Thursday, March 03, 2005

Visit with the neuro-opthamalogist

This tuesday was my long overdue appointment with an opthamalogist.

I met with Dr. Hamilton at the University of Washington. Seeing as it was my first appointment, I had to go through a series of tests given by a real nice resident doctor (Dr Yossef). It is good thing that I was able to get in earlier (my original appointment was not until April 26th). But after hearing of my currents symptoms from my neurologist Dr. Peterson, the opthamalogist wanted to get me in as soon as possible.

Not surprising to the doctors but quite a shock to me is that I was having swelling of the optic nerves. Apparently this is not uncommon for brain tumors the size of mine. The tumors are quite large and indenting the brain stem. So apparrently something is pressing on the optic nerves somewhere but was not detectable on an MRI. They discovered the swelling buy looking at the back of my eyeballs when they were dialated.

The symtoms I was having are as follows:

Lightheadedness and tunnel vision (or blackening of my field of vision) - for the past week
Loss of vision in the right eye for a few minutes upon awakening - tuesday morning
Occassional blur spot in my right eye - intermittent
Light flashes in darkness - 2 episodes when waking in early morning (between 5 and 6 am)
Double vision while driving or reading captioning on tv - 4 to 5 episodes
Vomiting - 1 epidsode in past 3 weeks
Nausea - intermittent but able to handle
Migrane Headaches/head pressure (past 3 weeks) - 2 a day (only remedied by Excedrin)
Ghost images and trailers while driving at night - has occured since October

Thus the determination is that my optic nerves are swelling due to intracranial pressure. The doctors here have decided to put me on 4 mg a day of the steroid Decadron and 500 mg a day of Diamox. I do not know anybody who has taken Diamox but I have read that this medicine is commonly used for climbers who succumb to altitude sickness and glaucoma patients.

Our hope is that these medications will reduce the swelling and prevent the need for a shunt that would relieve pressure in the brain. I have a friend with NF2 who experienced high intracranial pressure and optic nerve swelling (papillodema) 2 years following gamma knife radiosurgery. Due to the severity of the swelling, he needed an emergency brain surgery which resulted in a stroke during surgery followed by a 3 week coma. They gave him a shunt but he does not remember anything about it as he was in a coma at the time.

So lets hope these drugs do their job!

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