Eye, Eye, Eye!

After getting the bad news about my eyesight, I was very depressed. But after a couple of weekly visits, the doctor said it looked like the histoplasmosis was going dormant again. The active spot was turning into a scar and, although I would never regain my lost sight, I wasn't losing any more. So then I got to visit every other week, then once a month, then in six weeks.

amsler grid

But I never made it to six weeks because I noticed that the blurry spot had grown significantly in the fifth week. 

I have an Amsler Grid on my bathroom mirror. Every day, I close one eye and focus on the dot in the center. If the lines appear straight and parallel, all is well. In my left eye, there had been a blank spot in the bottom right. Suddenly, the blob swallowed the center dot. I noticed it was getting worse on Wednesday. Someone was asking me to sign a form and I literally couldn't see the spot she was indicating.

I made an emergency appointment for Friday. When the doctor's assistant tested my vision, I could barely make out the biggest E on the chart. I started to cry.

It was even worse than the first time because I had been feeling like I dodged a bullet and now I was back to feeling hopeless. They dilated my eyes and took a mess o' pictures again.  Dr. Ranchod decided to do another retinal angiography.
I had gotten blood drawn that morning and the tech had problems getting a vein so both my arms were bruised and red and irritated from the tape she put on despite my protestations. Then Dr. Ranchod tried to start an IV for the dye and couldn't catch a vein in either arm or my right hand. Yow! I have to sit really still with my chin in the strap so when they finally get the dye in, they can take a picture. All the while, he's digging around with a needle trying to pierce a vein. Fun.
The angiograph showed that the histo hadn't reactivated again. Instead, new abnormal blood vessels had formed in the choroid, a layer of blood vessels that provide oxygen and nutrients to the eye. It looked like a giant volcano in back of my eye. This is called choroidal neovascularization and Dr. Ranchod recommended treating it with a series of shots of Avastin which seals off the blood vessels and reduces the swelling. Oh, did I mention that the shots would be administered IN THE EYE????
And he didn't want to wait. He was ready to shoot me immediately. First the nurse put ananesthetic drops in my eye. Then she pulled my lower lid away and stuffed the pocket below my eye with anaesthetic-soaked cotton. Then she put a layer of ananesthetic gel over my eye. Then the doctor put on an eye speculum (another reason to hate that word) to keep my eye open. I was so terrified, I thought I would pass out. He assured me that I wouldn't be able to see the needle coming at me and I didn't. But I felt it and jumped six inches. After some antibiotic drops, it was all over. I told Debbie about the Avastin shot because she is my medical expert. She said that the FDA was trying to pull Avastin's approval but I assured her that it was an off-label use anyway.
My eye was watering and I wasn't supposed to touch it. I was trying to keep it closed whille driving home. It felt like there was grit in my eye. I was shaking and trying not to cry because that would make it worse.
Then the car dinged and all the warning lights on the dashboard lit up: the triangle with an exclamation point, the car with a an exclamation point, the letters PS and a battery. "Danger, Will Robinson!"
I made it home. Chris looked at it and said it was the power steering (PS) and I had an appointment at the dealership already because of a power steering recall. So our wonderful mechanic, Kunio, recommended taking it to the dealer to find out what was wrong.
That same day I received notice in the mail that I didn't get into the Lafayette or Alameda or Montclair Craft Fairs.
It was a terrible, horrible, no good, very bad day.

I blame Ohio

Well, I've spent an interesting week visiting many doctors.

A couple of months ago, I noticed a blurry spot in my left eye, like this:

After spending a couple of weeks trying to clean my glasses or get rid of a nonexistent eyelash, I went to my optometrist and explained what I was experiencing.

About 20 years ago, when I first saw him, he told me that I had scar tissue on my retina called histo spots that were caused by a histoplasmosis infection during childhood.



Dark places are histo spots



Histoplasmosis is a caused by a fungus that thrives in river valleys and is carried by birds and bats (I knew there was a reason for my animosity). He has tracked my scars, which are around the edge of my retina) for 20 years and noted no change and no significant damage to vision. He did not find any change this time either.

