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"Women's concerns about treatment for their seizures are not sufficiently recognized and addressed in research, drug development, clinical trials and medical management, therefore affecting the diagnosis, medical care and quality of life of women with seizure disorders. In addition, women themselves and their family members generally do not recognize the special problems, which the disorder may present." - Martha Morrell, MD, Director, Comprehensive Epilepsy Center, Stanford University.

Source: Epilepsy Foundation of America

Women & Epilepsy	Epilepsy and how you feel
Adolescent Women	At Work/ When to disclose? How to disclose?
Safety at home	Discrimination and your rights
A new routine: Taking your medication	Life insurance
Menstruation	Driving - Behind the wheel
Relationships & Disclosure	Leisure and social life
Birth Control	Photosensitivity and leisure
Pregnancy	Alcohol & Drugs
Child Safety	Sports
Epilepsy & Menopause	Travel tips
Epilepsy and your looks	Epilepsy is in your head!

Women & Epilepsy

Recent studies have shed new light on our understanding of the particular concerns of women with epilepsy. These findings offer specific information on how a seizure disorder relates to the various phases of a woman's life, from puberty to menopause.

Adolescent Women

Adolescence can be an emotional, psychological, social and physical roller coaster ride. It is a time of establishing one's self-identity and achieving a measure of independence. Epilepsy can complicate this important time of life. Although many young women with epilepsy adjust well, some feel isolated and very different from their peers. Parental over-protectiveness can have adverse effects on the adolescent's health by provoking rebellious behaviour, such as not taking medication. Young women and their parents need to negotiate appropriate levels of independence given the severity of the seizures.

Adolescence is also characterized by emerging concerns about sexuality. Young women need accurate information about normal sexual development, and if problems surface, these should not be viewed purely as a consequence of epilepsy.

Concern about dating, relationships, marriage and pregnancy, and how these relate to epilepsy, are often significant worries of adolescent females. It is important to reassure adolescent women that epilepsy does not define who they are -- it is only one aspect of a multi-faceted life. Having epilepsy does not exclude a young woman from having a well-rounded and active life.

Safety at home

Most seizures won’t hurt you, but there’s some risk of injury when they occur in certain places or during certain activities. Some hazards are obvious – in the water or heights – but some are in places you don’t suspect – bathrooms or kitchens. These dangers are not something to fear; they are something to prevent. Often, minor adjustments reduce the risk of injuries. The trick is: Think and plan ahead.

General safety tips:

• Pad tables and furniture to cover sharp edges. If you have nocturnal seizures, include your bed.
• Forced air heating instead of exposed elements, such as radiators, reduces the chances of injuring yourself if you fall.

Bathroom safety:

• Leave the bathroom door unlocked, so people can enter if you need help.
• Take showers rather than baths. They reduce the risk of having a seizure in water and drowning.
• Use a shower seat or tub with non-skid strips to prevent falling in case of a seizure.
• Turn cold water on first, adding the hot gradually. Adjust the water temperature, so it’s not hot enough to cause burns if a seizure or blackout occurs.
• Put padding and bathroom carpeting on the floor.

Kitchen safety:

• Microwave cooking is safer than using an electric or gas stove.
• If you use a stove, use the back burners as often as possible.
• Use plastic plates and drinking cups instead of glass or porcelain.
• Serve hot meals on plates rather than serving from saucepans or frying pans at the table.

A new routine: Taking your medication

Women with epilepsy sometimes feel they can “do it alone” or “tough it out”. They may even deny they have epilepsy. The truth is strength and independence is more about taking control of your life – by taking the necessary steps to live well.

Following your doctor’s advice is the best way to boost your independence. Your doctor is like a coach who knows how to play the game – the best strategies for treating epilepsy.

If you want better seizure control, you must learn to “play the game”. You and your doctor are part of a team. You must learn to work together.

Taking your medication, as prescribed, means:

• do not miss pills
• do not reduce your dosage
• do not stop taking your pills

Stopping your medication, without consulting your doctor, can be dangerous. You can have a seizure – a sudden, breakthrough seizure – just when you think everything is under control. It can happen almost immediately or quite a while after you miss or stop your pills. As a result, your epilepsy may be more difficult to treat than before. Status epilepticus, a life-threatening condition, can occur after suddenly stopping antiepileptic medication, i.e., “cold turkey”.

