Saturday, December 31, 2011

The Indirect Route

In May 2011, I made another excursion to New Hampshire. I told only one friend of the intended trip, just to get input from a respected opinion. I could sense something of a lecture on his lips, but he settled on saying only, "you be careful."
I was careful about everything but time. Even though I had left in early morning, I had dawdled too long and the angle of the setting sun also worked against me. I got on the highway home in the wrong direction. Darkness fell fast, and I was not quite certain of my wrong turn until it was too late. I’d driven only in areas I knew well enough to know where I was going without the use of landmarks that I could not quite see. The first time I got off the highway to turn around, I ended up getting back on in the wrong direction again.
I got off the highway and grabbed a bite at a burger joint. I had tried being subtle by reading the receipt to get my location, but I couldn’t see the receipt either. All forms of vision were getting slowly but steadily worse. I had to ask where I was, always a humbling experience. I was feeling very young and vulnerable and that I had seriously overstepped my bounds.
I remembered the way to the highway from the burger joint. When I got to the big sign that gave directions, I pulled the jeep off the road and got out of the car to read the street sign I otherwise could not see, just to make sure I headed in the right direction home.
I’d gone home to Providence from Nashua, New Hampshire via Worcester, Massachusetts.
It was my last excursion. The experience disheartened me. The third setback let loose within a couple weeks, leaving me less capable even after that setback mostly faded. Even shorter neighborhood trips seemed unworthy of the stress and effort. Even in the summer I was accepting rides to bowling because I did not feel confident driving home in the dark. I simply let go of more and more of my self sufficiency, moreso after my eyes began the Autumn 2011 slow fade without another obvious setback.
For the most part, I had stopped driving by September, 2011.
For the most part...

Friday, December 30, 2011

Plowing Ahead

The Jeep Wrangler I currently own is the first car that ever elicited remarks from friends "This is you." I can understand the analogy. It’s a rugged but stunted vehicle. It’s got one of those attention-getting mufflers, so it is rather loud and obnoxious. It’s gray, which on a Wrangler means it’s multiple shades of gray, simple looking yet complex at the same time. It’s propped up on oversize tires, so it can run through pretty much anything. And it’s a hard top model.
When buying the vehicle, I specifically wanted something that could plow snow. I’d had enough with relying on others to take care of the properties and wanted a vehicle that could accommodate my self sufficiency issues.
After the first setback in November 2010, I stopped driving again. No one took my keys away, nor did anyone have to. I stopped on my own because driving presented a clear and present danger to myself and others.
I was off road again for a number of weeks, but making short trips on my own in December 2010. I already related the trip that made me stop driving entirely at night in "Midnight Ride." (December, 2011) After even the first setback, my eyes could no longer process dim lighting well enough for me to feel safe driving at night.
I could still do OK in daytime, depending on angle of the sun and contrasting areas of bright light and deep shade.
I was surprised to see how well I could plow snow at night. That specific driving task proved easier at night than during the day due to sun glare. At night, the white blankets that covered Rhode Island on a weekly basis for six weeks probed a uniform cover of white that my eyes could easily accommodate. This does not mean I took extra jobs; I stuck only to my property obligations and one neighbor. I dropped the regular gigs outside my neighborhood and took my time. Nighttime plowing also proved easier because I had to contend with fewer cars on the road. The fact that I intimately know the areas where I worked also made the plowing a surprisingly trouble free task, so easy a blind guy can do it.
Unfortunately, the stress and exertion of so much plowing that year took its toll. While not scientifically proven, I am confident that the heavy workload triggered the second setback. I limped home from what luckily proved the last storm of the year with a stringy gray cloud further obscuring my vision. That took me off the road for several more weeks until things recovered enough for me to regain reasonable certainty that I would not endanger others.
I’d been cooped up again and wanted a taste of those old freedoms and my all-important self-sufficiency.
I felt ready for another excursion.

Thursday, December 29, 2011

Give Me the Keys, and I'll Drive You Crazy

How does a blind guy drive?
The glib answer: very carefully.
The current true answer is that I don’t. Or I don’t drive much or often, anyway The most recent excursion was really when I shouldn’t’ve. This phase of "elderly adolescence" that I find myself in overcame me a couple weeks ago, a few days before the last setback.
The entire field of vision is blurred and grayed out by the setbacks releases. As each floater absorbed into the eye, it left a greater haze behind and has proven more of a barrier to the pupil. The entire effect and disability is hard to describe because there’s multiple problems in the eye.
The pupil problem leaves me unable to quickly adjust between changes in brightness. Highbeams flashing in my eyes at night needs more than a momentary readjustment; it can blind me for minutes. N the daytime, the light seems to stay in the eye.
It is as if I am constantly looking through fog. The further away something is, the more heavily obscured it seems. When the sun is shining, it is like early morning fog, aglow with glare.
I did not have those problems when I resumed driving in late Spring 2010. The main problem then was the field of vision. I was used to being blind in one eye, but the PRP procedure had diminished the left eye’s field of vision to a sphere at the edges of the cataract lense. I adjusted to that largely by avoiding left had turns or street crossing at uncontrolled intersections. This focused me on just watching for traffic from the left rather than having to jerk my head back and forth in looking for multiple directions of approaching traffic and timing each side. Yes, I dud circle some block to make three right turns for the end accomplishment of the left turn I needed.
Highway driving was actually quite easy. I’d get in a non-merge lane and stay there until before my exit. I could see any distance I was looking at. So highway travel was actually quite comfortable. I had made a run to Nashua, New Hampshire on Columbus Day 2010. That had been a great day, the first to harken back to the pre-hemorrhage filled with 65 mph freedom accompanied by some favorite CDs in the deck.
Up through the release of the first retina hemorrhage (as opposed to the full blood vitreous hemorrhage triggered by a dose of Cialis) the only real "danger" I posed as a blind driver was a reduced ability to prevent accidents that would be caused by other people’s carelessness.
This changed after the first setback, just weeks after that soul-soothing trip to New Hampshire.

