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The Wake Up Call (Part 2)

The Wake Up Call (Part 2)

( …Continued. See Part 1 )

One year after my LASIK surgery, I started seeing double. It wasn’t as if I woke up one day and saw the world through beer-goggles. It was more of a gradual effect that I kept correcting by turning my head. After about a year, I was looking at everyone “cock-eyed” (or for those not familiar with the physiology of chickens, I turned my head to about a 45 degree angle to the right and “looked straight” using my one, good left eye). Basically, I was cross-eyed. My right eye turned inward towards my nose.

I was living in New York at the time and went to see an ophthalmologist that specialized in strabismus surgery and after several tests he confirmed: yes I was cross-eyed. Well no kidding.

“It looks like you are a 16 prism, which is fairly severe. The interesting thing with your case is that it is very uncommon for an adult to develop strabismus. This can be corrected with glasses or we can do surgery to adjust the muscles. Either way, I would like to do an MRI first just to make sure there isn’t something else going on.”

I looked at the 16 prism lens that he held in his hand. It was about 3/4 of an inch thick. I was instantly reminded of when I was 5 and about to ride the school bus for the first time. The yellow and black bus pulled up to my dirt road. The doors folded back and revealed an elderly woman with a halo of curly white hair, who looked to my 5-year-old-self to be about 125 years old. She turned her head and I saw she was wearing the thickest glasses I had ever seen. They magnified her eyes so each eye appeared to take up 1/4 of her head. They seemed to project beyond the edges of her face. Bug-eyed. Over the next year, I would hear kids referring to her as the “coke bottle glasses” lady.

Oh hell no.

I opted for the surgery.

My MRI came back negative and I had the eye-muscle surgery in my right eye. The procedure was fairly quick and after healing I went back to the doctor for a follow-up. My eyes were straight and my double-vision was gone.

Seven years later, it was back.

This time I was living in North Carolina. The same as before, my double vision didn’t just appear. It was a gradual change that kept worsening; but it got to a point where it was becoming a challenge to “correct” my vision by turning my head. When I looked straight at an object, a ghost of the object appeared about 2 inches to the right and about an inch higher. The further away, the more it separated. But of course, it was never just one object that is double; it was everything which can be quite disorienting. Turning my head to the right enabled me to line up my eyes, and also the images. The problem was I was walking around with my head turned all the time. So back to see an ophthalmologist.

This time was a bit different. My eyes were back to a 16 prism horizontally, but this time there was a vertical deviation of 7. That is why the superimposed images were to the upper right. The doctor I was seeing felt this was beyond her capabilities and referred me to Duke Medical in Raleigh.

Again a series of tests that confirmed a 16 and 7 prism and again, a concern that this was unusual to occur so late in life. She asked if I had an MRI before. I confirmed I did and that it was negative.

“Well, the only thing I can recommend is surgery. Glasses will not correct this.”

I had the surgery. My eyes were straight…ish. After the surgery, my right eye stopped turning out. As in the muscle doesn’t work to pull the eye out. So when I look to the right, my right eye stays straight. I call it my “dead fish eye” look. But I could see straight and one image.

Seven years passed. Then it was back.

I went to the same surgeon at Duke. Again they took measurements. This time my eyes measured 25-30 horizontal, 4-7 vertical and now I had a tilt to both eyes. Basically, I had googly-eyes.

“I just don’t know what to make of this.” Not something you want to hear from someone who is a leading surgeon in her field. “It is very, very rare to have strabismus so late in life and I have never seen a case where it was worse after surgery.”

“Two surgeries,” I corrected her.

“Remind me, have you had an MRI?”

“I did have an MRI before the first surgery.”

“I think it would be best if we had another MRI. A full brain and sub-orbital scan. Listen, I don’t want to worry you but this is highly unusual. Usually in cases like these, we see something neurological. Typically it is a slow-growing tumor. They are usually benign but they can also be malignant. I don’t want to worry you but I think we should have this scan done immediately and pending the results, we can book the surgery. I cannot loosen the muscle of your inner right eye any more. There is no more muscle to loosen. But what I would want to do is to operate on both eyes. It is a matter of tightening and loosening muscles to get your eyes to line up. Sound good?”

Tumor? “Ya sure doc.”

