Blind and Toothless 

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While typing away on my accursed clinic computer a couple of years ago, all of a sudden I could not see the bottom left of the screen. It was gone. Boom! No black hole. It was simply just not there.

It started to spread. Then, it was replaced by blurring that wound around to the center of my visual field in a sort of spiral with crisscrossing stripes of scintillating grays.

The realization hit me. My retina had clearly detached.

I was going blind!

There are two things that terrify me more than anything else in this world:

Losing my teeth and going blind.

I struggled to maintain composure as I wrapped up the visit with the patient and ran to the phone where I dialed the ophthalmology office down the street. I send them tons of patients. Surely they would find a way to work me in!?!??!? Of course it was 3:45 in the afternoon. Odds were not looking good.

After several holds and line transfers and some begging on my part, I was finally told to get my bo-hiney straight on over. By then, my vision was back to normal. I almost said, “Never mind!”

But I didn’t.

I didn’t want this spell to be the warning with the “big one” just waiting to strike the fatal blow to my vision and my livelihood.

My partner agreed to see my last couple of patients.

I sat anxiously in the sub waiting area while my eyes dilated. Try being bored for 45 minutes when you cannot focus on anything smaller than a two by four. Everyone around me was trying to avoid making eye contact with each other, but without the ability to see our smart phones, it was… awkward. There was nothing else to focus on, except the ceiling.

“Well, doc. What we have here is a case of ocular migraine. You are going to be just fine.”

My heart sank. I was a wee bit disappointed, I realized. I wanted it to be real. Real but fixable. An ocular migraine? That had always seemed like something “crazy” people complained about… Sometimes, until you experience something yourself, you cannot fully appreciate the reality of it…

Wait. Was I crazy?

Maybe.

“How stressed have you been lately?”

I paused, thinking. Stress? I mentally scoffed at the notion of stress. 

The optho stared at me, waiting.

“No stress.” I smiled sweetly at her.

I sounded convincing because I actually believed it myself.

She shrugged. “Well, it may happen again. Or maybe not.”

On the drive home, with my nifty disposable wraparound sunglasses, I thought about all of this.

First, I know what ocular migraines are. I talk to patients about them. I diagnose them. It struck me how when it is you (or someone close to you) how quickly you loose sense, reason, and perspective. A good reason for the quote from Sir William Osler: “The doctor who treats himself has a fool for a patient.”

Second, and more importantly, I was stressed out. My body recognized it before I did. In the midst of my denial, it decided to send me a message.

You can’t go on like this!

I might not have permanently lost my vision per se, but I was blind to my stress level.

If you ignore it, it doesn’t exist. Right?

Nope. It is still there.

Moral of the story? Give yourself a break. Not to say that I have. Yet. Maybe someday. Oh. And brush your teeth.

(If reading this gives you a strange sense of déjà Vu, that is likely because I originally posted this last year.)

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150 thoughts on “Blind and Toothless 

  1. Umm, it’s true. Most people don’t realize or often even recognize the damage that stress does. Stress is a critical part of our interaction with our world and it iscritical. It tells us when something is important and needs to be addressed. The problem comes with stress that you cannot control or address. It will get you. I belong to a non-profit organization that collects data about Canadian cancer patients both current and past. The purpose is to try and find commonalities that can be explored as causative agents, enablers and/or catalysts. For the colon cancer that I beat, the greatest common denominator between patients was stress. Over 75% of the colon cancer patients were experiencing or had recently experienced major stress in their lives(in my case it was doing a graduate degree while working, break up of a 12 year relationship, change of home, change of job, change of colleagues, change of friends, even change of car – all within a 1 year period). there are obviously chemical/biological mechanisms that are the antecedents of the disease but there seems to be no doubt that those mechanisms are at least in part catalyzed by stress.

    Addressable stress drives us for good and unadressable stress causes long term damage – the trick is to balance them.

    Liked by 2 people

    • This is true! So often we compartmentalize the emotional and the physical and neglect to see that the do not just overlap… They are intertwined. Over 50% of what I treat in a given day is due to anxiety, stress, depression. There are very real physical manifestations of emotional issues.

      Liked by 3 people

      • Yeah, as black humor, I often joke with those who ask me about investing, that they should put their money into companies that make anti-depressants- bound to do well.