Tips:

• Take your pill at a convenient time – at bedtime, mealtime or after brushing your teeth.
• Use a pill box or daily-dose holder.
• Refill your prescription on time. Never run out of pills. Write a note on your calendar to remind yourself.
• Ask your doctor ahead of time what to do if you miss a pill.
• Don’t take an extra pill when you feel a seizure coming on. It won’t help. There won’t be enough time for the drug to take effect. Antiepileptic drugs have to be taken on a regular basis in order for them to be effective.

Stay motivated! Taking your medication, as prescribed, improves your chances of effective seizure control. That betters your chances of getting a driving license, avoiding seizures in public and living a better life.

Menstruation

For over one hundred years, the relationship between seizures and menstruation has been examined. Studies have shown that fluctuations in female hormones prior to and during menstruation may elevate seizure frequency in some women. In a small percentage of women catamenial seizures (seizures which are related to menstruation) may occur only during the days just before their period, or during the period itself. Higher ratios of estrogen to progesterone may increase seizure frequency. Water retention, electrolyte imbalance, and even poor sleep are also contributing causes.

The connection between menstruation and seizures has been demonstrated in women with simple partial, complex partial, and generalized tonic-clonic seizures. However, different types of seizures are associated with different phases of a woman's menstrual cycle. For example, women with absence seizures have more seizures during days 16 to 28 of the average menstrual cycle and the least during their periods. Women with partial seizures, on the other hand, tend to have fewer seizures during the 16 to 28 day phase and more just prior to ovulation and during menstruation.

Menstrual disorders, such as amenorrhea (absence of menstruation), oligomenorrhea (scanty menstruation), cycles of irregular length and an absence of changes in the cervical mucus have been reported in women with epilepsy, especially those who have complex partial seizures.

Mood swings, often pronounced prior to and during menstruation, can be further aggravated by anticonvulsant medication. If mood swings become problematic, it is recommended that women discuss adjustments to medication with their physician.

Relationships & Disclosure

The question of when to tell someone that you have epilepsy can be a difficult decision. It may be less stressful to share this information early in a relationship. However, having epilepsy is not the most important fact about you. If your epilepsy is well controlled, this information could wait until you decide it is relevant to your relationship.

Epilepsy doesn’t stop a heart from loving

Accepting yourself and your epilepsy is important before you have an intimate relationship with another person. As you and your partner get to know each other better, a time will come when talking about your epilepsy is essential. Only you can decide when you’re ready. It depends on how comfortable you are with your epilepsy.

Talking about epilepsy is something you will have to do, if you are already involved in a relationship. You have fears, worries and questions about how epilepsy will change your life, and so does your partner.

Expressing feelings is not easy for any man. But the truth is, expressing emotions is not natural for anybody. It’s something you learn. Talking comfortably about your epilepsy may be hard at first, but it gets easier over time. And, it brings more peace of mind and harmony to your partner.

Birth Control

Before deciding to use oral contraceptives, women who take anticonvulsant medication should consult with their physician. The effectiveness of birth control pills may be impaired when women take certain types of anticonvulsants. Breakthrough bleeding can occur and the effectiveness of oral contraceptives can be lessened. However, not all anticonvulsants interact negatively with birth control pills. Your physician may recommend an oral contraceptive with higher estrogen content, or suggest alternative birth control methods.

Pregnancy

Pregnancy, labour and nursing can be uneventful for a woman with epilepsy, provided that she and her partner obtain answers to a number of important questions, preferably before the beginning of pregnancy.

Please address any questions that may remain to your doctor or an epilepsy association. This will give you peace of mind and a better understanding of what to expect and what to do.

Recommendations before pregnancy:

• Visit your doctor when you plan a pregnancy.
• Keep a diary of your seizures and medication. Determine if your seizures are triggered by certain events.
• Ask if your medication can be reduced or replaced by safer medications, especially during the first four months of the pregnancy.
• Ask your family doctor if a consultation with a specialist would be helpful.
• If you have had frequent major seizures during the past year, you should postpone pregnancy until better seizure control has been attained.
• Ask if your epilepsy can be controlled with one drug.
• Discuss the chances of your child having epilepsy or a congenital abnormality.
• Maintain a healthy lifestyle, don't smoke, and avoid alcohol.
• It is highly recommended that any young woman of child bearing age take folic acid supplements before becoming pregnant.

