Katie Update #18

First, I offer many apologies for the delay and for the fact that this update is posting only to the web and not via e-mail. I had to return to Athens for the weekend to take care of some business and don't have access to Katie's e-mail account here.

Thursday actually proved to be a very difficult day. Katie continued to wake up more and more. As she awoke, her discomfort was apparent, which was very difficult for all of us to watch. She was gagging on her ventilator tube, getting hiccups, breathing irregularly, and spiking her heart rate up into the 140's and 150's. As the day progressed and the neurologists continued to examine her EEG, the day became even more difficult. Katie's seizures were getting significantly more frequent and now were starting to lengthen to the point that they might cause further damage to her brain. It appears that the Pentobarbital was, in fact, a major part of the seizure control successes of this past week. After consulting with the medical staff, the neurologists decided to add Phenobarbital to her drug mix. While is in the same family (barbiturate) as Pentobarbital, this new drug works primarily as an anticonvulsant rather than as a form of anesthesia. The hope is that this drug will provide similar anti-seizure benefits while allowing her to remain conscious (and perhaps of more immediate importance, get weaned from the ventilator). Phenobarbital was actually a very common anti-seizure medicine for many years, but has fallen out of favor recently with the availability of newer drugs. However, the availability of years of clinical data regarding the use and effects of Phenobarbital may actually work in our favor.

I left Katie Thursday night only about an hour after her Phenobarbital was administered. It was immediately apparent from staring at the EEG for most of the time after the dosing that this drug was helping. I haven't returned to the hospital since, but from phone conversations it looks as though Katie hasn't had another seizure since I left. This is certainly promising, but the initial dose of Phenobarbital has rendered her completely unconscious, so there is no telling whether we have solved this puzzle yet. The real test of efficacy will come when the levels of the drugs in her body have been reduced far enough (or she metabolizes them well enough) to allow her to return to consciousness. Only then will we feel like we've found an acceptable answer to the seizures that will allow us to evaluate and move on to the next stages of recovery.

Again, please accept my apologies for the late posting. I won't promise to do better, but I will continue to try. Unless things change significantly, I will remain here in Athens until Sunday morning. I will certainly send an update Sunday evening if not before. Until then...

Paul