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Monday, September 7, 2015

Epilepsy and Exercise

Epilepsy and Exercise

 As many of you know I have Epilepsy and throughout my journey, I have often wondered if becoming more active, fit, and healthy has affected this seizure disorder. I know as a personal trainer that proper diet, rest and exercise can help increase one's over all well being and help prevent or reduce the effects of many chronic diseases and conditions such as Epilepsy.  As an epileptic myself I wanted to find out just how much living a healthy lifestyle can effect my seizure disorder.  The following information is based on my own research and what I have learned through my Post Rehabilitation Exercise Specialist Certification on the subject.

Please Note: * I am not a doctor.   These are my thoughts and personal experiences gained through my knowledge and research. Everyone is unique and every case of Epilepsy is unique. Keep in mind, because something has worked for me does not guarantee that it will work for you. Always discuss any diet or exercise plan with a Medical Professional. 

What is Epilepsy?

By definition Epilepsy is a neurological disorder marked by sudden recurring attacks of motor, sensory, or cognitive dysfunction, with or without convulsive seizures or loss of consciousness. But to put it visually  imagine Thor's hammer coming down with brute force on your brain disrupting  the  regular electrical impulses of the brain thus causing a seizure.  

For those who have Epilepsy it is more of a lifestyle. You tend to live on the side of caution because many times you have no idea when or where a seizure may occur. For some their seizures are so unpredictable and frequent that they have to wear a helmet for protection.  It's a life of testing and finding the right medication to help control you which often has harsh side effects. Being epileptic you may have to give up things such as driving or certain social events due to triggers and unpredictably of when a seizure may occur. Many times it means a life of solitude and isolation due to a lack on understanding what Epilepsy is. Those who have epilepsy find themselves fearing their disorder causing them to limit themselves in life. They want to live what they would deem as a normal life but their fear and the lack of knowledge or encouragement on where to begin often gets in the way of them pursuing their dreams. 

My goal with this blog is to give you some new found knowledge, hope and a place to start when if comes to achieving your life goals.

Can you exercise if you have Epilepsy?

Simply having Epilepsy does not mean that you cannot exercise. An individual with Epilepsy can take part in almost all sports an physical activities provided they do so using common sense and some restriction when indicated. A critical factor in recommending an planning exercise programs for individuals with epilepsy is seizure control.  You need to ensure that you are as safe as possible when exercising or participating in sports. Normally, families or the individual become overprotective when they or a loved one has been diagnosed with Epilepsy. They typically are not encourage exercise due to the fear of physical activity inducing a seizure which will lead to an isolated and sedentary lives, but studies have shown that people with Epilepsy can achieve the same physiological and psychological benefits from regular physical exercise that apparently healthy individuals do.
 
The fact is, that exercise can help those who suffer with Epilepsy and should be encouraged. Rather than triggering a seizure, physical activity may reduce your chances of a seizure by 30% to 40% for those who have epilepsy . Although the reasons are unclear, studies have shown that abnormalities on an EEG (a test that measures the electrical activity of the brain) decrease during exercise. My personal thought on why living a healthy active lifestyle helps reduce or prevent seizures from occurring is because many of the common triggers for those who have epilepsy are hormonal . Living a healthy lifestyle by getting proper rest, exercise and eating a healthy diet will help balance you metabolism in your hormones which in theory will help reduce or prevent some epileptic seizure from happening. 

If nothing else living a healthy active lifestyle will help those with epilepsy counter act some of the harsh side effects of anti-epileptic medications which are the most common source of treatment. Exercise has been  proven to benefit those with depression, anxiety, and fatigue by giving one the sense of over all well being and a boost in self esteem. Some anti-epileptic medications may lead to bone loss (osteopenia and osteoporosis) a large studies suggest a doubling of fracture risk in people with epilepsy. Weight-bearing exercise  along with a healthy balanced diet can help prevent these conditions by increase bone density making your bone stronger.

Other problems with anti-epileptic medications are blurred vision or problems with concentration, impaired coordination and slower response times, so it's best to take any new exercise program slowly so that you ease into it. You may have to modify the exercise until you become more comfortable in preforming the exercise or movement. Just because you may have trouble with coordination does not mean you will not be able to do the exercise or movement. With persistence, practice, motivation and determination you can and will be able to do anything you put your mind too.

Personal Note: I have fought with lack of coordination and do find it very frustrating when starting something new that take a lot of coordination, but have found that yes it may take me longer to get it right, but it is not out of reach and very much worth the self satisfaction of achieving that goal

I have said this in the beginning of this blog and will probably say many more times throughout this blog, before you start an exercise program consult your doctor. Another very important reason for this is because exercise can alter the levels of anti-epileptic medications in the blood. People taking anti-epileptic medications who exercise regularly should discuss with their doctor the need to have their blood levels monitored (especially in the first few months of training). Also make sure you do not take any type of supplement without consulting your doctor as well because many of the supplements may interfere with your medication.

