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Medical Forum / Diseases and Disorders / Epilepsy / November 2003

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When does epilepsy become a disability?

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M - 23 Nov 2003 09:57 GMT
Male, 46, fully controlled for about ten years, and driving for three.

I recently moved schools as Head of Science. Now, three-quarters of the
way through the term, I still cannot remember the names of many of the
pupils I teach :-(

If you were to stand a pupil in front of me, I could probably tell you
their character, and maybe what sort of work they produce, position in
the social hierarchy etc, but I can still only put faces to 70% of the
names on class lists. The same situation applies to naming my new
colleagues.

I knew my memory was getting soggy, but at my previous school I only had
a few additional forms coming up from below every year. The current
situation highlights the memory difficulties, especially with parents
wishing to discuss their child - in a third of the cases I have to BS my
way through the conversation.

The problem seems to be mainly with faces (a psychometric test some time
ago identified this) and I have no difficulty remembering the material I
teach, apart from the occasional word blockage. But obviously in order
to work efficiently I should at least be able to name my pupils, and the
difficulties encountered make me question my suitability as a teacher.

Memory problems are common in epilepsy, but they are often pushed aside.
What do I do when they begin to interfere with my professional life?

Signature

Malcolm    

Paul Oldham - 23 Nov 2003 12:58 GMT
> Male, 46, fully controlled for about ten years, and driving for three.
>
> I recently moved schools as Head of Science.

Aha, I was wondering if you'd sorted out a new job. You have. Good. ;-)

> Now, three-quarters of the
> way through the term, I still cannot remember the names of many of the
> pupils I teach :-(
> [...]
> Memory problems are common in epilepsy, but they are often pushed aside.

I have my suspicions about some AEDs in relation to this too, not just the
epilepsy itself, but whatever. I've found this be an problem too (although
in my case the brain injury from the stroke is probably the main cause).

The thing I was very impressed by, which I discovered more by accident than
design, is the trick advocated by Paul Daniels amongst others: making images
to remember names. So for me you might remember my surname by seeing me with
a smelly bit of bacon on the top of my head.

I discovered how well it worked when I was having my memory tested recently
(had to remember pairs of words) and tried it out while the testing was
going on. I worked amazingly well and even a month later I can still
remember the word pairs.

> What do I do when they begin to interfere with my professional life?

I think you're going to have start consciously doing these sort of exercises
to remember things. Bit of shocker after a lifetime of the brain just Doing
The Right Thing, but it does seem to work.

Signature

Paul Oldham, Milton, Cambridge, UK
http://the-hug.org/paul/stroke/

Robert A. Fink, M. D. - 23 Nov 2003 22:19 GMT
>Male, 46, fully controlled for about ten years, and driving for three.
>
[quoted text clipped - 22 lines]
>Memory problems are common in epilepsy, but they are often pushed aside.
>What do I do when they begin to interfere with my professional life?

If you have not had a neurological re-evaluation (including a scan of
some sort) recently, I would strongly advise such.  This set of
symptoms may not be due to your epilepsy.

Best,

Bob

Robert A. Fink, M.D., FACS, P. C.
2500 Milvia Street   Suite 222
Berkeley, California  94704-2636  USA
Telephone:  510-849-2555
FAX:  510-849-2557
<http://www.rafink.com>

"Ex Tristitia Virtus"
CyberCafe - 25 Nov 2003 22:32 GMT
> Male, 46, fully controlled for about ten years, and driving for three.
>
[quoted text clipped - 22 lines]
> Memory problems are common in epilepsy, but they are often pushed aside.
> What do I do when they begin to interfere with my professional life?

I agree with Dr. Fink that it would be a good to be examined.  For the time
being, I am going to assume that the remainder of your health is just fine
(except for the epilepsy and possibly depression, which is fairly common).
This whole memory problem thing is really important to me because it has
been so troublesome.  In my case, it has improved, and I can specifically
point to things that seemed to help.

First, before I forget, here are some pointers from the AAFP web site.

      Things to help you remember

           Keep lists.
           Follow a routine.
           Make associations (connect things in your mind), such
           as using landmarks to help you find places.
           Keep a detailed calendar.
           Put important items, such as your keys, in the same
           place every time.
           Repeat names when you meet new people.
           Do things that keep your mind and body busy.
           Run through the ABC's in your head to help you think of
           words you're having trouble remembering. "Hearing" the
           first letter of a word may jog your memory.

Now back to my stuff.

It is a big problem getting doctors, family, and others to treat this as a
serious problem.  I have gone through memory testing, which revealed my
memory/recall for visual things is pretty good when compared to other things
(like recall of conversations).  In other words, if I see something like a
picture taken during an event, then I am more likely to recall the event
(although I may not be able to recall EVERYTHING associated with that event,
just with the picture).  The things that really helped my memory were taking
a medical terminology class, which provided a lot of learning tools
including audio tapes, CD disks (games, self-testing, etc.), lectures, flash
cards, workbook, etc.  I had to use ALL those resources in order to
learn/memorize, and it worked to my surprise (everything I learned in
medical terminology class has NOT been lost!!!).  It took a huge amount of
effort, which I don't think would be possible in casual learning without
training the brain.  An anti-depressant also seems to have helped a lot,
much more than I expected.  It is much, much easier to pay attention, focus,
and concentrate now, and of course, it is definitely affecting positively my
ability to remember/recall.  I didn't start taking epilepsy medication until
about 20 years after I first started having them.  The medications for
epilepsy helped somewhat but not as much as the course and anti-depressant.

