Monday, July 16, 2012

Epilepsy: Anytime Anywhere – Be prepared

Chishala Mumba

By Meluse Kapatamoyo

Mental health illnesses remain one of the most misunderstood health conditions among many (African) communities and Zambia is no exception.
A neurological condition, Epilepsy (aka a seizure disorder), which affects the nervous system can be best explained by Chishala Mumba, 20, an Environmental Health Technology student at Lusaka’s Chainama College of Health Sciences who has experienced it firsthand.

“I started having seizures in 2005 and the doctors couldn’t come up with a proper diagnosis. It was irritating because I was limited on how happy or upset i could be because excessive happiness or sadness are said to trigger seizures.

Since then I have experienced a lot of scary moments. One time i was leading worship during fellowship, all of a sudden I felt a sharp pain in my spine, and was rushed to the hospital.  There, i was immediately put on oxygen because i couldn’t breathe. Ten minutes later the tank ran out and the nurses had to go in search of another.

I live in fear. For example, I was scared of having an attack when I went for a boat cruise on Lake Kariba. One of the most disturbing things I heard when I started to have seizures was when a certain doctor told me that I would not be able to get married or live far from home. But here i am living in Lusaka which is hundreds of kilometres from Kitwe where I am from.

Yes i have had challenges here too, like the time i had my first seizure at school and i had to break the news to my roommate. Luckily, she understood because she also had a rheumatic heart condition and we both needed to know what to do in the event that either one of us had an attack.

I am lucky that I have never had a seizure among strangers, during the times i have had the attack, people around me have been amazingly caring. They make sure that i have enough air and if i take long to regain consciousness, they rush me to the clinic.

But i know that people’s perception of the condition can be very negative. Some fear that they may contract epilepsy especially from those who have discharges from the mouth or pass urine when under attack, which fortunately i never do.

However, being a student at Chainama has not only helped me with access good medical services but it has also given me the chance to meet people with the same condition and hear about their challenges, as well as how society reacts to them. I appreciate the support from my family and friends during the times I get sick.”

As can be deduced from this story, the impact of epilepsy is not only on the person with the condition and the family but is also felt by the community because of the unpredictability of the seizures which can occur anytime and anywhere, and without warning.

But according to experts, if the patient is able to identify factors that trigger their seizures, they can help themselves a great deal by trying to avoid those things as much as possible. One way to identify the factors is by keeping a seizure calendar or diary.

In simple terms, Epilepsy can be defined as having recurrent seizures (convulsions) which are unprovoked. These are episodes of disturbed brain activity that cause changes in attention or behaviour.

The World Health Organisation (WHO) estimates that there are over 50 million epilepsy sufferers in the world today, with 85 percent living in developing countries.

In Zambia, although no epidemiology or study has been done to find out the extent of the burden of epilepsy, from hospital records, the prevalence is very high, says Anthony Zimba, who is Epilepsy Association of Zambia president and also International Bureau of Epilepsy (IBE) Africa region vice president.

Just like there are different types of seizures, not all seizures are epileptic.

And according to Mr Zimba, the management of epilepsy can take approximately two years. Only after two years and without experiencing seizures, can doctors recommend a reduction in dosage, which can last up to six months.  And if the condition remains the unchanged, the patient can then be declared free of epilepsy.

He expressed concern that in Zambia, there was a general lack of knowledge on how best to look after epilepsy patients whenever they had an attack because people had the tendency to panic.  The panic, he said, resulted in them using wrong methods of care which put the lives of patients at risk.

Mr Zimba gave the following tips as measures one should take when caring for someone having an epileptic attack, emphasising that the golden rule to remember was ‘You cannot stop someone from having a seizure.’

“Do not shake or hold a person who is having a seizure. Instead, get a soft cloth and place it underneath the patients head to protect them from injuries and then proceed to remove any hazardous objects,” he explained.

Loosen tight clothes such as shirt collars, or if someone wears glasses, remove them. If that person was eating you must open their mouth and remove the food but be very careful because they can bite you.

But while it a common trend to put a stick or spatula in the mouth of the person having a fit to protect them from biting their tongue, Mr Zimba said doing so introduces infection and may lead to the person breaking their teeth, emphasising “People do not swallow their tongues during a seizure. A bitten tongue can heal, but by placing objects you risk breaking their teeth and can even introduce infection.”

He also warned against rolling the person to the side while they were having a seizure. But once the seizure had stopped, the person could be rolled to the side to allow any vomit or saliva to drew down and avoid chocking.

However, in instances where the person having a seizure goes into a kind of altered state of consciousness for a short period of time (the person may look dazed and stare into space), it is enough to stay by the person and wait for the seizure to pass. After they have regained consciousness, he/she may be dazed so it is vital that you remain calm and reassuring. Do not talk in a harsh tone as this can scare them.

“But what in many instances what people do is that the moment they people see a person having a seizure, they lift them, put them into a taxi and rush them to the hospital. That is very unnecessary unless a fit lasts more than 10 minutes. Then it becomes a hospital emergency. One has to be put on IV line or injected with medicine to stop the seizure,” stressed Mr Zimba.

Chishala on a cruise on Lake Kariba

He said only under the following circumstances should a person having a seizure be rushed to the hospital; If the person is pregnant or if they have injured themselves or if that individual is diabetic or suffers from a condition which can worsen the seizure.

And if while having a seizure, the individual fell into a pool or river and had gotten chocked, they should be rushed to the hospital. This also includes anyone who fails to regain consciousness or is not breathing normally.

“Most importantly if that individual is having a seizure for the first time. They need to be taken to the hospital to investigate the cause and also rule out infections or other problems,” said Mr Zimba.


Boyd said...

I am always touched by these stories.....if only the media will have journalists like Meluse to highlight the plight of our brothers and sisters, authorities anss other concerned parties will shape strategies that would make care and support for our brothers and sisters easier.

My heart bleeds!!!!


Meluse Kapatamoyo said...

Thanks Boyd for your contribution. The onus is also on you and i to ensure that we educate ourselves on some of these conditions. Just by knowing the dos and donts of care when a person has an epileptic seizure, we can save a life. Its that simple. Community involvement is key.

Anonymous said...

"...One way to identify the factors is by keeping a seizure calendar or diary..."

This is a great revelation but yet unknownst to many.

I had close experiences with an epileptic for close to eight 8 years. A big guy, tall and powerful. He maintained one driver for the entire period I knew him and he never drove himself at all.

I got touched each time he had a seizure, usually in meetings. It mostly started with shuffling and ruffling of paper in documents. It was unique but, alas, it happenned. I developed a close relationship with him because he was also funny, cheerful and logical in the prresentation of his ideas.

I thought I knew him until one day, one of my colleagues provoked him. The aggressor, who probably was weighing around 90 KG, was lifted off his feet by this epileptic workmate with stretched arms the way you see people being lifted in wrestling matches. The only thing he said was, "I can break you up!" I was shocked but that made me get more interested in his case.

Until he left, I always sat near him in meetings because I felt duty bound each time he had a seizure. I dont remember him bitting his tongue but on several ocassions, his belt was unfastenned, his tie lossed and his shoes removed each time he had a seizure in meetings. He usually came around after about 5 minutes but shortly, did not manifest signs of having been affected.

Although it remains a puzzle to this day how he manged to travel abroad alone on aircraft, at least I knew why he maintained one driver. The driver had a lot of patience and was gifted with powers of persuasion which he used to great effect to help my friend, the big strong man who sufferred from epilepsy.Meluse, thanx for your work.

boyd said...

A reali life story indeed!!!!!