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​​​​​​​Jennifer McEachern and her eldest daughter, Grace
Jennifer McEachern and her eldest daughter, Grace.  With the help of Dr. Esther Bui, McEachern had a seizure-free pregnancy. (Photo: Michelle Collis)

Recently married and living in London, England in 2010, Jennifer McEachern was working a fast paced, high stress job in a public relations firm while getting ready to start a family.

But her plan hit a sudden and unforeseen bump in the road.

At the age of 30, McEachern began having episodes where she felt she was in a daze and couldn't speak or understand anyone. Doctors had difficulty diagnosing her condition, unaware that McEachern was experiencing complex partial seizures. However, when she experienced a tonic clonic seizure with the more recognized symptom of convulsions while she was at work, it was confirmed that McEachern had epilepsy.

"I really felt frightened, not knowing what the implications of epilepsy would be on my career and hopes of a family life," said McEachern, now 34 and living in Toronto. "I was already dealing with the anxiety and challenges of pursuing fertility treatment when I was suddenly presented with a new, complicated medical issue."

"Being diagnosed with epilepsy really worried me as to whether I would be an independent, capable, safe parent that I'd always expected to be."

McEachern and her husband moved back to Canada shortly after her diagnosis. Like many people who live with epilepsy, McEachern became fearful of going out on her own. Although she was taking medication to manage her seizures, she knew she could have one at any time.

This concern also weighed heavily as she continued to try to get pregnant. Would her medication harm the baby? If she stopped taking the medication, would her seizures harm the baby? And what about after the baby was born, how could she reduce the risk of having a seizure while caring for an infant?

Image of Dr. Esther Bui
Dr. Esther Bui, who joined the epilepsy team in 2014, is a neurologist who specializes in treating women with epilepsy with a focus on pregnancy and epilepsy. (Photo: UHN)

Finding the right doctor

Through a twist of fate, McEachern heard of Dr. Esther Bui, a neurologist with the epilepsy program at the Krembil Neuroscience Centre, who specializes in treating women with epilepsy with a focus on pregnancy and epilepsy.

"For many years, women with epilepsy were told they shouldn't even entertain the thought of having children because of the perceived risks both seizures and the medications to manage them posed to the baby," said Dr. Bui who joined the team in 2014.

"But women who have epilepsy need to know that there are both medical and lifestyle adjustments that can be made to ensure the best chance of a healthy pregnancy, and minimize the impact this disorder can have when caring for a child."

 

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Soon enough, McEachern overcame her first hurdle when she learned she was pregnant. She then informed Dr. Bui whom she had already started seeing to help manage her epilepsy.

Dr. Bui set to work mapping out a plan to keep McEachern's seizures in check during her pregnancy as well as prepare her for the demands of caring for an infant in the early, sleep-deprived days and weeks.

"I'm like the GPS system, helping patients navigate the route they want to take during their pregnancy," explained Dr. Bui.  "I present them with options and address their concerns, but ultimately the patients are in the driver's seat."

Managing epilepsy and pregnancy

Epilepsy is a neurological disorder characterized by different types of seizures. Although medical experts have gained a better understanding of the condition, they are still investigating the many causes and triggers for seizures.

Some known risk factors for seizures are variations in hormones, lack of sleep and stress – all of which are exacerbated during pregnancy and while caring for young children – which can make this phase of life especially challenging for women with epilepsy.

Although it may require some extra attention, planning and support from the patient's family, Dr. Bui knows it is possible for these patients to successfully become mothers. She recently published a textbook, Women with Epilepsy: A Practical Management Handbook, to help other physicians better understand the unique challenges of caring for these women.

For McEachern, the goal was to keep her seizure free during her pregnancy without the medication affecting the fetus. Keeping medication levels consistent while the body undergoes so many changes is challenging. Dr. Bui monitored McEachern closely, adjusting her medication doses to provide her with the minimum needed to prevent seizures without harming her baby.

"When I told people I was pregnant, they assumed I would stop taking my seizure medication and were shocked to find out I didn't – the feeling of being judged for taking care of myself wasn't helpful," McEachern recalled.

"There needs to be a lot more awareness for women with epilepsy that you don't need to sacrifice your health for that of your baby or vice versa."

The next step was ensuring McEachern would be able to stay healthy after the baby was born. Dr. Bui worked with McEachern's husband and family to set up a support network that would allow her to balance looking after herself to reduce the risk of seizures while she cared for a baby.

At the same time, Dr. Bui also prepared McEachern for how to keep the baby safe just in case she did have a seizure. Simple strategies like changing the baby on the floor rather than a change table and enlisting a partner when giving the baby a bath, reassured McEachern that she was doing everything possible to keep her baby safe.

The McEachern family
The McEachern family celebrates the holidays in 2014. Having the right doctor and the right plan gave Jennifer the confidence to manage her epilepsy and have a family. (Photo: McEachern family)

"Epilepsy doesn't define my life"

McEachern's pregnancy was seizure free and, in 2012, she gave birth to a healthy baby girl. She continued follow up appointments with Dr. Bui, and didn't have a seizure for a year after her daughter's birth.

"Dr. Bui really helped me build a life that keeps me healthy which in turn keeps my family healthy," said McEachern. "Although I've had to learn to accept my limitations, I've also discovered that I can live a pretty normal life by making adjustments to my lifestyle, listening to my body and making sure that my family and I are all on the lookout for any seizure warning signs."

Although McEachern did experience a seizure in 2013, she did not let that deter her from adding to her family. Again working closely with Dr. Bui to manage her epilepsy during her pregnancy, McEachern gave birth to healthy twin girls in 2014 – and has been seizure free since.

McEachern is now busy juggling the demands of an active household and raising young children. Although she still needs to balance a hectic life with her own health needs to manage her epilepsy, she has a better sense now that she is capable of handling it.

"I went from feeling like I wouldn't be able to have a normal life to being able to say that epilepsy doesn't define my life," said McEachern.

"Having the right doctor and the right plan has shown me that I can do this. Knowing I had good care gave me the confidence I needed to still achieve my dreams."

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