Surgery halts woman's seizures, allowing a family to start

SCHERERVILLE, Ind. (AP) - Many women face difficulties in getting pregnant. Some resort to medications or in vitro fertilization. But a Dyer woman's journey to motherhood involved an altogether different tactic: brain surgery.

Katie Bieker started having epileptic seizures when she was 18. She thought she might never have a baby because she was on so many epilepsy medications and experiencing seizures up to three times a week.

After years of failed treatment for the disorder, Bieker was referred to a Chicago neurologist who specializes in women's epilepsy. Dr. Elizabeth Gerard, of Northwestern Medicine, assured Bieker she could help her have a baby and potentially cure her of the seizures - if she underwent brain surgery.

Even though Bieker was shocked - she had never heard of neurosurgery as an option to treat epilepsy - she didn't think twice about doing it. Not only were the seizures preventing her from starting a family, they were increasingly putting her life in danger.

Once, her husband came home to find her passed out on the floor with her head bloodied and food cooking on the stove.

Another time, she felt a seizure coming on when she was preparing a meal. Instead of turning off the boiling water, she put everything from her kitchen table into the fridge, silverware and all.

In what she calls the scariest incident, she was working as a server at American Girl Place in Chicago when she started having a seizure. Her co-workers brought in her into the bathroom so as not to frighten the kids.

"I woke up, and there was a man over me putting a needle in my arm," Bieker told The Times (http://bit.ly/1yNSSVj ). "He was a paramedic, but you don't think that. I was sitting on the floor in the bathroom, and all I could see was the tiles and him. It was like a nightmare."

The seizures eventually forced her to stop working. Her doctors took away her driver's license. She went from neurologist to neurologist, but the medications they prescribed didn't help.

Her meeting with Gerard changed everything.

The doctor told Bieker she was a likely candidate for the curative surgery. But first, doctors would have to witness her having a seizure, live, to verify where in the brain it was happening. It took three visits and hours of monitoring before Bieker finally had a seizure in the hospital.

As doctors had assumed, the seizures were triggered in an area of the brain that could be removed without causing cognitive damage. This, along with the fact her epilepsy hadn't responded to two or more medications, made surgery a go.

In December 2012, following the eight-hour procedure and two weeks in the hospital, Bieker returned home.

She hasn't had a seizure since.

"If people are going to have recurrences, that most often happens within two years after surgery," said Dr. Joshua Rosenow, the Northwestern neurosurgeon who performed Bieker's procedure. "People who make it to two years often continue to be seizure-free."

Rosenow noted that epilepsy surgery is severely underutilized, as much of the general public, and even many doctors, are unaware of its effectiveness. Northwestern Medicine operates on about 20 patients a year for intractable epilepsy, the form of the disorder Bieker had.

In April 2013, physicians gave the Biekers the go-ahead to have a baby. Katie was pregnant the following month. Agnes Bieker arrived April 16, 2014.

"It's emotional for anyone really to have a child, but for us it just seemed that much more special," said Robert Bieker, a 33-year-old steelworker. "Everyone in her family was saying, 'What a miracle. What a miracle.' It truly is."

"Ten years ago, there's no way I would have thought we'd be here right now," Katie added.

She said this at the Schererville Starbucks, where she and Robert had their first date 13 years earlier and, on a recent day, 9-month-old Agnes played with an empty coffee cup and charmed the baristas with her cooing and smiling.

Gerard pointed out that women with epilepsy can still have children, noting their risk of complications isn't much greater than the general population.

"There are many women in my clinic who have epilepsy more severe than Kathleen who have babies all the time," she said. "For Kathleen, given how much she was dealing with the seizures and how they were causing loss of consciousness, she was much more comfortable going through pregnancy seizure-free."

If Bieker hadn't been a surgery candidate, Gerard said she could have helped her through the pregnancy by monitoring her medication levels and having the family develop a plan for keeping her well-rested after the delivery.

But Gerard likes to get women into her office as early as possible so she can put them on a medication regiment that fits with their family-planning goals. Some epilepsy drugs are more favorable to a future pregnancy; others can interact with certain forms of birth control.

The Biekers intend to have (at least) another child, though Katie noted that she's busy enjoying Agnes for the time being.

"Maybe when she's 3 or 4," said Katie, 32. "I originally wanted five kids, but now I think I'm too old."

"Two's good," Robert said.

"I'm glad we waited," Katie added, holding Agnes and wearing that new-mother glow. "We keep saying, 'Everything was meant to be.' If we didn't wait, she wouldn't be here. That's just ... I can't imagine her not being here."

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Information from: The Times, http://www.thetimesonline.com