Wednesday, December 28, 2011

On the Road Again

My first trip after recovering from the Cialis-induced hemorrhage was a quick "medical emergency" in early June 2010. I’d run out of insulin and needed the evening dose. I wasn’t sure is the Wal-Mart pharmacy was still open. (I won’t disparage Wal-Mart on this. To my knowledge they are the only ones who carry a generic of standard insulin. Even if other pharmacies have begun carrying this, Wal-Mart was the only one for 10 or more years who defied Ely Lilly and Company by carrying it. That saved me thousands of dollars and certainly bought some loyalty.)
Maybe I just didn’t want to ask the roommate for the ride when I was not positive how late the pharmacy was open. Maybe I was just being thick in the head in wanting to drive. The roommate’s on the deaf side and was watching TV at the front of the house. I slipped out the back without a word. Wal-Mart is perhaps a quarter mile down the same road I live on.
I did not have such severe night vision then. I moved slowly and cautiously and made the round trip without incident. I snuck back into the house without the roommate having known I was gone.
My blindness had put me in a position where I had to accept more well intended assistance than I cared for, from the roommate and one other friend in particular. Both of these dear friends have control freak tendencies that grated against my uncontrollable nature with exponential angst as I got slowly better through Spring 2010.
I kept my foray a secret. I made a couple other short jaunts over the next couple weeks, testing the waters of my partially regained abilities in secret from my caring, controlling jailers.
I’m not a very good liar or sneak and have no particular motivation to get good at those types of thing. I’m a bit of a smart ass and like confessing my misdeeds when its far too late for them to matter. The reaction often amuses me. I break out the old childhood stories of sins gotten away with when my parents get on my nerves. I only recently broke out the crown jewel of how I escaped a three day school suspension by asking the vice principal if he had f*d his wife the night before.
My secret excursions lasted a couple weeks before I revealed myself. The roommate generated a lot of noise about it, all white noise to me because I was able to name times and dates when I had been out before and where I went. The fact that I had been on the road a bit without incident left him little he could say.
I didn’t have to hide it anymore. I could drive, even though I remained legally blind.

Tuesday, December 27, 2011

Actos-ing Up

I "saw" a television commercial for the first time this week. The subject of the commercial was Actos, a Takeda Pharmaceuticals drug used to control blood sugar in Type 2 Diabetics.
The ad was for a lawyer’s class action lawsuit for people who developed bladder cancer after using Actos. This is not the first class action lawsuit ad for alternative insulin users. It seems to me there’s a new one every year, a rate that seems to match the availability of new alternative insulins.
You want to be part of a class action suit? Easy enough. Become a Type 2 Diabetic and take whatever new insulin your doctor prescribes. Don’t ask how new the drug is and how extensive testing might have or might not have been. Certainly do not ask your doctor how many prescriptions he must write before he gets that gold trip to Bermuda.
Your doctor will tout all the good effects of this or any other new insulin. Most and sometimes all of his information comes from the pharmaceutical company that owns the patent on the drug.
The only one likely to profit from diabetic patients taking new drugs is the pharmaceutical company pushing the drug.
The patient is the guinea pig. The pharmaceutical companies are betting on medicare patients being too ignorant to know that they are the lab rats. The pharmaceutical companies get money while the patients get heart attacks or one form of cancer or another from each new blood sugar medication pimped out.
I am a Type 1 Diabetic. I use the old Humulin insulin. I switched to humulin or "Humulog" only when Eli Lilly and Company stopped making old style insulin made from port and beef.
I understand that too many people are so afraid of needles that they will try anything rather than go on a standard insulin form. They need to get over it. Diabetic syringes are so tiny that the injection cannot even be felt most of the time. Chances are, if you developed Type 2 Diabetes, you have a lot of excess flab that can be taking needles without any sensation of pain.
Every case is different and not all Type 2’s need full insulin. Guided by research sponsored by the pharmaceuticals, the medical industry has been changing the definition of "diabetic" and "pre-diabetic" just to increase their customer base.
You can go blindly along with what the tools in the corrupted medical industry tell you, or you can be proactive in your own health and insist on older, effective medications that your doctor actually has some practical experience with among his patients. The older medications are also cheaper because they are not being sold at development-recovering profits or sustaining the advertising industry.
Surely not many doctors are thinking of their patients’ bladder cancers when they’re on the green in Bermuda.

Monday, December 26, 2011

Losing the Great American Liberty

In October 2009, the vitreous hemorrhage that resulted from a dose of Cialis filled the eye with blood. I saw everything through a red glow. I could not drive at night but managed for a while in the daytime, to places I knew. The visual effect those first few weeks was nothing more than looking through rose colored lenses. The discoloration darkened everything, but in the light I could function OK. I pressed on with life.
That changed with the healing process. He blood began to separate from itself and mix into the eye. It contaminated the vitreous fluid and the fluid in the dense existing cataract. This changed the visual effect from simple discoloration to a dense reddish cloud. The cloud obscured everything. Within a couple weeks I was uselessly blind at all things. At that point I stopped driving on my own. No one needed to take my keys away. I am typically responsible for myself and I recognized the dangers I posed to myself and society without needing some catastrophic event to smash the point into my skull.
I was off the road before the end of October 2009. Except for one time, I did not drive until late April 2010. I loved driving almost as much as I loved reading, which I also could not do. I was feeling great losses at this time.
The sole attempt at driving was during the only accumulating snowfall of that season. I felt lucky that it had been a light snow season where the storms all seemed to mystically miss Rhode Island. If I had been well I certainly would have driven to Virginia with the signs on the plow just to make money that year. Transported by teammates and reliant on them to know what pins remained target of the second ball, I still bowled twice per week. Otherwise I stagnated at home.
I almost wish I had some amusing story to relate with the attempt at driving that winter. I got behind the wheel in an attempt to plow my own parking area.
I quickly realized it was not something I could do. The ruddy haze was too blinding.
I carried the expectation that the cataract surgery would restore me. The treatment at the time was "preventative" PRP surgery then cataract replacement, and the doctors fostered those expectations.
Cataract replacement did remove a layer of the ruddy haze. I opened my eyes in bed the night of the surgery and seeing farther and better than I had since childhood.
Then I got up and moved. That was the first I learned of the vitreous fluid problem. An immense pool of blood still resided in the center of the eye. The blood and vitreous fluid acted as oil and vinegar. So long as I was perfectly still, the elements separated and I could see clearly. I could see the bubble of blood floating at the top of the eye. Any movement mixed the bubble with the natural eye fluids.
I’d be going nowhere fast, not until the blood dissipated, and no one could tell me when or if that would be.

