It was the top line, one letter only, an E. It was huge. With her right eye, Mary Ann could not read it. The Nurse had gone through all the sizes of letters available until finally she had the screen full from top to bottom with that one letter. She could not read it.
While Mary Ann seemed unfazed, I was taken aback by the impression that Mary Ann was essentially blind in one eye. She had been to the Optometrist within the last year and a half. She had gotten new glasses. It was hard to imagine what could have caused such a dramatic change so quickly. Neither she nor I had noticed her losing sight in that eye. It just did not compute.
The Doctor came in to get more information and do a check of her eyes before the dilating procedure that would follow. When the Doctor checked her right eye, she was able to read with difficulty letters on the screen that were large, but a size that allowed four somewhat smaller letters to show on the screen instead of only one huge letter.
After the glaucoma check and the dilating procedure had taken effect the doctor returned. I asked her what might have caused the swelling that appeared yesterday and had disappeared by today. She said it might have been a chalazion, a blocked oil gland. She observed that sometimes they will go away after a time and sometimes they have to be surgically removed.
Then I asked her about the large quantity of thick, dark mucous that would sometimes gather on the edges of her right eyelid. She mentioned the possibility that it might just be a flareup of blepharitis, an inflamation of the hair follicles of the eyelashes. She prescribed a topical antibiotic if that should flair up again. I will admit, having experienced blepharitis before, I am not convinced by that explanation, but we will use the antibiotic should it happen again to see if it helps.
Neither the chalazion or the blepharitis are anything of major concern. Then the Doctor checked the retina in each eye very thoroughly. Her observations were good news in that Mary Ann’s retinas appear to be in very good condition. The margins (?retina or eyelids) are in excellent shape, clear and clean. She has cataracts, but ones that are a long way from needing surgery.
The bad news is that the vision problems seem pretty clearly to be neurological. The images from her eyes mechanically are being transmitted appropriately, all the parts working well. The problem is in the processing of that information by her brain. The Doctor did not say it, but it seems reasonable to conclude that there is no treatment for that problem.
While I forgot to mention the stroke Mary Ann had about three years ago, it seems reasonable to consider that a factor in this problem. The cluster stroke effected her right side. The problem is with her right eye. Ever since her stroke she has had problems using utensils to eat. I mentioned in earlier posts the time she couldn’t see the meatloaf on her plate but could see the baked potato, the time she got up to get her Pepsi when it was right at the top of her plate inches from the food she had been eating.
When I asked Mary Ann how she felt about the appointment, she asked if she needed new glasses. I don’t know how much of what was said settled into her awareness. We will make our routine appointment with the Optometrist since we are due anyway. Mary Ann very often says she needs new glasses. She seems to be convinced that any problems seeing are the fault of the glasses. Since the iris of the eye is run by the neurotransimitter (Acetyl-choline) used by the Autonomic Nervous System (ANS), her compromised ANS (and the medications that treat it) has been affecting her vision for many years. More of what the Parkinson’s and the Lewy Body Dementia have brought along with them when they joined us on our journey through life.
As always, Mary Ann is just taking it all in stride. It seems to be something of a blessing that some of the things she is dealing with have just not fully entered her awareness. That may be by choice, or it may be a function of the Parkinson’s Disease and the Parkinson’s Disease Dementia. It may all be sinking it, may simply be choosing not to talk about it. It may be a defense mechanism to keep from dwelling on the problems. It may be any combination of all of them.
Whatever is so, there seems to be nothing resulting from the appointment with the Eye Doctor that changes our current version of normal. That is about the best we could have hoped for.
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January 14, 2010 at 4:00 pm
Peter: I would agree with your thoughts/insights regarding Mary Ann’s vision. And I believe it is indeed a blessing that she is focused on blaming her glasses for the poor vision.
As I continue to read your posts I amazed at the calm and serenity that comes across in your writing. And I do appreciate your posts for they serve as daily reminders to me as a professional helper of the challenges faced by those tho whom I am providing support.
On another note-I would like to develop a presentation about caregiving that could be presented to clergy, church professionals on the challenges (emotional/ spiritual and physical) faced by members of their congregations who are serving as caregivers. I have an assumption that many clergy/church workers are unaware of the true depth of the challenges faced by caregivers in their congregations. Would you be willing to provide me with insights/thoughts/ideas along those lines. I would value your input since you have the unique perspective of both of those worlds. I do not have a deadline for getting this accomplished so it would not be “another thing” on your to do list. We could do it by e-mail or phone or even face to face during the times I make it to Topeka to visit my mom. Let me know what you think. And it is ok to maintain your boundaries and to say no, not right now.
Blessings-Kent
January 15, 2010 at 2:38 am
Kent,
I will accept the “calm and serenity” assessment as long as the definition of those terms includes “feelings of utter frustration, angry words, moments of panic, passive aggressive acting out, irritation with God and anyone else who dares to come to mind, as well as times of feeling fulfillment, a meaningful sense of purpose, spiritual wholeness, love and commitment, and a deep sense of God’s unconditional love.
I would be glad to be a part of any effort to help church workers care more effectively for those they serve. Any approach to communicating is fine with me as long as it works in the context of my commitment here to caring for Mary Ann. Phone is okay as long as there is understanding if/when I need to leave the phone quickly to deal with a need here. Email and face to face are great too.