I had a patient I've been thinking about for the past few weeks. She is representative of one of the major issues we deal with in the ER. She suffered a severe head injury many years ago in a car accident. Since that time she has had problems with seizures. Several of the more commonly used seizure medications have not worked well for her in the past. Of course, the one that does work for her is quite expensive. She has no health insurance or prescription coverage. She uses her disability check that she gets at the end of the month to pay for her medications.

 She came into our ER as a priority one several weeks ago. She had had multiple seizures and required repeated doses of ativan by EMS. After she woke up from her postictal state, I was able to get some information from her. I found out that she ran out of her seizure medication weeks ago and couldn't afford another prescription. She kept telling me different names of seizure medications and seemed pretty confused about what she was actually supposed to be taking currently.

After her husband arrived he clarified the story a little. Apparently she still had plenty of the expensive seizure medication. But she also took xanax several times a day and had run out of that. Most likely, she developed seizures from the withdrawal of her xanax. Xanax is relatively cheap, so we were able to give her a prescription for it that she could get filled.