Category Archives: Kate

Kate awake

Woke up at 3:30

Kate was aware of an “episode” ( seizure ) at 4:15 that manifests as retching and sense of needing to vomit.

– no Clonazipam given

4:40am update:

Kate had two seizures in a four to five minute span, each lasting about 90 seconds, she described typical sensations associated

–  .5mg Clonazipam given at 4:49am

Kate Awake

Morning of October 31:

after sleeping through the night Kate had a series of seizures before breakfast (7:10am) that made her feel as if she needed to vomit, required Clonazepam to break the cycle: .125mg given ( 1/2 the regular dose )

Night of October 31

Kate woke up at 2 am, went back to sleep around 3:30 am.

no medication given

Kate Awake at night

Sunday Night October 27:

Kate woke up at 11:40 pm, went back to sleep after being up for 30 min.

She woke up again at 3:00 am, she grabbed barbs arm said the seizure was “a bad one”, the seizures continued, Barb gave her half a Clonazipam tablet (.25mg)

Clonazipam .25mg

Monday afternoon October 28:

After school, Kate had a series of seizures ( not the ones that maker her feel like vomiting ), she layed on the sofa and watched TV until her piano lesson at 5pm. She did well piano

Conazipam .125mg


19 Days

What can we cram into the next 19 days?

Well founded or not, Barb and I feel that a significant threshold will be crossed on April 15th 2015. I have heard myself refer to “life on the other side” of the surgery. The Hemispherectomy planned for Kate carries expectation and anxiety that life will forever be changed for each of us.

imageKate’s life will be radically changed, in several ways, some hopeful some concerning. The best outcome provides a vision of life without seizures and a bright developmental future where Kate is allowed to grow and thrive unimpeded by intractable seizure and sleep deprivation.

This will be the final post on this blog before the surgery, I will update Kate’s Caring Bridge site to share the process with family as it progresses.

Visit Kate’s Site:

Site Name: katecooke

Tonic Cafe

It’s been up and down, Kate is having a tough time with seizures at night, during the day since last week. That makes the exams difficult, she gets terrible anxiety from the sleep deprivation, that makes the MRIs challenging.

She had an MRI early Tuesday morning to map the veins and look at her old blood clot. Anxiety got bad, she had to be put under with anesthesia during MRI.

Wednesday morning she had a functional MRI to map the language and speech centers in her right and left hemispheres. We find out Thursday if the results are usable or if we will need to stay here longer for a more invasive type tests to get at the same answers for language and speech.

We meet with the neurosurgeon at 11 today, then Kate’s neurologist at 2 to review the results of the two scans and talk about next steps.

She’s a tough little person, amazes me still that she can power through the day with all the electrical chaos in her head.

Happy Place: “Tonic Cafe”
We have a favorite restaurant directly across the street from Mayo that serves locally grown food, cooked in real butter! Tonic has been a refuge each day for both of us. French toast, fried eggs, bacon and fresh fruit / vegetable smoothies. Wonderful people running the place, vibrant, loving folks that clearly know the power kindness.

Thanks for checking in, we hope to be flying home on Friday. Love Kate & Chance



Mayo 03/10/2015

Returned to Mayo Clinic in Rochester MN with Kate on Sunday night.

She will have two MR scans to asses risk with regard to surgical options to resolve her seizures.

Tuesday is the MRv to asses the state of the Venus sinus thrombosis from the initial stay in Seattle.

Wednesday is the functional MRI to asses the location of her speech center, right or left hemisphere.

The MR tech will be the same for both and she is great, she wanted to do the MRv without anesthesia, tried it, but Kate is having to much anxiety, she could not calm down enough to get good images.

Mike and I are waiting in the recovery area where Kate will be brought to when the scan is done in about 20min.

The failure to make it through the short MRv without anesthesia does not bode well for the Functional MR tomorrow. If she is not able to complete the MR tomorrow, we will be headed towards the WADA test that introduces greater risk to get at the same answers.