Last week, since the spot was still there despite my best efforts to deny it (maybe it's a floater? maybe a reaction to light changes?), I saw my primary care physyician who referred me to an opthamologist. She thought it was probably a pinpoint tear in the retina since I still "saw" it when my eyes were closed.

I saw the opthamologist on Thursday and, after triple dilating my eyes, he immediately sent me to a retina specialist. Although he didn't tell me what he thought was going on, preferring to let the retina specialist diagnose me, I heard the nurses calling to make the referral for "choroidretinis." They had to spell it several times since neither was familiar with the term. My appointment was for 9:00 a.m. the following morning, just enough time to go freak out and search the internet.




isn't he cute?



The retina specialist, Dr. Tushar Ranchod, was gorgeous!  Young enough to be my son, unfortunately. He is very intelligent and on the cutting edge of diagnosis and treatment. He has a very gentle manner, concerned but not too serious, and a melodious voice, well-designed for delivering bad news.



Retinal angiography



They dilated me and put dye in my veins (did you know it only takes about 15 seconds for the dye to make it from your arm to your eye?)Then they took many pictures of my eye (bright light!) and my urine was flourescent yellow for the rest of the day (TMI?).

I got to see all the photos onscreen. My eye looked like a lightning storm on Mars. A little scary until the doctor told me that I was looking at my normal eye and the "lightning" was the optic nerve.



OCT scan of normal retina thickness



From the "side," the OCT view of the retina is so pretty and colorful. The doctor uses one as a screen saver.

The guilty lesion looks like a volcano ready to erupt.



OCT scan of histo lesion



So. . . the diagnosis is that the histoplasmosis seems to have reactivated after more than 30 years. The new lesion is not on the periphery like the others, but closer to the macula which is responsible for centralized, high-resolution vision.

I get to see Dr. Ranchod every week for a while as they track the disease's progress. It may just stop on its own like it did before and I won't lose any more eyesight.



If it continues to grow, there is no effective treatment or cure. Steroids can reduce the inflammation but encourage the proliferation of the underlying fungus. Laser and other options kill the bad cells and those around them, resulting in a greater (but hopefully limited) loss of vision. If it continues to grow and threaten my macula, Dr. Ranchod may try some experiemental treatments to preserve some vision.

The good news (and I could use some) is that it is only in my left eye. Unfortunately, that's my stronger eye that I use predominantly. But I am not going to miss depth perception since I never had any. The histo is in my blood and it is always possible for it to reactivate in my right eye as well. In that case, I'll be looking for a new career. Any ideas?



How Attending a Paul Simon Concert Made Me Feel Old

Yeah, I got into a fight with the twenty-somethings in front of us at the Paul Simon concert and realized I am too old for this shit. I asked them to PLEASE be quiet and got mooned (by an unattractive, pasty white female butt, more's the pity).

This is how I know I'm old:

1. I went to a Paul Simon concert. The guy is old. His first hit album was in 1965 and I remember it, therefore I am old. He didn't wear his trademark baseball cap. Fortunately though, our seats were so far away, the blinding reflection from his balding pate did not affect us. We were so far away that he was the size of my pinky. Or is that his actual height?
   
   
2. The aroma of pot wafting through the theater was nauseating me. It's been a long time since I have been subjected to anyone smoking anything inside a building. I noticed that Chris seemed to be taking very deep breaths though.
   
3. My cell phone was turned OFF during the concert and I didn't use it to talk, send or receive texts, take pictures or videotape. I guess young people are used to the distraction of a glowing screen nearby. Not me.
   
   
4. I actually listened to the concert and didn't carry on a conversation with my companions. I figured I paid a lot to see and hear Paul Simon and I wanted to get my money's worth. I assume people around me feel the same way. Apparently some youngsters just think of a concert as background noise for their social interactions. Maybe they have a money tree at home.
   
