Tuesday, June 19, 2012

Small Changes = Big Consequences

As many of you know, I had my annual appointment with Dr. J. at the Kellogg Eye Institute last week. This was a routine visit, with the exception that I was scheduled for a visual field test that would map the "blind" spots I have in my retinas. By mapping these spots, Dr. J. and his team were able to give an assessment of how much my damaged retinas impact my visual field. In conjunction with the exam that determines my ability to perceive distance they could determine if I meet the legal visual requirements to be a licensed driver in the state of Michigan.
Scary? Yes. Physically painless? Yes.
The test was very cool. I went into a dark room and stuck my head into a giant inverted white cone. In the center of the cone was a small black dot. They put an eye patch over the eye not being tested and I was instructed to push a button on a clicker they handed me once a blinking white light came into view. The blinking light sometimes came in from the edges, sometimes from the center, and sometimes it would just appear randomly. Throughout the entire test I felt like a Jeopardy contestant and was SO consumed with my speed and accuracy of pushing that damn clicker I sometimes forgot that I was supposed to be looking for a white light. Luckily for me, my technician was patient and experienced. When I cursed in frustration that I felt as if I had forgotten to study for ACTs, she laughed, patted my shoulder, and said, "You're doing great. Just like the ACTs, you can always take this test again." The staff at Kellogg rocks.
Once we completed the test on both eyes, she put dilating drops into my eyes and sent me into the next room to wait for Dr. J.  Having my eyes dilated never bothered me pre-vision-loss. Now, I can't STAND it. When your sight is limited, you are acutely aware of every nuance of vision you have. As the drops took effect, I could feel my vision decreasing. One minute I was reading a book on my iPad, the next I couldn't make out the words no matter what size I increased the font to. Every time this happens, I realize how thankful I am that I do not have an eye condition that will progressively deteriorate over time. Having my vision be the worst it (should) ever be two years ago and slowly return to the less than stellar point it is now, is comforting.
After about 20 minutes of not-so patient waiting, Dr. J. called me back. He had a print out of my field of vision test and showed me the mapping of my blind spots. It was very cool and not really surprising to me at all that my left eye had a larger obstruction than my right eye, and in both eyes the damage to my retinas is just below and left of the center of vision. What did surprise me though was that in neither eye, my field of vision was compromised to cause me to "fail" the test. My blind spots aren't really blind spots at all. They simply blur my visual field in those areas, but the overall percentage of my visual field is not greatly affected. When I asked Dr. J. what that meant exactly he summed it up succinctly and calmly - "You meet the legal visual requirements to qualify for a driver's license in the state of Michigan."
Say what?
I can drive????
I was not at all prepared for the news that legally I could begin driving again and pushed Dr. J. to elaborate by asking him if I should drive. Being the professional he is, he wouldn't directly answer my question, choosing instead to list all the factors  that the two tests Michigan require can't determine - my confidence as a driver, the way glare & light affect my vision, my reaction time, etc. . . When I was sufficiently freaked out and mystified as to why anyone is ever allowed to get a driver's license he reminded me that just because I can, doesn't mean I have to or even should.  His advice - Try it out, take it slow. Stick to fair-weather, daytime driving, on surface streets and see how it goes. If you've adapted to a life where driving isn't necessary then why drive?
"Why drive? I live in the suburbs of Metro-Detroit. It's not like I have a whole lot of public transportation options to choose from." My response may have been a little snarky but the sentiment rang true. But his question has left me reeling. Why drive? I have many, many reasons why and maybe many more why not. But I'll save those for another post.
His last point before he left the room was that I've far surpassed his expectations of recovery but we've plateaued. My left eye hasn't shown improvement in over a year and my right eye hasn't changed significantly since last November. There is really no reason for me to continue to see him every year. He recommended my next appointment should be in May of 2014. Two years from now.
I thought I hit my emotional roller coaster threshold with the notion of driving again, but what really sent me into a tailspin was the reality that this was it. How I see right now, today, is as good as it's going to get. I've come a long way from where I was two years ago, but we've hit the ceiling and there is nowhere else to go.
While I did say (just a few paragraphs ago in fact) how lucky I am to not have an eye-disorder that progressively gets worse, I neglected to mention how much hope I had that one day my vision would return to what it was prior to May 27, 2010. Deep down, I always thought that since I had progressed so much that one day my eyes would heal themselves completely. That the constant adapting and adjusting of the last two years were just temporary, a long-drawn out nightmare to test my endurance, and that when I had proven I could rise to the challenge, I'd find I didn't have to anymore. I'd be cured. Ridiculous and illogical I know, but that's what hope often is.
I wish I had great inspiring words to wrap this post up. Most of it I'd written three weeks ago and I let it sit; hoping that some distance would give me some perspective and a fabulous ending. It didn't. I still haven't driven. I'm terrified of it and I will explore the fear of having my license restored in an upcoming post. Mostly I've been trying to focus on the positive, allowing myself the moments to grieve the loss of my vision, and then reminding myself how much I have to be grateful for.

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