Saturday, December 24, 2011

Gifts

Last year when my parents asked what I wanted for Christmas, I told my mother that her left eye would be fine. I didn’t care that it wouldn’t match my fiery hazel, just so long as it worked passably. I might have preferred my father’s blue, but his don’t work so well. Both of my mother’s eyes work well enough; I did just fine for almost a decade with only one functioning eye, so surely this seventy-something old broad with a relatively sedentary lifestyle could do with only one. I figured she could take to wearing a patch and train a parrot to sit on her shoulder; those things might match the rapier that she’s usually carrying around tp stab people who try cutting in front of her in line at Wal-Mart. She used to carry a horseshoe in her purse for those occasions, but I guess that got too heavy for her.
I could see well enough to get the look that fell on her face. Maybe she thought I already had a surgeon lined up or something. and that I had forged surgical consent forms like had forged absence excuses and warning slips through high school. That look gave me a brief flash of, well, something. It couldn’t be shame; I am pretty shameless about my sense of humor, and my mother knows that. She’s the one who always preferred Three Stooges over Sesame Street anytime there was conflict between me and an older sibling.. I think her look jarred me with interpersonal disconnection that she didn’t get my dry delivery. She’s my mother. She should know that if I were going to resort to black market solutions to the eye problems, I would certainly take a fresh eye not from an elderly woman, but from an infant. Babies can learn to adjust better to a life with only one eye far easier than an old person can.
I reverted to a more serious answer. There was a bit of scrap lumber and old doors across a few of the properties. I wanted a Seats Craftsman 19.2 volt battery circular saw to easily cut it down to pieces that would fit into the city trash bins. I didn’t get that either; something bout the dangers inherent in blind guys using power tools.
I got a set of deluxe Tupperware with airtight gaskets on the lids and snap locks on each side. That could come in useful for keeping an infant’s eye airtight for an hour or two until I can get it to that black market surgeon.
And my parents also still gave their annual gift: they renewed my AAA membership.

Friday, December 23, 2011

Reaching for the Light

As a result of the setbacks, my color vision diminished to almost nothing. The essentials of contrasting color to mark edges and boundaries is lost to me. The television is a hazed out jumble of shades of gray with occasional reds and tints of paled blue. This is not a retinapathy issue; I still see vivid color through the right eye’s misaligned pinhole.
The floater release earlier this month devastated me. Ot came o top of a dozen or more other stressful events crammed into too short a time. When I realized for sure that it had just inexplicably happened again, I nearly cried in the middle of the waiting room. Tough stoic me nearly cried. I’m still not sure how I kept it under control. I think I just focused on why I was in that office and focused on my foot. They eye could wait; my latest doctor is local to me, and indeed I was seen by his associate that afternoon.
The last few weeks have been pure hell for me. I’ve been kicked from every direction, often repeatedly, and most things I was just not able to see coming, figuratively and literally. My neatly compartmentalized life saw fires and floods in almost every compartment. (No worries, homeowners and tenants; that one’s just figuratively speaking.)
Many of these events tied the present with the distant past and a bleak future. My mind became like the TV, a grayed out jumble of indiscernible images that just flowed together incoherently.
The release of the floater was the last straw, the last thing to happen to make me feel like the perpetual victim. It became my call to pull myself together and deal with the whirlwinds swirling about me.
I did not rest at all with this setback. I resumed more of the things I had let go due to the blind eyes and the gimpy foot.
The floater dissipated completely in a matter of three days. It’s probably absorbed into the eye. The day it happened it was a solid black mass that danced from the blind perineal and into my tight circle of remaining vision. Day Two saw a tangled blur of webs and their accompanying spiders, morbid shadows that flickered past my eye like the fleeting peripherally-seen image of a fleeing black cat. By Day Three it was reduced to a fat hairy spider among slight strands of web. By the end of the day it was gone. The vision was really poor enough before this release that I cannot tell if things are a little more obscured now.
I’m working with the latest doctor. I am one stubborn son of a bitch. Things may be dark, but in so many ways in my life, they always have been.
I’m not done reaching for the light just yet.

Thursday, December 22, 2011

Setback Patterns

The other part of the pattern in the setbacks of mini floater "hemorrhages" stood out more prominently after each incident: the recovery proved less complete.
The first had robbed me of night vision, to the point that I knew I could no longer drive at night. Getting lost in the neighborhood I grew up in had driven that point home.
By the summer after that fateful ride "home." not only was darkness vision absolutely atrocious, but my light sensitivity issues had also grown distressing. Nearby bright lights such as streetlights swelled to three times their actual size, yet my eyes could process less of the light that shone to the ground. My adjustment time when moving between bright and dark environs increased. Light would seem to stay in the eye, casting a hazy glow whether my eyes were open or closed after I looked away from the light source. I suspected that my pupils just weren’t working correctly. Without solicitation from me, my latest eye doctor confirmed that exact problem the first time he examined me. He said I have the most complicated eyes he had ever seen.
My close up vision deteriorated further. That particular malady became the most progressive loss during Autumn 2011, the period of steady loss without the catalyst of a floater eruption. Reading became not just difficult, but impossible. The pupil also noticeably worsened in this time. Darkness became nearly total under any circumstance, and any light proves too much, as if my eyes are always dilated. There’s either nowhere near enough light or far too much.
My color vision diminished to almost nothing. The essentials of contrasting color to mark edges and boundaries is lost to me. The television is a hazed out jumble of shades of gray with occasional reds and tints of paled blue. This is not a retinapathy issue; I still see vivid color through the right eye’s misaligned pinhole. The retinapathy issues remain the distortions in the center of my vision and the waves in straight lines and checkerboards. At bowling, the lanes \have a C-curve to my perspective.
We’re now past the solstice. The days are getting longer and brighter. It’s time to turn this around.

