This piece is dedicated to my sisters Erin and Kelly.

“Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning.” --Albert Einstein

The house is dark; you can hear a pin drop. There is a tension in the air like hearing a gunshot. It’s something that elicits a reaction even if you don’t know where the sound came from. My phone volume turned to max next to my bed; waited to be active. This is the moment I go through every night because I know that I must be ready. Just in case something happens. Two of my sisters have epilepsy. With this disease, a seizure can happen at any time and anywhere.

I honestly don’t know what I could do to stop it. I knew it happened a few weeks ago, but I didn’t understand it at the time. Me being 15 didn’t understand much of the dangers of this disease. But when there was a problem, there had to be a solution.

It happened much to my surprise on a night just like this, late and silent. A single text is all I got: “can you go check on Erin?” Then I got the call. So, I sprung out of bed and walked over to her room. I called out to her, but got no response. I turned on the light and saw Erin laying there in a trance-like state. It was at this very moment that I knew something was happening. She wasn’t in her right state of mind.

There are 65 million people in the world who have epilepsy, 3 million of those are in the US; 6 out of 10 of those people have epilepsy where there is no specific cause. These are the facts that we face every day. In many cases, there will be absolutely nothing the average citizen can do to help prevent and cure epilepsy. However, there are certain precautions that we can take to help those in the middle of an epileptic episode. When asked about this, Erin disproved some myths about epilepsy: “Epilepsy is not a contagious disease that affects intelligence. Epilepsy isn’t always severe and people can still excel at school, have children, and lead normal lives. During a seizure, you can’t swallow your tongue. Seizures aren’t always medical emergencies and you should call 911.” We as loved ones may feel powerless, but in fact, we have a lot more control over how we can truly help those suffering.

To understand epilepsy, it needs to be broken down into its core components; there are seizures and then there is epilepsy. Seizures can happen to anyone, regardless of age. A seizure happens because of an electrical interruption in the connection between the nerve cells of the brain. This interruption can be triggered by a high fever, low or high blood sugar, drug and alcohol withdrawal or brain concussion. However, seizures can happen to their own accord for unknown reasons. This creates a huge boundary between what neurologists know about the disease and what is happening. Just like Erin mentioned before, there are a lot of precautions that she and the rest of my family must take in order to ensure her safety. One of them is to investigate every noise, no matter how sure we are of what it is. When someone goes into a seizure, they might be able to shout or scream. But nothing is guaranteed, so being overcautious is better than no reaction.

In its simplest form, epilepsy is defined as a disease that causes the victim to be more prone to seizures in rapid succession. Having one seizure does not mean you have epilepsy but having two to three is another story. “Epilepsy is characterized by the type of seizure and the symptoms that come before and after the incident. There are 13 different variations of seizures that range from mild, requiring no emergency assistance, to deadly” (Shemeth). While they are both much more regulated now, when I first saw my sisters have their seizures, it was frightening to see it happen. After a seizure, Erin cannot drive for months at a time and need “supervision” for specific activities like going off alone. “Sometimes I really don’t know when I’m going to have a seizure or if there will be a second one after I’ve gotten out of the first. I need to leave the door unlocked when I take a shower or have to use the bathroom, just in case something happens to me” says Erin. There is a difference between a fear of something and a fear of the inability to do something. With epilepsy, it is the latter.

Epilepsy can be broken down into two main categories: partial seizures and generalized seizures. Partial seizures start in one part of the brain to affect others, but as the name suggests, it is not the whole brain that’s affected.

Partial seizures are also broken down into both simple and complex seizures. These may include moments of euphoria or doom, a sense of déjà vu, and a subconscious premonition of the seizure before it happens. The simple variation can affect just a single muscle group like fingers or arms and legs. The complex variation will lose complex variation involves a loss of consciousness. In this form, the person will seem to be awake, but they usually have weird behaviors. Once this person wakes up, they won’t remember what happened and will feel tired. I would consider these the mild variations.

