EPILEPSY AND YOUR LIFESTAGE
Men and Epilepsy
If you are a male with epilepsy
Men and women experience the effects of epilepsy in different ways and for different reasons. It is important to understand that epilepsy is a health condition like any other and to get as much information as you can on what epilepsy is, how it can be treated and how to manage the condition so that you can lead the healthiest and most productive life possible.
Epilepsy is often called an ‘episodic’ disorder because seizures come and go and in fact might only occur on very rare occasions. The problem is that epilepsy happens in your brain, which is the key centre of all your body’s other activities, so even if it is a very small problem for the brain, if left to its own devices it can become a great burden to you.
Finding a neurologist who specialises in epilepsy is often the first important step towards appropriate self-management of your epiilepsy. Most people have their seizures completely controlled or very well-controlled indeed within two years from their first seizure and are successfully getting on with their lives.
Freedom from seizures should be one of the highest priorities you set yourself. Your best chance for gaining this freedom is to follow the advice of your medical practitioner or neurologist.
Men and compliance
Taking the tablets you have been prescribed in the way your doctor has advised is known as ‘compliance’ and it is reported as a greater issue for men than it is for women.
Treating epilepsy is not like taking a course of antibiotics to treat an infection. It requires you to take tablets and keep taking them until your doctor or neurologist gives you the all clear to reduce or stop.
What happens if you stop or reduce your tablets?
If you stop taking the tablets prescribed, or even decrease the dosage, you are likely to experience what are sometimes called ‘breakthrough seizures’ and it may then be harder to get your seizures back under control the second time than it was the first time.
You may well be able to reduce or even cease taking drugs once you have been seizure-free for a couple of years but that is far from the case when you are still at the stage of getting them well and truly under control. Compliance is a vital step in managing seizures.
There are many reasons why some people find it hard to take their medication as prescribed, such as:
- Difficulties remembering what they are to take and when they are to take it
- Some dosing routines can be complicated and involve taking very specific doses of different medications throughout the day
- The adverse side-effects of particular drugs.
- Tablets are sometimes resented and rejected because they are associated with the ‘stigma’ of epilepsy.
If, as an adult, you have been seizure free for two or more years there is a possibility that you may be able to undergo a supervised reduction in the number of tablets you take and even to stop altogether. It’s not a guarantee that seizures will not return but, with care and appropriate supervision, it can be worth doing.
Supply is a key issue
Keeping your medication where you can get to it is as important as remembering to fill scripts in the first place.
Alcohol and recreational drugs
Epilepsy shouldn't stop you having a beer or two or a glass of wine with dinner, but you need to moderate your alcohol intake.
Alcohol can increase the sedating effects of some antiepileptic medications and can trigger seizures under some circumstances. Some antiepileptic medications specifically recommend that you not drink while taking them and some neurologists expect their patients to follow this restriction to the letter – especially until they get their seizures under control.
If it is a problem for you, speak about it with your doctor. You may be able to try another medication or even have the occasional drink and do so with little or no adverse reactions.
Street drugs such as cannabis, ecstasy, cocaine, heroin, amphetamines or solvents can trigger seizures. When combined with a change in lifestyle that involves late nights and alcohol your risk of seizures is greatly increased. Seizures provoked in these circumstances are serious, can be life-threatening and usually require emergency medical intervention.
Is marijuana as good for seizures as many people claim?
Marijuana smokers with particular kinds of seizures will tell you that they can control seizures by smoking dope. The fact is that they may be right. But there are other facts that are equally relevant to what is happening here.
Antiepileptic medication must be taken with clocklike regularity every day to control seizures. As marijuana is generally illegal and its supply erratic, relying on marijuana to control your seizures is fraught with danger. If you stop because your supply has dried up, you can be placing yourself at great risk and your seizures may come back with a vengeance.
Research also shows that young people, in particular, are at increased risk of experiencing psychotic episodes while using marijuana. In addition to the issues of quality and reliability of supply, there is the potential harm that can be caused by using this drug to consider.
Growing a small amount of marijuana is legal in some states and in some countries, but growing enough to maintain a reliable supply usually lands you in hot water for possessing what is called a trafficable amount. You can be charged with trafficking and summarily convicted of a criminal offence.
If you do use recreational drugs, you will need to talk about it with your doctor or epilepsy counsellor and they will almost certainly tell you that they can trigger the very seizures that you are seeking to avoid.
Self-image
Compliance can become a particular problem for men whose self-image rests at the more rugged end of the masculinity scale. It can be a problem for both men and women in the workforce where they have not told their colleagues or employers, or where there is a habit of spending time in the pub with mates or colleagues after work.
