luvrhino (luvrhino) wrote,

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splaying my midbrain

Note: i'm still not proofreading this eyes are broken.

Brain update. A few weeks ago, i received a phone call from my Disability Coordinator saying that she had just received a fax from Dr. Foroozan, my neuro-ophthalmologist, releasing me back to work full-time with no restrictions starting the next day. This surprised me since i hadn't talked to the doctor in over a month and back then he approved extending my disability until October (which also seemed absurd). Anyway, i called him up and he explained, "Yeah, well there doesn't look like there's anything physically wrong with you to cause your light sensitivity problems and i don't have any solutions to help you, so since i can't help i just released you. Feel free to get a second opinion."


My eyes had improved somewhat, but i'm still at the 30-40 minute range for computer use and ~5-6 hours doing anything else before i need an eye timeout. That doesn't equate to being a computer engineer with no restrictions. I talked to my supervisors at work and they informed me that i had completed most of the non-computer work that they had and that they needed me to either: A) work full-time as a computer engineer -> 6 hours of computer use a day, B) receive medical clearance to go on full disability (the partial disability was a voluntary program and i could have stayed at home if i wished), or C) find other employment.


So, i've been working full-time, which hasn't been as bad as i thought. It has involved the killing of many trees, since i print almost everything. For the first week, i abused ibuprofen to survive the day (3x800mg per day), but that didn't sound like a good long term solution unless i wanted to turn my stomach into Swiss cheese. Instead, i've been tossing ice packs (or beauty masks) in the freezer, using them to ice my eyeballs for 90-120 minutes a day, which isn't exactly fun. I still need to take eye-timeouts during the day, but i've discovered that they only need to be for 15-20 minutes before my eyes are good to go...not the 45 minutes that were required in January-March.

There are only three neuro-ophthalmologists in the Houston area, one of whom is in Galveston about 50 miles away. I went ahead and made an appointment with the other neuro-opth. person in town, one Dr. Schiffman, after checking the web to make sure she was competent. After my first appointment, i must say that it appears that she is. During one appointment, she tested me for more than 3x longer than Dr. Foroozan had in three, repeating many of the same tests in each appointment. By doing so, we learned things like that i still have double vision (diplopia), that only manifests itself in my left and right gaze (i.e. keep my head straight while looking at an object at approx. 45º or 315º). I had noticed this side-gaze diplopia post-surgery, but i couldn't remember if it existed pre-surgery making it "normal" or not, so i never mentioned it. Instead, it's a likely "sixth nerve paresis" as a remnant from my surgery and you all know what that means. Yeah, i don't know, either. It's probably not a big deal, but it does provide me a handy excuse for fucking up while playing volleyball.

Dr. Schiffman also noticed that my left eye doesn't seem interested in reading. Rather, my right eye does all the focusing, while my left wanders off somewhere. My left eye does appear to focus upon objects at a distance. I suspect this reading anomaly has always been the case, since my right eye has forever been extremely dominant and my depth perception sucks. Again, this probably has nothing to do with my light sensitivity issues, but it's good to have diagnosed. To help correct this, i get to do "eye-pushups" by taking a pencil and a reference object behind it (e.g. a finger) and focusing upon the pencil in front of my face, about 2' away. At this distance, both eyes will focus on the pencil. Then, i bring the pencil slowly towards my nose, focusing on it the entire way, and then slowly take it back. Theoretically, this trains my left eye to focus at all distances. I think the eye-pushups are working, but, like regular pushups, i find them painful and annoying.

Like my therapeutic optometrist (who's been consulting me post-surgery) and unlike Dr. Foroozan, Dr. Schiffman did a dilated eye exam and found that my reading vision is slightly far-sighted (+1.0 and +1.25). This shouldn't be related to my brain surgery, though it differs quite a bit from my last post-LASIK dilated eye exam (July 2004) in which i was within +.25 diopters of perfect in each eye. Undilated, my vision is a bit better than 20/15, which says that my eyes are strong enough to compensate. This makes sense, since i was born with a big astigmatism, but had significantly better than 20/10 vision as a kid. Though i've been able to read books just as long as i do anything else non-computer related, Dr. Schiffman, like my optometrist, suggested i try using reading glasses while using the computer, the theory being that handling the additional light in addition to correcting for faulty reading vision may be more work than my eyes can handle. Sadly, this hasn't worked at all (point Foroozan), but at least Dr. Schiffman's trying something. She also suggested using artificial tears, which appears to helped a little, but it's hard to tell.

Before seeing Dr. Schiffman, i had to give her a detailed medical history and get all my medical reports sent in from my myriad of doctors. Because she agreed to see me so quickly, i went in before my MRI scans had arrived via snail-mail and she only had the radiologist's report. During my appointment, she told me that the radiologist's report was clearly wrong, because there was no way that a cyst from the suprasellar region of my brain could be located in the pontine and other regions indicated in the report. I explained that i the report was probably correct and how my neuro-surgeon portrayed the ginormous, record-breaking size of said cyst. She remained highly skeptical. When the MRI scans came in a day or two later, she excitedly called me and confirmed that radiologist was correct and that this was fascinating. Her notes read:
Reviewed the MRI from 12-04 pre op which shows a remarkable appearance of a huge suprasellar multicystic mass that directed itself into the interpeduncular cistern and appearing to splay the midbrain in that area, the lesion also extends down into the pontine region. There was prominent hydrocephalus likely secondary to a compressed aqueduct of sylvius.
2-03-05 is a postoperative film that shows the cystic lesion to be removed and there is an amazing widening of the interpeduncular area...
I guess i like being "remarkable" and "amazing," but this isn't exactly why i want to be found compelling.

My case is also unprecedented because Dr. Foroozan had never referred a patient to Dr. Schiffman before. I got the impression that they didn't get along very well. Don't know what to make of that.

She wants me to have another MRI scan now, since she found a region that warranted closer monitoring (slightly larger ventricles in my 2/3/05 MRI vs. my post-op one), whereas my neuro-surgeon didn't want one until December. She didn't think it was of great concern, but we'll see. I'm going to see her again on the 28th for follow-up, which, in itself, is impressive as Dr. Foroozan was hesitant to ever see me since he had no idea what's wrong.

Wee. I'll try to keep you people updated, but my putzing around time on the computer is severely hampered now that i'm working full-time and need to save my eyes for computer engineering work and keeping my job. If any of you have said anything recently that i would find particularly interesting, please point them out to me cuz i haven't been reading your journals. Cuz i care about money more than i do about you. PBTHTHTH.

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