I Tried My Best

I was raised to be responsible. I am responsible. I go to work and the job gets done. I have done the job between bouts of vomiting, with fevers and with migraines.

I am responsible but I am not crazy.

OK. Maybe the word is not crazy. However, I am definitely not one for not using good judgment or not looking at the big picture. Now, this is especially true when it comes to my vision.

I was at a professional gathering on Friday. One person there asked me about the circumstances of my sight loss. This person had an eye bleed that had started on Tuesday! That is three, count them, three! days. I advised an immediate trip to an emergency room. I told this person his sight could be very much at risk but was told in turn he had other, important obligations to attend to and he would, essentially, get around to it later.

I tried one more time and was again rebuffed. Are we truly our brother’s keeper? I wanted to call 911 and get this person to the hospital. That would not have been appreciated, but would he have appreciated my efforts if I had saved his sight? If he gets to a doctor sometime next week and gets told he has done irreparable damage to his vision will he appreciate I tried? Will he wish he had listened?

I assume our readers have more common sense, but since assuming can make an ‘ass of u and me’, I am going to spell it out. Never, as in NEVER, ignore an eye bleed. Mary Lowth wrote about vitreous hemorrhages for Patient. She stated vitreous hemorrhages are one of the most common causes of sudden, painless vision loss. Vision can be totally obscured by blood in the vitreous. Even if nothing serious is wrong that caused the bleed to begin with, you can be left with floaters. Not to mention blood is cleared from the vitreous at the rate of only 1% a day. That is over three months of impaired vision!

There is a whole list of things that can be horribly wrong to cause bleeding in the eye. Because I have dry AMD and have been warned about the potential of developing wet AMD, a bleed due to neovascularization was the first thing I thought about. There is also diabetic retinopathy and posterior vitreous detachment. PVD can be associated with a tear in the retina. None of these are problems to take lightly. [Lin/Linda: if you ever see what looks like a curtain drawing over your visual field or part of your visual field is obstructed, that IS an emergency which requires IMMEDIATE attention because it can mean that you do have a retinal tear. Most PVDs are accompanied by lots of floaters & sometimes flashes of light that are more noticeable at night (that’s the vitreous tugging at the retina. If in doubt, call your doctor.]

Lowth stated “retinal detachment must be excluded urgently”. In other words, should you have a bleed, run, don’t walk to the doctor and make sure your retina is still where it is supposed to be. Waiting three days is not an option.

Some of you are also sadly aware that bleeding can cause scarring and even more significant vision loss. Bleeds should be diagnosed and controlled as quickly as possible.

So, there you have it, some people believe they have more important things to do. They believe satisfying responsibilities is more important than taking care of their eye health. These people are wrong. If you even think you have an eye bleed, get to your doctor.

As for this person yesterday, I tried my best. Matthew 10:14 [“And if anyone will not receive you or listen to your words, shake off the dust from your feet when you leave that house or town.”]

written December 3rd, 2017 Continue reading “I Tried My Best”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 4.00/5
Applies to topic
Avg: 4.00/5
Helpful to me
Avg: 5.00/5
I Tried My Best
Total Avg Rating: 4.35 out of 5 with based on 1 rating(s)
Overall quality
Applies to topic
Helpful to me

Sue’s Best Pages – Part 1

If you are new to our website, you might have looked at the LONG list of Sue’s pages and felt overwhelmed.   I hope this series of “Sue’s Best Pages” will help you to navigate through some of them.  We hope you will eventually read them all.

Spoiler Alert – why should you read these pages?

After a year of learning how to deal with her visual impairment both physically and emotionally, Sue has a rather ‘normal for her’ life: At age 64 and with advanced AMD geographic atrophy, she works several jobs, attends regular exercise classes, rides her bike safely, travels, walks her dog, kayaks, attends social events with her friends.   We are not suggesting that reading her journal will ensure you the same results but we hope that Sue’s Journal of Her Journey will be educational and inspirational.

For the newly diagnosed
  • You need to start In The Beginning.  Follow the sequence of pages with the links that are at the bottom of each page.  The first 13 were written in the early days of this journal.
  • Page 13 “A Human Doing” is where Sue starts to talk about her experiences with Pennsylvania’s Office of Vocational Rehabilitation’s Bureau of Blindness and Visual Services.  Because she wanted to continue to work, they were instrumental in getting her the assistive devices and training she needed to do that.
  • Of course, we hope you continue to read from there.  If not, please continue with the next section.
Pages highly recommended by our readers

We ask readers to rate the pages.  I’ve taken the ratings and comments to select these pages.

