h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Ok... so I'm looking like a pirate right now.

Last Monday night I started getting a headache. I used to get migraines on a fairly regular basis but hadn't had one in over a year. It's been pretty stressful lately so I wasn't too surprised. All day Tuesday it was really bad. It wasn't exactly like my previous ones which usually on one side of my head at a time. This was mostly right at the base of my skull and behind both eyes. Well it still hurt like hell Wednesday morning, but it was letting up a bit. I had started to notice Tuesday that it was hard to focus on my monitor, but I just figured it was the headache. Wednesday lunchtime however convinced me other wise. I was riding my motorcycle to lunch when it became obvious that I was seeing double! By alternately closing each eye I was able to get back to work and home afterwards. It seemed to get better that night as I watched tv. The next morning I got in my car to drive to work. Five miles down the road I realised what a mistake that was when I couldn't tell which road of the two I was driving on.

I turned around an made an appointment to see my new doctor (I had just changed insurance and I wanted to fire my last doctor anyway). When I call to make the appointment I'm told it sounded like a possible drug reaction. I don't think it is since I've only taken some OTC pain relievers. After I hang up I go to my medicine cabinet and see that the ketoprophen I took was six years expired. (It probably wasn't that though since I was noticing some vision problems before I took them.)Anyway, I see her and she does some cursory blood work and checks my blood pressure and gives me a referal to see an opthamologist (I had a heck of a time pronouncing that word for some weird reason).

I get in to see him the next day (there was some confusion between me and my primary physician about whether I needed to wait to get my records transferred or not.) By this point all kinds of scary scenarios are running through my head. (and my joking impersonation of Arnold Scharzennegar in Kindergarten Cop, "It's Not a toomah!" is seeming less funny. Luckily the opti.. opthma... Opthamalogist didn't think it was a 'toomah' either. Everything he could see made him think it was a viral infection around the sixth or seventh nerve...whatever he said... extra orbital palsy or summat. Anyway, it would probably go away on its own, but since I had a headache with it he said that bought me an MRI.

Luckily I get an early appointment that evening to get the MRI. In the meantime the Opthilmoloi... Dr. Sawyer says to get an eye patch. I get the eyepatch, eat supper then get my head put in a vice for nearly an hour with the most annoying sounds imagineable going on around me. I probably won't get the results of that ordeal back till probably tomorrow or Wednesday.

After the MRI I stop by the pub. I need a drink or five. When I walk in the entire bar as one yells out "AAARRRGH!!!" It became a bit of a theme for the rest of the weekend.

Wot shaw we dohh wif a drooken saylore, ear lie in the morn'



shore fings will b'ok

I know one thing is sure... When I get home I'm going to 'doktor' this eyepatch with some foam weatherstripping to give me some eye relief. It's pressing against my eyelash and is getting rather tearstained.

ARRGGH.

Well then, you'll be all ready for Talk Like a Pirate Day on 19/9! (http://www.talklikeapirate.com)

Arrrrrr!

Aww, I would be so embarrassed if everyone in a bar did that to me!

Glad you are getting the proper tests to get to the root of the problem.

Tell me, Count, how *do* you get about with that eyepatch of yours? Seeing as you've only one operational eye (and therefore no depth perception) I really can't imagine you zooming down roads on your motorcycle.

I haven't ridden my bike since that first day I noticed it... it was VERY disturbing.

Since then I've started driving my car with the eyepatch. It's a bit disturbing but not too bad.

Actually my double vision has improved over the last few days and I've stopped wearing the eyepatch for most of the day. If I turn my head to the right I can see almost normally.

The good news is that it has been improving over the last few days. The very bad news is that it is not viral. The MRI showed a pituitary adenoma is pressing on my optic nerve and I have sinusitus. I think as the infection is going away the pressure is going with it. Unfortunately it looks like I'll have to have the tumor removed surgically. I'm in the middle of sending records and films to a neurosurgeon. Once he's had a chance to look at them he'll see me and we'll go from there. From what I've read so far this thing is benign but since it's near the optic nerves they'll have to do something. Whether they do surgery and radiotherapy or just radiotherapy or just surgery or maybe drug therapy depends on exactly what the adenoma is doing and what hormones it is or isn't releasing.

Anyways, I'm still waiting to find out more.

(I've had better weeks than this).

Hi, Count,

I'm sorry for your trouble, as the Irish say.
I had some similar symptoms, sinusitis, headaches, resulting in my left eye becoming fixed. It was eventually put down to a virus. It took three months before the eye started to move again and several more before the headaches went. My aunt had a tumour removed which had reduced her eyesight and removed her sense of smell. She made a full recovery more quickly than I did, and that was 30 years ago.

Good Luck. I'll be thinking of you.

I appreciate it.

I haven't heard much new since last week. I've looked some stuff about the surgery up on the internet and it doesn't look that bad (for brain surgery).

I did get out on the motorcycle this weekend. I probably shouldn't have, but I couldn't resist. It was beautiful weather for the end of summer.

