Apr. 6--WANDA BARNETT, 47, Sinking Spring, said she never suffered an epileptic seizure in her life until the birth of her fourth child more than 20 years ago.
Diagnosed with a chemical imbalance that led to the seizures, Barnett was prescribed medications to treat her condition, but the drugs didn't always work and came with debilitating side eff ects.
She often experienced headaches and nausea. She also gained weight and suffered a battery of physical ills from heartburn to chest pain to diffi culty swallowing.
While on medications, she said she still had some type of seizure at least once a week.
While her physical condition worsened, Barnett described her day-to-day life as a shell because of the anxiety, embarrassment and depression she suff ered worrying about the onslaught of a seizure or suffering in its aftermath.
For an extended period, she gave up working full time, driving a car and many outside social activities.
It wasn't until she watched a medical commercial on a late-night television program for an implantable device called a vagus nerve stimulator (VNS) that she fi nally felt there could be a more effective therapy for her.
The one- to two-hour outpatient procedure involved implanting a pacemaker-type device in the left side of her chest area. A thin wire attached to a pulse generator runs under the skin to the left vagus nerve in the neck and works automatically to stimulate various areas of the brain.
"In 2001, I had the implant operation at Temple (University) Hospital (Philadelphia), and I can honestly say I got my life back," said Barnett, a drug and alcohol counselor who loves gardening and activities that take her outdoors.
"For years, I was afraid to drive my car or even leave the house just because of the fear of having an epileptic seizure," she said.
Since the operation, Barnett once again drives her car, works full time and is working to earn a master's degree in clinical psychology.
Epilepsy no longer imposes such severe limitations on her life, she said.
An often misunderstood and stigmatizing medical condition, epilepsy is a neurological disorder characterized by recurrent seizures that are caused by electrical abnormalities in the brain.
About 3 million Americans suffer with epilepsy, with about 200,000 new cases diagnosed each year.
It is estimated 25,000 to 50,000 people will die of seizures and related causes, according to the Epilepsy Foundation of America.
Enter the VNS therapy, which was originally approved by the Food and Drug Administration in 1997 for partial onset seizures, with expanded use in 2005 as a therapy for depression,
It is deemed an alternative for those suff ering refractory epilepsy when seizures are not adequately controlled by antiepileptic drug therapy or when drug side eff ects become intolerable, seriously aff ecting a patient's quality of life.
The VNS operation and follow-up monitoring and treatment is now off ered in appropriate cases at Reading Hospital through the almost one-year-old Epilepsy Monitoring Unit under the direction neurologist Dr. Sowmya Lakshminarayanan.
Dr. Thomas G. Psarros, neurologic surgeon at Reading Hospital, performs the surgery and last year changed Barnett's VNS battery, which lasted about eight years.
"Wanda was the perfect candidate for this, and her surgery went terrific," Psarros said.
Psarros said part of the VNS therapy also involves the use of an external magnet by a patient to produce an immediate extra dose of stimulation if needed at the onset of a seizure. Use of the magnet can abort or lessen the intensity of a seizure, giving the patient more control over the condition, he said.
"I have the magnet, but I've only had to use it maybe four times in eight years," Barnett said. "It does give me greater control if I get a fl oating sensation or the feeling that a seizure is coming on."
While Barnett still takes some medications, she has reduced the dosages. That has led to signifi cantly lessened side effects. She also has had fewer and milder seizures.
Lakshminarayanan said one-third of the patients who undergo VNS therapy show a signifi cant reduction in seizures, while another third show some reduction and a final third indicate no improvement.
The doctor said the therapy allows physicians to regularly meet with patients to prescribe, control and monitor the therapy's effectiveness over the course of months or years by using an external programming system.
"We can adjust the timing and amount of stimulation a patient receives and have some control in the treatment program," she said. "Since the opening of the unit (Epilepsy Monitoring Unit) last year, we are able to save patients from having to travel to major metropolitan areas such as Philadelphia or Baltimore for this type of treatment.
"This (VNS therapy) is a good option for those who have experienced problems with multiple other medications or have had serious comorbidity problems aff ecting their quality of life. Side effects of VNS therapy are usually mild, such as hoarseness, coughing and tickling in the throat and usually diminish over time. This is a safe, effective therapy and often used in conjunction with medications."
Contact Bruce R. Posten: 610371-5059 or bposten@readingeagle.com.
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