How She Does What She Does

Sue was 62 when her vision deteriorated so quickly that she had to stop working and driving. She could have started early retirement but she is not the ‘retiring’ type. ::smile:: She contacted Pennsylvania’s Office of Vocational Rehabilitation’s (OVR) Bureau of Blindness and Visual Services (BBVS).  The services she received included low vision, technology, orientation & mobility and rehabilitation.   Counselors for each of these services came to her home and workplace to deliver assistive technology, software and training. There was a one-time co-pay based on income. Some people pay nothing. Sue paid a small fraction of the true cost of the services, software and devices.

166.  A Day in the Life which covers the time she is not working.

288. A Day in the Life: Work Day

Continue reading “Sue’s Best Pages – Part 1”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 0/5
Applies to topic
Avg: 0/5
Helpful to me
Avg: 0/5
Sue’s Best Pages – Part 1
Total Avg Rating: 0.00 out of 5 with based on 0 rating(s)
Overall quality
Applies to topic
Helpful to me

One Foot in Front of the Other

We recently had a reader ask how it is possible to maintain hope, faith and optimism, etc. when “everything” is slipping away. She stated she does not want this disease because she had watched it “destroy” others. Her friends do not want to associate with her because of the “doom” she is facing.

Oh, my…where to start. First of all, I guess I need to say “I’m with you! I don’t want the damn thing either.” But wanting it or not wanting it really does not make a bit of difference. We do not get to make decisions like that in our lives. We only get to accept (or reject, but if you fight reality, I can practically guarantee you will waste a whole lot of energy and in the end, still lose. To paraphrase “I fight reality, reality always wins!”). We also can find ways of coping.

That appears to be a magic word: cope. This is not a fatal disease. If you are still breathing and conscious, you are capable of dealing with things and trying to make them better. Your hope is in every breath you take. Breath.

Remember one of my favorite people whom I never met, Viktor Frankl, said “the last freedom left to any man is determining how he will react to his circumstances.” This disease will not destroy us. It may take things from us, but not destroy us. We destroy ourselves through our reactions to it.

Our reader may not realize it, but she IS coping. She reached out to this website. She has sought professional help and she is involved with the state services for the visually handicapped. She is doing what she can do.

We don’t have to like having AMD and losing sight. We don’t have to be happy about it. We just have to keep moving. I mentioned this before but another one of my favorite, never met people, Winston Churchill, said something like “when you are going through Hell, keep going!” It is in pouting and denying reality – in stopping in the middle of Hell – that we are destroyed.

To address the part about being hopeful, optimistic, etc, a bit more, there are times all of those pretty thoughts are going to desert us. Times there seems – as in appearances and impressions – there is no hope. Those are the times we simply put one foot in front of the other. Determine what is next and do it.

I have been told I am “in love” with DBT. I am, for the simple reason it works. Mindfulness and staying in the moment work.

For example, the Beastie Baby has been diagnosed with lung cancer, but right now she is sleeping peacefully on the floor next to me. Right now, life is good. We will take one day at a time, one hour, one moment if need be. We will not grieve (much) and ruin life when things are good. Lesson: stay in the moment. Deal with the now. By dealing with each moment as it comes, we can handle a scary future. Buying future grief and hardship is a bad investment.

I could address the absolutes – always, never, everything – but I won’t. Not much, at any rate. We just need to remember few things in life are truly that black and white, that cut and dry. Every dark cloud has a silver lining and every silver cloud has some dark inside.

This has been a little jumbled, but that, after all, is my mind. I guess in summary, what I want to say is:

Accept this is happening, Recognize you are not powerless, we all have choices we can make.

Understand if we take care of each moment as it comes, the future will take care of itself. Don’t get ahead of yourself.

We don’t need to be hopeful or optimistic all of the time (even though there is reason for hope). If you cannot muster any faith in your future, just put one foot in front of the other and move. You will be surprised where you end up.

Continue reading “One Foot in Front of the Other”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 5.00/5
Applies to topic
Avg: 5.00/5
Helpful to me
Avg: 5.00/5
One Foot in Front of the Other
Total Avg Rating: 5.00 out of 5 with based on 4 rating(s)
Overall quality
Applies to topic
Helpful to me

One Good Eye

Just heard from a reader who said family and friends made her feel guilty about making a ‘fuss’ when she lost sight in her first eye. After all, she was older and you need to expect these things. Also it was ‘only’ one eye. She had two; did she not? She should have been happy she had one good one! They did not think she should fear vision loss.