Generalized seizures are a bit more complex than Partial because they encompass both sides of the brain. The one that has affected my sisters the most are tonic-clonic seizures, a.k.a grand mal. This variation is a two-staged seizure that can be deadly. In the first phase--the tonic-- the victim’s muscles will tighten and they can lose balance. All the pressure from the stiffened muscles will push air out of the mouth resulting in a cry or scream. The victim loses consciousness here. The clonic phase involves an involuntary movement of the arms and legs while the victim is unconscious. This kind of seizure can last anywhere from one to three minutes only to result in the victim slowly regaining consciousness. Grand mal seizures are considered very deadly for the victim can get stuck in a cycle of going in and out of these seizures for minutes on end. The repercussions of this seizure could involve the victim needing emergency treatment. On a scale of one to ten, if partial seizures are a four, then generalized tonic-clonic seizures are a nine.

There are certain triggers that are counted as universal across the types of epilepsy. The first of these are strobe lights. The lighting-pace-changing lights overload the visual stimulus thereby creating a disruption in the electrical current of the brain. My sisters can’t go anywhere with the lights, watch movies with the lights, and they even have to censor themselves from Fireworks. Another trigger is hyperventilating. When they have to go to the neurologist so their epilepsy can be further diagnosed, the doctors had my sisters blow into a pinwheel until they were essentially hyperventilating. This puts them in a critical state mentally to where the brain is trying to do too many things at once, so it can trigger a misfire that causes a seizure.

What can be done about epilepsy? Is there no hope for those who suffer from it?

The problem with epilepsy is the fact that its symptoms are so widespread that there is no one treatment to cure, or even to prevent it. Epilepsy can also be hereditary. “If a parent has idiopathic epilepsy, which is epilepsy believed to be caused by genetics, the child’s chances of having epilepsy rise by 9-12 percent. In a similar fashion, if one sibling has epilepsy, there is a higher chance the other(s) will have it too but there isn’t much in terms of hard numbers to specify how much greater chance it is” (Shemeth). Beyond this, a simple chemical imbalance in the brain can be all it takes to trigger epilepsy.

The current plan for epilepsy is to attempt to regulate the chemical balance with medication. In some uncommon cases, surgeries are performed to help mitigate the frequency of seizures. The medication can provide some hope but is not a definitive cure to the whole disease.

One of the best things to do for someone having a seizure is to make sure that they are as safe as can be in their environment. This means removing any sharp or dangerous objects from the person. Chances are, you will not be able to move them (nor is it recommended) but by securing their environment, it helps them to not hurt themselves. In most seizures, the victim loses consciousness and has lost all control of their actions. In the example I described, Erin was about to throw herself down the stairs to get to the bottom floor faster. She had an unbridled urge to get to the first floor. Let me make it clear that she is not completely conscious when this is happening. She goes into a trance-like state where she seems awake, and can somewhat respond to you but she is in her own world. The urge to go downstairs, to me, was her subconscious trying to take her to a place where she felt safe. It took all my strength to hold her back at the top of the staircase while I yelled for my parents. While it’s necessary to use force to stop her like this, I always need to keep in mind that I need to be careful, so I don’t hurt her.

The next best thing is to lay the victim on their side while not restricting their movement. With involuntary movement, it is hard for anyone else to try and control it to keep the person safe. However, by laying them down on their side, it allows an airway to remain open so they can breathe. This also helps with any bodily fluids that exit the person’s mouth, so they don’t choke on them.

After dealing with this for close to a decade now, my family’s priorities have shifted to maximize the safety of everyone. Living on a farm bring us the sense of urgency that we need to deal with the unpredictable moments of Erin’s epilepsy. I focus heavily on Erin’s epilepsy because sadly, it seems to happen regardless of how the doctors adjust her medicine. Sometimes adjusting the medicine is the factor that triggers her. My other sister, Kelly, went through epilepsy as well, but hers have been managed through medicine. But, epilepsy is something they will live with for the rest of their lives. What they can do is understand what triggers them and learn to live life revolving around that knowledge.

For a full list of sources cited in the piece, check the story out at shortstorybook.weebly.com !