Recommendations during pregnancy:

• Consult your doctor at regular intervals, especially when your seizures are not well controlled.
• Tegretol can cause a false-negative pregnancy test. Have it repeated when in doubt.
• Discuss a possible reduction of your medication, if you didn't before. Aim for the lowest possible dosage during the first four months.
• If you have to take Mysoline, Phenobarbital, or Dilantin, don't panic. At least 90% of women on these medications deliver healthy babies. Having major seizures can do more harm.
• During the first and last three months of the pregnancy the seizures may increase. Blood levels will determine how your medication has to be changed.
• Blood levels of antiepileptic drugs are often lower because of morning sickness, diminished absorption by the stomach, increased metabolism and volume of mother and fetus. Only increased seizures require adjustment of the medication.
• Avoid alcohol and smoking. Vitamins are generally recommended, particularly folic acid, because certain antiepileptic medications tend to lower its levels. For the same reason Vitamin K supplements are given during the last month, since certain antiepileptic drugs can cause an increased bleeding tendency.
• After the third month an ultrasound examination is indicated and, if there is a possibility of congenital abnormalities, it should be repeated, combined with laboratory tests and other specialized investigations when indicated.
• At the end of the third month all major organ systems have been developed. Therefore, one should not be overly concerned when the medication has to be increased after the third month.

Recommendations after pregnancy:

• During labour, the chance of seizures is increased because of exhaustion and other factors. Home delivery is not recommended.
• Depending on seizure control and medication changes during the pregnancy, adjustment of the medication may be necessary following labour.
• Seizures during labour or shortly thereafter can be controlled with intravenous medication.
• Vitamin K is administered to the newborn, when an increased bleeding tendency is suspected.
• The newborn may be irritable or even have mild seizures as a result of withdrawal from the medication the mother was taking during the pregnancy. This does not mean that your child has epilepsy.
• In general, breastfeeding is safe. The amounts of Dilantin, Epival and Tegretol in breast-milk are relatively low. Phenobarbital and Mysoline can cause sedation or irritability of the child.
• Nursing the baby can become a tiring experience. Sleep deprivation can trigger seizures. Therefore, family members should assist with non-nursing activities to provide more rest for the mother. Incomplete seizure control and exhaustion make formula feeding at an early stage sometimes necessary.

Child safety

Having seizures is not a barrier to safely raising children. You just have to take some precautions – an extension of normal childcare.

Here are a few safety tips:

• If you’re feeding a baby, sit on the floor. If you always fall on the same side during a seizure, position yourself to prevent you from falling on the baby.
• You can dress, change, and sponge bathe a baby on the floor. Don’t bathe a baby in a tub, if you’re alone.
• Teach older children how to care for younger siblings during your seizures.
• Fix safety brakes on the baby’s stroller, so it won’t roll away, if you have a seizure while out for a walk.
• If you have an infant, catch up on sleep, whenever possible. Fatigue can trigger seizures.

What happened to mommy?

As they grow, your children will probably have questions about your seizures. A seizure occurring without warning and followed by no explanation may leave your children scared or perplexed. It’s important to discuss epilepsy with your children. Keep it simple. Use words that your children understand. Be calm and positive. Make it clear you won’t be hurt but may need some help during a seizure. Teach children how to react during a seizure. Show them how to call 911 – in case you’re unconsciousness after a seizure. When children are older, you can add details about your condition.

Epilepsy & Menopause

There have been various findings on the effects of menopause on epilepsy. Studies indicate that seizure frequency often decreases, especially if seizures had been related to menstruation. Findings also suggest that epilepsy improves during menopause if epilepsy started later in life, and if seizures have always been infrequent. Sometimes epilepsy may completely disappear.

Some increases in the number of seizures have been found in women who have frequent tonic-clonic or complex partial seizures. During menopause, fluid retention may also increase seizure frequency. Occasionally, for unknown reasons, epilepsy may occur for the first time at menopause.