        Liked by 1 person

  2. New post to me, and amazing. I have never heard of this. Is it connected in some way to traditional migraines? I used to have those every month with hormone fluctuations. Why does it take a major scare or crisis to make us aware…and why do we push ourselves to that point? Never any answers to questions like that.

    Liked by 2 people

  3. So, your eyeball is okay now? I had my first ocular migraine a few months ago (looked like a bunch of trinagles) and I am in same boat with eyeball woe now. Doc says nothing wrong with eyeball (had same dilation test, but it’s a (big) floater obscuring lower part of vision and my brain will eventually compensate. Any comforting tips for somebody with same eyeball fear? And, yes was under lot of stress both before, and this time. LOL Hope everything’s okay now, with your eyeball.

    Liked by 1 person

  4. I have those very very rarely. The first one was terrifying. I understand your fear. I’ve also had the experience of mocking people’s health problems only to have fate hit me upside the head with something even weirder and all too real. I’ve decided to try to keep my mouth shut since I clearly can’t reserve judgment. As for stress? I think for some people NO stress is more stressful than “stress.” If I were a doc I’d probably recommend drink more water and have a cup of coffee next time it happens, but I’m just a retired English teacher.

    Liked by 2 people

  5. Emotional stress is awful! Sometimes you really don’t register how significant it is until you have physical symptoms. I had terrible facial flushing (my face felt like it was on fire) for a couple of weeks last fall and couldn’t figure out why. I was recently told by my dermatologist that I have mild Rosacea. Apparently it can be triggered by severe emotional distress. It’s fine now but not fun at the time.

    Liked by 1 person

  6. You forgot “Wear sunscreen”.
    Bizarrely, I only heard this for the first time this afternoon in the car driving back from a funeral. I guess the rest of the planet is tired of Baz Lurhman’s rendition of a kind of Desiderata, but it will be the hotel fruit basket of good advice against stress — for me at least.

    Liked by 1 person

  7. I’m so glad that it was just (although just is hardly a good word) an ocular migraine. I was plagued by migraines for most of my working life – sometimes one sided, the worst when it was both. They were always preceded by a visual anomaly – dancing patterns across my visual field. Retirement and getting my BP under tight control have relegated them to the past, but I worried as you did!

    Liked by 1 person

  8. I have a fear of losing my teeth and dream of it often. I suffered migraines when in a stressful job with strict deadlines. I’d work through the week on adrenalin but at 5.30 on a Friday night migraine would hit and stay with me until 10.30pm Sunday. Funny enough redundancy in 2001 cured my migraines as I’ve had very few since! Everyone needs a break and ‘Me time’. Take care. 🙂

    Liked by 1 person

  9. My husband was so stressed a couple of months ago that one side of his face and arm started drooping. This started and stopped 5 times in one night during the course of his hospital stay and they thought he was having TIAs (he’s only 38!). They dx’d him with conversion disorder, but after seeing a neurologist it turned out to be a certain type of migraine headache! A HEADACHE cause stroke-like symptoms! I was shocked. Take care of yourself doc!

    Liked by 2 people

  10. That sounds very scary! So glad you’re okay now. As for judging others about conditions that may or may not be “made up”, I have probably been guilty of that in the past. However, when I started experiencing restless leg syndrome that changed. I scoffed at RLS when I first heard about it but it’s very real for me and a lot more annoying than you’d imagine. I made a concerted effort to not judge anyone else after that. You’d think with our years of life experience we’d be better at “walking a mile” in someone else’s shoes.

    Liked by 2 people

  11. Very scary. I was reading your description and thinking, “that’s what my ocular migraines feel like,” but I know that fear. I had my first one on a sailboat somewhere in the San Juan Islands and I thought I was having a stroke. It passed which was great since there wasn’t a hospital within 50 miles of my sailboat.

    Liked by 1 person

  12. I’ve never had one. I’ve had plenty of horrible four and five day long migraines where everything got dark (like wearing the darkest of sunglasses indoors) and I had to hang on to the wall to figure out where I was going. But yours sounds so freak-out-scary that it cannot be ignored.