5. I didn't drink during the concert and was appalled that they allowed alcohol in the theater itself. The Fox Theater in Oakland was recently renovated and is gorgeous (for now- it won't be for long with drunks in the seats). Plus the brats in front of us kept getting up to get more booze. They probably spent as much time going back and forth as they did in their seats.
   Since I am old, I am used to people sipping champagne in the lobby during the intermission, not guzzling vodka from plastic cups in the audience. Van Morrison doesn't allow alcohol sales during his concerts. He's a cranky and old like me.
6. My bladder couldn't last through a 2 hour concert. It's sad. I'm old. But at least I waited until the end of a song to leave and return.

The concert itself was great. He alternated new songs with old favorites. The band was impressive because they all doubled up or tripled up on other instruments, i.e. the bass played blew the sax and the drummer played a mean washboard. His voice has never been great and age is not improving it. (He needs Artie although Artie's voice is probably shot, too.) His great talent is songwriting and his new album seems to have some gems. I'll be listening to recordings a lot since I am too old for live shows now.

Sleep, O Sleep

I am the Queen of Sleep. If there was a Sleep Olympics, I'd get at least a silver medal. I almost never have insomnia. I can sleep anywhere at any time. When I was in hard labor, with contractions three minutes apart, I'd fall asleep and dream between contractions. I go to sleep easily and wake up fine. I rarely complain about being tired in the morning but I love to nap.

My husband is really good at many things but sleep is not among them. He especially sucks at napping. At night, every little sound (the garbage truck, the newspaper delivery) disturbs him. Ironically, a crying baby never really intruded on his rest. But that remains a mystery.

Many years ago, he told me that I made "cute, purring" noises when I sleep. As we have aged, the cuteness seems to have evaporated and now he tells me that my snoring wakes him and when I am not snoring, he can't sleep in anticipation of my snoring. So he flees to Mike's empty bed. I know a lot of couples sleep apart with no ill marital effects but I can't stand it.

I tried BreathRight strips and nasal sprays and decongestants but nothing has been effective enough to satisfy Chris. So I finally asked my doctor for a sleep study. Actually, I asked her if there was a surgery to fix snoring but she said the current procedures were not very effective for women and that I should lose weight. In the interim, I settled for a sleep study because Chris was convinced that a CPAP machine would solve our joint problem.

A few weeks later, at 10:30 p.m. I drove up to an office building in Concord and buzzed to be let in. The tech showed me to my bedroom for the evening. Former offices had been converted to nice little hotel-like rooms with doctor's office accouterments. The tech was really nice and friendly and chatted as he attached big bands around my chest and stomach and 22 wires to various points: my forehead, jaw, neck and legs. Then he gathered them all up into a big ponytail and hooked them all into a box beside the bed. Now, I was trapped in bed. He had me try several different masks with a CPAP machine since, if he noticed any apneas, he would add the machine later. He stuck an oxygen meter on my finger and left the room to check on the camera that filmed my every move. He had me perform various movements (blink, bite down, move my eyes) so he could identify those actions from the readouts. Then, around midnight, he came back and turned off the lights. What??? No reading before bed? And I have to sleep on my back?

I eventually did fall asleep and slept more or less until 4 a.m. when the tech came in to reattach a wire I dislodged. I was wide awake and ready to go home then but he made me stay. When I went back to sleep, I dreamed that I was in a classroom with a bunch of other people who had undergone a sleep study. The leaders stood in front of the room and critiqued our sleep styles. 

At about 6:30, he woke me up, yanked off all the tape and sent me home. Since he hadn't added a CPAP, I thought I hadn't had a problem. A week went by, then two without hearing anything. I called my doctor and she hadn't received the results. A week later, I got another authorization for a sleep study. Did they lose the previous one? When the sleep center called to make an appointment, they said the second one would be using a CPAP machine all night. What joy!

The next Friday night, I was back at the office building. Different room, different tech. This woman was all business, no friendly chatting. She also took additional pains to cause me discomfort: she drew (hard) marks where she intended to attach wires, used some crazy freezing gel to clean the spots, attached the wires with huge amounts of goop that turned rock-hard overnight and taped everything with many, many pieces of tape that would remove much skin in the morning.