For some men their self-image can take a battering when they are not permitted to drive for a certain period until seizures are controlled. Some men would rather tell their work mates and friends that they’re off the road for drink driving, rather than admit to having seizures. Being a male brings with it a range of expectations that can make epilepsy an especially hard condition if you allow yourself to be ruled by stereotypes.
Driving
Most professional drivers are men, whether they drive trains, taxis, trams, buses or road transports. The farmer on the tractor is more likely to be a man. And indeed one of the rites of passage for many young men is get a licence and to get some wheels. Driving and unpredictable seizures can be a lethal combination. the best solution is to get control of your seizures so they are no longer an impediment to your safe driving.
If you have epilepsy or seizures you can hold a learner's permit or driver's licence for private vehicles as long as your seizures are well-controlled. National medical guidelines have been developed by specialists to assist with the assessment of applications from people with epilepsy and seizures.
Each application is considered individually. If you hold a current learner's permit or driver's licence you are required by law to notify VicRoads if you have or develop a serious medical condition, such as epilepsy and seizures.
Sport
Men tend to play more physically aggressive sports than women. There are major sports stars that have epilepsy who compete in some of the toughest sports played, but these guys have their seizures controlled.
Without freedom from seizures it is inadvisable to play rough contact sports. Interestingly, head protection gear is increasingly seen as an important element to playing contact sports safely, but from basketball to football there seem to be very few men with the guts to actually wear even the most comfortable helmets.
Participation in sports like weight lifting or bodybuilding, skydiving or mountain climbing should only occur under well-supervised circumstances in people with complete seizure control.
Being a good provider
For many men the idea of supporting a family is what keeps them going to work. It’s the idea of being the traditional breadwinner and it’s tied up with notions of male physical strength and the ability to protect those you love.
Seizures can threaten this – they can lose you your job. They can cause you to have a serious work injury. They can leave you without an income, at home with the possibility of seizures while your partner is out earning money.
An epilepsy counsellor at the Epilepsy Foundation of Victoria can help you understand where to go for help. Some superannuation schemes offer periods of temporary ill health retirement. Sickness benefits, carer benefits and a range of support that you might need for a period should be talked about early so that applications can be made and arrangements made.
Sex
While some seizures (central or parietal lobe seizures) can involve sexual feelings and actually cause erections and ejaculation, the experience of epilepsy is more likely to lead to a decline in sexual energy or libido rather than an increase.
The culprit most often blamed is the sedating effect of many Antiepileptic Drugs (AEDs). While this can be a difficulty, for many men the fatigue from the drugs usually wears off or becomes manageable.
However, the mechanisms of seizures can be implicated in reduced libido (or sexual drive) and reduced sexual function (potency) even without the added impact that some medications bring into the picture.
There are things you can do to help ensure that you are functioning optimally. If you do have sexual function difficulties and epilepsy, do not assume that one is necessarily the cause of the other.
If you are in a slump since being diagnosed with epilepsy discuss it with your doctor. A counsellor at the Epilepsy Foundation of Victoria can also help, or advise on where you can get further help.
Safety in the home
Your doctor will give you advice about any restrictions while you continue to experience siezures.
Motor mowers, power tools, hammers and chisels, saws and bladed tools, ladders and being the one who climbs onto the roof, are all things most men deal with. If you have epilepsy you’ll need to be particularly careful.
If you could potentially hurt yourself during a seizure while doing anything with tools or any other potentially dangerous activity, then you need to adapt the activity, or not do it, until you know that your seizures are under control. You owe it to yourself and those around you to be careful.
Anger
We sometimes talk with men who have epilepsy who have been angry and whose anger has caused their marriages to break up or their friends to become distant or their colleagues to complain.
Everyone can get angry at a diagnosis of epilepsy and it is normal to feel some anger – as well as some anxiety or depression.
It is important to talk about these feelings because they are manageable. However, many men are not good at dealing with their emotions, or talking about them. However, if you are able to do so, you will learn that there is a lot you can do to improve things.
The one thing you can’t do is try to excuse anger by telling people that they just have to put up with it because you have epilepsy. Anger is a useful emotion but not if you can’t keep a lid on it. Anger, if left unchecked, can do you a great deal of damage. Talk to your doctor or epilepsy counsellor at the Epilepsy Foundation of Victoria and get through it.
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Support Nyah and families just like hers by donating to our Christmas Appeal. We need to raise $181,000 to support programs like our emergency medication training.
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