Friday, January 29, 2010

Alcohol and Strabismus

Don't Mix!
I have never been a big drinker. Maybe in college I had my fair share, but I have always been a bit of a lightweight and not terribly fond of the feeling of being tipsy.

Yesterday I was at a lunch meeting and had a glass of wine and then in the evening at dinner I had another glass of wine, which is really unusual for me. As I went to sleep last night I had a slight feeling that this was not good for my eyes. I woke and had a bit of a headache (lightweight hangover) and you guessed it, my eye is crossing!

Part of me is annoyed by this, as I am seeing I have to start living like a Mormon. I don't want to live like a Mormon, no offense to Mormons, but I want to be able to stay up late occasionally and have a drink now and then without my eyes going haywire.

This all reminds of of something. I am allergic to seafood. I can eat lobster but mollusks and most other crustaceans make me deathly ill. Linda Blair in the Exorcist comes to mind.

Occasionally people will ask me, "Oh, that is too bad, don't you MISS it, I mean I just LOVE OYSTERS..." For a moment the image of eating a juicy delicious oyster comes to mind, but then my Pavlovian response is me seeing myself violently ill.

Now I associate imbalance in my life (staying up late, drinking over one glass of any alcohol) with crossed eyes and like my allergy to seafood, I don't want to pay the consequences.

This might not always be the case. As I get better and better at learning to use my two eyes at the same time, I may not be so easily thrown into crossed/wandering eye land, but for now no more alcohol.

Wednesday, January 27, 2010

Heather's Unofficial Straight Eye Protocol

Chester my Pug

Eyes have been aligned for 4 days in a row. For the past month I have been paying close attention to what keeps them straight.

In addition to vision therapy once a week and daily exercises at home, I have come up with a few things that I need to do.

MEDICAL DISCLAIMER: I am not a MD and none of this information is medically supported. I am just a strabismic gal trying to keep my eyes straight, see in 3D and have found these things have worked for me. Please do not embark on a salt diet or exercise program without clearance from your own MD.

Heather's Straight Eye Protocol:
  • Sleep! Without any disruption in sleep pattern. I need 8 hours, but I have found it essential to stick to a bedtime and wake time. I can't go to sleep at midnight if I normally retire at 10 and expect to make up for it by sleeping in... My eyes cross if I do this! Same hour to bed, same hour to wake makes my eyes not deviate!
  • Water! I have asked 10 people with strabismus if they have low blood pressure and every single one said yes. This has convinced me that staying hydrated with 5 glasses of water a day is essential and to get plenty of...
  • Sodium! My MD told me that with my blood pressure on the low side putting more salt on my food is fine. So, I do this and it makes me feel better, but please check with your own doctor before increasing your salt intake!
  • Exercise! Gets my blood flowing and my muscles relaxed and the movement through space in the outdoors opens up my peripheral awareness. I should note here that I have been fairly athletic all my life. Swim teams, marathons, triathlons, etc. So I do not find extreme fitness tiring, but invigorating. If you find exercise tiring, then your eyes will probably deviate. I suggest cycling as the best option. There is no impact and it gives you a terrific chance to see all around you as you move through space.
Please also note: I had extreme strabismus for my entire life. No amount of water, sleep or exercise would have straightened my eyes. I write this having just had 2 years of vision therapy with a COVD certified optometrist as well as recent adult strabismus surgery (followed by more vision therapy). If your deviation is as severe as mine was, 80-90 PD, these tips will probably not help. If on the other hand your eyes are sometimes straight or if your misalignment is not severe, then these things might work for you, as they have worked for me. I do not write this to give people a false sense of hope, but rather share what seems to be working for me.

Wednesday, January 20, 2010

AM Crossing, PM Straight

All excited about my new water theory I woke this morning and drank my big glass of water only to look and see my left eye was crossing again. When I did my Brock String exercise, the string was crossing everywhere! I did everything I could to look at the bead closest to the wall but the darn string kept crossing. At one point I swore I was looking at the furthest bead and the string was making an X at least four inches in front of it. I could not uncross that string. Which told me of course, that this is where my eyes were focusing.

I thought a walk on the beach would help. I drank some more water, harnessed up Chester and took a long walk along the beach at low tide. Beautiful morning. I focused on the estates that dot the coast along the harbor and then shifted my gaze back to shells near my feet and then back up again towards the houses figuring that it would help to do some near and far focusing.

