arm and leaned back in my chair. As my legs straightened, my shoes kicked the bottom of the neurologist’s desk. What was he saying? None of this made sense.

Dr. O’Rourke licked his lower lip. “How often does this happen, Conner? This ding?”

Conner shrugged. “I dunno…I dunno. I don’t!”

“Well, what would you say? Does it happen every day? Does it happen every few days, or every few weeks or months?”

“I dunno. A couple of times, I guess.”

“Did it happen today?”

“No.” Conner sniffled.

“Did it happen yesterday, Conner?”

“No.”

“Does it happen a lot?”

 “It doesn’t happen every day…I think.” He shuddered and hiccupped back a sob. He looked at me. Tears started to roll down his cheeks. His chin trembled. When I leaned over to wrap my arm around his shoulders he sobbed louder. “I’m scared. I’m scared, Mom!” He wiped his cheek with his sleeve.

I stared out and couldn’t move for a moment. I was in slow motion. Everything was in slow motion. I took some tissues out of my pocket and began to wipe his tears. My ice-cold hand shook. “Don’t be scared, honey. You’re doing fine.”

My gaze darted between Conner and the doctor. Sam stared at our son; his cheek muscles rippled.

“Yes, you are doing just fine, Conner. This is very good, very helpful.” Dr. O’Rourke kept his gaze fixed on his patient. “Now, do you ever imagine that you smell something that’s not really there, that nobody else can smell? Do you ever get a taste that just came into your mouth without eating anything?”

Conner gave a tiny nod.

“Is it a smell or a taste, Conner?”

 “I think I smell something…um, uh…but I don’t know what it is.”

“Well, is it like something bad, Conner? Like, burning rubber? Something like that?”

“Yeah!” Conner’s face brightened. He nodded vigorously. “That’s it! That’s what it is. It smells like the things Daddy burns in the yard at work.” Animated now, he scrunched up his nose and his body rocked back and forth as he nodded. “It’s gross,” he added.

I couldn’t believe what I was hearing. I looked at Sam. What was Conner talking about? Why had he hidden this?

The neurologist continued, “And then what happens, Conner?”

“I don’t know!” Conner wiped his nose on the cuff of his shirtsleeve.

Dr. O’Rourke turned to me. “Have you ever witnessed one of his ding spells? Have you talked with his teacher about them?”

“I don’t even know what Conner is talking about. I’ve never seen anything like that!” I looked at Sam. “Have you? He’s never said anything about them to me.”

“No. I’ve been away so long. I served in the Army in Iraq this past year, Doctor. I just got back two months ago.”

Dr. O’Rourke held his gaze on Sam. “I see.”

“The school had him evaluated by a school psychologist because he wasn’t completing his class assignments,” I volunteered. “Everybody thought his problem was stress from, you know, because his father was deployed in Iraq. I arranged for him to be treated by a psychologist, Dr. Frank Thomas. Conner has already seen him a few times.”

Conner lowered his head and curled his fingers in his lap.

“I know him.” The neurologist nodded.

“Could these spells be causing him to fall behind in school? You know, it turned out that his teacher from last year thought he could do better work then, too. They had no idea why he was not. And now, you’re saying that these things…these things could have…could have been going on for a whole year, Doctor?” I turned to Conner. My eyes narrowed and my voice got louder. “Conner, these have been happening for a year? Or more? Why didn’t you say something, honey? Why didn’t you tell us?”

“Sandra.” Sam reached for my hand. I snatched it away.

 

 

Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is his first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.

 

Thursday, February 25, 2021

Blog #127: INVOLUNTARY STERILIZATION FOR EPILEPTIC PEOPLE




I write my monthly blogs on LanceFogan.com, 127 to date, in order to raise epilepsy awareness.  One percent of all Americans and one percent of world citizens live with epilepsy and they include all levels of intellectual and physical abilities.

In the early 19th and 20th centuries epilepsy was lumped in with individuals considered to have mental retardation, physical handicaps, and genetic disorders. A frightening fact is that these individuals, including those with epilepsy, could be sterilized against their consent and without their knowledge in more than 30 American states to “stop spreading bad genes.” This was achieved by state-ordered-law. The U.S. Supreme Court allowed this injustice to continue beginning in the 1920’s. These state laws finally changed in the 1970’s.

Virginia’s forced sterilization law in 1924 authorized involuntary sterilization to rid society of "idiocy, imbecility, feeble-mindedness or epilepsy." 1 Carrie Buck, age 20, along with her mother, Emma, was an inmate in the Virginia Colony for the Epileptic and Feebleminded. Dr. Albert Priddy, the institution’s superintendent, authorized Carrie’s sterilization without her personal consent. She was the first person to be so subjected to “end her bad gene-line. The Virginia Times Daily, May 2, 1927, wrote that Carrie Buck had the mental age of 9 years. Others wrote that she was “dull but not stupid.”

Adam Cohen's recent book about the Buck case, Imbeciles, takes its name from the terms eugenicists used to categorize the "feebleminded."2 In it, he revisits the Buck v. Bell ruling and explores the connection between the American eugenics’ movement of “erasing bad genes” and the rise of the Nazi party in Germany. Cohen notes that the instinct to "demonize" people who are different is still prevalent in the U.S., particularly in the debate over immigration. This poor young woman, Carrie Buck, was said to really have nothing wrong with her physically or mentally. She had been a victim of a terrible sexual assault. After a brief hearing she was declared feebleminded and was sent off to the Virginia Colony for the Epileptic and Feebleminded. Subsequently she was surgically sterilized.  

The American Eugenics Society promoted ideas of racial betterment and genetic education through public lectures, conferences, publications and exhibits at county and state fairs — like this chart labeled "The Triangle of Life" from the Kansas Free Fair in 1926.

 

Epilepsy does not correlate with mental retardation although these conditions may coexist. A seizure is but a symptom of a brain dysfunction, it is not linked to intelligence or mental status.

  1. The United States Once Sterilized Tens of Thousands –Here’s How the Supreme Court Allowed It.  Cato Institute COMMENTARY JANUARY 27, 2016. By Trevor Burrus
  2. Cohen, Adam. Imbeciles. Published March 1, 2016

 

Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. “DINGS” is a medical mystery and is his first novel. It is a mother’s dramatic story that teaches epilepsy, now available in eBook, audiobook and soft cover editions.