Studies indicate that women who experience complex partial seizures have a higher rate of premature menopause than those who have other types of seizures. To date, there is little data with which to evaluate the impact of hysterectomy, which surgically induces menopause, on the frequency of seizures.

Epilepsy and your looks

Your medication can change your physical appearance. Weight changes, rash, acne, gum overgrowth, subtle tremors, hair loss and many others are side effects of some medicines. If these changes bother you, ask your doctor to adjust your dosage or change your medication.

Epilepsy and how you feel

Because it affects the way your brain works, epilepsy can affect the way you feel. So can your medication. It can cause irritability, mood changes or tiredness. Life with epilepsy can be difficult. At times, you may feel anxious, angry or even depressed – part of the ups and downs of everyday life. Denying your feelings won’t help. Accepting and learning how to deal with them are the only things to do. That’s easier said than done but, with the support of others, you can do it! Asking for help is a sign of strength, not weakness. It is a signal that you have the will to do something about it.

Having a hard time?

Have you felt out of sorts for some time? Share your experiences with your doctor or a psychologist. They will know how to help if you:

• cannot sleep
• always feel tired or sleep excessively
• have lost your appetite or overeat
• have no interest in sex
• feel no motivation to do anything
• feel no pleasure in life anymore
• have suicidal thoughts

At work

If you’re qualified for a job, epilepsy shouldn’t keep you from getting it. Seizures are brief and don’t usually interfere with work performance.

A few jobs have some restrictions, for safety reasons. Unfortunately, it may be harder or even impossible for you to do the following jobs, especially if your seizures are not under control:

• airline pilot
• transportation and professional driver
• construction worker
• surgeon
• dentist
• Military services: Before you can sign up for The Canadian Armed Forces, your seizures must be well controlled. Even if your seizures are controlled, there may be restrictions on the use of firearms or driving heavy vehicles.
• Royal Canadian Mounted Police: Each member is assessed on an individual basis by a doctor.
• Firefighters and policemen: It depends on each fire or police department’s policy, but the decision to hire is usually based on a doctor’s recommendation.

If you’re turned down for a job, don’t give up. For anyone, finding a job requires patience, perseverance and a positive attitude.

Should I tell the employer about my epilepsy?

To disclose epilepsy or not? This question often arises when you’re searching for or starting a new job. It’s a delicate matter – and a personal decision. Consider this information as a guide:

• If seizures are going to affect your work performance or your safety and others’, it may be wise to disclose. It will protect you and your co-workers from potential injuries, and it will give your boss the opportunity to make accommodations in your working environment.
• If epilepsy does not affect your work performance or your safety and others’, it’s your choice whether to disclose or not. Many women find it better to disclose their epilepsy after being hired – to relieve any stress or worry over the possibility of having a seizure at work.

When to disclose?

Before you’re hired

Advantages

• If hired, you will probably have no problems due to epilepsy.
• Honesty
• Peace of mind
• Opportunity to discuss epilepsy
• Opportunity to discuss job accommodation

Disadvantages

• Discrimination
• Emphasis on epilepsy instead of your ability to do the job

Other considerations

• Do you feel comfortable talking about your epilepsy?

After you get the job

Advantages

• You have a chance to prove yourself.
• In some provinces, if disclosure affects your job status, you may take legal action against your employer.

Disadvantages

• Fear of having a seizure on the job
• It could affect your relationship with co-workers.
• If you have a seizure, co-workers won’t be prepared or know how to react.

Other considerations

• The longer you wait, the harder it may be to disclose your epilepsy.
• You may not know how to disclose and to whom.

Never disclose

Advantages

• You are safe from discrimination – as long as you don’t have a seizure on the job.

Disadvantages

• Fear of having a seizure on the job.
• Without disclosure, having a seizure at work can be a source of myths and misunderstandings.
• If you have a seizure, you may be hurt by co-workers’ inappropriate reactions.

Other considerations

• Studies show that people who do not disclose have a higher chance of having a seizure on the job.
• If you’ve been seizure-free for a long time or if your seizures are unlikely to happen at work, disclosure may be less important for you.

How to disclose?

Be prepared. Anticipate questions your boss or co-workers may ask. Get ready to give them clear answers. Your attitude about your epilepsy and the way you talk about it will affect the way people see your condition. Be positive, factual and realistic. Do not dwell on epilepsy. It is not and should not be the main concern in your workplace.

