A Phenomenon Potpourri

My 44th came and went without much fanfare. I sorta wanted to post a “Lordy Lordy, look who’s turning 4040!” meme from Aqua Teen Hunger Force though, because of course I do!

Besides decade-old cartoons, I took the week off and just played Final Fantasy 14 for the whole time. I started it about a week earlier than that and am actually enjoying it quite a bit. I never thought I’d say that about a MMORPG, but hey, they clearly know what they’re doing. My only real problem is that while playing it on Linux works, I can’t use my mouse, as single-clicking seems to be transformed magically into a grab instead, so I have to use a controller. Not ideal, but it’ll do.

Mom’s birthday was also recent, and unfortunately her remaining cat from a brother / sister litter died literally that day. I know how much that hurts after losing Luna, so it’s like a double slap in the face to have that happen on what’s supposed to be a day for your enjoyment in some respect. After a lot of Facebook well-wishes, it looks like she’s going to be acquiring a couple kittens, and I’d be right there with her in the same situation if I didn’t still have three others of my own.

A few months ago, my right big toenail stopped growing mysteriously. I even let the nails on all the other toes keep growing as a point of comparison. It also hurt like I’d smashed it in something, but it didn’t turn black as you’d expect in that situation. In fact, it only hurt at the bottom of the nail bed itself.

I went to a podiatrist and he said the nail probably detached somehow and there was likely a new one growing under it, which was the cause of the pain. He said to soak it once a day in epsom salts and come back if it looked infected or inflamed. I did that a few weeks later and he basically said he’d have to take the nail off to see what’s actually going on.

So he numbed my toe and took the nail out and declared that there was no new nail beneath it. So why did it stop growing? Why the pain? He suggested the existing nail may have been blocking the matrix from advancing new growth, but obviously didn’t want to speculate. He gave me antibiotics as that area can get infected in situations like this, and it’s best to be safe. I have several instructions on cleaning it until it heals, and have no idea whether I’ll have a toenail after it heals.

I finally leveraged my new Illinois FOID card and acquired an AR-15, specifically a Ruger AR556 MPR. I plan to spend some quality time with the instruction manual and break it down a couple times to orient myself with everything. Then I need to schedule some kind of class just to have my bases covered. I don’t think I ever imagined myself owning a rifle like this, but I like to have my bases covered. Even if society doesn’t collapse due to the economic fallout of Covid, hey, I can always go plinking. Now I just need more ammo than the paltry 100 rounds I picked up for emergencies.

We also need to call an arborist soon. There are two trees in our yard that have been dropping branches like crazy, and about half of the upper boughs seem to be completely bereft of leaves. It’s not quite fall yet, and they’ve been like that for months. Lots of trees in the neighborhood seem to have the same problem, and our neighbor is actually having one of his cut down after having it evaluated. It would really suck to lose two trees, but we’ll see what they say about it.

I really need to update more often. I don’t know when my toe actually started hurting, or when I started playing Final Fantasy 14, etc., and I like having timelines in case I need them. All the more reason to be more proactive, I guess.

Until Tomorrow.

Bringing it Home

Well, it’s finally done. I just finished all the inspections, negotiation, offers, paperwork, and bank wire necessary to buy a house. Of course, Jen and I have already gone through all of this after moving out of Urbana, but this time the house wasn’t for us, but for my mother.

It’s not a grand affair; just a 3 bed, 2 bath for around $125k basically in the middle of nowhere. Despite that, the mortgage costs less than her current apartment, for more space, with actual equity in the property. Who could argue against that?

This has been a long time coming, and honestly I should have initiated the process years ago when it was easier to accomplish thanks to the current state of the market. There’s a long story here about how I grew up in poverty and fought hard to escape it, but I already told that story.

For the most part, I look at this as just me being fiscally responsible. Mom has spent decades doing custom seamstress work without pause. But that’s only a way to keep a roof over your head, not to build up a retirement fund, or to keep your head above water when work is slim. So I’ve already spent tens of thousands paying her rent occasionally over the years. Why not buy her a house instead?

She already loves it, which should be obvious given she did all the hard work trekking around with her real estate agent and vetting the available options. She now has a home for the first time, and I can certainly relate to the sense of security that brings. It’s one less thing to worry about in a world of uncertainty.

It’s a new chapter in a family that started with nothing. I’m hardly rich, but I bought a house for my mother. That’s something, I suppose.

Until Tomorrow

Second Shot at Sight

I got my second eye injection on Thursday, and so far the experience has been roughly the same. My eye’s still a bit score and scratchy, but oddly enough, I don’t seem to have gained any more floaters compared to the last injection. The doctor says the bleeding under my macula appears to be receding and suggested I may not need any further shots after this one. We’ll see in six weeks, I suppose.

