First do no harm

A film that inspired me to the fullest to do a Msc in Nutrition and then if possible to apply for a Msc/PG Dip degree in Diet Therapy, after finishing my degree in Pharmacy . I strongly believe that it is true that sometimes drugs do not work as they should do as it is revealed in the true-based story of the film. The film is about a boy- Robbie, who was diagnosed with epilepsy. His condition was complicated and severe and as there was not a clear-cut drug therapy for his case, it was suggested to his parents to undergo an experimental stage and he was prescribed with multiple drugs that made him have multiple and severe side effects. His behaviour, learning abilities and memory were distorted, he had physiological side effects as well, such as constipation which was treated with other medicines, which in turn brought the boy other side effects. Since his condition was not improving, the doctors suggested that he should undergo a surgery and part of his brain to be removed. It is true that that is hemispherectomy can help in the treament of epilepsy, especially of young children, whose epilepsy cause is a dysfunction in one brain side. Suitable candidates are patients who have an underlying disease, such as Rasmussen's encephalitis or Sturge-Weber syndrome, which has damaged the hemisphere.

http://www.epilepsy.com/epilepsy/hemispherectomy
http://my.clevelandclinic.org/services/Functional_Hemispherectomy/hic_Functional_Hemispherectomy.aspx
Hemispherectomy worked as expected in some cases due to the brain's feature of plasticity, also known as neuroplasticity or brain malleability. "This is the brain's ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.
Brain reorganization takes place by mechanisms such as "axonal sprouting" in which undamaged axons grow new nerve endings to reconnect neurons whose links were injured or severed. Undamaged axons can also sprout nerve endings and connect with other undamaged nerve cells, forming new neural pathways to accomplish a needed function.
For example, if one hemisphere of the brain is damaged, the intact hemisphere may take over some of its functions. The brain compensates for damage in effect by reorganizing and forming new connections between intact neurons. In order to reconnect, the neurons need to be stimulated through activity.
Neuroplasticity sometimes may also contribute to impairment. For example, people who are deaf may suffer from a continual ringing in their ears (tinnitus), the result of the rewiring of brain cells starved for sound. For neurons to form beneficial connections, they must be correctly stimulated."
http://www.medterms.com/script/main/art.asp?articlekey=40362

Cases of children who have undergone this brain surgery are:


http://www.youtube.com/watch?v=oSnTJnXSL9U

However, sometimes parents are scared of letting their child undergo such risky surgeries and certainly they are devastated of seeing their child suffering from all the drug side effects, hence although not recommended by doctors due to absence of double-blind evidence-based studies, parents do not hesitate trying the ketogenic diet therapy. This therapy, as it is mentioned in the site of Charlie Foundation http://www.charliefoundation.org/#, "might not be recommended for children with partial seizures, as they may not respond as well, but ketogenic diet helps control seizures in up to two-thirds of children refractory to anticonvulsant drugs. The role of ketone bodies as markers of seizure control is imprecisely defined and their role as direct anticonvulsant agents is also unknown. Tests for transporter defects and enzyme deficiencies help screen diet candidates, however testing is quite difficult as urine dipsticks commonly used for this purpose measure acetoacetate, the less prominent ketone body. Which ketone body actually correlates best with seizure control is unknown. If beta-hydroxybutyrate ketone is actually the preferred marker, a new reflectance meter (Keto-Site™, GDS Diagnostics) will assay the D-isomer from a small drop of blood. But then, what is the “therapeutic concentration” Although, important clinical questions about the ketogenic diet remain unanswered" http://www.charliefoundation.org/frames/diet/overview.php, the fact that this diet helps patients overcome their seizures and not relapse again cannot be denied. In the film, Robbie was treated in the end and didn't appear to have fits anymore. The same hold true for several other patients who had been treated with this diet and have participared in the film. And finally, Charlie Abraham, whose parents founded Charlie Foundation, has also been treated with this diet after anticonvulsant drugs didn't help improve his condition. After being treated, he didn't appear to have fits anymore and he has even participated himself in this movie.

Doctor and all the other healthcare professionals (including me as a one-to-be) please remember, choose the best therapy for your patient, so as never to do harm. FIRST DO NO HARM!http://en.wikipedia.org/wiki/Hippocratic_Oath