Tuesday, October 29, 2013

Seeing Damn Straight!

I can see, therefore I am free. With my vision restored, I have regained my independence. I can’t express how grateful, and relieved, I am. After months of experiencing double or blurry vision, with all the attendant side effects, I got a clean bill of vision health today from my neurological ophthalmologist specialist. Overseeing my case all the while was my stroke neurologist, who’s been there for me since my stroke 16 years ago. He persisted in following every path to determine a cause. He listened to every detail, every clue, every nuance I could provide and in so doing provided a classic example of doing less pontificating and letting the patient guide the diagnosis.

There’s a maxim in medicine that goes something like this: When you hear hoofbeats, think of horses, not zebras. In other words, consider the expected rather than the exotic. We know why they call it the “practice” of medicine. Because each patient presents with a unique set of variables, it becomes a guessing game of trial and error to coax a diagnosis. In my case, it was my stroke that was the red herring for the practitioners who tried to tie it to my vision problems.

Just as my double vision shifted from eye to eye, so too did my diagnosis, from one presumed abnormality to another. First it was decompensated phoria, or possibly an ocular ischemic stroke. Then it was ocular myasthenia gravis for which I began treatment. Now it has shifted again to what appears to be related to an inner ear infection. This makes sense to me as one constant I have experienced is a lightheaded sensation similar to being on an elevator. As I alluded to earlier, it was the guidance of my stroke neurologist that helped me navigate this minefield. Given our history together, I used to joke that I got the white glove treatment because I was his “special” patient. But the reality is this is how he treats all of his patients. He encompasses all of the compassionate qualities that I evangelize for in integrating humanity into the science of medicine. Would that we could clone him.

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