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November is National Epilepsy Awareness Month!

Nearly three million people in the U.S. are living with some form of epilepsy.  Most can be well controlled by medication, and seventy percent of people with epilepsy can be expected to enter remission – defined as five or more years without a seizure on medication.  College students can experience increases in seizures as a result of lifestyle changes that affect their sleep, stress levels, routines and adherence to medication regimens.

What is Epilepsy?
Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. It’s also called a seizure disorder. When a person has two or more unprovoked seizures, they are considered to have epilepsy.

A seizure happens when a brief, strong surge of electrical activity affects part or all of the brain. One in 10 adults will have a seizure sometime during their life.
Seizures can last from a few seconds to a few minutes. They can have many symptoms, from convulsions and loss of consciousness to some that are not always recognized as seizures by the person experiencing them or by health care professionals: blank staring, lip smacking, or jerking movements of arms and legs. 

First Aid
When providing seizure first aid for generalized tonic clonic (grand mal) seizures, these are the key things to remember:
• Keep calm and reassure other people who may be nearby.
• Don’t hold the person down or try to stop his movements.
• Time the seizure with your watch.
• Clear the area around the person of anything hard or sharp.
• Loosen ties or anything around the neck that may make breathing difficult.
• Put something flat and soft, like a folded jacket, under the head.
• Turn him or her gently onto one side. This will help keep the airway clear.
• Do not try to force the mouth open with any hard implement or with fingers. A person having a seizure CANNOT swallow his tongue. Efforts to hold the tongue down can injure teeth or jaw.
• Don’t attempt artificial respiration except in the unlikely event that a person does not start breathing again after the seizure has stopped.
• Stay with the person until the seizure ends naturally.
• Be friendly and reassuring as consciousness returns.
• Offer to call a taxi, friend or relative to help the person get home if he seems confused or unable to get home by himself.

Is an Emergency Room Visit Needed?
When these conditions exist, immediate medical attention is necessary:
• Diabetes
• Brain infections
• Heat exhaustion
• Pregnancy
• Poisoning
• Hypoglycemia
• High fever
• Head injury
An un-complicated generalized tonic clonic (grand mal) seizure in someone who has epilepsy is not a medical emergency, even though it looks like one. It stops naturally after a few minutes without ill effects. The average person is able to continue about his business after a rest period, and may need only limited assistance, or no assistance at all, in getting home. In other circumstances, an ambulance should be called.

When to Call for an Ambulance
No Need to Call an Ambulance if:
• medical I.D. jewelry or card says "epilepsy," and
• the seizure ends in under five minutes, and
• consciousness returns without further incident, and
• there are no signs of injury, physical distress, or pregnancy.

An Ambulance Should Be Called if:
• the seizure has happened in water.
• there’s no medical I.D., and no way of knowing whether the seizure is caused by epilepsy.
• the person is pregnant, injured, or diabetic.
• the seizure continues for more than five minutes.
• a second seizure starts shortly after the first has ended.
• consciousness does not start to return after the shaking has stopped.
If the ambulance arrives after consciousness has returned, the person should be asked whether the seizure was associated with epilepsy and whether emergency room care is wanted.

Myths and Facts About Epilepsy
Myth: A person having a seizure can swallow his tongue.
Fact: Efforts to hold the tongue down or putting something in the mouth can hurt the tooth or jaw.
Myth: People with epilepsy are dangerous or posessed by the devil.
Fact: Epilepsy is a neurologic disorder, and it is rare that someone having a seizure will harm another person.
Myth: You should hold a person down while he’s having a seizure.
Fact: You should make sure the area near the person is safe and that there is nothing hard or sharp.
Myth: You should perform artificial respiration.
Fact: Artificial respiration is only needed if the person does not start breathing after the seizure has stopped.

The above information has been adapted from the website of the Epilepsy Foundation Massachusetts and Rhode Island. 
Please visit their website for more information: http://www.epilepsyfoundation.org/massri/

Art Klossner, PA-C, MBA
Director of Health & Wellness Services

Important Change in Immunization Supplies and Fees
The state of MA will no longer be supplying vaccines to private offices (like Suffolk Health & Wellness) as a result of recent funding cuts. This means that we will have to purchase the vaccines that we administer from the manufacturer directly or from a medical supply retailer.  The result will be a significant increase in the amount we will need to charge students for each vaccination.  Currently we charge an average of $15 - $20 for the required immunizations. 

These prices will rise to $60 - $90 per immunization dose, effective  JANUARY 1, 2009.

For example, if you need all of your Hepatitis B vaccine - which is a series of 3 injections, you will be charged $60-$90 for each injection.
It will be important for students and their parents to make greater efforts to obtain documentation of immunizations received in the past to avoid unnecessary charges and immunizations in the future.  These records often take time to obtain, particularly for students who:

Are from a foreign country
Are returning to school after a break in education
Received immunizations from multiple locations/providers in the past.

Historically, many of these students have chosen to get re-immunized in our office because of the relatively low costs of the state subsidized vaccines.  unfortunately these are no longer available.
Please make every effort to get the immunizations you need ahead of time or obtain documentation from your health care provider or the educational institution you last attended.