Wednesday, December 21, 2011

No Rest for the Wicked

The floater releases held a pattern besides being mostly three month intervals. They all made mu vision worse in an apparently permanent way. There’s been four releases, and the only month that skipped saw the beginning of undeniable gradual regression without a sudden shadow.
I had to seek advice in dealing with them by looking online. That’s not easy for me, but necessary. Most setbacks occurred while I was in the "care" of Doctor Arrigg at Joslin. He did little but shake his head sadly and talk about surgery on the long-dark right eye as a means of getting what backup I could from that. That operation was something he never intended to do anyway. In the meantime, he had wasted more than a year of crucial treatment time and thousands of my dollars.
The advice I gleaned read the same for the floater hemorrhages as it did for the bloody vitreous hemorrhage induced by the Cialis dose: rest easy until the floater absorbed into the vitreous fluid. I did that the first time, even with responsibilities pressing. I sat in the recliner and listened to the TV day after day. When I could, did internet searches and tried to keep up on things. I had been at a good clip with the fiction writing through 2010, but the first setback curtailed that. The ever-growing backlog of responsibilities has kept those ambitions curtailed. I only have so much computer time before the screen burns the eye out for the day.
Absorption into the eye took a few weeks, and more recovery of function took longer.
With the second setback, I considered more of my experience than the book learnin’. I had slept in the recliner for months after the hemorrhage, as advised by online articles. After a few months I was just missed my own bed upstairs. Absorption of the bloody haze seemed to pick up speed when I began lying down. I had assumed that this was just the time of the healing process.
I did not rest as much after the second setback. I couldn’t. While plowing was over, shoveling at the properties remained, and by that time in the winter of 2010 even enterprising neighborhood kids didn’t want to deal with it anymore. Three apartments were empty and needed work, and countless projects remained backlogged. Squirrels were invading one house as mice were invading two others. Electrical problems developed. A newer and higher priority always emerged. I couldn’t rest anyway.
And the healing process went more quickly.
I rested less after the third setback. By that time I felt shame for the length of time apartments had been empty and was having problems farming assistance. Despite assurances of payment, some friends were charitable in offering help but had little desire to follow through and/or weren’t as capable as they thought they were. If I wanted things done, I needed to do them myself.

Shameless Plug

I generally keep the blog and my fiction separate (there’s that compartmentalization thing again)but of all stories I have ever written or probably ever will write, this one deserves an extra push.
Some have noticed my "bitterness" about the blind thing while others have noted the humor I try to infuse (and other have noted both with the connection between angry people and that over-the-top Three Stooges humor.)
WTF?!
Paperback or Kindle http://www.amazon.com/dp/0982991347
http://www.barnesandnoble.com/w/wtf-rose-mambert/1107930675?ean=9780982991343&itm=5&usri=wtf%3f%21
I do have to add a language advisory to this one as I do usually avoid excessive cussing in my writing, but what’s a few F-bombs between friends?
is finally available...too late for Christmas, unfortunately. If you only ever get one anthology with one of my short stories, this is the one! This urban fantasy is full on with my warped, politically incorrect humor in a sharp satire about Providence during the shameful Ciccillini administration. "The Rats of the Renaissance City" in WTF?!
es, the book's cover illustration was inspired by my story!

Tuesday, December 20, 2011

The Fourth of the Apocalypse

The last sudden setback occurred on the morning of 14 December. Yeah, that 14 December, as in last week.
They call these releases of floaters hemorrhages, but they are nothing like the blood surging hemorrhage that set this descent to darkness in motion in October 2009. It was black, not red, and did not happen as I woke, but when I was sitting at a sports medicine office to have a serious ongoing problem with my foot more thoroughly examined.
I had never been to that office before. The waiting room is a large expansive room with scattered chairs and café type tables and inconstant lighting from fixtures and large picture windows. I thought the dancing shadow that streaked through my vision might be some oddity of the unfamiliar room. My roommate said the glass door was casting reflections.
If my eye chased after the darting shadows, they moved or got worse. I realized quickly that the problem was in my eye, not the room.
Maybe stress caused it. I was under no stress for being in the doctor’s office; I had been looking forward to the appointment as resolution to a problem that had gone on for too long. The injury to my foot was two months old and not getting better. I could deal with it OK, except that it was a very inconvenient injury that further decreased my mobility and self sufficiency. Even if I wanted to get to the convenience store a quarter mile away, I couldn’t drive because I’m too blind and I couldn’t walk because I’m too gimpy.
While the doctor’s visit created no stress, I have to consider the impact of stress on the setback. Since Thanksgiving, every area in my neatly compartmentalized life has been exploding with unanticipated events that became even more frustrating by my inability to do anything about anything, or imploding through extreme boredom by my inability to do anything about anything..
My blood pressure, normally around 140/80, read at 212/123. Safe to say (or perhaps unsafe to say,) I was slightly upset.
My vision has been in further decline since late summer. I’ve been coping with that stoically, sharing nothing unless someone noticed and addressed it to me on point. When my right eye faded, there had been no setbacks, just a steady fade to black. I had not noticed that fade as acutely because I had another functioning eye and the muscle damage to that eye had made it more distracting that useful anyway.
This release of a huge floater drastically and suddenly made it even worse. I could only think, this is it This is the one from which I will not recover. Each of the prior setbacks had left more obstruction. I don’t think even my current doctor can accurately differentiate some effects between retina separation from vitreous obstruction. The results are the same. Instead of just being legally blind, I am heading towards totally blind.
That means doors are closing. For every one that does, I intend to kick open two others.
I’ve got the sore foot to prove it.

