Medical Forum / Diseases and Disorders / Diabetes / August 2007
Eye police: ophthalmologist visit
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Susan - 01 Aug 2007 22:43 GMT I went for my routine eye exam with the new information that I have been diagnosed with Cushing's syndrome, which has been causing me vision/focusing problems at times.
I mentioned to the eye doc that my vision is very variable and that sometimes I have to use the reading portion of my progressive to read things across the room.
He responded that my blood glucose spikes probably caused that and I told him that I don't have them, that my bg stays in a narrow range, even after meals. I told him "I don't eat starch, period."
He said: "That's the way to do it!" :-)
I have to have two more appts. for visual field testing, because pituitary tumors often compress the optic nerve, but he said I have absolutely no signs of retinopathy or macular degeneration.
Susan
Alice Faber - 01 Aug 2007 23:25 GMT > I have to have two more appts. for visual field testing, because > pituitary tumors often compress the optic nerve, but he said I have > absolutely no signs of retinopathy or macular degeneration. I've just had the new hi-tech visual field testing. My ophthalmologist told me that they're not entirely sure how to interpret "spot" (one-time) results, but that he wanted this as a baseline. I had to go a second time, as I had a little trouble getting the hang of the task. That time, I did fine, but it did occur to me to ask him whether the manufacturer of the system had provided any normative data. He said that they hadn't, but that the data was becoming available.
I was probably being too analytical, as we use eyetrackers for research at my lab, so I probably know as much as he does about the nuts and bolts of the system.
 Signature AF "Non Sequitur U has a really, really lousy debate team." --artyw raises the bar on rec.sport.baseball
Susan - 01 Aug 2007 23:51 GMT > I've just had the new hi-tech visual field testing. My ophthalmologist > told me that they're not entirely sure how to interpret "spot" [quoted text clipped - 7 lines] > at my lab, so I probably know as much as he does about the nuts and > bolts of the system. Thanks for the info. Not having norms is a problem, no? I like this doc, I've seen him twice. I have two tests scheduled because the tech feels that doing both in one day is too fatiguing to the eyes. I'll ask the doc what he knows or has seen in terms of norms.
Susan
Alice Faber - 01 Aug 2007 23:57 GMT > x-no-archive: yes > [quoted text clipped - 14 lines] > feels that doing both in one day is too fatiguing to the eyes. I'll ask > the doc what he knows or has seen in terms of norms. I suspect that there's a class of cases that would be obvious problems, even without a norm. And there's a large number of people who, once they get the hang of the task, will essentially get everything right. It's the middle group I worry about. However, if you do fine this year, and not next year, that change would indicate a problem. It's much more detailed than the bit where the doctor holds a finger up in various parts of your visual field.
 Signature AF "Non Sequitur U has a really, really lousy debate team." --artyw raises the bar on rec.sport.baseball
Susan - 02 Aug 2007 00:04 GMT > I suspect that there's a class of cases that would be obvious problems, > even without a norm. And there's a large number of people who, once they [quoted text clipped - 3 lines] > detailed than the bit where the doctor holds a finger up in various > parts of your visual field. I hope that by this time next year, that toomah is EVICTED from my skull!
Susan
Alice Faber - 02 Aug 2007 00:17 GMT > x-no-archive: yes > [quoted text clipped - 7 lines] > > I hope that by this time next year, that toomah is EVICTED from my skull! Absodamnlutely!
 Signature AF "Non Sequitur U has a really, really lousy debate team." --artyw raises the bar on rec.sport.baseball
Cheri - 02 Aug 2007 00:32 GMT >> x-no-archive: yes
>> I hope that by this time next year, that toomah is EVICTED from my skull! I hope that for you too. :-)
Cheri
Susan - 02 Aug 2007 00:34 GMT >>>x-no-archive: yes > [quoted text clipped - 5 lines] > > Cheri 1.2,3,4, kick that toomah out the door!
Susan
Cheri - 02 Aug 2007 01:19 GMT >x-no-archive: yes > [quoted text clipped - 11 lines] > >Susan 5,6,7,8, then we'll really celebrate!