The ice-cream on the cake was the CPAP (Continuous Positive Airway Pressure) machine. A tube forces air from the machine into your nose and mouth to keep the airway open. Some masks only cover your nose and some go right up your nostrils. When I opened my mouth while the machine was running, the moving air formed a vacuum that totally freaked me out. But at least I could wear my glasses. Having learned something from my last visit, I took my IPhone and listened to Terry Pratchett in lieu of reading or being read to by Chris. I fell asleep on the very edge of the bed, flat on my back, holding the air tube on my stomach with both hands. I swear I didn't move all night. Well, all five hours of night. The tech turned off the light at midnight and sent me home at 5:00 a.m. I didn't remember a single dream but I didn't have any hot flashes either. So???

Another couple of weeks passed with no word from my doctor before I got a call from a medical devices company saying they had received approval from the insurance company for a CPAP machine but they were waiting for some additional paperwork from the doctor. A week later, someone from the doctor's office called to tell me that they had sent the paperwork but NO ONE EVER TOLD ME what my my sleep study showed and what it meant.

Another week passed until the medical devices company called to make an appointment to meet with a respiratory therapist and receive my machine. I thought I might get some information then but it turned out to be a group "class" in using the CPAP. On one side of me was a 26 year old mouth-breather who was texting the whole time. On the other was an older African American couple who were wearing competing perfumes and colognes (I was the loser). The gentleman smacked his lips and made slurpy sounds the whole time.

The RP gave me a barely legible copy of my sleep study results. I had NO REM sleep (no wonder I didn't remember my dreams) and I woke up about 40 times per hour (0-5 is the norm). I don't know what the results were for the first test (sans CPAP) but I'm sure they were better.

Anyway, I got this mask. It's very fashionable. Next Fall, it'll be on all the runways. I started using it last night while reading before bed. It feels so odd to have air pushing into you. For some reason, a little claustrophobic although nowhere near as bad as those full face masks. When I turned it on, the cats went about a foot straight into the air. Al wouldn't come near me and Tiger kept looking around worried.

Lying in bed listening to my breath was not helping me sleep so I had to listen to some Terry Pratchett until Chris called me trying to find my phone so he could play Scrabble with Robin.

I think I slept for about an hour until an asthma attack made me fling the mask to the floor. Wish me luck!

Sleeping is no mean art: for its sake one must stay awake all day. ~Friedrich Nietzsche

Sleep that knits up the ravelled sleave of care
The death of each day's life, sore labour's bath
Balm of hurt minds, great nature's second course,
Chief nourisher in life's feast.
~William Shakespeare, Macbeth

Cats Rule, Dogs Drool

I am a cat person. I like all cats indiscriminately, from lions and tigers to mangy alley cats. I'm not crazy about dogs. That is not to say that I don't like any dogs.

  

ANDY

I am quite fond of some dogs but I can count them on the fingers of one hand. Robin's Andy is sweet and funny. 



KIRBY, Robin and me



Kirby was smart and loyal.



ROCKY



Rocky is gorgeous and loving.

Shasta was smart, incredibly tolerant and sweet.

And then there's Buttons.


 

When we moved into this house, one of its great advantages was our neighbors, Corky and Dona. They were retired and Corky spent most of his days working in his yard or sitting in his open garage, drinking beer and surveying the neighborhood: our Neighborhood Watch. He had the keys to almost every house and was always helpful to new home-owners. He taught me a lot about gardening and set a standard for the neighborhood. If my gutters were getting full, he'd make some gentle remarks and then get me to climb onto the roof with his leafblower.