Monday, December 19, 2011

The Latest Setback

There’s been time and distance to most of these blog entries. That’s made a candid telling easier for me. It feels less revealing because it’s old news for me. My brain tends to overthink; this can lead me to talking too much I’ve processed and settled things, even those with ramifications that are still ramming me.
I can be absolutely candid with some friends. Often, however, I find I get candid only about certain things with certain people and hold back other things.
Think of me as Woody Allen: I compartmentalize. If one area gets rough, I can always hop into another box until things calm in the first or I decide it’s time to close the box off for good. Maybe this is a sign of some undiagnosed paranoid schizophrenia. I’d read more to find out, but I can’t see to comfortably read anymore, and me reading that might turn into a hypochondriac reading medical journals.
Mentally I picture certain audiences when writing specific posts, like I am talking to specific people about specific things rather than an general audience that includes people I haven’t had much chance to talk to in too long, or complete strangers.
I am pretty candid in talking about my past doctors. I have not been afraid to name names because as long as I stick to the truth I cannot be sued for libel. But when it comes to current doctors, whether for the eye or my GP, I am treating them as I treat friends in the blog: they are rendered anonymous, male whether they are truly male, female or undetermined. That’s the respectful and polite thing. It also makes sure that I don’t piss off someone who is in control of a situation where I am anesthetized and could be hypnotized into wetting myself any time I hear the word "snowflake."
I talk about my difficulties in current things now because life has been hell since Thanksgiving and every compartment is on fire, it seems. Blindness has robbed me of a lot of self control and no less than five of the compartment fires all touch on other people’s control freak issues or my own self control/self sufficiency issues.
I expected the fourth setback in August, but I suffered no sudden appearance of a floater. That would be a good thing, but instead of a sudden onset, I have experienced a steady gradual fade out since September. The light haze is worse. The shadows grow weekly, it seems. Everything appears darker, literally and figuratively. Anyone I look at seems backlit and can’t be identified easily. I’m quicker to ask who I am talking to, and that has taken some people aback. My own physical vulnerabilities are the one area that people are not used to me being so blunt about.
The floater setbacks skipped August but compensated with something that was not an event I could cope with, but a gradual erosion that has kept this blind fool on uncertain footing.
The latest setback was Wednesday, 14 December 2011. I’m coping, best I can, but I need to give fair warning to those who care, those who control, and both: don’t try tugging on my leash now, because you will be in for one hell of a ride when this scrawny mutt drags your ass across the yard.

Sunday, December 18, 2011

Spontaneous Eruption

The third setback of a dislodged floater that obscured my vision yet again occurred in May, 2011. This one came with no apparent cause. No temper loss or general over exertion preceded it. Life was calm enough at the time.
The primary pattern of these releases was timing. More gunk had spontaneously appeared in the eye every three months: November, February and then May.
Doctor Arrigg at Joslin Center proved himself no value to me in diagnosing or explaining the setbacks. In hindsight–quickly becoming my only form of vision–I know he just wasn’t one to share bad news. His failure to communicate about these specific concerns of floater releases was one of the major influences on my dissatisfaction and disillusionment with him. He left me alone to figure out what was going on. He seemed to have plenty to say to other doctors when I was out of earshot, but he offered me no causation or solution, just generic "These things happen to people who have been through what you have."
I tried to convince myself that all was OK, that the releases of massive black shadows and clouds in my eyes was just scar tissue from the original bloody vitreous hemorrhage. I think I did a good job convincing concerned parties of that. I am not a very good liar. I was better at lying to others than to myself.
Each release left aftereffects in its wake. Some of the effects were consistent with retinapathy, but others proved completely different from anything that had happened with the comparatively quick loss of my right eye.
Gridlines warped, where tile floors looked wavy. The general increased haze healed less each time; the visual effect could have been retinapathy just as easily as it could be simple contamination of my already dirty vitreous fluid.
Some aspects proved nothing like what happened during the retinapathy loss of the right eye. Through the right eye’s pinhole, I see poorly. The small field of vision looks through a dense cataract, and the eye is misaligned. The eye cannot quite look where the brain commands it to look. Yet that eye retains excellent color vision while every setback in the left eye reduced color vision more.
The right eye is also not overly light sensitive. The left eye refuses to process light. It’s either too light or too dark for me in most environments. The controlled lighting of the regulated sports venue of the bowling alley is my easiest environment. There, no lights flash into my eye but there is even, surrounding illumination.
Outside at night, a streetlight is too bright for me to look at and emits a size-doubling halo. Yet I can see very little of its light hitting the ground.
Adjustment between light and dark increased in difficulty. The shadow of a tree on a sunny day conceals almost everything.
My newest doctor said I have the most complicated eyes he has ever seen. The general combination of problems has rendered me increasingly helpless on all fronts and is fading fast.

