I continue to try to solve the mystery that my brain and DFW neurology are putting me through.
On most mornings, lately, I watch YouTube instructional videos about EEG or about neurology in general.
Today I watched this one. It deals with a patient who has frontal lobe epilepsy.
The patient's seizures all occur during sleep, so much of the video is about pointing out what a sleep EEG looks like.
Here is a screenshot from the video.
See how it's kind of smooth. It's like the gentle waves of the Atlantic ocean at low tide.
Calmness.
One thing the EEG expert pointed out is that what's missing from the picture is eye blink artifacts. These look like periodic v's across the page.
Here is a picture of one of my EEGs while awake. Despite all my studying, I am far from being an EEG expert. But I THINK these are probably eye blink artifacts.
That EEG picture is from 2:57 in the afternoon.
Besides the (maybe) eye blink artifacts, you can see the lines are quite bumpy. It's like what people might see if they asked me to write a straight line while I was having low blood sugar issues.
By counting the bumps on these bumpy lines, doctors and other EEG experts, can tell what kind of brain activity we're having—Beta, alpha, theta, and delta.
Beta and alpha are the ones that occur when we're awake...unless we're meditating or something like that.
Beta and alpha are more bumpy than theta and delta.
DFW neurology sent me home with three snapshots where the computer guessed there might be seizure activity.
Out of the three, one happened at 4:41 am and the other happened at 11:37 pm.
They looked like sleep to me, and now after watching the YouTube video, they look even more like sleep.
Note: It's hard to take a photo of the whole EEG with my phone, so those are actually pieces of the snapshots. The snapshots themselves are about 9 seconds long. The little pieces are about 4-5 seconds long.
Those EEG bits are missing the eye-blink artifacts. So if anything, my eyes were probably at least closed.
I also think the line bits are much less bumpy than the ones I see in my afternoon EEG.
Yes, there are some breaks in the smooth waves. There are some mountain type things. But I THINK those might be the abnormal spikes.
OR they could be perfectly normal sleep variations that are sometimes mistaken for seizures.
Was I sleeping?
Was I not sleeping?
Was I having seizures in those snapshots?
Was I not having seizures?
According to the EEG report DFW neurology sent home with me, it should NOT be seizures. Or it shouldn't be sleep.
The report says: All stages of sleep were obtained and sleep is considered to be restful. There are no reported events with the event trigger or diary entry in sleep. No clinical, subclinical, or electrographic evens were observed. There are no focal or paroxysmal waveforms.
Okay?
Here are the different explanations swimming through my head.
A) DFW Neurology is just totally nuts and incompetent. The two snapshots they gave me DID occur during sleep. I'm having seizures in my sleep, and they completely fucked up when writing the sleep portion of my EEG report.
B) DFW Neurology is just totally nuts and incompetent. The two snapshots they gave me DID occur during sleep, but what the computer picked up was not seizures. It's just normal sleep-time stuff. But I asked DFW neurology to provide me with snapshots of my maybe-seizures. Why would they send me home with two snapshots that they determined were NOT seizures? How is that helpful to me or any future neurologists I might go to?
C) I'm misreading the EEG, and I'm not sleeping. This is possible, because I do tend to wake up several times during the night. The lack of eye-blinking artifacts? Maybe I was closing my eyes, TRYING to fall asleep. But shouldn't the report reflect that. If I'm waking up in the middle of the night having abnormal spikes, is it fair to call my sleep restful?
There is one more thing I want to say about DFW Neurology. I hope it's the last thing...at least for awhile. I don't really want to turn this into a medical blog.
It's about the Google rating.
I still haven't changed it back to a one star rating.
DFW Neurology does NOT deserve a 3 star rating from me. But I feel I have to keep with what I told them I'd do.
When I talked to Sai Duvvuri, the manager, I told him I'd delete or change the review. But I would put my very bad review up again if I saw someone else adding a bad review.
Now of course I wouldn't do that for any bad review. If the bad review seemed ignorant or thoughtless, I wouldn't pile on. But if someone wrote a detailed bad review and it seemed somewhat similar to my experiences, I would conclude that DFW Neurology wasn't moving in the right direction, after all. I would conclude they're still quite awful.
Duvvuri didn't seem to pleased with my plan. He then said something like people sometimes give them bad reviews because they're addicts, they want pain medication, and DFW Neurology refuses to provide them with what they demand.
I don't doubt that this does happen sometimes. But I don't think this is the reason behind most of their bad reviews.
I think most people who go to neurologists aren't after addictive drugs.
What are they after?
A good listener who is intelligent, understanding, thorough, and logical.
They want the right tests. They don't want to be denied tests because the doctor thinks it's "all in their head". Nor do they want to be pressured to take tests they don't need.
They want someone who can correctly read the tests...and not LOSE the tests.
They want doctor offices that can return phone calls and emails in a timely manner.
They want bills that make sense and are affordable.
They want doctors who are educated about medication side-effects and communicate with patients openly and honestly about it.
They want doctors who accept their insurance and continue to accept that insurance, so the patient doesn't have to rush and find a new doctor.
They want doctors who care! Personally I'm not bothered if the doctor sees me as a whole person or not. If a doctor wants to see me as a disease or ailment, I'm fine with that. But it seems to me, many doctors are not even really that interested in our health issues. They seem to be lacking curiosity. It seems to me a lot of doctors just want to rush through the appointments and get paid.
P.S-Despite some misgivings, in the midst of writing and editing this post, I made a referral to a second neurologist. That's in November. I'm hoping that between now and November, my blog will take a break from my medical stuff. But come November....I'm sure I'll be writing more posts.
Hopefully I'll like this new Doctor better than what I encountered at DFW Neurology. I have my doubts, though. The doctor himself gets good reviews. The center...not so much so.