Employers are usually concerned with how seizures will affect your job performance and safety in the workplace. Explain to your employer how epilepsy will not affect your job.

What you can tell your boss

 
Studies show that people with epilepsy:

• Do not take more days off than other workers.
• Do not cause more accidents at work.
• Often want to prove themselves, so their output is as good as or better than other workers’.

If changes to your work environment may reduce the likelihood of seizures, discuss them with your boss.

It may be a good move to teach your co-workers what to do if you have a seizure. The more people know about seizures, the less they’ll be afraid and nervous if you have one.

Ask your doctor to write a letter explaining your condition to your boss.

When deciding whom to tell about your epilepsy, be selective. Your employer is probably the first person to inform. Your boss is in the best position to make any changes in the workplace. Should you tell your co-workers about your epilepsy? That’s up to you.

Discrimination and your rights

Unfortunately, discrimination against women with epilepsy does happen sometimes – often due to ignorance and misconceptions.

Because most jobs fall under the jurisdiction of provinces and territories, rules and laws for employment differ across Canada. Here are some reasons to appeal to your provincial or federal human rights commission for help against discrimination:

• The employer makes a distinction between you and other workers.
• The employer refuses you a job, based on a prognosis of a medical condition – i.e., based on what could happen with your epilepsy in future instead of your current medical condition.
• The employer fires or refuses to hire you, because of your eligibility for pension or insurance plans.
• The employer has more severe job requirements for you than others, because of your epilepsy (e.g., a higher education).

Canada/Quebec Pension Plan disability benefits

Most women with epilepsy are able to work, but some cannot. If your epilepsy prevents you from working, you could be eligible for the Canadian Pension Plan Disability. This federal plan pays a monthly benefit to people unable to work. Quebec has its own pension plan disability benefits. If you live in that province, contact the Régie des Rentes du Québec.

Are you eligible?

• You have contributed to the Canada/Quebec Pension Plan Disability in four of the last six years.
• Your disability is severe and prolonged.
• You are incapable of earning any substantial income and can no longer hold your previous job.

You need to know…

• Each case is reviewed on an individual basis.
• If accepted, it takes a minimum of one year from your application date before you can get disability benefits.
• When you turn 65, your Canadian Pension Plan for Disability benefits will be automatically converted to Canadian Pension Plan retirement benefits, based on your income at the time you became disabled.

Some similar plans may be available in your province or territory. For information, contact the pension board in your region.

Life insurance

For women living with epilepsy, it’s harder to get life insurance. Some companies refuse to insure you. Others accept your business but at higher premiums.

Tips:

• Shop around! Every insurance company is different. An insurance broker, who deals with many insurance companies, can help. Talk to this person about your epilepsy.
• Join a group or organization with collective life insurance. There is usually no medical inquiry for collective life insurance that applies to more than 10 members. A collective life insurance plan may be available at your workplace.
• Insurance with limited coverage without medical inquiry is sometimes easier to get. These policies are expensive for their coverage. Some contain exclusion conditions for accidents arising from a medical condition. It’s important to verify.
• Never falsify medical information! An insurance policy is a contract. If you lie on the application, the company may not be obligated to respect the contract.
• If your application is refused, ask for the reasons for rejection in writing. The insurer may review your application more closely and reverse the decision. And, you’ll have a chance to reply and describe your situation in detail.
• Reapply when your situation improves.

Driving - Behind the wheel

Now that you have epilepsy, will you be able to drive? Yes, under certain conditions. The main concern is safety: yours and others’.

Uncontrolled seizures and driving don’t mix. If your seizures aren’t well controlled, you’ll have to take the bus or ask a friend to give you a ride. It may be annoying, but it’s better than ending up in a hospital.

Laws about driving and epilepsy

Across Canada, two regulations for drivers with epilepsy apply in all Canadian provinces and territories:

1. By law, drivers must report to the Ministry of Transportation any medical condition that may interfere with their ability to drive safely.
2. People with epilepsy must have their seizures controlled either on or off medication for a specific period of time (varying across provinces and territories) before they can drive.