Good grief. Not sure what species these people are from but we humans have a pretty strong fear of vision loss. In fact WebMD published results of a survey that found vision loss is what Americans fear the most.

This is a consistent finding across varying racial and ethnic groups. We ALL fear going blind.

In fact, fear of loss of sight was the same or greater than fear of losing hearing, memory, speech or a limb. And what is so scary about loss of sight? Quality of life and loss of independence, of course. Having good vision can be seen as a key to one’s overall sense of well-being. Good vision is frequently seen as essential to overall health and daily functioning. Good vision is seen as basic to just about everything.

There are five – just five – basic fears according to Psychology Today and I can see sight loss as feeding into three of them. First is the fear of mutilation, the loss of a body part. I took a little poetic license with this one, equating loss of function with loss of the organ itself. Then there is loss of autonomy, pretty self-explanatory, and separation. Sensory loss can certainly lead to a lack of social interaction. Is it any wonder we get so upset about sight loss? It taps into three out of five primal fears!

Fear is not just for weaklings and sissies. Fear is a valuable emotion. It tells us something is wrong and we had better start paying attention. There is something that needs to be dealt with. It is not only necessary but perfectly acceptable to listen to your fears.

To address their first point, vision loss is not an inevitable part of aging. There are a number of vision changes that occur but it seems only one of the common ones is not considered a ‘disease’. This is presbyopia – literally ‘old eyes’ from the Greek – or farsightedness. Presbyopia can be fixed in one of two ways: corrective lenses or grow longer arms!?

The Washington Post article entitled Vision loss is a part of old age but it’s not inevitable then goes on to list the rest of the causes of vision loss in older folks: cataracts, glaucoma and retinal disease. Please note the word ‘disease’.

Disease is not a normal part of anything and yes, you get concerned, and, yes, you see a doctor.

Our reader still did have one eye left, but would you like a good obsession? Try wondering when you will lose function in the second eye! That should afford you untold hours of uninterrupted worry! Somewhere I read waiting for the second eye to go is one of the most stressful things about progressive eye disease. Don’t know where, though. I read quite a bit on the subject.

Take away points: sight loss is not inevitable. Most causes of sight loss in older folks are considered disease and there are treatments for most of them. Don’t let anyone but a retina expert tell you there is nothing wrong. Most importantly, although I did not say this earlier in this page, if there is a sudden onset of symptoms, act quickly and get to the doctor.

Continue reading “One Good Eye”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 5.00/5
Applies to topic
Avg: 5.00/5
Helpful to me
Avg: 5.00/5
One Good Eye
Total Avg Rating: 5.00 out of 5 with based on 1 rating(s)
Overall quality
Applies to topic
Helpful to me

Will I Go Blind?

“Will I go blind?” is one of the most common and emotionally-charged questions asked when a person gets a diagnosis of many of the retinal diseases such as Age-Related Macular Degeneration, Stargardt’s Disease (and others) that damage central vision.  I did several searches with different variations of the question and here are some of the the answers I found.