The most annoying part of the last injection is the slight scattering of dots in my vision extending from the center to the bottom right edge, which slowly fans out the further it gets away from the middle. What’s weird about them is that they don’t move with my eye, so they’re not floaters, and they’ve been there since I got that first injection. Still, despite this, it will be worth it assuming my macula continues to heal and no further vessels form beneath it.

To me, the only remaining questions are regarding what steps I should take regarding monitoring to ensure I’m not forming new vascular tissue in the coming months and years. For both of my eyes, even though I’ve only had this problem with one thus far. From what I’ve read, there are non-invasive scans they can use for this. But how often should I go, given my high myopia and the demonstrable fact I’ve already had one bleed?

This whole thing is a bit odd, really. I’ve found that I need more light to see things clearly now, and it’s that same light that reveals all the new imperfections in my vision. Aside from the blank spot in my central vision, there really is quite an increase in several different distractions. There’s some kind of dark haze that hangs out in the upper left quadrant, the previously mentioned spray of dots in the lower right, multiple new and fairly large oval floaters that swim across my vision like some kind of drunk amoebas, and a stark black pinpoint in the lower left of center like the inverse of a star in the night sky. It’s like trying to observe the world through an aquarium that has long since been forgotten by the owner, and it’s slowly becoming more filthy and opaque with each passing day.

I see all of this every time I take a walk to get some sun and exercise. Yet it’s not a universal thing. My brain is trying valiantly to mix the disparate signals from both of my eyes and erase some of these imperfections. The blank spot in the center for example, merely becomes slightly blurry when using both eyes. All the floaters are still there, but not as prevalent. The spray of dots seems to be the only universal that doesn’t vary, and it’s much more obvious under sufficient lighting conditions.

I suspect I’d need a vitrectomy to truly rid myself of all of the new detritus, but because of my myopia, any kind of surgery vastly increases my risk of a retinal detachment. Even these relatively minor injections can trigger such an outcome, so I may have to end up living with it. It’s better than going blind, either by allowing the macular degeneration to continue unchecked, or having my retina detach. I vaguely wonder what my visual field will resemble once all is said and done.

Anyway, we’ll see how it goes.

Until Tomorrow,

Ocular Occlusion

While I was vacuuming up some fur-based tumbleweeds around the house Sunday morning, I noticed that it seemed as if I’d stared too long into a light bulb. That misshapen blob that suggests light has seared an indelible purple smear into my vision until it eventually fades. “Huh, the bathroom lights must be brighter than I thought,” I thought to myself. I shrugged in annoyance and kept vacuuming.

But it didn’t go away. It didn’t fade. Confused, I tested by covering my right eye with my hand, and then the left. The discolored spot was only in my right eye. Worse, wherever I looked took on a pincushion effect, as if whatever I gazed upon was being sucked into a black hole, distorted, shrunken, and swirled. Given all of the warnings chanted to me by a ceaseless string of opticians, optometrists, and ophthalmologists, I immediately worried I was experiencing a retinal detachment.

Why would I worry about something that’s normally extremely rare? My eyes are bad. Awful. Terrible. You know that big E on the eye chart? If you can’t see that, your eyes are marked as -2.5 diopters. My eyes are around -14.5. Myopia is caused by the eye elongating and causing the visual image to fall short of the optic nerve, and in my case, my eyes are practically footballs.

That kind of stretching pulls the retina extremely thin, and as a result, raises the risk of it coming detached. Scared I was about to go blind, Jen and I called the local ophthalmologist, and her answering service suggested going to the local ER to make sure it wasn’t the worst case scenario. So we went.

After a bit of waiting, I was brought into the back room and given a quick triage. During this, they asked me to look at an eye chart, and even with my glasses on, I couldn’t make out the top line because the single letter E was engulfed in a thirsty black hole that distorted any sense of what the letter could have been. I knew it was the letter E, but I couldn’t see it; a far more important distinction.

So they called the ophthalmologist to get her opinion, and she actually agreed to come in on a Sunday to see me herself. Upon examination, she said it looked like the spot causing the distortion was “tenting” due to blood leaking between layers in my eye. So rather than retinal detachment, I’d incurred a wholly different malady: Myopic Macular Degeneration.

Based on what I’ve read, prescriptions as high as mine carry a roughly 95% or higher chance to experience this around middle age, and for similar reasons as retinal detachment. The bloated mass of the elongated eyeball requires extra vascularization, and these extra blood vessels are more likely to leak. It’s just a matter of when.