After that I went home to do some work, and checked to see my eyes which were still crossing. After a lunch meeting I finished up work at about 5:15 PM.  I wonder why my eyes straighten in the evenings? My water theory is not holding up here! Or maybe it is...I don't know. Perhaps this eye wandering is much more random and I am trying to make sense of something that really has no pattern or cause. I have vision therapy tomorrow and I am going to ask the therapist what they think.

Monday, January 18, 2010

Question for anyone with strabismus...

Do you have strabismus and have ever been told you have low(ish) blood pressure or had a dizzy spell upon standing up too quickly? I would like to hear from you. Please leave me a comment or send me an email.

Something incredible seems to be happening. I was a bit discouraged last week by my eyes deviating, so this weekend while running on the treadmill I started trying to think of all the things I did the month that my eyes were perfectly straight. I have been doing my Brock String, peripheral letter chart exercises, saccades with numbers on my wall, red/green exercises, etc. but I also tried to think of what else I was doing or not doing during that month. My optometrist told me that fever, fatigue and fear are three things that can cause wandering eyes for someone with strabismus, but I was well rested not afraid or fevered.

Suddenly it hit me. For the first month, I had a friend who kept insisting that I drink more water, so I did. At my follow up exam my surgeon told me that he wanted me to drink a lot of water to help with any nausea, so between the doctor and my water nagging friend I increased my intake of water substantially.

I have never been someone to drink a lot of water. In fact, I don't really drink any. I drink a fair amount of juice or other liquids like coffee and tea, but never been one to drink a glass of water. In fact, it kind of makes me gag, so drinking it was a chore, but drink I did, about five full glasses a day. I remember feeling actually quite good on the first day, like my body really needed it. But old habits die hard and mine are no exception. I slowly resorted back to my no water routine.

When my eyes began to cross inwards last week I thought, what is going on? How can I change this? What can I do to help them stop crossing in? HELP ME! I may be grasping at straws here, but I can only speak about my own experience with the hope that it might help someone else. I started drinking more water.

It has been three days of five glasses of water a day and I am a stunned to report that my eyes are almost straight again. Here is a photo I just took a minute ago on my Apple laptop. Could the water be helping with this? I know the Brock String is teaching me more and more every day, but could it also be the water?

I have been told I have low blood pressure (nothing serious, but my doc just told me to eat more salt) and I started thinking, could there be some correlation between low blood pressure, water intake and my eyes deviating?

After some informal research I found out that spontaneous adult strabismus can be caused by many factors including a spike in blood pressure. If a spike in blood pressure can have an effect on the alignment of one's eyes, could low blood pressure do anything? I have read that dehydration has serious consequences on the brain. Could there be some kind of connection here?

I emailed three people I know with strabismus, one in Malaysia, one in the UK, and one in Seattle to ask them if they had ever been diagnosed with low blood pressure and all three said yes! (Thank you for your responses!) POSTSCRIPT: I HAVE NOW A TOTAL OF 14 PEOPLE WITH STRABISMUS AND ALL HAVE TOLD ME THEY HAVE LOW BLOOD PRESSURE. Could this be a coincidence?

I would love to hear anyone's comments on this.

Friday, January 15, 2010

Music in the Operating Room

During the adjustable suture part of my surgery I remember being in a round operating room with someone named "Nelson," who the surgeon would instruct to give me more meds every time I groaned with discomfort, which he did beautifully. I can recall almost every detail of being awake while he pulled at the fishing wire like material coming out of my eyes.

One of the things I remember clearly was the music. There was a radio in the operating room and as the surgeon tugged and knotted the wire Kings of Leon's, Use Somebody was playing in the background. The sound was coming from an area around my feet about 10 feet away closer to my right foot from a boom box on a shelf. (Funny how I remember things like this!) Despite being horrendously overplayed on the radio, I really love this song and despite the circumstances I was under it actually put me in a good mood. For a moment I felt giddy lying there.

Weeks after my surgery, I was running on the treadmill listening to this same song and never having listened that closely to the words, I stunned when I heard the first line, "I've been roaming around always lookin' down at all I see..." Here I was having had Strabismus surgery to correct my eyes and one of them was actually looking straight down! The song made me sob and had to push pause on the treadmill to catch my breath. My friend Nicole, running next to me was like, "Oh my GOD are you alright?" The memories of hearing that song again and what the words said made me incredibly emotional. I thought about the success of the surgery, how lucky I was to have it go well and it being over and how I am no longer, "lookin' down at all I see..."