Big Sky Intervention

Mission accomplished, thank you Mike and Gale for the vehicle, equipment, financial and emotional support. The trip to Big Sky was the the perfect remedy for the whole family after Barb and Kate being at Mayo Clinic for a week and half.

Being in Big Sky for the weekend, removed from all the trappings of home, surrounded instead by family, friends and the beauty of the Rocky Mountains. We focused our energy on Paetra and Isabelle with the help of the ski team community. The hurt and fear they experienced from Kate and Barb being away faded into the fabric of the weekend. The interweaving of races and family meals created a shared set of goals that brought us back together in a rapid and concise way.

Twelve hours together in a car over three days was a bit much, but it worked. The further we got from home the problems and concerns Paetra and Isabelle had built up faded. Getting out of the familiar environment and breaking the routine of home accelerated their ability to let go of what they had built up inside.

Paetra and Isabelle were forced to leave behind the feelings of sadness and neglect from the weeks prior. The races gave us an opportunity to put them back on center stage, within the context of their friends, and an activity they love.

The weekend felt like it was tailor made for our benefit, the distance from home, the hyper focused setting of the kids races and the community support for Kate made it feel like a three day therapy intervention.

New helmets, boots, speed suites and legitimate race skis gave the big girls a sense of purpose. They embraced the gear and the opportunity to apply what they have learned from their coaches to achieve a new standard of personal performance.

Paetra rose to the challenge on her final slalom run of the weekend, laying down a time that was faster than all but two of the girls in her U12 group. It is notable that she is the youngest and possibly lightest athlete in the group. Lighter than the top girl by 50 to 60 pounds, significant in a gravity sport. Her final run was benefitted by several pep talks from different parents and coaches that took her aside to work on letting go and having fun while she raced. She knew she could ski faster than she had in her first three runs but needed help finding her way. A small but significant personal measure of success was recorded when her final time was faster than her younger sisters. This fact was more significant than beating the majority of the girls in her age group.

Isabelle has become the standard for success, winning all four of her races this weekend by 4 to 5 seconds each while recording times that would put her on the podium in the the next two older age groups.

Isabelle is fiercely competitive, vigilant with details and race preparation. These traits combined with proper gear set her apart from her competition all weekend. Bayard predicted this outcome last year after she did one race on good skis.  I was guardedly proud of how she competed and delivered the beat down, but most proud of how she behaved in the limelight, exhibiting respect and humility beyond her years.

Barb was a superstar all weekend. After an exhaustive week and half living in the epilepsy ward of the Mayo Clinic, watching Kate go through hell, Barb jumped back into family life. Providing love and support for us all with no hesitation from fatigue or depression.

The regiment of Kate’s testing last week was terribly difficult on both of them. The need to record her seizure activity using 24 hour EEG and video monitoring was trying. Kate was not allowed to leave the bed where the video was recording for five days. Add to that, an abrupt 50% reduction of her anti seizure medication. Barb had to watch helplessly as Kate experienced a sequence of seizures each night that grew in frequency to around fifty in an eight hour period. Understanding the importance of these tests only gets you so far… the gap between intellectual understanding and the ability to handle it emotionally is vast.

The EEG results will be the foundation for a surgical recommendation from a team of advisors at the Mayo Clinic. We are living in an odd space for the next week while we wait for the committees review and recommendation. Knowing the implication for the result of the tests but not having the formal conversation about scheduling a surgery or seeking a second opinion…we are in a zone of suspended reality. Not having to face our fears of the surgery and the risks it brings but knowing full well this is the likely path.

More now than ever, I hold Kate a little closer, hug her a little longer, look into her eyes as she speaks with me. I want to hear her and see her with a lasting clarity as she is today, full of wit and humor, a vibrant engaged 5 year old. I am irrationally frightened by what waits on the other side of the phone call with the team at Mayo this Thursday. Knowing intellectually what is best for the “future Kate” I struggle with the potential impact for the surgical path we are on. There is an unsettling permanence to the procedure without the guarantee of a successful outcome.