I have the same problem as you of trying to recall people's names, plus if a
person changes their looks in the slightest, it throws my brain completely
off.  For myself, I've got to really get to know people before I can recall
their names.  And it does help to use their names when you talk to them.

As far as solutions, you will have to be creative, and you will probably
have to use multiple methods, ways, cues to help with this problem.  You
might have to use permanent seating plans and seating charts (with pictures
and names if necessary).  If the school has photographs of the students and
faculty, get copies and put them to use.  You have to get so familiar with
people that you know them by voice, by the way they walk, by mannerisms,
etc.  You might have to create classroom activities that allow the students
to present more of their personality, characteristics, etc.  You might have
to take steps that you don't really want such as allowing students to phone
you, attending or participating in their events, etc.  Maybe you can run out
a print copy of thumbnail images of each student and ask them to paper clip
the picture to their hand-in homework.  Or if there is a school yearbook
with pictures, turn to the student's photo before you start checking their
papers or when they call you.

In the US, a lot of speech therapists have training needed to work with
people with memory problems.  Maybe there is someone with similar background
in your country who would be able to help you.

Barb

> --
> Malcolm
All In One Pest Control - 27 Nov 2003 22:18 GMT
Malcolm, it is a disability the day you are diagnosed with it. It is not
different than being diagnosed with Diabetes, you have to do what is
required to live with it. When there are some jobs that you simply cannot
get because you have a disease it is a disability.

Tim

> Male, 46, fully controlled for about ten years, and driving for three.
>
[quoted text clipped - 22 lines]
> Memory problems are common in epilepsy, but they are often pushed aside.
> What do I do when they begin to interfere with my professional life?
M - 27 Nov 2003 23:21 GMT
>Malcolm, it is a disability the day you are diagnosed with it. It is not
>different than being diagnosed with Diabetes, you have to do what is
>required to live with it. When there are some jobs that you simply cannot
>get because you have a disease it is a disability.
>
>Tim

That means that life is downhill all the way from the day you are
diagnosed. Memory problems seem to be guaranteed with epilepsy, so
therefore life can only get worse. If I'd been told when I was diagnosed
in my twenties, maybe it would have made sense to have chosen a career
with less cognitive demand.

Now, of course, my faculties for learning and options for starting a new
career are minimal. All my eggs are in one basket, and my basket is
f.cked.

Welcome to the real world, Malcolm.
Signature

Malcolm    

CyberCafe - 28 Nov 2003 21:47 GMT
> >Malcolm, it is a disability the day you are diagnosed with it. It is not
> >different than being diagnosed with Diabetes, you have to do what is
[quoted text clipped - 6 lines]
> diagnosed. Memory problems seem to be guaranteed with epilepsy, so
> therefore life can only get worse.

> If I'd been told when I was diagnosed
> in my twenties, maybe it would have made sense to have chosen a career
> with less cognitive demand.

Hey, nobody knows what the future holds.  Any occupation can go flat.  Look at
all the people who have been put out of work over the years due to the
appearance of technology and then the transfer of technology or services to
other parts of the world.  Today, it is rare for a person to remain in one
career for their entire life because things change.

> Now, of course, my faculties for learning and options for starting a new
> career are minimal. All my eggs are in one basket, and my basket is
> f.cked.
>
> Welcome to the real world, Malcolm.

First, you've got to be evaluated by at least a general practitioner because
there could be another medical problem interfering with the
learning/remembering thing.  I hate bringing up the subject of depression over
and over again, but it is more common in us folks than the general public, and
from your writing, you sound like you are depressed because you have no hope
for the future.  My doctor put me on antidepressants about two years ago (at
my request a couple of years after I had been diagnosed with depression at a
different facility), and it has made a huge difference in my ability to focus,
concentrate, listen, pay attention, which has made a big difference, a
positive difference, on my ability to remember.  There are a bunch of other
things that changed or improved after I was on the antidepressants.  Granted,
some of the effects took months to appear, but they were all unexpected and
beneficial.  In addition to the focusing and attention thing, I can socialize
better/easier, have more stick-to-it (can tolerate things for long periods of
time whereas before I would quit or go and rest).  My productivity has
increased quite and bit and with less frustration.  Everyone seems to think
antidepressants made a person all happy and giddy, and I have not found that
to be the case with me.  The antidepressants have significantly reduced the
hopelessness, flat affect (which I miss), anger (which I didn't realize was
connected to depression), ability to make decisions, and all sorts of things
like that.

Enough said.

Barb

> --
> Malcolm
 
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