Medication is a powerful thing. The medicines we prescribe and take can change the lives of people.
So when they stop using the medicine the change is phenomenal.
On the train back home, I watched an old lady suddenly turn her head and fall to the floor while convulsing. I responded and identified myself and then began to administer aid.
There is not much you can do in a grand mal seizure. It looks terrifying with the patient thrashing about and unable to do anything but shake and twitch and jerk. Their eyes roll and they may even bite their tongue.
But the thing to remember is that you should not give them anything to eat or drink or put in their mouths. So what ensued was a quick education for the people in a crowded train. Don’t give water, don’t give food, don’t put your fingers in their mouth and don’t try and put anything inside as a gag.
Just clear the area and stop them from hurtiing themselves. When settled take them in for a proper consult with a proper plan of treatment from an expert. In my case it would be to stop the seizures using a simple plan of treatment for status epilepticus and call for a consult form neurology.
It’s a 40 minute ride with the patient to the nearest town with a hospital. We cannot turn the train around to get to mine so we do the best we can. We call an ambulance and tell them to bring phenytoin. I can start the line at the station to control the seizures earlier.
Phenytoin treats close to 98% of all sudden seizures. We go to the hospital where her son arrives bringing treatment history. She’s a new epileptic. Undiagnosed from childhood and on meds for less than a month. The cause for her seizure?
She stopped taking the meds. She was not told what would happen if she left the medicine she was taking. She didn’t like the taste.
There is always gratitude from people for doing this but people never realise that I and many other people would do this irrespective of gratitude. We want to help and we are fundamentally good as people. There was no amount of people who helped today. From the entire carriage of standing people who hopped out of the train to let us carry this thrashing woman through. To the train driver who used his train as a bridge to help us not take the stairs with a seizing woman between platforms. To the countless dozens of strangers who tried to help.
And then in my next train I nearly got punched when a fight broke out because people were pushing to get out… Strange right?
And that’s how my day ended.
And that’s where we learn the point of keeping to prescriptions and the point of teaching patients why they should stick to their medication. And that people are fundamentally good if they aren’t under pressure.