    Liked by 1 person

  13. A scary incident as you say when it it you or someone you love however much you know flies out the window with logic! I am glad you are okay, did you have another ocular migraine? i hope you learned your lesson and de stressed xxx

    Liked by 1 person

  14. One night class, I was making some comments before the class. I saw a green slime roll down my left eye. I was blinded for a few seconds. I dismissed the class, then called my eye doc. An emergency session in his office. “ER docs don’t know what to do.” Imagine meeting a physician in his office at night! I was awed. A detached retina. Then a few years later I walked into a wall at a shopping mall. Eye doc office (on a Saturday!) again. Temporary blindness. Hypertension. Both of my eyes are windows to my soul. I’ve worn glasses since a sophomore in high school (1956), single, bi-focal, now tri-focals. We do take our eyes for granted, too often. Read Milton’s “On Blindness.” Thanks for the post-posted posting.

    Liked by 1 person

  15. This stress level issue is why I am taking this certification in Trauma Informed Organizations. This program is for working with clinicians and organizations who deal in any facet of medical/or mental health service. It really is way too common for providers and all clinicians to push themselves too far and suffer either compassion fatigue or burnout. Even worse is vicarious trauma stress or secondary PTSD.Seems a lot of you don’t know when to stop. And what is worse, often there is fear of failure to report such conditions. We are so quick to point out the failure but in reality it is strength to know when to give yourself a break. Physician, heal thy self and do no harm! Good words.
    Part of it is “The System” which just makes bigger demands on time and effort. To counter that, I have just introduced Mindfulness Based Stress Reduction into our second day of orientation. EVERYONE takes it. I also teach basic breathing methods and some spot relaxing techniques to get through the day. It took me three years to convince the CLINICAL operations that simple prevention and tools like these will help in the long run with retention.
    So I prescribe Doc, two days off, go to a spa and pamper yourself and then just sit with your kids outside somewhere and breathe. ( see, I am never stressed….lololol…oh that is so wrong…)

    Liked by 1 person

  16. Wow. So glad to know it was not permanent damage. But I agree, so many of us burn both ends of the candle and we become blind to it (no pun intended). I remember during a very busy season a few years ago, working like a madman (but not as busy as you, of course). I developed sever pains in my lower abdomen. After a few hours, I was doubled over and could barely walk. Reluctantly, I hobbled over to a nearby clinic, and was told it was appendicitis and that I should go to a larger hospital to have it looked at immediately. And what did I do? I went back to the office and proceeded to work over-time for another few hours. It was my husband (bless him) who phoned me at the office and demanded I come home. Asap.

    The next day, I went to a large University hospital and took all the tests. I had the operation later in the afternoon. Apparently, my appendix was very swollen. Looking back, I realise how stupid I was to ignore my body like that. But I was just so caught up with everything, it somehow affected common sense. I promised hubby & myself to never allow that to happen again. Yet, I find myself still running furiously on that hamster wheel… Sorry for the long comment! Reading your post made me remember this 😉

    Liked by 1 person

  17. I keep telling you how what you write keeps reminding me of my Med college days. 🙂
    The “Third Year Syndrome”, when we started clinical rounds and reading Harrison’s and Bailey and Love. Every posting brought out a different disease in us. Hell in the final year of Ophthal residency I thought I’d developed PVD with VR traction! I hounded my Sr. resisdents. Turned out all I had was pre-exam stress. 🙂
    We don’t always have the capability to look at ourselves objectively, though I have words from a purported higher authority to counter Sir Osler, “Physician, heal thyself!” Luke 4:23. 😀

    Liked by 1 person

  18. Roseanne Barr isgoing blind from macular degeneration. The worst thing about going blind, for me, would be not being able to look at myself in the mirror. Mmm mmm, he sure is handsome, that boy. I’m off to brush my teeth now.

    Liked by 1 person

  19. Yep. My two biggest fears as well. When I was working in a very stressful field in 2006 I sometimes had fantasies of fracturing a leg. People in the helping professions are able to numb themselves to their own needs. It’s odd.

    Liked by 1 person

    • I get a physical high from helping others. On some level, I really enjoyed working in the hospital setting because people really needed me. Now that I am only outpatient, most of the things I do any number of hundreds of doctors in the area could do just as well. There is something to be said for feeling needed.

      Liked by 2 people

      • I do too. I also got high from successfully advocating for patients. Most people don’t understand how much is available to those who won’t take no to a reasonable clinical request for an answer.

        Liked by 1 person

      • I don’t even know everything that is available. I wish social workers were more readily available to assist those patients that need it. It is difficult for even those familiar with it to navigate the system.

        Liked by 1 person

      • I have to tell you that the best case managers are in the public sector.