Relationship Between MMD and Spherical Equivalent

What I experienced on Sunday was merely my first symptom. So the ophthalmologist called a retinal specialist a couple hours away and conveyed my problem. He agreed to see me Monday afternoon, and so I went to bed unable to see through the middle of my right eye, hoping it wouldn’t get any worse by the time I saw him. I was also hoping this hadn’t progressed to a macular hole, because those require surgical intervention and carry a substantial decrease in visual acuity.

The visit itself was fairly uneventful. Apparently the doctor is extremely busy, and employed a kind of production line in his practice. One room for every major check, one person in each room at all times, patients in the waiting room until it’s their turn for one test or another. It was my “turn” about four times, until eventually he agreed that the tenting was being caused by blood between layers of my eye, and prescribed Anti-vascular endothelial growth factor (Anti-VEGF) therapy to prevent it from getting worse, and maybe eventually revert things back to some degree of normal.

That meant an injection of Avastin directly into my eye. Despite three applications of numbing drops and gels, I distinctly felt the puncture, and it left a dark black perfectly spherical hole near the bottom of my visual field. I can also see a few tiny bubbles where the injection disturbed my vitreous fluid. Still, if it works, it’s a small price to pay to avoid slowly going blind over the course of 3-5 years.

As of now I still have the visual warping distortion and it feels like I got punched in the eye by a particularly annoyed cat. I can barely read what I’m writing here, looking at the words obliquely so the dead spot in my visual field is temporarily displaced. I’m not sure how I’m going to be able to work long-term like this. It’s better than the alternative, but it’s hardly easy. I’m not even sure it’s viable long-term.

I see the retinal specialist in another five weeks, but I may have to ask him what I can actually expect so far as how well my right eye will be able to see when this is all over. Presumably the leaked blood will stop, and eventually be re-absorbed, but when? Can I expect any long-term issues from this occurrence? I’m going to be making a long list of questions for that appointment, especially if things haven’t cleared up by then.

What I find most odd is that every single eye doctor I’ve ever seen has warned me about retinal detachments, but not a single one mentioned MMD. Given the above chart, that seems patently ridiculous; I’m far more likely to experience MMD than retinal detachment (and sooner), even though I’m at high risk for both. What exactly happened there? Is it just that regular eye doctors don’t expect to see macular degeneration—a disease usually associated with older people—in younger populations?

Whatever the case, this is a new chapter in my life I was expecting, but hardly looking forward to. Here’s hoping it doesn’t interfere too much.

Until Tomorrow

Mysteriously Missing Melatonin

Well I just discovered something pretty interesting while watching a conference talk from Christian A Stewart-Ferrer. He’s a psychologist that seems to specialize in autism-spectrum disorders, and he spent roughly three hours outlining tendencies and dispositions of people with Asperger Syndrome.

At one point, he said something almost out-of-hand about melatonin production and quickly moved on. I’ve known about my Asperger’s for over a decade now, but I never really did much research afterwards, and it turns out that was probably a mistake. Apparently there are numerous studies and meta-analyses that suggest deficiency in melatonin production that can at least be somewhat alleviated with supplementary melatonin.

Why does this matter? Because I’ve never been able to sleep easily for as long as I can remember. Full day of playing outside as a kid? Can’t sleep. Kindergarten nap times? Forget it. I’m still convinced the other kids were just laying down and being quiet while not really sleeping. Winter, Summer, Spring, or Fall, no distribution of light made any difference.

I strongly recall either sleepovers or nights at a babysitter and listening to everyone’s breathing change as they fell asleep, while I simply lay there with my eyes closed waiting for my turn. One specific night I remember being told my mom would be picking me up soon if I just lay down and closed my eyes for a while. So I closed my eyes and waited, increasingly bored out of my mind. At the time I didn’t understand that the babysitter expected me to fall asleep, and most children probably would have.

About the only time I was capable of nodding off was before my heart surgery when my oxygen stats slipped so low that I blacked out. Little did I know that I merely needed melatonin. Decades of this, all because research in the area was—and still is, to an extent—in its infancy.

In my defense, I did try to use Melatonin once or twice in my 30s, but the studies suggest amounts of 500ug to 1mg rather than the vastly excessive 3-10mg normally available, and that best absorption is sublingual. Maybe if I knew I’ve been under-producing melatonin for essentially my entire life, I may have tried harder to make it work.

I’m glad at least that I stumbled upon the right solution one way or the other. I’ve been taking 1mg of melatonin about 1 hour before bed and I do seem to fall asleep easier than I recall in my past. I still have to find a way to fix the damage done by the Lexapro, but one thing at a time.

Until Tomorrow,