Personal note:  Since I began exercising, I have noticed the levels of my medication have dropped. The reason this happens is because exercise and a good diet help your metabolism go in high gear meaning it processes everything faster.  From digestion to burning fat to how fast your medication goes through your body. Though my levels have been low, I have been mainly controlled and have only had seizures when my blood sugar is low or I am stress/tired. This tells me from my personal experience that it may be  possible to control at least the frequency of seizures in most cases by proper diet, exercise and rest.

Can you have a seizure while exercising?


It is very RARE that someone will have a seizure while exercising. Physical activity can lead to dehydration and low blood sugar, both of which can make a seizure more likely post workout. If one were triggered, a seizure would normally occur 15 minutes to 3 hours after your work out. Prevention is key and knowing how to listen to your body and knowing your seizure triggers (more on this later in the blog)  will help prevent a seizure from happening during or after exercise. You must stay hydrated throughout the day, during your workout and after. Be watchful for signs of low blood sugar such as: headache, nausea, dizziness confusion, agitation and hunger. To ensure your blood sugar does not fall below normal, it’s best to eat a well balanced meal before and after a workout. Also, do not push yourself to hard. Fatigue can also increase your risk of a seizure as well as lack of sleep and an elevated body temperature.

Personal Note: I have had a seizure while exercising. I did have a pre-workout meal but time got the best of me and I was unable to begin right away. This caused my next meal to be late and my blood sugar to drop.  I have also noticed on days where I don’t get enough sleep that my eyes play tricks on me (my way of knowing something is off and that I may have a possible seizure). On days like this, I take off from training and just rest, which does help. I have ended up having seizures if I try to push myself to hard. So from personal experiences, I have to say yes, these things are very important in ensuring your safety while exercising and just in general. 

It is important for people with difficult to control seizures or are new to exercising need to have someone with them who knows what to do if they have a seizure. This person must be able to carry out the necessary first aid.

 Also great care must be taken when participating in water sports. Activity in and around water should never be performed when alone. Friends and family should be aware of the possibility of the occurrence of a seizure and be CPR certified and trained for an emergency situation.

ALWAYS DISCUSS ANY EXERCISE PLAN OR SPORT WITH A MEDICAL PROFESSIONAL BEFORE EMBARKING FOR YOUR OWN SAFETY.

Other ways to stay safe during exercise if you are Epileptic are

  • Before starting a new exercise program, consult with a Medical Professional (I know I repeat this a lot but it is VERY important)
  • Avoid known seizure triggers ( more on this below)
  • Always take your medication as prescribed and have an adequate supply available
  • Don’t continue to exercise if you feel faint, lightheaded or nauseous
  • Don’t overexert yourself, know your limits
  • Make sure your coach/teammates are aware of your condition and know what to do if you have a seizure.
  • Wear protective gear appropriate to your sport, such as helmet or knee pads. Always wear a life jacket when involved in water sports.
  • Let family or friends know you are walking, jogging or other solo activity and know the route before you leave and how long you will be gone.
  • Consider wearing a Medical alert bracelet to let other know you have Epilepsy
  • Consider carrying a mobile phone with an ICE (in case of emergency) telephone number listed
  • If swimming or exercising in water, make sure you NEVER swim alone
  • If swimming or exercising in water, make sure who you are with is aware of your condition and is physically capable to support you and know what to do if you have a seizure.
  • If swimming or exercising in water, make sure you swim in supervised areas, such as in a public pool with an attendant or at the beach between the flags where lifeguards are on patrol

There are certain exercises you may want to avoid if you suffer from Epilepsy especially if you are uncontrolled and they are:

  • Contact sports, scuba diving, bungee-jumping and boxing
  • Solo aerial sports such as hang-gliding and skydiving
  • High altitude activities such as mountain-climbing
  • Motor sports
  • Horseback riding
  • Gymnastics
  • Ice activities such as skating or hockey
  • Skiing
  • Solo water sports such as sailing or sailboarding.

