Seizure protocols outline how to manage seizures with emergency actions and maintenance treatments. For Emily Pappas, who had a grand mal seizure for the first time when she was 16 years old, the most essential step that went beyond any protocol was finding a physician to guide her and stick by her side during all the hurdles.

Pappas, now 24 years old, has been supported by Takijah Heard, MD, a pediatric neurologist and epileptologist at Endeavor Health, since her first appointment.

“I was a teenager in a lot of denial when I first had my seizure, and my mom was leading the way for our family,” Pappas said. “Dr. Heard listens to parents, who are advocating for their kids, and takes into consideration what they want and how treatments will affect their lifestyles. As I got older, Dr. Heard left decisions up to me. Through it all, she has been so thorough, smart and responsive.”

Dr. Heard added, “Listening and relationship building is a major part of the wellbeing of my patients. To me, health is measured by how functional the patient is in the environment in which they live. My motto as a doctor is to allow them to live to their best potential and thrive with my help.”

Life-changing diagnosis

Although Pappas has a sibling with complex medical conditions, she was a typical high schooler involved in competitive dance with no underlying medical conditions. After the surprising first grand mal seizure, Pappas had an appointment with a physician who said the event was a one-time fluke that sometimes happens. One week later, Pappas had another grand mal and her mom, Kim, sought a second opinion within the Endeavor Health system.

Dr. Heard’s bio stood out to Kim, particularly Dr. Heard’s experience with children with special needs. Pappas’ older brother, Tommy, has Down syndrome and epilepsy with absent seizures. Kim finds physicians who work with special needs patients to be very understanding. 

Dr. Heard diagnosed Pappas with epilepsy at the first appointment and warned the family that more seizures were coming. Several tests were run and medications were prescribed.

“The medications were somewhat helpful, but I still was having seizures,” Pappas remembered. “I started having them at school, dance and home where 911 was called probably twice per month.”

Pappas was eager to go to college in fall 2020. After many discussions, Dr. Heard agreed with Kim and her husband, George, that Pappas could attend with close monitoring.

Emily and Dr Heard patient with doctor

Pictured above: Pappas and Dr. Heard

VNS stimulator

Pappas had a seizure in her friend’s dorm room soon into freshman year, and Dr. Heard determined it was time to consider a vagus nerve stimulator (VNS). A VNS is a small device (called a stimulator or pulse generator) that is implanted in the chest. The battery-like device is connected via a lead wire to the left vagus nerve in the neck to sends electrical stimulations that quiet the nerve and brain activity that causes seizures.

“Getting a VNS was completely my choice because I was 18 by then,” Pappas said. “That’s what I love about Dr Heard;  she does not pressure patients. She made it 100 percent my decision about whether I wanted this device put in my chest.”

The outpatient surgery took place in December 2020. Pappas recalls that the procedure was fast and easy with the total recovery taking about one week.

The device is activated by a magnet, which works to stop the seizure. Plus, the device is programmed to do this on its own routinely, whether asleep or awake. As long as the device is on, it helps to treat seizures known and silent ones. The frequency and intensity of the VNS are set by Dr. Heard and her team.

In spring 2021, Pappas had a significant grand mal seizure while on a walk, and she was found alone on train tracks. This terrifying incident brought her support team together to determine that Pappas had to come home for monitoring in the summer after her freshman year. She was admitted into an epilepsy monitoring unit in summer 2021, where all medications were stopped and the VNS was turned off to track brain activity.

“It was really scary to be in the unit,” Pappas said. “I had two code blues and almost died. Dr. Heard was with us every step of the way. She was very pregnant at the time, and she came in during the middle of the night to consult with all the doctors.”

Dr. Heard advised that Pappas stay at home for the next semester of college to monitor the VNS use and medication management. This news was not taken well by Pappas, who said, “I was fighting with Dr. Heard, and it was so hard. I wanted to be independent and did not like the restrictions she was putting me on, like not going to college and not getting a driver’s license. I can now see this was for the greater good of my health.”

Pappas had her last seizure in December 2021. She returned to Illinois State University in spring 2022, and graduated with a degree is special education. She works in a therapeutic day school with children who have epilepsy. She got her driver’s license when she was 22 years old.

Living with epilepsy

Pappas wants people to know the complications of epilepsy and side effects of the VNS, like fatigue, brain fog and voice hoarseness, are daily challenges. But with the support of her family and Dr. Heard, Pappas is able to navigate the symptoms and find a balance in her life.

“As I get older, I know I will work with other neurologists,” Pappas admitted. “Dr. Heard tries her best to collaborate with other doctors now, like informing specialists that my VNS has to be turned off during an MRI. I know that transition of care will continue as I age out of pediatrics, but I like to think Dr. Heard and her amazing staff will always be supporting me.”

Dr. Heard said, “I carry my patients over into their 20s to help with life transitions, like college, extended high school or vocational programs, to aid in seizure-free lifestyle stability. The transition from child to an adult making big healthcare decisions can be daunting for both the child and the parent, so I am here to make it a smooth transition.”

Endeavor Health provides personalized, comprehensive care for people of all ages with epilepsy. The team of neurologists and neurosurgeons goes beyond treating symptoms. We use the latest diagnostic tools to understand the root causes of your seizures, then offer leading-edge therapies, like neuromodulation, alongside tailored lifestyle guidance, to help you regain control and confidence. Learn more.

Superior neurological care you can trust

Endeavor Health Neurosciences Institute experts provide compassionate, world-class care for diseases and injuries of the brain, spinal cord and nervous system.

Back to top