Epilepsy and lifestyle

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1 Epilepsy and lifestyle Depending on your type of epilepsy, frequency and predictability of seizures, you may have to make adjustments to your present lifestyle. It is important not to become obsessed by them. Many people miss out on wonderful life experiences by restricting their lifestyle unnecessarily. With some forward planning you can do whatever you want to and enjoy it. Epilepsy will have an impact on your life, but you can minimize that impact by recognizing those issues that affect you and managing them in a positive way. Alcohol Epilepsy shouldn t stop you from having the occasional beer or two or a glass of wine with dinner. Most people with epilepsy can drink a moderate amount of alcohol. Moderate drinking means having 2 standard drinks a day. A standard drink is equal to: One small glass of wine (100ml) One middy of full strength beer (285ml) One nip of spirits (30ml) Be aware of the quantity of alcohol you drink and don't let anyone persuade you to drink more. Alcohol and antiepileptic medications interact in specific ways. AEDs can make you more sensitive to the sedating effects of alcohol while alcohol reduces the effectiveness of AEDs making seizures more likely. Excessive drinking can result in: Hangover seizures as the alcohol level in the blood falls. However some people find that even small amounts of alcohol can trigger seizures. Ask your doctor about the effects of drinking alcohol with the medication you have been prescribed. Career options A diagnosis of epilepsy can sometimes mean you have to change your career. In some cases, you can stay in the industry and retrain for another area, while in other cases, you may have to abandon your chosen field altogether. The loss of your job or career can make your diagnosis harder to bear. Contact Epilepsy Queensland to speak to an epilepsy counsellor during this stressful time for advice on employment options. Driving If you have epilepsy, you will be able to hold a driver s licence or learners permit as long as your seizures are well controlled. National guidelines have been developed by epilepsy specialists to assist with the assessment of applications from people with epilepsy. These guidelines are intended to protect your safety and the safety of the community. Each application is considered individually. The period that you must be seizure free before driving depends upon your type of epilepsy and the circumstances surrounding any recent seizure you might have had. For up-to-date driving regulations contact the licensing authority in your state or territory. Poor seizure control due to late nights Missed meals and forgotten doses Employment Skills, abilities, qualifications and experience are the qualities that employers are most important to any potential

2 employer. Your epilepsy is only relevant if you have seizures that are likely to interfere with your ability to do your job. The Disability Discrimination Act 1992 makes disability discrimination unlawful and aims to promote equal opportunity and access for people with disabilities. Under the Act, individuals can lodge complaints of discrimination and harassment with the Human Rights & Equal Opportunity Commission (HREOC). HREOC undertakes a wide range of activities to assist individuals and organizations to understand their rights and meet their legal responsibilities. Federal and State anti-discrimination laws legally protect people with epilepsy from discrimination. You are entitled to take legal action if you believe you have been discriminated against because of your epilepsy. Family planning Some drugs for epilepsy can reduce the effectiveness of the contraceptive pill and increase the risk of unwanted pregnancy. Your neurologist, gynaecologist or general practitioner can help you decide what the best form of contraception is for you. If you are a female with epilepsy and planning to become pregnant, pre-pregnancy counselling is very important. A successful pregnancy will depend on: a clear understanding of your seizure pattern well controlled seizures the most appropriate medication to suit you and your future baby a folate supplement to protect against spina bifida and neural tube defects. Most types of epilepsy are not inherited therefore the risk of passing it on to a child is small. See an epilepsy or genetic counsellor for further information and advice. Sex Lots of people of people worry unnecessarily about whether or not it is safe to have sex when they have epilepsy or when their partner has epilepsy. Millions of people living with epilepsy either their own or that of a partner will happily attest to the fact that their sex lives are just fine. For most of us sex is an important part of our lives and worrying about our sexual abilities or about our sexual performance can lead to sexual problems. So if you do experience a loss of libido or sexual energy speak about it with your doctor. It may just be that the AEDs you are taking are contributing to a reduced desire for sex. If this is the case it is usually easily remedied. There is evidence that some epilepsy syndromes can reduce libido. It may not be a great worry to some people, but it can be for others. It s possible that a person with epilepsy will feel less like sex than their partner. It is therefore important that partners talk openly and supportively to one another about this. For some men, there is evidence that actual arousal rather than desire can be adversely affected. This was once thought to be a direct outcome of particular antiepileptic medications for the particular people taking them. It is now understood that for some people it is a direct consequence of their epilepsy. If you have experienced this, tell your doctor. While it is not necessarily something that can be fixed instantly, it is certainly possible that some of the newer antiepileptic medications might be more helpful or that some of the newer medications available for rectifying sexual dysfunction might be of help. Sex is a big part of our lives. Sexual thoughts and feelings are a constant part of normal adult life. It is nevertheless, for many of us, a difficult matter to raise with a doctor or counsellor. Nonetheless, if you have concerns about your sex life and the impact of any aspect of epilepsy upon it, talking about it with your doctor or epilepsy counsellor may be the best thing you can do. If they cannot help you they can certainly support you in finding the solutions that you would want. If your doctor or epilepsy counsellor dismisses your concerns as 'nothing to worry about' because you are too old or too young, or because they feel that sex really isn t such an important thing in our lives, then tell them that you disagree. Tell them that you are expecting their support and if they feel unable to assist you with your concerns ask them to refer you to someone who can. If you live in a remote area and specialist services are limited, an epilepsy counsellor at Epilepsy Queensland can help you find out what your options are for seeing another specialist.