BUTTONS

 Dona couldn't really stand to be outside. She always had the air conditioning on when she was home and when she wasn't home, she was playing bingo. She adored her little white Maltese named Buttons. He was yappy and nippy and she made him wear a stupid bow in his topknot. She had a very bad limp and couldn't walk him so I offered to take him out with Robin and Kirby. Pretty soon it became a morning ritual. Although it felt like a burden sometimes, it was mostly enjoyable.
Then Corky had a stroke and was never the same. He was cranky and mean and we could hear him yelling at Dona and the poor dog all night and day. We were all getting old and Buttons passed away. They were very sad but not ready for another pet since, by now, Corky was in a wheelchair (or his electric chariot).
They had a son who they didn't see, a former daughter-in-law that still stayed in touch and brought over their grandson occasionally but they had two "adopted" grandchildren who they babysat after school. These folks were their closest "family". They brought Corky and Dona a new Buttons, another Maltese puppy.
Here's a piece of advice for free: Do not buy a pet for another person.
Corky and Dona couldn't handle the puppy. Dona would spoil him rotten because it was easier than trying to discipline him. Then when she hit her limit, she would smack him with a rolled up newspaper. I'm not saying that rapping a dog is abusive but it should at least be based on the dog's behavior and not on the mood of the owner. Buttons II was a brat who demanded constant attention. He bit and barked incessantly. But he was an angel when we went for a walk.
Dona went to the doctor to finally get her hip replaced and they found she had widespread, terminal cancer. Before she died, she begged me to promise that I would adopt Buttons and not leave him with Corky. She knew he couldn't take care of him and said Phyllis (their best friend and our other neighbor) didn't like dogs because she had white carpet. When she passed away, Corky didn't want to let Buttons go and we certainly didn't need to introduce a yappy canine to our beloved cats. Corky was gone within a couple of months, although he apparently enjoyed hiding his scooter in the house during that time (Dona wouldn't allow it).

His son took Buttons back with him to his Missouri farm where he joined three big dogs. Buttons was not happy. He was not a farm dog. The son brought him back to Phyllis of the white carpets. Guess what? Phyllis had her carpets removed and put in laminate floor. She and Buttons love each other to death. She is firm and his behavior improved dramatically. They go for hour-long walks at least twice a day and watch TV together at night.

Phyllis's granddaughter got married in San Diego last month and she asked me if we could keep Buttons for a few days. Of course. How much trouble could a dog be?

We had a dozen trial runs where Buttons would stay with me while Phyllis went to social events or the casino for the day. Buttons whined at the door the entire time and whenever anyone opened it, he would take off like a shot for his own house. He wouldn't play with me and I felt clearly inadequate.

Then the big day came and Phyllis drove off to San Diego without Buttons. Until about midnight, he carried on as usual, whining for his mommy. Then it seemed like he figured she wasn't coming back, so he might as well settle for me. He curled up with me in Mike's bed and fell asleep. (The cats rule in our bedroom).

Remember, I am a cat person. Cats are self-reliant. They know where to got to the bathroom and require no assistance from us. Buttons not only needs to be walked in order to poop, he has to be reminded to pee every couple of hours. Put some food down and cats will eat what they need as they need it. Dogs will eat themselves to death if allowed. They will eat cat food and even cat poop.

When a cat deigns to pay attention to you, you feel honored. Buttons attentions were exhausting. He not only insisted on accompanying me to the bathroom, he wanted to climb up between my legs to see exactly what I was doing. Most important of all, cats can be left alone. In fact, they prefer it. I felt like I was chained to the dog. I couldn't leave him alone in the house so Chris and I had to coordinate our schedules so that someone was always home.

And I missed my cats. Tiger was indifferent to Buttons and only hissed if Buttons overstepped the bounds of decency. Alcibiades, on the other hand, has always been skittish and would run whenever he saw Buttons (which, of course, prompted Buttons to chase him.) Since the dog was attached to me most of the time, I rarely saw the cats.

Chris agreed to sleep in Mike's room with the dog so I could have some alone time with the cats. But the next morning, Buttons came into the bedroom ( a NO DOGS ALLOWED space) and barked at me to get up since he couldn't jump up onto the bed.

No one was happier than me when Phyllis returned five days later. And I mean that. Buttons was annoyed with her for abandoning him and let her know it. Every time she opened her door, he'd run over to our house. It took a couple of days for him to forgive her.

And probably as long for our cats to forgive us for bringing that creature into their home.

Yoga for Round People

When I fell while hiking in Joshua Tree, I realized that I was not only out of shape but also had really poor balance. I decided that when I recovered I would start taking yoga to improve my flexibility and balance.

