65: Occluded

I learned something yesterday that blew my mind! To properly fill you in, I need to go into storyteller mode - please bear with me. This is a true story, not at all like my fable about the clinical trial that bemused so many of you a few months ago.

6:30 AM. The alarm rings its shrill, robotic tone, and I roll over to hit the snooze button. Besides me, Wendy stirs and grumbles her way into wakefulness. I rub the crusties from my eyes and sit up. Stumbling to the bathroom I splash water on my face. Something is odd. I can’t get the morning goop out of my right eye. My vision is blurry and something feels wrong. Knowing that I work at a residential boarding school (not one of the residential schools that they forced the native and first nations people to “attend”, but an upper crust high school where kids wore jackets and ties, and went on to ivy league universities) I presume that there’s some sort of eye-rot-fungus-pink-eye type thing going around, and I decide to call the health center to get some cream or drops or gel or at worst case, an antibiotic. I wasn’t alarmed - these things happened on the regular. The joys of living with and working around teenagers.

I grab my coffee and get dressed, still attempting to wipe the sensation of goop from my eye to no avail. Walking over to the health center, hoping to avoid the morning rush of students, I looked around at the beautiful campus I was blessed to work at. We’d weathered the non-existence of the global “calamity” that was Y2K that past winter (OK, that was just to give you an idea of when this is taking place), and all our computer equipment was humming along nicely. It was a beautiful spring morning.

I sat with our school doctor, and he used his silver light magnifier thing to look into my eye and he said “I think you should go to an ophthalmologist. I really don’t see any sort of eye-rot-fungus-pink-eye type thing. You could be getting a cyst or sty or something like that. Most likely they’ll tell you to keep a warm compress on it, but I’d get it looked at just to be safe.”

Now, in contrast to every other medical appointment mentioned in this blog, I am able to get into a local eye doctor that same day. In those days, remember, medical care was still readily accessible, cost effective and quite often, delivered by pleasant caring professionals. So, I call out sick, and drive myself, vision issues and all, into the next town to see the doctor.

I’ve never been to an eye doctor before. My vision has always been stellar - no glasses needed and no real trauma to report, so I am unfamiliar with the process. The initial exam went smoothly, with lights being shined in my eyes, and eye charts being read (well in one eye, not so well in the other). The doctor sits back in his chair and says “We need to dilate your pupil”. I think back to my high school days when having dilated pupils could get you sent home from school - for a myriad of reasons, all of them drug related, and am glad I called out of work. So, the drops go in, and lights are shined and a magnifier is used, and hmmms and harumphs are uttered. When the doctor was done, he turned off all the lights and said “I need to take some pictures of your retina. I’ll bet you thought I was going to tell you that you had some sort of eye-rot-fungus-pink-eye type thing and offer you some cream or drops or gel or at worst case, an antibiotic. I promise you, that’s not going to be the case today. You’ve had what we call a retinal vein occlusion. This is when a calcium deposit somehow makes its way into your ocular system and clogs a vein causing a blood flow stoppage. This, in turn, deprives your tissue of much needed oxygen, and it dies. I need to get some photos to see just how bad it is. I want to warn you that when I take the pictures, you’re going to be injected with a dye, and the dye will make you feel like throwing up. You haven’t eaten recently have you?” I hadn’t. So we went ahead with the pictures. Again, right away. No new appointment needed, no check for insurance coverage - just the care that was warranted being dispensed as it was needed. I do miss those days.

I’ve gotten to the important stuff already in this story - but I’ll add in, for the sake of transparency, that the photos showed a pinpoint scar dead center of my right retina which has, to this day, made my vision in that eye useless. I describe it as opening one’s eyes in a pool. You can see light, vague shapes, motion - and given enough time, might even make out a who or a what. But as for usable eyesight, it’s useless. Books are a blur, road signs, the same. Even faces are difficult to make out. However, over time, the brain - which is a completely amazing thing - learns to compensate for the loss of vision, and what was, at the beginning a constant headache, mind warping pain with frequent floaters and even a hemorrhage in the middle of the street one night has become something I don’t even think of any more. In fact, I rarely mention it as a past disease or trauma. This will become very important to this story. (It comes to light at the DMV, where I have to prove I have depth perception (I do) and good peripheral vision (I do). I cannot, though, read an eye chart with my right eye - although I do just fine with both eyes open. As I said, my brain has compensated really well. This has only ever caused problems when I moved, briefly, to California. They require a one eye closed eye-chart test, which I could not pass. This meant I needed a doctor’s note and I had to take a road test - both of which I got (although it took months to get the road test scheduled - almost like trying to get into a doctor these days).

Funny aside here: When I lived in Jordan, I had to get a driver’s license there. I went in for my eye test (in this case, because I could not read any Arabic, the charts were stylized U’s pointing in different directions, and the task was to raise my finger in the direction of the opening of the U (because the test giver couldn’t speak English any better than I could read Arabic). I had a translator who explained that I had had some “trauma” in my eye and so the gentleman giving the test, laughing, referred to my eyes as “Super Eye” and “Trauma Eye”. And while I had to do the test one eye at a time, he gave me the answers in my Trauma Eye so I could pass. And to this day, twenty years later, I refer to my bad eye as “trauma eye”.

And now, to the reason for this tale: Yesterday I did a zoom event for the Pennsylvania Department of Aging, The Alzheimer’s Association and Dementia Friendly PA called Virtual Alzheimer’s, Dementia & Related Disorders Symposium - Navigating a New Era of Dementia Care: Treatment Breakthroughs, Brain Health, and Caregiver Support. One of the speakers was a doctor, and he, as he was finishing off his segment, mentioned the changes in cause over the last few years. The things that had been learned in order to provide some form of preventative prediction. He went through the usual: Food, exercise, socialization, etc. and then said: “And just the other day, a report came out stating that Retinal Occlusions could lead to Alzheimer’s! Consider my mind blown. I’ve had hundreds of conversations with doctors, and I almost always fail to even mention this episode, because I am so adjusted to the new normal and it is completely healed. I don’t even think of it - the only time I notice it is when I’m scratching my nose on the left side - thus blocking the vision, and everything goes wonky.

In any event there was an article published on January 8th called Eye Vessel Blockages: Early Warning for Alzheimer’s Disease? This study postulated that people with retinal blockage were nearly two times more prone to getting Alzheimer’s than others. In my book, there’s a lengthy bit where I talk about the potential causes of Alzheimer’s and also all of the misinformation surrounding both cause and cure. I’ve mentioned it here in the blog as well. So while this information doesn’t actually change anything for me in the present, it is something that people who have these eye issues can then become on the alert for. The more precursors the science folks discover, the more likely it is that we can start the process of ending this scourge.

And with that said, I want to welcome the new readers of the blog, many of whom signed up at the aforementioned web conference. I hope you enjoy the reading as much as I’ve enjoyed the writing. If you haven’t yet dove into the pit here, and this is your first live update, I suggest you start right from the beginning. It’s really a good chart of an interesting journey.

Also, here’s the full video of the event on the 9th of December in Marlborough MA, pro shot. I come in at about the 41 minute mark, but the whole thing is good!

For those of you in research and care, keep it up! You’re doing great work, and I - for one - salute you and all your efforts.

And thanks, as always, for the steadfast readers, for being along on this journey with me.

Next up: Live in Elizabethtown PA on the 27th, and then in Hatfield MA on the 29th.

Sean