Ten Questions

Ten questions to expel the ignorance and fear: “peri-insular hemispherectomy”

  1. What are the risks associated with this specific procedure?
  2. What is the expected or typical medication for seizures look like after this procedure?
  3. Please provide reference material for the surgical procedure that will help us understand the details of what will be done?
  4. Where can we read about case studies for patients that have had this surgery that cover a spectrum of outcomes?
  5. What are the results of the behavioral study Kate completed on January 13th at Mayo Clinic and how does that inform the decision making about the surgical option?
  6. What is the likelihood or percentage of stroke during this specific surgical procedure?
  7. Specifically who will be doing what part of the surgery, who is the surgeon going to be?
  8. Will there be surgical residents / fellows present during the surgery and how are they involved? (Who does what, who will touch Kate during the surgery?)
  9. What is the time frame for scheduling the surgery?
  10. What is the duration of recovery after the surgery, in hospital and at home?



Ignorance and fear:

Barb and Kate have been at the Mayo Clinic in Rochester MN since Tuesday January 13th for behavioral evaluation and an extended EEG study. The goal is to identify the origin of the seizure activity in her brain and identify an informed course of care.

After living in the observation lab (hospital room) at St Mary Hospital (part of Mayo) they have collected enough seizure information data to make a recommendation for a surgical option. In order to accelerate the information gathering, Kate’s seizure medication was reduced by 50% the second day of the study and reduced again the next day.

The smaller seizures increased in frequency and intensity over the three day period, Kate has been miserable throughout the process. Along with the seizures she experiences periods of intense anxiety and anger. The “spike” activity recorded during these periods has confirmed the origin of the seizure activity. The larger “Partial Complex” seizures were not captured on EEG, this was an initial goal of the study, to insure a consistent source that might be addressed with a surgical solution.

Today, Monday January 19th (Paetra’s Birthday) the doctors are re-introducing Kate’s combination of seizure medications at the full dose to provide her some relief from the continuous seizures of the last five days. The neurologist Dr Wirrell, is satisfied with not pursuing the triggering of a larger seizure (Partial Complex) in the interest of recording it. She is satisfied with the data collected to this point and feels the medical team guiding Kate’s care can make an informed decision / recommendation with what has been collected to this point.

The prospect of the surgical procedure scares me in a deep way, at this point and I am struggling to develop a set of knowledge and coping skills to insulate myself. Without them I run the risk of falling apart at any point in the day when the thought of it takes me over. Ignorance and fear are my opponents.

Barb and Kate will hopefully be traveling home to Whitefish on Tuesday or Wednesday to rest and recover from a tough week in the hospital. Paetra and Isabelle are scheduled to compete in an alpine ski race in Big Sky Montana this weekend… will be a stretch to make it all happen. Understandable they are scarred for Kate and want the girls home soon, but also disappointed at the prospect of missing the race they have been training for since early December.




Varsity Level

Reviewing the notes from last week at the Mayo Clinic in Rochester MN. Kate had completed a one hour EEG and we meet with her neurologist Dr Elaine Wirrell for the second time.

After education Barb and I about what she was seeing on the EEG, Dr Wirrell narrowed the conversation down to two key points:

#1 Intractable focal epilepsy
#2 Continuous spike wave in sleep

This is remarkable for us. We worked with medical professionals from Tampa Florida to Seattle Washington without gaining ground on a cause. Kate has had over 30 hours of EEG / video recordings collected in the last two years and no one has been able to connect the dots until now. The folks at Mayo identified a significant issue after one hour of observation. Barb and I were floored by the efficiency and competence.

We will return to Mayo Clinic next month for a more focused monitoring to confirm the origin of the “spikes” seen in Kate’s EEG. The monitoring will include “inducing” seizures by dialing back her medication. Intellectually I understand this approach…