Tell your Ministry of Transportation if your seizures:

• Occur only during sleep
• Leave consciousness intact
• Are preceded by a reliable aura
• Are controlled by a vagus nerve stimulator
• Are the result of a medication change or missed pill

Safe driving

It’s safe for you to drive if:

• you are totally seizure-free
• you are taking your medication and have not missed any pills
• you are not sleepy or tired

If you drive against medical advice, you may be liable for accidents – even if they are not your fault. Your insurance may not cover your damage.

While driving, if you feel a seizure coming on:

• get off the road

If you run out of pills:

• ask someone to drive you to the pharmacy
• get your prescription delivered
• ask a family member/ friend to pick up your prescription

If you have a seizure:

• ask someone to drive you to the doctor’s office.

If your medication is changed or discontinued:

• until you and your doctor know how it will affect you, wait before driving

Never drink and drive. Alcohol increases the likelihood of seizures. Antiepileptic drugs amplify how alcohol affects your body.

Getting around:

• Car pool
• Walk
• Take public transportation (buses or subways)
• Take a taxi
• Use special transit services (buses)
• Ask friends, relatives or co-workers for a ride

Working as a driver

In many places, people with epilepsy cannot work as professional drivers or operate heavy motor vehicles. If you plan to drive one of the following motor vehicles, you should ask the Ministry of Transportation of your province or territory to find out about any driving restrictions or conditions:

• heavy trucks and vans
• emergency vehicles (ambulance or fire truck)
• public transportation (buses or subways)
• taxis, cabs
• minibuses
• heavy private motor vehicles (motor homes or trailers)

Car insurance

Car insurance can be more expensive for women with epilepsy. Costs and coverage vary among insurance companies, so shop around for an insurance plan that fits your budget and needs.

Leisure and social life

What’s stopping you from leading a normal social life and enjoying leisure activities? Nothing! You may have to choose your activities more carefully, but your choices still depend mainly on your interests. You have to consider how you act during a seizure and how it affects your safety. If you like an activity, ask yourself if you can do it safely, despite your seizures. Most of the time, your answer will be “yes”.

Photosensitivity and leisure

Photosensitivity is a condition that makes people with epilepsy react to natural and artificial light, leading to seizures. Seizures are triggered by video games, flashing lights or sunlight reflecting on leaves or wet surfaces. The most common trigger is television.

Only 3% to 5% of all people with epilepsy are photosensitive. There’s a higher proportion of photosensitivity among women.

Television

Tips:

• Watch television well away from the set. Sit at a distance of 2.5 meters or more from the screen, depending on screen size.
• Watch television in a well-lit room.
• Use a remote control.
• If you have to approach the television cover one eye with the palm of your hand.

Computers

A very low scan frequency (below 60/seconds) can trigger seizures in photosensitive women. Very few computer screens flicker that slowly.

Video games

If you play video games and are photosensitive:

• Read the instructions and warnings on your game packs.
• If you’re tired, avoid playing.
• Take frequent breaks and rest between games.
• Quit playing if you feel dizzy or have blurred vision.

Nightclubs

Stroboscopes and lights flashing at a certain speed can trigger photosensitive seizures. If you feel a seizure coming on, try to cover one eye with your hand.

Cinema

It’s very rare for a movie to trigger a seizure, but it can happen during scenes with flashing lights. You may – but won’t always – get a warning.

Theme park

Rides with flashing lights may pose some risk, if you have photosensitive epilepsy.

Alcohol & Drugs

Alcohol and seizures

Some people with epilepsy can drink alcohol in moderation without increasing the risk of a seizure. For others, the smallest amount of alcohol triggers a seizure almost every time – so they avoid drinking completely.

Determining whether to drink or not is a very personal issue. Sometimes, the decision depends on what type of medication you take.

Drinking alcohol along with epilepsy medication can worsen the effects of alcohol and side effects of antiepileptic drugs. Alcohol can make your medication less effective.

Heavy drinking is never a good idea. Binge drinking is likely to lead to a seizure – and more likely to make you forget to take your medication. Changes in lifestyle that sometimes come along with drinking may affect your seizure threshold. Sleep deprivation and late nights, missed meals and forgetting pills are seizures triggers for many epileptics.