Epilepsy Triggers and Exercise-related epilepsy triggers

Epilepsy is unique for each individual that suffers from it depending on what area of the brain the seizure occurs and what functions that part of the brain controls. Those who have Epilepsy have what we call triggers and those too will differ from person to person who suffer from Epilepsy. The triggers may not always be clear but those who do suffer from Epilepsy, like myself, seem to be very in tuned with their bodies. Many still lack the knowledge on why they feel that way or why the trigger may be happening.  Symptoms such as feeling dizzy or light headed, which is commonly caused by low blood sugar or low sodium levels, are common seizure triggers. There are several common natural remedies that may aid in alleviating triggers and reduce chances of having a seizure. There are several forms of Epilepsy so there is not a common cure. These remedies may not work for all of us, but with known triggers, should be considered with the guidance of their doctor.

Common Epilespy triggers 
  • Specific time of day or night
  • Sleep deprivation – overtired, not sleeping well, not getting enough sleep
  • At times of fevers or other illnesses
  • Flashing bright lights or patterns
  • Alcohol or drug use
  • Stress
  • Associated with menstrual cycle (women) or other hormonal changes
  • Not eating well, low blood sugar
  • Specific foods, excess caffeine or other products that may aggravate seizures
  • Use of certain medications
  • Sudden temperature change in the body
These are the triggers that are related to exercise:
  • Extreme fatigue
  • Lack of sleep
  • Dehydration (and electrolyte loss, due to severe dehydration)
  • Hyperthermia (elevated body temperature)
  • Hypoglycemia (low blood sugar levels)

Suggestions to help you avoid these triggers include:

  • Make sure you take your medication according to your doctor’s directions.
  • Drink plenty of water before, during and after exercise.
  • Don’t push yourself to the point of physical exhaustion.
  • If you are feeling very hot and tired, slow down or stop.
  • Make sure you have at least two rest days every week.
  • Make sure your diet is nutritionally adequate.
  • Get plenty of rest and good quality sleep.
  • Limit or abstain from alcohol
  • Make sure you do a proper warm up and cool down before and after exercise
I would like to share some practical knowledge, instead of facts gleaned from research. While reading, I immediately thought of the wealth of information I have obtained as a Personal Trainer. I realized what I already knew had a lot to do with some of the common triggers for Epilepsy which are due to hormone fluctuations such as low blood sugar, lack of sleep, stress, menstrual cycle and puberty .

Common triggers for those who are epileptic:

*Extreme fatigue lack of sleep
*Stress
*Dehydration and other electrolyte loss due to severe dehydration
* Hyperthermia
*Hypoglycemia (low blood sugar levels)
* Menstrual Cycle and puberty

You may be noticing that I am repeating myself, I am. All of these triggers are hormone related. We have some control in maintaining optimal hormone levels with proper diet exercise and rest. The only hormones we may not be able to control is during puberty or for women their menstrual cycle.  In this day in age, we as a society have completely lost connection with our bodies. We have disregarded the difference between whole foods and processed and refined junk. We fill our bodies with meats full of synthetic hormones and steroids and a myriad of other products that contain GMO’s coupled with poor food choices and busy lifestyles, we do not eat at appropriate times. Finally, when we do eat, we end up overeating, causing our metabolism to go all out of whack. Not getting the proper amount of sleep, eating healthy and exercise  right just because we believe we do not have the time to do all these things can factor into throwing our metabolism off.

Don’t think this plays a big factor? Well, all these things affect our metabolism which is our hormones. Now, as I stated above, hormone fluctuation is a common seizure trigger. Starting with our sex hormones as we grow and change from children to adults, to our Insulin hormones, which affects our blood sugar.  Since Insulin is a hormone, knowing that low blood sugar is a common trigger for those who not only have Diabetes but Epilepsy as well. If you exercise and don’t eat before your workout, your blood sugar will drop. When blood sugar drops and you are an epileptic, you put yourself at risk of having a seizure.

OK, so here's what am I saying. Managing Epilepsy is simpler with physician-managed medication, proper diet, regular exercise, and adequate rest.  Exercising can actually be more beneficial to you and could reduce the amount of seizure frequency. This is what this whole blog is about. We, who suffer from Epilepsy, should not fear exercise but embrace it, as it could be the missing link in controlling most types of Epilepsy.

If you are new to working out and have no idea where to start contact me at alisha@fancifit.com and I will be glad to guide you in the right direction by either giving advice or making a workout plan that best fits you and your goals. You can also visit my site at www.fancifit.com.

Summary:

*Exercise is important and beneficial to those who suffer from epilepsy because it may help reduce the frequency of a seizure and other health issues.
*Always make sure you take all the necessary safety precautions while exercising.
*Anti-Epileptic drugs can affect sporting performance.
*Making sure you live an over all healthy lifestyle with diet, exercise and proper rest may reduce frequency of a seizure.
*Always consult a Medical Professional before embarking on a diet or exercise plan.

References from www.betterhealth.com
 ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities