Today is “Purple Day” — the international day for epilepsy awareness. If you’re a regular reader of this blog I think it’s safe to say you are aware that there is this thing called epilepsy, and have a vague idea of its effects. But don’t just just take my word for it, if you would like to know more here are some useful resources.
It’s been a while since I’ve written anything that wasn’t just about me, but I think it’s time to revive the “Other Info” section of my blog 🙂
If you live in Spain, or you have been on holiday here, the name “Ramón y Cajal” might ring a bell or two. The street in the centre of Fuengirola where all the shops are is Avenida Ramón y Cajal. If you leave the centre of Marbella heading east (towards Málaga), the street becomes Avenida Ramón y Cajal. If you go to Barcelona there is a Carrer Ramón y Cajal fairly near the centre, and in Madrid they are Ramón y Cajal crazy!
Just north of the centre you will find a law firm and a courier company, both named after him. Then on Avenida Ramón y Cajal, as expected, you will find several more businesses similarly named, including a a veterinary surgery. Travelling north you find primary and secondary schools, and then just a little further on there is the Hospital Ramón y Cajal. Judging by the map this is obviously a pretty large hospital. I haven’t looked in to where it fits in the hierarchy of Madrid hospitals, but this one has its own station on the suburban rail system, or “Cercanias”. So if you catch the train to “Ramón y Cajal”, this is where you will find yourself. In the grounds of the hospital you will find a large bust of the man himself, but that isn’t the only statue of him in Madrid. In the Parque del Retiro there is a large statue of him, pictured below.
By Benjamín Núñez González [CC BY-SA 4.0 ], from Wikimedia CommonsThat long and winding paragraph should have impressed on you how important Santiago Ramón y Cajal is or was. When I eventually decided to look the name up to see who all these streets were named after, I was pleasantly surprised to find that rather than being a singer or a footballer he was a doctor and scientist. And also, especially relevant for me, that his most famous piece of work was that of discovering the structure of the human nervous system, for which he was awarded science’s highest honour. And something I missed earlier, there’s a “Cajal Institute” in Madrid, a Research Center in Neurobiology that belongs to the Spanish Research Council.
You can read about the sciencey bits in much more detail on this page entitled “The discovery of the neuron“. For most of the 19th century there were two schools of thought, either the nervous system was a continuous network of tissue, or “reticulum”, or it was made of up distinct cells like the rest of the body. Through the course of the century advances in microscope technology allowed scientists to discover the truth. One proponent of the reticulum theory (later shown to be wrong) was the Italian doctor Camillo Golgi. His major contribution was a new technique for staining nervous tissue for examination under the microscope. For this, although he was initially on the wrong side of the debate, he shared the 1906 Nobel Prize for Physiology and Medicine with Ramón y Cajal, which was awarded for their work on the structure of the nervous system and discovery of the neuron (aka “brain cell”), which we now know as the basic building block of nerve and brain tissue.
I wonder how many brain cells I lost when they took out my hippocampus? Some days I think it may have been quite a few! 😀
Yesterday the Epilepsy Society shared something interesting on Facebook. That’s not to say they don’t usually share interesting things, they often do. Check them out: https://www.facebook.com/EpilepsySociety/. But yesterday they shared something particularly interesting. It was an episode of the BBC’s Inside Science programme, check it out for yourself here: https://www.bbc.co.uk/programmes/b0b42q6f. They were reporting from the Hay Festival and interviewed three authors on brain-related topics. Suzanne O’Sullivan, a neurologist who works for the Epilepsy Society, spoke about some of the more unusual symptoms displayed by people with epilepsy and also gave a brief history of how epilepsy surgery has got more accurate over the decades. On the basis of the interview I’ve gone on to Amazon to buy her book, Brainstorm, and it’s already on my phone. Got to love modern technology!
So, why don’t you go off and listen to the interview and maybe read some of the Epilepsy Society posts on Facebook. I’ll go and read Brainstorm by Suzanne O’Sullivan and I’ll see you back here in a few days for a review. OK?
PS I’ve also bought a brain. Admittedly it’s a very small one, and it’s plastic, but it’s one of those that you can take apart and see how it all connects together. More on that later.
