I pregnant woman stands next to a large test tube of bloodwork.

My Pregnancy Care Plan

As the new year approached, I solidified my transition to my new neurologist. During our first meeting, we discussed my care plan for my pregnancy and related it to my previous care plan.

I believe I have mentioned this before, but I have an optimal working liver. Due to this great fact, I process lamotrigine relatively quickly. Additionally, he explained to me that while pregnant, the increase in blood volume can dilute the medication levels.

Treatment of epilepsy in pregnancy: my customized plan

My new neurologist decided to implement a plan where I have my lamotrigine levels checked every 2 weeks. This bloodwork will show if my lamotrigine levels are staying in his preferred range to reduce the chance of me having a seizure. If they are not, more than likely my medication will increase.

I was initially surprised by the increased frequency of bloodwork. (This is quite more frequent than with my previous pregnancy.) However, I have no problem doing what is best for the baby and my health.

My neurologist continued to explain my care plan by instructing me on the best way to get my bloodwork taken. I will need to check my levels before taking my medication for a more accurate level count. This, of course, makes a lot of sense. However, I have not always approached my bloodwork in this way...

Checking epilepsy medication levels

I took my lamotrigine levels right before I saw my current neurologist for my first visit. My results show how much lamotrigine I had in my system after taking my medication. I had my bloodwork taken around noon after taking my first dose around 7:00 a.m. that morning. My bloodwork showed my levels were at 11.73.

My neurologist told me his goal is to get my lamotrigine levels closer to 13.0. Then I had my second blood draw before I took my medication. My lamotrigine levels dropped to 3.8. This was astounding to me. The blood draw was 3 weeks apart due to being ill. However, the drastic difference is still incredible.

The simple change of having my bloodwork drawn before I take my medication that day made a huge impact on my results. Lesson officially learned after this experience. It only took about 18 years to make sure I committed this process to memory. Yikes!

So my word to the wise... Ask your doctor if you should get your bloodwork done before you take your medication that day. For me, this was an important piece of the puzzle.

Grateful for my neurologist

The next part of my care plan is also interesting. Once my baby girl is born, I will immediately stop my additional medication and return to my previous pre-pregnancy dose. Then I will have follow-up bloodwork to see if further adjustments need to be made. Again, this makes total sense since I was taking the additional medication specifically due to the impact pregnancy has on how the medication is absorbed in my system.

There is one final part of my new care plan that I am extremely excited about. I am no longer taking Briviact. I am grateful that I was able to take it for the past year and a half. However, I am also grateful to be able to stop taking the medication. My neurologist gave me the option to discontinue the medication and I happily agreed. If I don't need to take additional medication and have that in my system while pregnant, I am all for the change.

I am so grateful that I have been able to find my new neurologist at Banner Health here in Arizona. I am confident that I am in competent hands and that I will continue to have care plans that work for the different stages of my life.

Always remember, you are not alone.

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