Terminology
  • This is just a partial list of terms, please go to the the complete list – click here:
    • Total blindness refers to an inability to see anything with either eye.
    • Legal blindness is a level of vision loss that has been legally defined to determine eligibility for benefits. The clinical diagnosis refers to a central visual acuity of 20/200 or less in the better eye with the best possible correction, and/or a visual field of 20 degrees or less. Often, people who are diagnosed with legal blindness still have some usable vision.
    • Vision loss refers to individuals who have trouble seeing, even when wearing glasses or contact lenses, as well as to individuals who are blind or unable to see at all.
    • Visual impairment is often defined clinically as a visual acuity of 20/70 or worse in the better eye with best correction, or a total field loss of 140 degrees. Additional factors influencing visual impairment might be contrast sensitivity, light sensitivity, glare sensitivity, and light/dark adaptation.
Links & Answers
  •  From http://www.southlandeyeclinic.com/FAQ/macdegen.html
    • “Will I go completely blind from AMD?
      No. You will never go totally blind from AMD. AMD affects only the central vision. Around the macula is the retina responsible for side vision (peripheral vision). The side vision lets you know what is around you. You will be able to walk around, dress yourself and do most daily tasks. Peripheral retina is not affected by AMD and there is no loss of side vision.”
  • From http://www.besteyedoc.com/milford/macular-degeneration-faq.htm
    • “Q.  Will I go blind?  A.  No, patients do not go blind from wet or dry macular degeneration. You can, however, unfortunately become legally blind which means that the central vision is poor enough to result in your better eye seeing no better than 20/200 vision. However, being legally blind is not the same as medically blind.”
  • From https://nei.nih.gov/health/maculardegen/armd_facts
    • “AMD by itself does not lead to complete blindness, with no ability to see. However, the loss of central vision in AMD can interfere with simple everyday activities, such as the ability to see faces, drive, read, write, or do close work, such as cooking or fixing things around the house.”
  • From http://www.nhsdirect.wales.nhs.uk/encyclopaedia/m/article/maculardegeneration/
    • “AMD doesn’t affect your peripheral vision (side vision), which means it will not cause complete blindness.”
  • From http://www.brightfocus.org/macular/chat/what-you-need-know-about-dry-age-related-macular
    • “GUY EAKIN (interviewer): So you say 10 to 15% progress to the wet form, I like to hear 85 to 95—85 to 90 don’t progress to the wet form, but it’s the same message either way. We know that many people out there are fearful that AMD will blind them, it’s described in so many places as a blinding disorder and I understand that has some technical context to it that may, it may not be the complete story just to say that it’s blinding.  So what do you tell patients when they ask you, “Will I go blind?”
    • “GAYATRI REILLY (The Retina Group of Washington, “who has excelled in research, patient care, and educating other eye care professionals about treating diseases such as age-related macular degeneration) : Well, you know, I think it’s a question I get every single day, and it’s extremely important to address.That answer has changed over time, as you know. First of all, with even the most severe form of macular degeneration, this affects the central vision only, which—the difference between that—you use your peripheral vision less often, but when you’re not focused on something, you still see other parts in your vision, and that’s your peripheral vision, and that will always remain intact with even the most severe form of macular degeneration.  And the reason why this answer has changed over time, it was only as little—about 15 years ago, we had no treatments at all for wet macular degeneration, and the central part of the vision was something that we would expect for patients to lose, but now, over the past 10 years with research, and the treatments have changed dramatically, and what we can actually tell patients and have the expectations are that we hope to maintain good vision—and good vision including vision that’s capable for driving, for reading, and that’s the expectations that I would hope with early diagnosis.”
  • From https://www.secondopinion-tv.org/episode/macular-degeneration

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 0/5
Applies to topic
Avg: 0/5
Helpful to me
Avg: 0/5
Will I Go Blind?
Total Avg Rating: 0.00 out of 5 with based on 0 rating(s)
Overall quality
Applies to topic
Helpful to me

BIG News!

Woke up with a start at 2 am last night. Probably several things.

First thing that happened was a call from one of my contracts. She had called my third place of employment to schedule an evaluation and was told I did not work there anymore!

News to me! Now, I don’t get there a lot but the plan was for me to go and do a case or two when called. Maybe something like once every six weeks or so. I was never told I was being fired!

Of course it turns out someone got something wrong but it did get me to thinking. Once again, how does one graciously bow out or – hopefully equally graciously – be shown the door? Inquiring minds.

The second thing that has me a little anxious is my big ‘field trip’ tomorrow. I am going to do some sightseeing on Manhattan with an acquaintance from school. First time that far away from home without my husband since my sight loss. I know it can be done, but it is still a little scary.

Third thing: I saw Regillo yesterday. My eyes are getting worse slowly. (I am not so sure about the slowly part!) He confirmed scotomata (aka blind spots) get darker but did not necessarily say they go black. He said that he would not expect a central vision loss to cover 60 degrees of arc. That wide a loss would be ‘extreme’. Those two answers at least get us slightly closer to settling two of my burning questions from this Spring.

The big news, though, is he wants to try me on lampalizumab next winter. It appears the phase 3 clinicals are going to wind down by the end of the year and phase 4 trials will be starting.

People, the numbers of subjects in phase 4 trials is BIG. HUGE! Phase 4 trials take place after the FDA approved the marketing of a new drug. The drug is made available to the public through local physicians. They look for effects and side effects in diverse populations.