But I'll try to keep and open and hopeful mind.
On most mornings, lately, I watch YouTube instructional videos about EEG or about neurology in general.
Today I watched this one. It deals with a patient who has frontal lobe epilepsy.
The patient's seizures all occur during sleep, so much of the video is about pointing out what a sleep EEG looks like.
Here is a screenshot from the video.
See how it's kind of smooth. It's like the gentle waves of the Atlantic ocean at low tide.
Calmness.
One thing the EEG expert pointed out is that what's missing from the picture is eye blink artifacts. These look like periodic v's across the page.
Here is a picture of one of my EEGs while awake. Despite all my studying, I am far from being an EEG expert. But I THINK these are probably eye blink artifacts.
That EEG picture is from 2:57 in the afternoon.
Besides the (maybe) eye blink artifacts, you can see the lines are quite bumpy. It's like what people might see if they asked me to write a straight line while I was having low blood sugar issues.
By counting the bumps on these bumpy lines, doctors and other EEG experts, can tell what kind of brain activity we're having—Beta, alpha, theta, and delta.
Beta and alpha are the ones that occur when we're awake...unless we're meditating or something like that.
Beta and alpha are more bumpy than theta and delta.
DFW neurology sent me home with three snapshots where the computer guessed there might be seizure activity.
Out of the three, one happened at 4:41 am and the other happened at 11:37 pm.
They looked like sleep to me, and now after watching the YouTube video, they look even more like sleep.
Note: It's hard to take a photo of the whole EEG with my phone, so those are actually pieces of the snapshots. The snapshots themselves are about 9 seconds long. The little pieces are about 4-5 seconds long.
Those EEG bits are missing the eye-blink artifacts. So if anything, my eyes were probably at least closed.
I also think the line bits are much less bumpy than the ones I see in my afternoon EEG.
Yes, there are some breaks in the smooth waves. There are some mountain type things. But I THINK those might be the abnormal spikes.
OR they could be perfectly normal sleep variations that are sometimes mistaken for seizures.
Was I sleeping?
Was I not sleeping?
Was I having seizures in those snapshots?
Was I not having seizures?
According to the EEG report DFW neurology sent home with me, it should NOT be seizures. Or it shouldn't be sleep.
The report says: All stages of sleep were obtained and sleep is considered to be restful. There are no reported events with the event trigger or diary entry in sleep. No clinical, subclinical, or electrographic evens were observed. There are no focal or paroxysmal waveforms.
Okay?
Here are the different explanations swimming through my head.
A) DFW Neurology is just totally nuts and incompetent. The two snapshots they gave me DID occur during sleep. I'm having seizures in my sleep, and they completely fucked up when writing the sleep portion of my EEG report.
B) DFW Neurology is just totally nuts and incompetent. The two snapshots they gave me DID occur during sleep, but what the computer picked up was not seizures. It's just normal sleep-time stuff. But I asked DFW neurology to provide me with snapshots of my maybe-seizures. Why would they send me home with two snapshots that they determined were NOT seizures? How is that helpful to me or any future neurologists I might go to?
C) I'm misreading the EEG, and I'm not sleeping. This is possible, because I do tend to wake up several times during the night. The lack of eye-blinking artifacts? Maybe I was closing my eyes, TRYING to fall asleep. But shouldn't the report reflect that. If I'm waking up in the middle of the night having abnormal spikes, is it fair to call my sleep restful?
There is one more thing I want to say about DFW Neurology. I hope it's the last thing...at least for awhile. I don't really want to turn this into a medical blog.
It's about the Google rating.
I still haven't changed it back to a one star rating.
DFW Neurology does NOT deserve a 3 star rating from me. But I feel I have to keep with what I told them I'd do.
When I talked to Sai Duvvuri, the manager, I told him I'd delete or change the review. But I would put my very bad review up again if I saw someone else adding a bad review.
Now of course I wouldn't do that for any bad review. If the bad review seemed ignorant or thoughtless, I wouldn't pile on. But if someone wrote a detailed bad review and it seemed somewhat similar to my experiences, I would conclude that DFW Neurology wasn't moving in the right direction, after all. I would conclude they're still quite awful.
Duvvuri didn't seem to pleased with my plan. He then said something like people sometimes give them bad reviews because they're addicts, they want pain medication, and DFW Neurology refuses to provide them with what they demand.
I don't doubt that this does happen sometimes. But I don't think this is the reason behind most of their bad reviews.
I think most people who go to neurologists aren't after addictive drugs.
What are they after?
A good listener who is intelligent, understanding, thorough, and logical.
They want the right tests. They don't want to be denied tests because the doctor thinks it's "all in their head". Nor do they want to be pressured to take tests they don't need.
They want someone who can correctly read the tests...and not LOSE the tests.
They want doctor offices that can return phone calls and emails in a timely manner.
They want bills that make sense and are affordable.
They want doctors who are educated about medication side-effects and communicate with patients openly and honestly about it.
They want doctors who accept their insurance and continue to accept that insurance, so the patient doesn't have to rush and find a new doctor.
They want doctors who care! Personally I'm not bothered if the doctor sees me as a whole person or not. If a doctor wants to see me as a disease or ailment, I'm fine with that. But it seems to me, many doctors are not even really that interested in our health issues. They seem to be lacking curiosity. It seems to me a lot of doctors just want to rush through the appointments and get paid.
P.S-Despite some misgivings, in the midst of writing and editing this post, I made a referral to a second neurologist. That's in November. I'm hoping that between now and November, my blog will take a break from my medical stuff. But come November....I'm sure I'll be writing more posts.
Hopefully I'll like this new Doctor better than what I encountered at DFW Neurology. I have my doubts, though. The doctor himself gets good reviews. The center...not so much so.
But I'll try to keep and open and hopeful mind.