Anyways, I'm now more looking forward to getting this over with than dreading any surgery. I just hope the surgeon opts for the fully endoscopic version. The other kind they lift part of your face out of the way!

Well, here's hoping that they opt for the endoscopic procedure then. Cheers mate, and you have my best wishes that all goes well.

I appreciate it.

I can actually see straight now. Of course that doesn't mean I want to leave it, but at least it's easier to drive now... And I have a motorcycle run to do this weekend that I was afraid I was going to have to miss. It was my idea, and I'd have hated to miss my own ride. I need to call the neurosurgeon today since I still haven't heard from him. ... I want to know why I haven't. Is he just that busy or have I fallen through the cracks?

Great news about the improved vision but it's a good job that you sought attention before the improvement.
Take care on that bike, especially as you arranged the route.

... actually my ride is about not having a route! I call it the "No Maps Allowed" run. We are going around Galveston Bay. The basic rule is keep turning right until you see the water, then make a left. There aren't a whole lotta roads on the East side of the bay so it's not too difficult to find one's way. My vision has been almost perfect for the last couple of days so I'm not anticipating any problems.

I have an appointment next Tuesday so I will be making this run.

I talked to the neurosurgeon yesterday...


He doesn't know what that thing in my brain is.

It doesn't look like a normal tumor.

Also, if it was a normal tumor I shouldn't have gotten my vision back.



He wants to remove it anyway of course and I agree, but...

I just had to be different I guess.

That sounds like good news to me.

Have you checked in your ear?
It's not your that's slipped?

I'm calling it a brain cloud. Anyone who's seen the movie Joe vs. The Volcano will know what I'm talking about.

But actually it's neither good or bad news. But I'm more likely now to need radiation after surgery.

Again!


I'm glad I had this journal to refer back to.

My returned last Thursday, 5 December, 2013.

I'll be getting another MRI sometime this week and will be seeing a neuro-ophthalmologist as soon as I can get an appointment.


I'm not overly concerned this time since I've been through this before. I have to assume whatever freaky thing happened last time is happening this time. My neurosurgeon's best guess last time was that maybe some type of leakage from the tumor (Dubya) had irritated my optic nerve. Nearly all of the tumor was removed by surgery and proton radiation therapy, but there is a small bit of it remaining. Now, the big question is has anything drastically changed around there in the last year since my previous MRI? I don't really expect so. But we'll know in a week or two.

By reading this journal entry, I know that the last time my vision started improving after a week and had more or less normalized after about 3 weeks. So, let's see if this progresses similarly.



Baron Grim (formerly Count Zero)

(I'm rather saddened to see several here.)

I saw the neuro-ophthalmologist today. He's an enthusiastic young doctor. He brought in two med students for that thing Dr. Cox always had so much fun doing with J.D. and the Scrubs gang. Heh, it was kinda funny. He used complicated terminology for, "Can you tell by the orientation of his head which eye is being affected" and, "he went through proton beam treatment rather than x-ray treatment, can you tell me why". They both hesitated in doubt before the cute one offered up a close enough answer. I was raising my hand. After he agreed, but explained more, I added, "That, and I would have been blinded." This lead to a discussion about how proton therapy differs from traditional radiation treatment and how it isolates the treatment area. And it turns out I really was a Guinea pig. Not only was I one of first patients at the Houston Proton Center, even before they were officially open. I was one of the earliest patients to be treated with proton therapy for a tumor like this. They seemed rather impressed.

Anyway, there wasn't a whole lot to learn from this visit. He did see a mass on the clivus (that sloping part of the skull where the brain stem and optic nervers pass through). But he hasn't seen the previous MRIs so that could likely just be scar tissue. I've got follow-up appointments in March and April and I'll probably be seeing him annually from now on as well. (I'm gathering quite the team of brain-care specialists.) He suggested three options.

1.) Do nothing for now. I keep wearing an eye patch when I feel the need and we see how it progresses.
2.) I could wear a prism on one of my eyeglass lenses to correct for my directly ahead vision (but wouldn't help with my side vision).
3.) Do corrective surgery.

No. 3 really isn't even an option until I see my neurosurgeon on Thursday anyway. I need to know how this last MRI compared to the one last year. If there's some significant change, well, we'll need to address that before we go mucking about with my optic nerves and muscles. If there's not, we still need to wait and see how this progresses.



And that's where this journal just became important. I just reread the whole thing and I'd forgotten about that mention from my first ophthalmologist, over 9 years ago, about *SINUSITIS*.

I did have a (mostly upper) respiratory infection in the weeks previous to my diplopia . I've also been having some serious mucous coming out of my nasal passages including a few blood clots.

From what I understand from all this, if this 6th nerve palsy was caused directly by the tumor, it wouldn't have gone away the first time... and I think it would be more pronounced and I would have trouble turning my right eye to the right at all. As it is, I can see with either eye individually. I'm still expecting this to go away on its own. I just think that it's taking longer now because I'm 9 years more . Everything takes longer to recover these days.