A New Diagnosis

After eight hours in the hospital Emergency Department, "Ken and I went home and crawled into bed. It had been an exhausting and frightening six hours for Ken, and eight hours for me. The question of whether I was going to acquire another diagnosis loomed over me, but I was too tired not to sleep.

"Thursday morning arrived too soon. At 8:00 am my cell phone rang, followed by the sound of someone leaving me a voice message. The ophthalmologist's office was following up on the events of the day before. I rolled over in bed and slept another hour. Later, after following my usual morning routine, I picked up the phone and scheduled two appointments, then canceled a routine dental visit I'd scheduled weeks ago. Clean teeth could wait a few more days!

"The first appointment of the day was at the neurosurgeon's hospital clinic office to meet with Stephanie, the certified nurse practitioner who had followed my case from my first brain surgery. She was ready with the magnetic device that programs the valve on my brain shunt, changing the pressure setting at which the valve is set to open. She applied a small amount of gel to the area on my head where the valve is located. Then she gently applied the programming apparatus to that area, holding it steadily in place for, maybe, one minute. This painless procedure is completely non-invasive, and only requires removing the gel from my hair when we're finished. The comfortable setting varies from person to person, but is always within a specific range. For some patients, she sets the valve just prior to surgery and never needs to change it again. In more sensitive patients, like me, she may have to tweak the setting in order to provide maximum comfort.

"I left the clinic in a good mood, thankful that one more loose end was tied. As I drove up in front of my house, I saw a Cooper's Hawk tearing at his kill, on the ground in our yard. Having striking coloration, Cooper's are handsome and powerful, yet compact, raptors. A family of them has remained in our neighborhood for several years, but this was the first time I'd seen one munching his lunch in my yard. I watched from my car until something scared him off. I wanted to see what his kill was, so looked intently at the area as I walked past. Only feathers remained of the bird he'd eaten, probably a House Sparrow.

"I ate my lunch quickly, so I could jump into the car again to drive my reliable, old Saturn to my second appointment. This one would be less comfortable for me. The ophthalmologist wanted to complete a few more tests in his clinic, in order to finalize my diagnosis. Particularly, he wanted to check the field of vision in my affected eye. We had discussed two of the diagnostic possibilities the night before. The first was a serious one: arteritic anterior ischemic optic neuropathy, or AION. This was part of a vascular disease that could effect my whole body and cause blindness. The second possibility and the one he finally chose was non-arteritic anterior ischemic optic neuropathy or NAION. Even he could not say that ten times fast! In essence, my left optic nerve had experienced an ischemic event, or stroke: the blood flow to it had been briefly cut off for an unknown reason, likely having nothing to do with hydrocephalus, but possibly the result of my sleep apnea. The doctor said I needed to allow it time to heal, but that it may not heal completely, and it may happen again. Another diagnosis to add to my ever-growing list.

"I usually went straight home after an encounter such as this one, to research the items from my discussion with my doctor, in order to understand my condition better. This time, however, I canceled my plans for the rest of the day and took a brisk walk with my neighbor friend. A brisk walk is good for relieving stress when paddling a canoe is not available!"

From The Lakes In My Head: Paddling An Unexplored Wilderness