What do ya'll think about htis level?

[Mom2HeathandKynzer]

Ok...Kynzer's neurologist is a complete idiot I think. He doesn't take any calls after hours or weekends..and has no one that does it for him..he says just go to the ER. Ok..so I have talking to them all day about what happend with the dose of tegretal yesterday and they ordered bloodwork...20 hours after his last dose...and it shows that his level is 5 with 4-12 being normal. Ok..I know this is good..but he hasn't had any meds. in 20 hours...should it still be that high? Does it stay in his system this long? And get this...after they got the results...the doctor went home for the day and he'll let us know tomorrow about what dosage to give him...which will be 48 hours since his last dose. Needless to say we are going to Baton Rouge Wed. for a new neurologist with a big practice...so there is someone at least on call even if it's just a nurse.

[lorilou]

I would think that is a pretty high level after 20 hours has gone by. I know Noah's levels were always taken right before his dose so we'd know his lowest level. If Kynzer's level is 5 that long after his last dose..what was his level right after he took it?

Good luck finding a new neurologist...it's not easy to find a good one...

[langansmom]

It depends on the half life of the med, and I don't remember what the half life is of tegretol. I know that some of the AEDs, like phenobarb, have really long half lifes so that you can miss a dose and the level won't change much. Other meds with shorter half lifes should show a much larger change with a missed dose.

Anyone here know the half life of tegretol?

[lorilou]

I did some quick research and it looks like it's half life is 16-20 hours so maybe the level isn't too bad. It did say that children usually metabolize the drug quicker than adults (also explains why children sometimes require higher doses).

Noah took Tegretrol as his first seizure medication. We had problems with the suspension being different concentrations because the pharmacy would dispense only partial bottles (so it depended how hard the bottle was shaken before it was poured). His neuro ended up writing the script so they had to give us the whole bottle.

We had better seizure control on Trileptal (new version of Tegretrol). He actually did very well on it until last year when he maxed out his dosage and we just couldn't go any higher (couldn't hold his head up, fell asleep everywhere, etc..)

HTH -

[kathleenandjoe]

That level is pretty much what is to be expected even after a missed dose or even two. 5 is pretty low in the spectrum.

Hugs,
Kathleen

[kathleenandjoe]

I had to go back and look - but usually they like it in the middle of that range (8-10). It takes a while to fall out of range as the drug stays in system for a while (that's where the whole half life comes into play - every drug is different).

I would HIGHLY suggest trying to get your ped neuro under the same roof (or at least with privlegdes) at the same hospital. Seizures often come into play at hydro/surgery times and they go back and forth. It helps to have the neuro at the same place as the ns so you're not having to start from scratch neuro-wise. YOu would think that the ns would know and be able to deal with the seizures - but they do not at all unless it's coordinating for an epilepsy surgery. They don't do seizures nor do they even know much about the meds.

Just my 2 cents based on experience.

I hope things get straightened out for you today. . . .

hugs,
Kathleen

[Denae]

((hugs))

I hope you are able to find a neuro that you are comnfortable with. We have been playing the med change and phone tag game for an entire MONTH now, it makes me crazy!

Twice we have had to wait from Friday until Monday to find out what to do with meds.