PPS Yes, it’s June. It all could be getting very close. Pre-op tests on Thursday…
There was a report this week on BBC News about a brain surgery op that went slightly wrong in Kenya: right procedure, wrong patient! In fact there were two patients in, one needed an operation and the other one didn’t, and the unthinkable happened. Thankfully, both patients are recovering well from their ordeal. The CEO and other staff have been suspended while an inquiry is carried out, but it sounds like it will come down to a simple human error of identification tags that unfortunately were attached to the wrong people.
This is a freak story and unusual enough to make it onto international news, so nothing to worry about: the risk of this happening is infinitesimally small. I had an operation for a broken ankle a few years ago, and at 4 points in my journey to the theatre I had doctors and nurses confirming that it was my left ankle they had to operate on, and at one point one of them drew a cross on my left knee with a marker pen. Hmm, that’s an idea, maybe I should draw a big cross on the right side of my head the night before my op.
But as well as all that I love the health service here. My epilepsy care has always been fantastic.
When I first realised I was having seizures I went to my GP. He asked me some basic questions and immediately said he would refer me to the Neurology Department of the local hospital (where I still go today for my routine check-ups).
Six weeks later I had my first consultation with a neurologist. She took a full history and then sent me for a full battery of tests. Not just one test, get the results, then another test, get the results etc. The full monty, no messing around. She told me I would receive appointments for an MRI, an EEG, an ECG and blood tests. I had these tests done and saw the neurologist again 8 weeks later where I got my initial diagnosis – epilepsy of unknown origin. I had further appointments through the year to check my progress. And now I have a routine check-up once a year. I’ll just repeat that, as patients in some countries don’t receive this level of care. I have an annual consultation with a doctor who specialises in epilepsy, in the Neurology department of the local hospital. It was at one of those consultations that Lucinda described in detail a seizure I had had, which led the doctor to find the cause of my epilepsy and set me on the path to surgery, so these consultations are kind of important.
A shocking tale, although there is one thing I would dispute. A consultant who specialises in epilepsy is a neurologist. I don’t understand the distinction made in the article. But apart from that the stats are horrendous. Here are a couple of shocking highlights (lowlights?).
23% waited more than 12 months to see a neurological specialist after their first visit to a GP
12 months? It was 6 weeks for me!
42% of patients saw a GP five or more times before seeing a neurological specialist
I hope the other 58% were referred straight away like I was, but somehow I doubt it.
I keep hearing complaints from the UK about “health tourism”. This is where people from other countries supposedly go to the UK to take advantage of the wonderful free healthcare. Really?
My journey to work on Monday was uneventful — right up until the last 10 seconds. As I approached the door I felt a partial seizure coming on. I just had time to get through the door, lean my bike against the wall and sit down.
Everyone looked after me really well, I’ve got a great bunch of colleagues. 🙂 After I had sat down for a while and had a couple of glasses of water, I carried on with my day. Not the best day, and I was wiped out by the end of it, but I was back to normal the next day.
Fast forward to today. One of my colleagues mentioned that she had been talking to someone who works for another company in the same building and had said that I had had a seizure. This person’s friend has had epilepsy surgery recently, in the same hospital where I will be having mine, and they were out of hospital in 3 days! It appears their surgery was more invasive as well, as I heard it they had to “take the top of his head off”.
I suppose the main lesson from this is that if you’re one of my Málaga-based friends and you would like to see me in hospital after my op — don’t leave it too late!
Having epilepsy brings with it certain restrictions. Not being able to drive is a fairly obvious one, at least until a year has passed since your last seizure. Partial seizures, like the ones I have 2 to 3 times a month, count, so I’m not going to be able to drive for a while… Other effects on your life are less obvious. Like not being able to walk your dog, because if you have a seizure you might let go of the lead and then what happens to your dog? In the case of my dog, Scamp, based on previous experience we thought that she would probably just sit on me, but it wasn’t until a few weeks ago that we found out for sure.
As somebody with active epilepsy I obviously can’t drive a car, so I’ve been avidly following the news about driverless cars for a while now. But according to this BBC article I shouldn’t get too excited, because as things stand driverless cars are still going to need, er, a driver! Will you need a driving licence in the age of self-driving cars?
Our understanding of the role of the hippocampus in memory formation has changed. It was always thought that memories were formed in the hippocampus and then moved elsewhere to become long term memories. But now neuroscientists have discovered that both copies are made at the same time.
For me this would suggest that long term memory on the right side of my brain (visual memory) shouldn’t be affected by my lack of a working hippocampus. Happy days!
(I need that) like a hole in the head 