Drinking or not is a decision to discuss with your doctor – the best person to know what can happen if you drink alcohol while taking a specific medication. With this information, you can make a well-informed decision.

Drugs and seizures

Marijuana: There’s no conclusive evidence that marijuana provokes seizures. Some say that it helps to control certain types of seizures – if taken in moderation – while others say the opposite – that it may trigger seizures.

Ecstasy: Taking ecstasy increases the amount of some chemicals in the brain that cause overstimulation. It can provoke seizures. And, ecstasy is often taken while dancing all night long, leading to dehydration and making seizures more likely to occur.

Heroin: Heroin can cause seizures.

Amphetamines (speed, pep pills, uppers): At abnormally high doses, these drugs can trigger seizures. Side effects, such as lack of sleep, increase the risk of seizure.

Cocaine: It causes seizures, lack of sleep, poor nutrition and missed medication.

Solvents: They cause brain damage, leading to or worsening epilepsy.

Steroids: There’s no evidence these drugs lead to seizures.

Tobacco: Smoking doesn’t seem to trigger seizures. However, nicotine preparations intended to help you quit smoking may cause convulsions (as can bupropion).

Caffeine: Drinking coffee, tea or soft drinks as part of everyday life does not usually cause seizures.

Any drug can interfere with your medication. If you take some of these drugs it should be discussed with your doctor.

Sports

There’s no reason for epilepsy to keep you from playing sports – as long as you take some commonsense precautions. An active lifestyle benefits everyone, and women with epilepsy are no exception. Regular exercise brings better sleep and decreases stress – improving seizure control. Sports are good for physical and mental health. At sporting events, you can gather with friends and lead a fruitful social life. Don’t deprive yourself of such a valuable part of your life!

Before you get involved in a sport, take the following things into account:

• The type, severity and frequency of your seizures.
• Your known triggers, e.g., stress, excitement and more. In very rare cases, playing a sport can trigger seizures, possibly through hyperventilation.
• The presence of a warning (aura) before a seizure.
• The risks of playing the sport: Scuba and sky diving, mountain climbing, bungee jumping, car racing, hand gliding, parachuting and other sports are risky for anybody, especially if you have epilepsy. If you want to play these sports, be cautious. Use your common sense. The rule is if loss of consciousness or a seizure could endanger or threaten your life as you play a sport, it’s wiser to avoid it.
• How much supervision is available? Some sports are moderately risky and must be practiced under good supervision, e.g., swimming, skiing, canoeing, hockey, tennis, cycling and weightlifting.

Tips:

• Talk to your doctor before you begin a new sport, especially if it has some risk.
• Tell your coach or teammates about your epilepsy to ensure they know how to help during a seizure.
• Play sports with a friend who knows about your epilepsy and your first-aid needs. It’s safer and friendlier than playing sports alone.
• Always wear protective gear, especially head protection.
• If you lose or gain weight substantially, tell your doctor. Changes in weight can alter the blood level of your medication and a dosage adjustment may be necessary.
• When swimming, inform the lifeguard to keep an eye on you, because you have epilepsy.

Travel tips

• Plan to carry extra medication and prescriptions.
• Find out what your travel insurance will pay, if you have to see a doctor in another country.
• Get enough sleep before and during your trip. A lack of sleep and jet lag can trigger a seizure.
• Wear an epilepsy ID bracelet or necklace.
• Make sure you take your medication at regular intervals when traveling through time zones.
• Take your insurance card and the names and phone numbers of your doctor and pharmacist with you.
• Ask your doctor if immunization shots can interfere with your medication.
• Carry medicines in your handbag or carry-on luggage. Keep your pills in their original bottle.
• Ask your doctor for the chemical or generic name of your medication, because the drugs you take may have different trade names in different countries. Carry a list of these medications.

Epilepsy is in your head!

How epilepsy affects your life is partially a matter of perception and attitude. Epilepsy can interfere with your life – if you let it. Of course, epilepsy imposes limitations. So what! Everyone faces limits of some kind for different reasons. Change your perspective, and you’ll find obstacles become challenges – defining what you can and cannot do. Take control. Don’t let epilepsy get in the way of a satisfying life.

If you can avoid the traps of taking unnecessary risks and being too proud to ask for help, epilepsy won’t limit your enjoyment of life.