“In the meantime, let’s get that MRI scheduled. I will let you know the results within 24 hours. Call me if you don’t hear from me. Sometimes things get lost on my desk”.

Sometimes Google is not your friend. I researched tumors that cause double-vision and within a week I am convinced I have a pituitary adenoma. A slow-growing tumor that would press on the ocular nerve. It made sense. It could have been too small to show up in the first MRI. It explains the headaches and vertigo…of course so does double vision. Could the combination of solar burn and the PRK laser have caused a tumor? Great. I fried my own brain. I read on about surgery, radiation, and chemo.

Sonofabitch.

Ever the prepper, I start to make plans. How will I tell my kids? What loose ends do I need to tie up? Is my Will up to date? How will my husband care for me? Will I go blind? Is surgery an option? Chemo most certainly is not. I start making a list of everything that I can think of from buying a burial plot to securing finances. I spiral down a mental path that everyone, and yet no one, should ever go down.

Two weeks of fighting the insurance company, I walked into the Cancer Center at Duke for an MRI. My oldest daughter kept me company on the long 2-and-a-half hour drive. Of course, she is only told that I need a scan for surgery.

We check in and the receptionist asks if I have fallen recently. "Well, I fell yesterday”. I was getting out of the truck and slipped on some gravel. My feet went right out from under me and my ribs hit the truck door.

“Would you like someone to assist you to walk?”

“No. I am fine. I just get dizzy.”

We sit in the open waiting room. An elderly volunteer a level below us starts to play Adagio for Strings on a baby grand piano. I look around at the patients. Most are here for cancer treatments. One woman who looks to be about 35 is in a wheelchair and vomiting in a bag. She seems to be embarrassed at me looking at her. I glance away to give her privacy.

Finally I am called back. A technician introduces herself and escorts me to a small room with a frosted, sliding glass door. Inside is a locker, a large chair, and a computer desk for the tech. “We are going to start an IV on you. Your doctor requested that we do scans both with and without contrast. Do you have an arm you prefer?”.

She proceeds to stick me in my right arm. She misses the vein and moves the needle around trying to catch it. It is not a pleasant experience. “I am so sorry. I am going to get someone else that is a bit more experienced. You have some tough veins!”. I’ve been told that before. They are small and tend to roll.

The other technician comes in and proceeds to prick my left arm. She misses. “Wow. You really do have tough veins! Where else can we try?” I suggest my wrist. She gets the smallest needle and hits the vein. She injects a syringe of saline and tapes down the protruding tube.

I am then led to the MRI room and told to lay on the hard table. A warm blanket is placed over me and the technician inserts earplugs in my ears. She covers my ears with foam pads, all to muffle the loud sound of the MRI machine. I look up at the decorative light on the ceiling. It is a blue sky surrounded by flowers and plants on each side. I suppose it is meant to calm those who might have reservations about being trapped in a tiny cylinder.

The technician leaves the room and the table begins to slide into the small tube. I hear a small, muffled voice on a speaker, “First scan is 30 seconds”. The machine makes a series of beeps and noises. I try to keep my eyes closed. I am not claustrophobic, but I can’t help but think this must be what it is like to be buried in a coffin. The noise stops. “Second scan is 1 minute”. The technician’s voice and the machine continue taking pictures for the next 30 minutes, stopping halfway to inject the contrast into the IV on my wrist.

When the scan is over, a new technician removes my IV and escorts me from the room. I am tempted to ask him if he saw anything on my scan, but I know from my previous MRI they are not allowed to say anything. I gather my purse from the locker and walk out to the waiting room. My daughter is patiently waiting with a smoothie. We navigate back to the massive parking garage, pay the parking fee and drive home. My mind is racing with promises and regrets. I would spend the next 24 hours going over my checklist.

***

My cellphone rings.

“This is Doctor Lee. I am the attending surgeon. You called about your MRI results?”

“Yes! How did they turn out?”

“Well, we only have the preliminary results back from the technician. But they didn’t show anything.”

“Wait. Nothing?”

“No. Nothing. Of course, the radiologist will still need to take a look and review them but that won’t be for a couple days. But the technician didn’t see anything concerning.”

I am shaking.

“Well thank you.”

I hung up and went back to spending Harry Potter Day at the library with my girls.

The Wake Up Call (Part 1)

The Wake Up Call (Part 1)