I have never done yoga (friends know how the atrocious "Laughter Yoga" was the bane of my existence in Hayward). But Pat used to swear it helped her marathon training. And a lot of Mike's friends do yoga and Lisa R. does yoga and they're cool so, of course, I want to be cool too.

It took a couple of weeks to screw up enough courage enough to actually attend a class at my 24 Hour Fitness. It's intimidating to start with a class that's been together for a long time. It's also intimidating when you know you are going to suck at something and everyone else is much better.

 

I arrived early and put my brand new bright orange mat at the back of the room, so as to be less obtrusive. The teacher, Rachel, asked if anyone was brand new to yoga and I raised my hand. I think I heard some sniggering but it could've been my paranoid imagination.

The teacher was really practical and physically oriented so not so much of the spiritual stuff that can make me uncomfortable. I was doing OK, surprising myself at my flexibility when - BAM - hot flash! And it coincided with the transition from easy warmup to actual work.

I expected to gain a nice gentle hour of relaxation and "centering  breath." I didn't expect to be sweating and so exhausted that my legs were wobbling and I was worried about steering the car. I should have known better. Within a few hours, every muscle in my body had seized and I felt like a guitar string that had been over-tightened and was ready to snap. The next day was better - sore muscles I can deal with - and even be proud of.

I have been going twice a week for a month now. I would be able to follow along better if the poses didn't have all those long, weird Indian names. I can only do about half the "plank" poses they run through. The rest of the time I am just trying to catch my breath. And every teacher seems to pop in some suggestion that seems actually insane, like putting one leg behind your neck.

I actually do feel more graceful.  I am definitely getting stronger and more flexible which should benefit Chris - if you know what I mean. (Sorry, Mike.) I never thought of myself as a yoga person. I want to crack jokes when everyone else is so serious and thoughtful. One of the most difficult things for me is to be silent and still for the "corpse pose" or Savasana. Do they have competitive yoga?

A note about these illustrations: I do not dress in revealing clothes - ever. I wear huge T-shirts and sweats to the gym. But this image of "child's pose" demonstrates why some yoga positions are impossible for me at this time. You try folding a rubber ball into thirds.

I LOVE Photographs!

I love taking pictures. I love preserving a moment or a feeling or a thing. I love capturing colors, textures and shapes.

But I also love other people's pictures. Maybe it's my voyeuristic nature. I love seeing the art of photographs but I also love getting a glimpse into other peoples' lives: vicariously experiencing their vacations and family events or the growth of their children.

Historical photographs mesmerize me. I am entranced by old pictures of my ancestors and those of my family. They represent a time I'll never know and a culture I will never really understand (both the bound feet of Chris's Chinese great-grandmother and the hard-scrabble face of my great-grandparents on their farm).

But even when I don't have a horse in the race and the photos are of people unrelated to me and mine, I still feel drawn to them. I want to know who they are, what brought them to this moment and what happened to them after. I stare into their faces and wonder what makes them laugh or cry.

I look at the things surrounding them: the rugs, furniture and gewgaws and gimcracks and wonder which of these things matter to them.


Vintage professional photos are interesting because they strip away the personal from the setting and allow me to concentrate on the faces. Because the subject had to sit still for a long time (compared to today's instant cameras) and because portraits were expensive and not to be taken lightly, they almost always look very serious. What were they like when they were at home?

I love restoring old photos, removing the ravages of time and revealing their original appearance. It's also very zen to clean one pixel at a time. When I magnify the picture, I can see details that I would never have seen with my poor eyesight. It allows me to concentrate on each portion of the picture and get a clearer image of the whole.

These are pictures of Chris's mother's father as a boy. You can see that I eliminated the scratches, tears and spots so you can concentrate on the face rather than the white blob on his nose.

But, of course, once I see the photograph I have to find out as much as I can about the person so then I start delving into genealogy. And that's a never-ending process.

I hope that I am preserving my family's history and making it more widely available. But I also just get a kick out of it.