Then a few days ago I heard this on NPR's Sound Check with John Schaefer, Soundtracking Surgery. The brilliant segment talked about studies that have shown music helps surgeon perform better, improving speed and accuracy. Here is also a link to an article about the same thing in NY Times. Also check out John Schaefer's blog entry, Music and Medicine, A Toxic Mix?

People were calling in to say what music they heard while undergoing surgery, how music is healing and calming-especially the harp and the violin. (I am afraid harp music would have made me feel like I had arrived in heaven, and violin probably would have irritated me.) but they said that if the music is familiar and not necessarily calming, it can also have a healing effect, even if it's Metallica. One woman who called in told of having to endure a horrible song playing as she was having a delivery with complications and it pissed her off. She didn't say anything, but years later still wished she had. I am so glad that I actually had a song that I liked.

The NPR segment then said that perhaps hospitals should ask people what they would like to have playing while they are being worked on. I started to think about this. What if the songs I picked put my surgeon in a bad mood and he didn't perform as well doing the operation? My healing Jazz might be his worst nightmare. I think in my case it worked out well, as I do remember the surgeon kind of rocking out while the song was playing (all this while holding metal instruments over my eyes, gotta love a young hip surgeon!) I think we landed on a song with both liked and it helped us both be at our best.

Thursday, January 14, 2010

Esotropia / Exotropia

It has been almost two months since my Strabismus surgery. While my eyes were pretty straight for several weeks they are now wandering around again. I am pretty tired right now, so perhaps I should make it a rule not to take photos when I should be taking a rest.

My left eye turns in when I look at things about 12 inches from my face and it wanders out when I look across the room. The first photo I am looking close up and the second photo I am looking far away and you can see, my right eye is fixating while the other is ditching the two eyed system.

I still feel grateful because my eyes are so much better than the way they used to look, and my vision feels more natural. The surgeon was right in saying a lot can happen in three months. But again, I am sure with work in VT I can correct this. No one said this would be an easy journey and I know I just need to keep working in Vision Therapy as hard as I can and have faith.

Tuesday, January 12, 2010

Trying to Find a New Way to See With my Brock String

I am at a place where my eyes are much more aligned due to my recent surgery and the work I have been doing in Vision Therapy, so why can't I fuse the beads on my Brock String yet? The therapist told me to shorten the normally 4-6 foot string to just a few feet and only use one bead, which has helped eliminate a lot of the confusion and makes it easier to decipher the feedback the string gives me as to where my eyes are pointing, however I am still not able to fuse the bead. Instead, I have two beads dangling centimeters away from each other.

The two beads appear to be different shades of the same color. I tell myself that the fused bead will be a compilation of the two shades and for a split second sometimes I think it flashes and I can see it, but I can't be sure. Maybe my mind is playing tricks on me or maybe my eyes are playing tricks on my mind. This new language is a tough one to learn.

The other day I realized that when I look up at the wall slightly above where the bead is supposed to fuse, I see the strings create a perfectly balanced X and the bead becoming sort of singular (although I still have yet to see the two strings going into that one bead...I can never seem to see that. Perhaps a bigger bead, although I did try ping-pong balls last year and that was too big!)

Why did the bead appear to fuse when I looked at the wall above it? The next day I tried to get the perfect X again by looking at the magic spot on the wall, but nothing happened. I blinked to try to get it and it happened again, and I realized in that split second that it wasn't the wall I was looking at, it was the air above the bead, towards the wall. My focus was on the air, not the wall! I was looking slightly above and ahead just past the middle of the X as it goes back out.

So then I wondered, why does the bead fuse when I look in the air above it? I have come to this conclusion: Maybe what I think is pointing my eyes at something is just not so. Seeing with both eyes at the same time is so foreign to me that perhaps it only felt like I was looking in the air above the bead, when in fact it was probably in that moment that I was looking at the bead with both eyes, aligned and seeing in-stereo.

I could be wrong about all this. Perhaps there is a scientific, measurable reason for this, that by looking slightly above the bead it compensates for some small misalignment I still have and I am really seeing the Brock String fuse out of my peripheral vision, I don't know. The string is so invaluable to me, as it tells me what I could never know, where my eyes are actually pointing.

In the end, this has taught me that I don't really know what using two eyes feels like. This is a great revelation to me. Perhaps the route to stereo vision will feel strange, like I am looking elsewhere, I think now that I know this, I will better be able to create a map towards it.