How clean living has conquered my epilepsy: An Olympic hero's remarkable recipe for beating seizures – without drugs
23:21 GMT, 28 May 2012
Olympic gold medal hopeful Dai Greene has had to overcome more than just track hurdles in his career.
The world 400m hurdles champion suffers from epilepsy, a condition which affects the brain and causes repeated seizures.
But while the condition usually requires daily medication, Dai has chosen to control his symptoms without drugs, opting instead for a strict healthy-living regimen.
'Thankfully, I've never had a seizure while competing and the thought of having one on the track doesn't enter my head either,' said Dai Greene
For the 26-year-old Welshman from Llanelli it’s now no alcohol, a healthy, balanced diet, lots of sleep and a set daily routine.
The approach is working for Dai and he has been seizure-free since coming off his anti-epilepsy medication in 2006.
He has since become one of Britain’s top elite athletes — culminating in winning the 400m hurdles World Championships in South Korea last year.
He is now one of Team GB’s brightest hopes for a gold medal at the Olympics.
‘When I’m on the starting blocks I can honestly say my epilepsy is the last thing on my mind,’ says Dai, who lives in Bath with his girlfriend Sian Davies, 27, a primary school teacher who is also a 400m hurdler.
‘Thankfully, I’ve never had a seizure while competing and the thought of having one on the track doesn’t enter my head either.
'I’ve learnt to be very cool and calm.’
Epilepsy affects around 465,000 Britons, usually emerging in childhood, although it can start at any age.
During an epileptic seizure, electrical impulses in the brain are disrupted, causing a range of symptoms including temporary loss of consciousness, twitching and stiffness of limbs and loss of balance.
Dai Greene has since become one of Britain's top elite athletes – culminating in winning the 400m hurdles World Championships in South Korea last year
The symptoms vary according to the part of the brain affected — for example, a seizure in the frontal lobe (which controls consciousness) may leave the patient feeling as if a wave is going through their head.
There are around 50 different types of epilepsy.
But essentially they fall into one of three categories: idiopathic — where there is no structural brain abnormality and the epilepsy is thought to have a genetic basis; symptomatic epilepsy, where there is damage to the structure of the brain (caused by head injury, strokes, meningitis, brain tumours); and cryptogenic, which may be linked to learning difficulties or autism spectrum disorders.
Dai’s symptoms started out of the blue in 2002 when he was 16.
‘It was the morning after a New Year’s Eve party,’ he recalls.
‘I’d had some alcohol but not an excessive amount as I was at my friend’s parents’ party, but obviously got to bed in the early hours and didn’t get much sleep.
‘One minute I was sitting at my computer in my bedroom chatting to my brother Darren and the next I had fallen off the bed and was on the floor having a seizure.
‘Darren says I looked like I was twitching and he called my mum and dad, who dialled 999.
‘I don’t have any memory of what happened after that — I woke up later in hospital feeling really tired and all my muscles ached. The doctor told me I’d had an epileptic seizure.
'The doctor explained that sometimes people just have one seizure and never have any more so there was no need to put me on anti-epileptic medication at that stage.’
Then, seven months later, Dai had just arrived on holiday in Majorca with his college mates when he suffered a second attack.
‘We’d only been in Magaluf a few hours when I collapsed in the street — I hadn’t been drinking but was tired because I’d not slept that well because of catching the plane.
'This time it was a lot more serious as I’d fallen face down on to a concrete floor and was covered in cuts and bruises on my nose and cheeks.
‘One tooth was totally missing and two others broken off. I looked a mess, like I’d been in a fight.’
Dai’s friends rushed him to hospital, and then when he got home he underwent an electroencephalogram (EEG), which measures the electrical activity of the brain — and was diagnosed with idiopathic epilepsy, the genetic form of the condition.
Dai Greene's strict regimen helped him develop as an athlete
Dai was prescribed the anti-convulsant drug lamotrigine, but then he had another seizure six months later while getting up in the middle of the night to catch a plane to go on holiday with Sian.
‘Fortunately, I didn’t need the hospital that time and we still went on holiday.
'But I was starting to realise that it seemed to be tiredness, disruption to my routine or alcohol that triggered my attacks.’
Dai began studying sport and leisure management at the University of Wales when he was 18 — he joined an athletics club and trained hard.
‘I found I was a good hurdler and I just got more and more into it.
'Gradually athletics became my main focus and I had to become disciplined about my lifestyle.’
His strict regimen helped him develop as an athlete.
‘I went from being a virtual unknown to being the No 2 junior in the UK in little more than a year,’ says Dai.
But he also realised the regimen was helping control his epilepsy symptoms. In 2006, he decided to come off his medication.
‘Despite being on epilepsy drugs I was still having seizures — although only six in three years,’ recalls Dai.
‘But I was taking the drug sodium valproate and I worried that it could impact on my performance.
'My doctor agreed I could try to come off the drugs. This isn’t an option for everyone who has epilepsy, but as I had infrequent seizures it was considered safe because I was following a strict sportsman’s lifestyle.’
Dai is in bed by 11pm every night and doesn’t drink at all apart from during the four weeks a year when he’s not competing — ‘but even then I take it easy’, he says.
‘I have to be very careful not have any inconsistency in my sleep patterns at all.
'If I fly out to Korea for a competition, for instance, I have to make sure I’m there is plenty of time for my body clock to readjust.
Around 30 per cent of epilepsy patients are unable to control their symptoms with drugs and still suffer seizures, and for them lifestyle control such as Dai’s — avoiding alcohol, sleeping properly — could be a useful second line of defence.
‘The effects of alcohol are magnified by up to four times if you are taking epilepsy medication,’ explains Professor Helen Cross, Prince of Wales chair of childhood epilepsy at Great Ormond Street Hospital for Children.
‘People with epilepsy can also be at risk of a seizure the morning after drinking alcohol.
‘Disruptions to sleep and lack of routine can also trigger seizures.’
A recent authoritative Cochrane review found a high protein (or ketogenic) diet is as effective as drugs in controlling epilepsy in children whose symptoms had not been controlled by drugs.
The diet, which can also be used by adults, is based on a 4 to 1 fat to carbohydrates and protein ratio — the theory is that ketones, an acid chemical produced by the body burning its own fat affects brain chemistry, somehow suppressing stimulation signals to the brain.
To induce the production of ketones patients gradually increase the proportion of fat in their diet, while the amount of carbohydrates and protein is reduced until seizures are controlled.
Patients can’t eat rice, pasta or bread and their carbohydrates must come from fruit and vegetables or foods made with artificial sweeteners and ground almond rather than sugar and flour.
‘The diet is restrictive, but you can be creative and make cakes with ground almonds instead of flour for instance — it just requires careful planning,’ says Professor Cross, who in 2008 led a clinical trial on ketogenic diets in children whose symptoms were not controlled by drugs.
After three months, 40 per cent of children had the number of their seizures reduced by over half and could reduce their medication.
More flexible and palatable versions of the diet are being used — but any new diet must only be followed under the supervision of a specialist dietician.
An excess of ketones is linked to ketoacidosis, a potentially serious condition.
‘Controlling epilepsy without drugs won’t work for everyone,’ says Dai, who is now an ambassador for the charity Young Epilepsy.
‘And drugs should always be the first treatment to try — but lifestyle changes are an option provided your doctor agrees.They’ve certainly paid off for me.’