No Sight for Sore Eyes

In my last entry, I promised to explain why it had taken so long to tell you about our trip to Dutch Harbor. The explanation begins last August. I learned that I have diabetes 4 days before I was leaving for Alaska. My doctor didn't want to educate me about my condition because she wasn't going to be able to monitor me. That means that I got no instructions about diet, exercise, or blood sugar testing prior to my leaving. There were no medication changes. All I got was "You've got diabetes. Good luck."

I did the best I could in modifying my diet, but the only tool I had was a scale. I have yet to find two scales that agree on my weight. Besides, the significant number would have been glucose levels, but I had no way to measure that. The clinic here in Atka, as I've mentioned, will only provide acute care for non-Alaska Natives. I wasn't eligible for either chronic care/management or wellness care.

Fast forward to March 5, the day after we returned from our Dutch Harbor trip. I woke up with double vision. I called a friend and asked her to come look at my eyes, since I couldn't see them. Nothing was bleeding or swollen, but my left eye was not aligned with the right one. I called the community health aide who runs the clinic and told her what was going on. Coincidentally, the eye doctor was expected to arrive on Monday. The health aide assured me that I would be the first patient the eye doctor would see as soon as she arrived and set up.

The weather was bad on Monday, and no plane arrived, hence no doctor. I tried all afternoon to call the clinic to see what I should do, but the phones were out, probably because of the weather that canceled the plane. I called first thing on Tuesday, and the health aide told me to come in so at least she could examine me. A friend gave me a ride to the clinic; I kept walking into walls, so I didn't think I should drive! she checked me out, told me she suspected an infection, and sent the data to the doctor who supervises her.

A couple of hours later, she called to tell me that a med-evac plane was coming for me, and I should be ready to leave in about 2 hours. The reason was that the doctor wanted to rule out a tumor, aneurysm, or an infection that was filling the space behind my eyeball. Since there had been no planes for 2 days, and storms in the area, the commercial flight was unlikely to be able to get me to Anchorage. Therefore, the med-evac plane was coming.

This was a Tuesday. I was already scheduled to fly to Anchorage on Friday for my spring break trip. The advice I got from everyone was to pack as if I wasn't coming back before going to Portland. That turned out to be good advice!

The trip was somewhat surreal. There was a pilot, a nurse, and a paramedic, just for me. I was having a lot of pain around my eye; in fact, I thought at first the condition was related to sinuses. Lying down was painful, but the only "seat" for me was a gurney. At one point the pilot said that he wanted to climb higher, since he'd be able to make better time. The medical team checked with me, talked it over, and told the pilot to go for it. When the pain got worse, I got really scared that my eyeball was just going to explode all over my face! Of course, nothing like that happened. Upon landing, I was transferred to an ambulance and taken to a hospital.

Once in the hospital, it was the usual routine of "hurry up and wait." They did MRIs and CTs, which were all thankfully negative. I spent the night in the ER, and was discharged the next morning with referrals to an ophthalmologist and a family physician. The ophthalmologist examined me and told me I have a "partial palsy of the 3rd cranial nerve, without pupil involvement." It should resolve on its own within 3 months.

That Friday, I met my new doctor and then spent a couple of hours while his nurse taught me everything I needed to know to start managing my diabetes. It's not clear that the diabetes was out of control and caused the damage to my eye. It may have been related to my high blood pressure or the interaction of the two conditions. However, it's a vascular injury, and diabetes affects vascular health. I'm now checking my blood glucose levels daily and keeping a food diary, looking for patterns that tell me what I should and shouldn't eat.

I'm wearing a black eye patch. I can see perfectly, 20/20, out of each eye separately, but they won't work together. I sometimes switch the patch to let the left eye get some exercise, but I can't walk like that. Those walls insist on jumping in front of me! And, with my left eye covered most of the time, my left side is covered with bruises from things I walked into that I couldn't see! It's only been 4 weeks, so I'm hopeful the 6 weeks to 3 months duration the ophthalmologist quoted turns out to be correct.

Meanwhile, I'm in the market for a stuffed parrot to wear on my shoulder.