What this means for you is simply this: the first actual TREATMENT for geographic atrophy may only be six months away! This is the first breakthrough!

Lampalizumab is an injectible drug. It has been proven to slow the progression of geographic atrophy and to “reduce the area of geographic atrophy” by 20%. Dosing occurs monthly or every six weeks.

Will I do it? Probably. I really believe stem cell replacement of RPEs is the way for me to go, but it is taking forever and I don’t have time for forever. Lampalizumab can be administered locally and would avoid lots of trips to Philly. I don’t like the idea of intravenous injections but I don’t like the idea of a vitrectomy either! A 20% decrease in disease progression might win me enough time (and macula!) to have a more successful intervention later.

If you have dry AMD and geographic atrophy, it might be worth your while to broach the subject of lampalizumab with your retinologist. Let him know you are interested. This could just be the start of something big for all of us.?

Continue reading “BIG News!”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 5.00/5
Applies to topic
Avg: 5.00/5
Helpful to me
Avg: 5.00/5
BIG News!
Total Avg Rating: 5.00 out of 5 with based on 1 rating(s)
Overall quality
Applies to topic
Helpful to me

Not Your Parents’ AMD

3 pm Monday and so far it is a good day. The pool guy is working on my new liner. The funny thingee on my tummy is a normal, benign growth and the transportation company got new vans with fancy logos painted on them. No more confusion with two dozen, white vans. Life is looking up!

Lin told me there was a conversation thread in the Facebook group about parents who struggled with AMD. People remember what their mothers and fathers went through and they are determined not to become like them.

I am reasonably sure my father’s vision problems were AMD. The more I think about it his father’s vision problems may have been AMD. I remember both of them using a handheld lens to read the newspaper as well as the really strange interpretations Daddy would have when it came to TV shows. I have no idea what HE was watching but it was not the same thing I was watching!

I have said it a couple of dozen times and I will say it again: this is the best time in the history of the human race to be losing our sight. Absolutely the best. You may not realize it. You may remember what you saw and think we are doomed to go there too but we are not. We really are not.

I tried a handheld magnifier for a couple of weeks. Not doing that again. They are very inefficient. I have my CCTV, my handheld reader and my iPad which can go in the Justand.

[Lin:Linda: To see what Sue uses on a daily basis, check out these pages: A Day in the Life and A Day in the Life:Work Day.]

I can get newspapers on my phone and books from BARD (there are other sources, too, as well as magazines which are available).  I’m able to take a picture of pretty much any text I want and my KNFB Reader will read it to me. The zoom feature on my iPad will allow me to read email and research pretty efficiently. ZoomText allows me to work. (refer to the “Day in the Life” pages above)

If I want to look at something a little distance away I can use my max TV glasses or my monocular. Not too bad.

Depending upon when Lin publishes this page, you either have or will be hearing about audio description services (coming soon!). If my father had had those for the TV we would have been “on the same page” a lot more than we were when we watched programs together. Audio description can also allow you to go to the movies and live theater and actually know what is going on.

Do I want to be losing my sight? Hell, no! This is not a walk in the park but it is not what Daddy endured either. Just the same he made it into his mid 80s and managed to take care of himself until other issues brought him down. If he could do it without all of the toys, I can do it.  [Lin/Linda: My dad had geographic atrophy & took care of my mother who had Alzheimer’s using several different handheld magnifiers & a few other low vision aids.]

Yet another reason to be optimistic is all of the exciting research happening. We are poised for a veritable explosion of treatments. Not cures, mind you, but treatments. Thirty years ago there was nothing.

[Lin/Linda: To see what’s in the research pipeline, click here.]

What can you do? Be willing. Use what has been provided. If you put that iPad your son gave you in the drawer you have absolutely no grounds for complains. Bluntly put? Your extra suffering will be your own damn fault.

What else? Volunteer. Sign up for clinical trials. Join support groups. Share your knowledge and skills.

Life – and this vision loss bit included – is the craziest thing you will ever experience and none of us get out alive. Make the most of it while you can.

Continue reading “Not Your Parents’ AMD”

Ratings

  • Rate this
  • Summary
Current Average Ratings
Overall quality
Avg: 5.00/5
Applies to topic
Avg: 5.00/5
Helpful to me
Avg: 5.00/5
Not Your Parents’ AMD
Total Avg Rating: 5.00 out of 5 with based on 1 rating(s)
Overall quality
Applies to topic
Helpful to me