Saturday, December 17, 2011

Setbacks and Disappointments

I call the incidents of large floaters breaking loose in my eye "setbacks." That is a gross understatement. Each could have stopped me dead in the tracks of whatever I was trying to achieve at the moment, and for that day or week or month. The first setback in November 2010 did just that. I let it. I reverted to the state of blood obstructed vision from the original vitreous hemorrhage. I sat in the recliner day by day, listening to the TV.
The February 2011 release caused more stress. The winter had been rough in regards to maintaining my responsibilities. Three apartments had emptied. I was not up to the work of rehab. A quick job such as upgrading window blinds became next to impossible. I couldn’t see up close even when things were clearer, thanks to Doctor Negrey’s decision to install a cataract lense that killed my close vision.
In 2003 I had single handedly turned over six apartments in one month. This time it took nine months to turn over three. Getting help proved difficult. Friends with good intentions made promises out of pity. Some made it worse when they realized they didn’t really want to help. They became too embarrassed about their second thoughts to even call to cancel. In some cases, waiting for the promised dat of help then waiting around all day for someone with no intention of actually showing up wasted weeks.
I ca be a pretty difficult guy in a lot of ways. I’m strong and cocksure. I fought since adolescence for self control and self sufficiency. I’m not arrogant–I do not believe myself better than anyone else, just equally good as anyone else, better at some things, worse at others. Cocky, yes. Arrogant, no. But a lot of people can see that distinction about as well as I can see the directions on the back of an aspirin bottle.
I was never big on relying on other people and the multiple disappointments with multiple people I am genuinely fond of did lead to emotional shut down. I’m prone to those. In some ways the lifelong fight for self sufficiency was too successful. Failed results when reaching out to or relying on others kicks me back to cold and fierce independence.
I’m struggling to accept that those lifelong default modes just won’t work well anymore. Each helping hand I push away usually leads to another stumble over a curb or down the stairs.
Parents, teachers and mentors found my strength of will banes of their existence. People always found my infamous "don’t care, don’t need anyone" attitude abrasive.
That cocksure strength prompts me to call these massive regressions and relapses "setbacks." I recover from each less completely. To apply a more serious label for them will only speed my loss of self control, a loss that seems inevitable at this point.
But I won’t let it happen any faster than nature rips it away..

Thursday, December 15, 2011

Snowblind

The first setback on the vision recovery was due to a high blood pressure, low blood sugar moment in November 2010.
The second occurred the first week of February 2011. I was back on the Prozac, which calms the biochemical temper. This time the stress seemed rooted in overexertion. New England had been hit by massive snowstorms six weeks in a row, and that added responsibilities for someone responsible for multiple properties. The plowing and shoveling took a greater toll for an inferior finished hob. {;laces to put the snow had run out. Neighbors’s tempers and frustrations with the winter grew. As a middle aged guy out shoveling, I had been popping aspirin to avoid dying of a heart attack in the snow. I hate the cold.
The exertion and the aspirin probably played together to let the blood flow a little too freely, and while I did not drop into the temper issues, my sugars were surely running at relative lows during that time.
Another floater popped, accompanied by dirty gray tendrils that clouded the vision. This was not a minor floater like a fleck of pepper in my vision, but a big dancing hairy creature. It moved in and out of my vision from above when I moved my eye.
The doctors call this a hemorrhage, but these floater formations are nothing like the original vitreous hemorrhage that had filled my eye with blood.
The new shadow and cloud only added to the ongoing problems when the last floater pop had mostly subsided. It had happened while I was plowing the last property after the storm. I struggled to drive the eight blocks home. I knew from the incident the prior November that I would not be able to drive again for several weeks or longer, and future shoveling would be impossible as I had a hard enough time seeing well enough to get myself around the house.
Despair set in. U continued to bowl as normal with stalwart partners providing the transportation, but that was about all I could do.
Eventually the floater dissolved into general obstructing haze. The snowstorms stopped with that one, so I never did have the crisis of how to uphold my responsibilities to the tenants and the homeowners.
Aren’t I lucky?

Wednesday, December 14, 2011

Christmas Ride

I had always loved driving. I listen to CDs, never a radio. The familiarity of beloved music both lulls and excites me. My mind cleared up for free association thinking. I would plot stories behind the wheel, "write" scenes and let my subconscious work through back burner-ed issues in fiction and reality.
In my infinite wisdom, I decided I would drive to my parents’ house on Christmas Eve 2010. I’m a Polack, kinda-sorta. Christmas Eve is supposed to be important. I had missed the prior year. I was better. I thought there was no reason to miss another. I was, after all, better.
I had not seen the only sibling I had any relationship[ with in a year or more and for some reason I still do not fully understand, I had a yearning to. Maybe in my mind there was a knowledge that my ability to see him would only get more limited, literally. I go through those phases sometimes, feeling nostalgia for relations that never truly existed. The last time we had spent together was when I helped him move into his house, circa 1985. I had nothing specific to say to him. I pictured the conversation we might have in free-thought imaginings during the forty mile highway road "home" to my parents’. The thoughts didn’t fill either his or my mouth with witty repertoire or fraternal bond. It was more of a rehearsal for the dry and generic questions he could ask of a former coworker than someone raised in the same house for ten years. (He’s a bit older.)
The drive down was incidental, mostly highway where I am buffered from oncoming headlights that would misadjust my focus. I knew the areas where I was coming and going, including the maze-twisted development in which my parents lives.
I had forgotten how dark the old neighborhood was. Planning had included underground wiring that left no poles for street lights. My old-fart, over-cautious, can’t-see-it-til-you’re-past-it driving allowed someone with highbeams to overtake me. The highbeams blinded me. I missed a crucial turn and could not see houses well enough to regain my bearings. I couldn’t call my parents or brother for help because I could not have told them where in the maze I was lost.
I found my way out of the neighborhood over the next hour. I went around the long and easier way with only two turns.
As for that conversation with my brother, my imaginings might have well been a script. He asked each of those generic, boring questions I had anticipated, no more and no less. I wondered why I had bothered. The answer came in my reflections on the way home, those free association subconscious resolutions. Over years of warm silence and close distance, I had come to realize that I had no relationship with any sibling, including this old favorite one. I knew with increasing certainty that the days when I could just hop in the car and visit him were ending for me. (Not that I had ever done so in decades.) I had gone to wordlessly say goodbye.