3 Stress Stress is a normal part of life. In fact we need a certain amount of stress to motivate ourselves and to stay healthy. It s how we manage the stress in our daily lives the pressures of financial survival, work, travelling in crowded cities and fulfilling our personal responsibilities that is so important in keeping balance in our lives. For people with epilepsy there will be additional, associated stresses. These include the need to take medication regularly and the unpredictable nature of seizures, and there may be any number of difficulties to overcome in gaining and retaining a driver's licence, dependency on others for transport and other help, difficulties with work, difficulties with memory and so on. As well as taking your prescribed medication, stress management techniques including relaxation and breathing, exercise, time management, assertiveness training and anxiety management may help you better manage your seizures by better managing your general levels of stress. Extreme stress, however, may lower your seizure threshold and trigger seizures. It is important to recognise the signs and symptoms of harmful levels of stress and to employ strategies that you find helpful in reducing it. Such strategies can include: Regular exercise Try to avoid stressful situations Rearrange your schedule so that you are not rushed cut back on your commitments if necessary When stressful situations can t be avoided, plan ahead make sure that you get enough sleep, take your medication on time and focus on trying to stay relaxed. A variety of relaxation techniques exist which aim to relieve the stress and tension and tension in our lives. However certain relaxation techniques (namely meditation) have been reported to be potentially dangerous for people with epilepsy. Lowered blood pressure and brain electrophysiological arousal can be triggered which are associated with triggering seizures in some people. Reporting for The Epilepsy Report, Michelle Bellon, PhD, from the Department of Disability Studies at Flinders University, SA reviewed popular relaxation techniques for people with epilepsy, looking at the benefits, as well as the potential risks, of the various techniques. Sports & Leisure When people are busy and active they are less likely to have seizures. When choosing a sport or leisure activity, give some consideration to your type of epilepsy and your degree of seizure control. Some activities involve a greater risk than others but with appropriate safety precautions most risks can be minimised. High risk activities Scuba diving and boxing are considered to be high-risk activities and should only be considered if your seizures are very well controlled. Activities such as bungy jumping are probably best avoided. Night clubbing If you enjoy the social atmosphere of nightclubs, being diagnosed with epilepsy does not mean you have to give up going out with your friends. Strobe lighting or flashing lights can in some people, trigger seizures. This is known as photosensitive epilepsy. However it is quite rare and affects only a very small number of people with epilepsy. Nightclubs and DJs generally display warnings if strobe lighting is used. If this is a trigger for you it would be advisable to avoid such clubs. If flashing lights make you feel uncomfortable, closing or covering one eye can lessen this discomfort. Travel Any holiday requires planning. Having a regular supply of medication is most important for anyone travelling away home for any period of time. Always carry a copy of your prescription with you. If something unforseen happens to your medication you can have it replaced immediately. Travelling overseas requires some extra planning: Take enough of your medication in its original packaging to last your holiday. If you are going for less than six months, you should take enough medication to last the whole time. Pharmacists are able to dispense the full amount of the script, including all the repeats at once if the script is endorsed by the doctor with the words Regulation 24.

4 Carry a letter from your doctor listing your medications, including their generic [chemical] names, since brand names may vary between countries. This is useful for customs and in case you need to get tablets while you are away. If your seizures are not fully controlled and/or you are travelling alone, ask your doctor for a brief letter about your condition in case you need to see a doctor while you are away. Always carry extra medication in your hand luggage in case your main luggage is lost or delayed. Find out if vaccinations are recommended for the country or countries you intend to visit. Most vaccines are safe for people with epilepsy with the exception of malaria. Your doctor will be able to discuss your options with you. Avoid excessive alcohol during the flight. Take out travel insurance for the duration of your trip. While epilepsy is considered a pre-existing condition, seizure control can be taken into account. Even if a higher premium is charged, it will be far less than paying for medical treatment overseas. Taking medication on long haul flights Long distance travel can disrupt your sleep pattern and your medication routine. What to do when changing time zones depends on how many hours the change will be. Former President of the Epilepsy Society of Australia Dr Ernie Somerville offers the following advice based on medications taken twice a day. If the time at your destination is less than 4 hours ahead of or behind your home time take your medication in the normal way. While on the plane, take your medication about 12 hours apart. This applies if your destination is between 8 and 16 hours ahead or behind your home time. The easiest way to figure this out is to compare the time at home and the time at your destination, ignoring whether it is am or pm. [Don t worry about the International Dateline!] If you take your medication more than twice a day, talk to your neurologist. There are epilepsy organizations in many countries if you need advice or referral. Epilepsy Queensland will be able to give you the relevant contact details. Team and contact sports Your epilepsy should not stop you from playing team and contact sports unless the epilepsy was caused by serious head injury. Some people choose to wear head protection while playing regardless of whether or not they have epilepsy. It is always a good idea to wear protective headgear in contact sports regardless of your health status. Television and Computer Games Unless you have been diagnosed with photosensitive epilepsy watching television, using a computer or playing video games should not affect you. However, if your seizures are triggered by photic stimuli there are things you can do to minimise the risk of seizures. Watch TV in a well-lit room and do not sit too close or directly in front of the screen. When playing computer games, sit 2.5m from the screen, again in a well-lit room and reduce the brightness of the display. If a seizure is to occur it is more likely to happen within the first 30 minutes of play. Generally, playing the game for prolonged periods doesn't pose a risk unless it is for so long that you become sleep deprived. Sleep deprivation is a recognised seizure trigger. Although every effort has been made to ensure accurate and up to date information is provided, Epilepsy Queensland and its advisors cannot accept any liability in relation to the information provided. It is strongly recommended that you discuss any information with your doctor or other relevant organisations. This fact sheet was written by Epilepsy Australia and appears on Epilepsy Queensland is an affiliate of Epilepsy Australia and has permission to print this information.

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