        A good case manager forges relationships with other care providers and develops a reputation for complete referrals and clinical presentations.

        The problem that you present in the close of your comment is interesting.

        If these systems are difficult for the people who work within the system to navigate; then what is it like for a patient whose reasoning may be compromised by anxiety and fear.

        For reasons I can’t fathom I can’t focus to fill out paperwork that may mean the difference between spending thousands of dollars in co-pays and having it covered.

        I simply can’t do it.

        To my surprise, neither can my Kaiser Care Manager…and the program is a Kaiser program.

        What I will never understand is why this billion dollar a year HMO Non-Profit (cough) doesn’t train it’s staff.

        I think that learning how to find and use community resources is best done buy professional case managers.

        They should be on the staff of all facilities and perhaps even assigned to patients as a matter of course.

        Liked by 1 person

      • Agreed. But I cannot afford to hire one. Insurance companies are pushing to have them but they are assigned only to patients that are costing them too much money… to presumably decrease the amount of money they are spending.

        Liked by 1 person

  20. Well thank you for giving me the “what it feels like” for all of the patients that come through my window (now I have an idea)….also I have had a few of those ocular migraines with the fancy light show and the black cloud. In my case if I get some serious caffeine in me (extra shot of espresso kind) as soon as the light show starts, then the migraine isn’t as “I’m going to die now” bad. I was scared to death the first time I had one, so I feel your pain.

    Liked by 1 person

  21. Omg! I was just reading about detached retinas because I have this big hairy floater in my eye and saw some little flashes of light! I’m calling my optometrist first thing in the morning. I know what you mean about not wanting to admit to our own stress, or at least saying, yeah, I’m a little stressed, but I can handle it, I’m used to it. I would love to find out I just have an ocular migraine.

    Liked by 1 person

  22. Pingback: My Article Read (4-30-2015) | My Daily Musing

  23. ACk! That is scary. Stress does amazing things to our bodies and our minds. Migraine is one, and I call it a ‘wake up call.’ My stress reactor is grand mal seizure. You can bet I took away extra activities and work, started up with yoga and meditation (NO medication), and began to slow down my speech pattern (somehow that helped too). I want to work and write for a long long time, so changes in my life made/make sense. I take house calls – perhaps you should ring me up? 🙂

    Liked by 1 person

  24. That had to be frightening for you, Doc. Just a note on stress…I wonder how much research has been conducted on the relationship between stress and cancer ? I’ve seen a bit of this connection in my own family. Van

    Liked by 1 person

  25. OMG! I experienced the same sequence of events when I was in my thirties. I thought I had a brain tumor. They occurred with increasing frequency, stressing me out further. I went to my doc at the time and he put me through a bunch of tests – the diagnosis was ocular migraines. I’ve not met many others who experience them. Over the years, I still get one from time to time, but not so often anymore. Sometimes sunshine (blinding sunshine) will set one off. They last about twenty minutes – I see an arc of different colors, my visual field looks almost ‘cracked’ – and then they subside. I haven’t had one now in about five years.

    Liked by 1 person

  26. The first time i had an ocular migraine… (once i got control of the initial panic!) I was so glad that i had heard of them one time a few months before. After a few minutes of hanging onto the edge of my desk for dear life, i realized what it was. Still frightening even then. I don’t get them often, but would prefer them to the regular migraine… Yeah re the stress… mega-stress. So glad you aren’t still getting them. Great big hug. 🙂

    Liked by 1 person

    • I was JUST commenting how generally these are so rare but it seems a lot of bloggers have them. Perhaps because so many of is are stressed to start with and we have turned to blogging as a therapy of sorts? Interesting phenomenon, really…

      Liked by 1 person

      • Yes, i’m sure you’re right (blogging — stress outlet). I think all the staring at the computer screen can’t help either. I mostly have gotten them at work (computer all day there too).
        Interesting indeed, and like you said — the lights are pretty. 😀

        Liked by 1 person

  27. Reblogged this on Conversations I Wish I Had and commented:
    I loved this post. Especially:
    ““How stressed have you been lately?”

    I paused, thinking. Stress? I mentally scoffed at the notion of stress.

    The optho stared at me, waiting.

    “No stress.” I smiled sweetly at her.

    I sounded convincing because I actually believed it myself.

    […] My body recognized it before I did. In the midst of my denial, it decided to send me a message.”

    Like

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