Tuesday, December 13, 2011

Stepping up from the Setback

The first setback in the vision recovery in November 2010 showed various effects. I was back to being uselessly blind for several weeks. Bowling teammates had to identify pins after the first ball. Driving had to stop. Reading was impossible and the TV unclear. I was back to being a toddler who wanted to do so much but couldn’t quite figure out how to get out of the car seat restraints.
The direct effects of the vision ranged from symptoms between retinapathy and vitreous problems. It started as a chunk of a floater with spider-leg tendrils. The chunk faded to a cloud within a few days. The cloud lessened over the following weeks.
My peripheral further diminished. Everything seemed darker. Gridlines were wavy at the edges, to the point that doorframes looked jagged in the middle. My color sense diminished, though I did not quite notice at the time.
I have been off the generic Prozac; diminished capacity depressed me but I did not look at that as a biochemical problem needing biochemical solution. The fact that this setback had resulted in one of my infamous low sugar rages convinced me otherwise. I resumed because the Prozac did control those breaks when my sugar was down.
Things improved by December. In my infinite wisdom, I decided I would drive to my parents’ house on Christmas Eve. I’m a Polack, kinda-sorta. Christmas Eve is supposed to be important. I had missed the prior year. I was better. I thought there was no reason to miss another. I was, after all, better....

Sunday, December 11, 2011

Arrigg-ance

I remained a patient at Joslin Center’s Eye Clinic for multiple visits from early Summer 2010 to late summer 2011.
Dr. Paul Arrigg saw ne on the afternoon of my first visit after I had been abandon by Dr. Deborah Schlossman ’s urgency to leave for the day without a full address to the concerns of a patient with serious multiple problems.
Arrigg made me feel listened to. On that first day, he gave careful examination to the left eye, which Schlossman had not.
I also learned some private emphasis on the value of second opinions. He did not agree with all of the assessments that Schlossman had recorded but had not discussed with me, including lifting restrictions.
Here’s the catch: while Arrigg listened, he did not necessarily communicate. He went over issues with the left eye, but he did not want to explore options he thought were necessary or might become necessary. Simple truth here: eye doctors do not like doing risky procedures on patients who have only one functioning eye, because of the surgery just doesn’t work, they can be held responsible. I understand that. I just want all the information up front so I can make an informed decision. If the procedure were to go wrong, O wouldn’t complain or sue unless the doctor had been drunk or grossly incompetent. My complaints about O’Brien and Negrey at Koch lie entirely that I was not told of the risks, and I feel that they withheld information for the sake of their company’s profits.
Arrigg’s approach could not satisfy or placate me over time. I have an almost psychic ability to sense lies or holes in a story. I’m also smarter than I ever found particularly useful and am very good at filling in the blanks with considerable (but not perfect) accuracy with minimal information.
The important thing to me is to be receiving accurate information. This has always been a quirk of mine in professional contact, relationships familial, romantic and just casually personal, and any other aspect. You don’t have to be nice, just be honest and forthright.
Arrigg fir more of the pattern of the great listener who tells you what they think you want to hear rather than what you need to hear. He would, among other things, continue conversations about my medical state with other doctors after they had walked away from me.
He outlined an overall plan that may have been Schlossman’s original but uncommunicated intention: he wanted to do cataract surgery and retina reattachment on the right eye and then so r4etina reattachment on the left eye. We moved in that direction including with Sonograms of the eyes that were massive overcharges in comparison to the other two facilities where I had the same procedure done. I was eager to proceed with anything that might give me some restoration and prevent further deterioration in the left eye.
Dr, Arrigg was not so gung ho about it. Maybe grin prognosis, unguaranteeable results and cost to this out of pocket patient for something with a potentially negative risk benefit analysis. He’d hinted during prior visits, but finally said in Summer 2011 that he absolutely did not want to do any surgery and said I would be better off staying closer to home for my treatment.
On my own again.

Tuesday, December 6, 2011

What Real-World Folk Need to Know

My intention was to write the blog roughly chronologically in terms of the physical condition of blindness. For reasons that include the declining condition and the fact that my mind works by association rather than in any linear fashion, that’s not quite practical.
I am not seeing too well.
When people approach me, more often than not, I cannot recognize them. I have always been good at voice identification, which helps. People with distinct body shapes provide better cues automatically.
Environment of where I know people narrows down the field, but is far from foolproof. The smaller of my two bowling leagues has an active roster of fifty-four people. The larger approaches eighty. More people are not on the active rosters. I’ve lived in same neighborhood for eighteen years. I’m in a successful community group. I’ve worked in countless places, many with large staffs. I’ve managed seven apartment buildings over the past twelve years. I have more family than I can count, even if there are so very few actual relationships among them. I have three years of college and went to a high school with some four hundred people per graduating class. Frankly speaking, in my younger years I was a he-ho. I know a lot of people from a lot of different places.
Please do not be offended if I do not recognize you, even when we are in an environment we regularly share
This happened twice in department stores in the past week. The second time went well. Voice helped, and the person casually said something that identified from where we knew each other. As contact is still regular, he knew I probably couldn’t place him, and I think he was slightly flattered that I did correctly identify him.
The first incident went badly. First off, the person touched me as first contact. I was big on personal space even before I went blind. I mistook the touch as some ignoramus in the store bumping into someone he could not identify as blind. When he said my name, my sneer turned into a squint of trying to see to identify. There might not be as much difference between those two expressions as I might hope.
In those circumstances, I have become quick in waving my hand in front of my own face and saying I don’t see too well and asking who I am talking to.
Please ignore the fact that after that point, I have a hard time with the social grace of pretending to remember someone that I just don’t remember among the thousands of people who have passed through my life.
My advice in any circumstance is to identify yourself when you approach, and if we are outside the common environment where we met, indicate from where we know each other. And don’t be insulted..

Monday, December 5, 2011

Biochemically Speaking

My first setback after recovering from the October 2009 Cialis-induced vitreous hemorrhage happened in November 2010. Temper loss triggered the sudden release of a massive floater. The wedge shaped dark spot had spider web tendrils and a slight cloudy aura. I saw it appear like a ghost emerging from a wall, just instantly appearing where nothing had been there moments before.
The temper loss was not a tirade, but what I call one of my "low blood sugar, high blood pressure moments. The high blood pressure came from frustration and annoyance, the low blood sugar from not eating. When those two factors combine they cause a genuine biochemical reaction. Eating fixes the problem fairly quickly, bur until I eat, I am just not right.
The floater release happened while I worked on something minor at home. The task required my close-up vision. There’s always more difficulty and frustration in that. The eyeglasses could bring things in focus, but in needing to constantly look away, the refocus time on each of too many little parts then needing to see things a distance away. Anyone who’s looked across a room through a magnifying glass know it doesn’t work. It had been a morning of constant glasses on, refocus, look, glasses off, refocus, look, refocus, etc etc etc.
Tick
It’s easy for me to loose myself in what I am doing and loose track of time. Time loss is even more pronounced by the measure of how long it took me to do things, and I still have not relearned just how long some basic things now take. My insulin had been taken that morning and I had run into the "three hour surge" when the time release insulin first kicks in. The suddenly lowering blood sugar can make me testy.
Tick
Add in some minor mistakes that got me in a self abusive mindset.
Tick
The final straw came with a cat leaping on the table and "helping" by tossing around the little parts that I would never be able ton find if they hit the floor.
Tick
Boom
I will say now in complete honesty that no companion pet or person has ever been hurt or attacked during one of my low blood sugar, high blood pressure moments. Inanimate objects, yes, many have been smashed or kicked. I have hurt myself during these biochemically imbalanced fits, including a recent serious injury. But somehow, despite the loss of almost all rationale, I’ve always directed that bloodlust rage inwardly. The cats run when I start screaming like a lunatic.
Eating corrects the imbalance, but aftereffects remain. I often need to nap to fully reset my mood. The severe swing and my shame for how I can get can trigger a bout of depression that can last for days.
The tendency to fall into those uncontrollable rages has also saddled me with some control issues. I’, not a control freak; my control issues are matters self control., at least the way I see it. Given my overall strength of personality, however, not everyone sees me that way....
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Sunday, December 4, 2011

Storm of the Eye

When November 2010 rolled around, I had settled to my new status quo of being legally blind but functional. The vitreous hemorrhage induced thirteen months before by a dose of Cialis had left me legally blind, but I could do most things, even if with great difficulty. I am a strong person, too strong by some accounts. I’d rolled with some pretty severe punches and salvaged what I could. I was writing more short fiction and getting published more. I could drive myself, at least to places where I knew where I was going without having to distract myself by looking for landmarks instead of concentrating on the side of the road. I could read with the aide of eyeglasses so powerful I could burn ants with them on sunny days. Refocusing between different lighting and distances took time, but the eyes did adjust. I was off the generic Prozac, and dealing with my handicap and my usual seasonal depression. The drug had begun to mix with life’s circumstances to give me"suicidal thoughts and feelings," so I had thought it best to stop.
I had reclaimed enough of my life to satisfy my self control and self sufficiency issues.
I lost that to a diabetic "low blood sugar, high blood pressure" moment.
This time it exceeded the biochemical rage. Something in the eye popped and a large floater let loose. My vision hazed over in a smear of gray and a large dancing chunk of a black.
It may have been scar tissue that released from the inner eye. It may have been a retinapathy thing. I called my doc at Joslin Center. He wasn’t concerned enough about it to push up my next appointment. The release of floaters, it seems, is to be expected in an eye that had been so traumatized.
The visual effect matched the cloud from the original vitreous hemorrhage, only this time in gray rather than blood red.
Driving and reading were lost to me again. When bowling, my teammates needed to tell me what pins remained standing after the first throw. The TV became indecipherable jumbles of quick motions in black and white.
The momentary loss of self control led to a more sustained period of self control and self sufficiency. The depression, now a combination of seasonal effect, helplessness, boredom, and a natural downswing of shame for the biochemical temper loss, worsened..

Saturday, December 3, 2011

The Long and Winding Road

In October 2009 I took a Cialis to counteract the ill effects of taking antidepressants that I needed after having gotten my diabetes "under better control." I woke the following morning to see a vitreous hemorrhage gushing blood in my only good eye.
Blood filled the center of the eye and an existing cataract. I got scared into PRP surgery, with sessions before and after the cataract procedure. As neither doctor involved bothered to tell me that both PRP laser and cataract surgery increase risks of diabetic retinapathy, I was foolishly surprised when retinapathy developed while I was still undergoing the PRP
I was also not told of lense options for the cataract. I did not understand why I had NO reading vision while old men I knew had no problem reading with their new cataract lenses.
By summer of 2010 I was finding my new groove in life. I could not do some things at all, could do others with increased effort and caution, and could almost carry on with other things like my old self.
The more familiar I had been with what I was doing before going blind, the better I could handle it blind .
This blog is one guy’s personal and subjective experience, but it contains important take aways for general readers, particularly diabetics and eye patients. I have been accused of being a caustic cynic long before I ever started blogging.
By law of averages alone, I can’t be as dumb as I look. One important objective of this bit of cyberspace is to throw out ideas and experiences that should be given some thought by patients.
These warnings include:
Ask every question of your doctors, because they may not tell you.
Do your own thorough research on any procedure before undergoing it. Be sure to include the term "risk factor" or "side effect" in your search terms.
Diabetic light sensitivity may be caused by the routine dilation treatments during exams.
You have a right to your medical records and you should be familiar with them.
When you find a good doctor who is knowledgeable about his field and honest to you when he just doesn’t know, hold on to him. No one knows it all and the arrogant doctor who pretends to know everything can do you more harm than someone who recognizes and admits his limitations.
Treat people who developed physical handicaps late in life as you did before, and like they were whole people. Blindness and amputations are not catchy. Humor is what we gimps usually need most.
Appreciate those around you!