Cheri
Susan - 02 Aug 2007 02:09 GMT > 5,6,7,8, then we'll really celebrate! > > Cheri
:-) If the surgery is successful, I hear the aftermath is really awful, severe adrenal insufficiency, pain, headaches, vomiting are all good signs. OTOH, the cure rate for large, longstanding pit tumors with the best neurosurgeons is about 56% the first try, and 50% the second.
Susan
Billie - 02 Aug 2007 11:53 GMT Susan, maybe that is the worst it can be, and you will not have it to its fullest. I was afraid of the IVIg side effects, and aftermath, but though I've had some, the effects have not been as bad as they could be. I'm about to get used to the headaches, and bad neck aches (like meningitis). Hmmmmm.... one I could do without, though, is it's affect on my blood pressure. It was 179/102 today when the HH nurse was here, just after I'd been up to go to the bathroom. No more activity than that. Up until the IVIg, I've always carried a very low blood pressure.
You're tough! You can handle it!
Billie
"Striving for a world without Myasthenia Gravis" Myasthenia Gravis Foundation of America http://www.myasthenia.org Muscular Dystrophy Association http://www.mda.org/disease/mg.html http://www.mda.org/publications/fa-mg-treatment.html Myasthenia Gravis Association UK http://www.mga.superbuilder.net/mgaforum.html
::-) : [quoted text clipped - 4 lines] : : Susan Susan - 02 Aug 2007 15:14 GMT > Susan, maybe that is the worst it can be, and you will not have it to its > fullest. I was afraid of the IVIg side effects, and aftermath, but though [quoted text clipped - 6 lines] > > You're tough! You can handle it! Billie, the worse it is, the more likely it's a cure, so I'll welcome it when I get there. :-)
It's kind of like taking a high dose of Prednisone for years, then quitting it all in one day...
Susan
Billie - 02 Aug 2007 11:51 GMT We'll form our own cheering squad, and "celebrate one whom we appreciate!!!" LOL
My 12 y/o granddaughter *says* she popped a wheelie in my chair. Guess I'll need to get her to teach me some electric chair tricks!! Seriously, though, the guy that delivered my chair said that they have been able to pop wheelies and do other things with them. Guess they put the chairs through the ringer to see all they can tolerate!
Billie
"Striving for a world without Myasthenia Gravis" Myasthenia Gravis Foundation of America http://www.myasthenia.org Muscular Dystrophy Association http://www.mda.org/disease/mg.html http://www.mda.org/publications/fa-mg-treatment.html Myasthenia Gravis Association UK http://www.mga.superbuilder.net/mgaforum.html
: >x-no-archive: yes : > [quoted text clipped - 15 lines] : : Cheri Billie - 02 Aug 2007 11:22 GMT Oh, Susan, I do, too. ((((((HUGS))))))
Billie
"Striving for a world without Myasthenia Gravis" Myasthenia Gravis Foundation of America http://www.myasthenia.org Muscular Dystrophy Association http://www.mda.org/disease/mg.html http://www.mda.org/publications/fa-mg-treatment.html Myasthenia Gravis Association UK http://www.mga.superbuilder.net/mgaforum.html
: I hope that by this time next year, that toomah is EVICTED from my skull! : : Susan Susan - 02 Aug 2007 15:08 GMT > Oh, Susan, I do, too. > ((((((HUGS)))))) Thanks, Billie, I'll expect you to be leading the cheer with your pom poms flying!
Susan
Emily - 02 Aug 2007 00:15 GMT > x-no-archive: yes > [quoted text clipped - 17 lines] > > Susan I have visual field testing regularly for my graves disease. I used to get them every six months, but I've graduated to yearly. So far I have had no eye complications from either the grave's or the diabetes. (the eye piece of grave's is a separate entity from the thyroid piece, so even though my thyroid has been ablated and is no longer over active, I could still get eye problems, however, most research indicates that once the thyroid has been fixed, eye problems are less likely to happen. Of course, that could be because it takes time to fix the thyroid, and if one hasn't had eye problems prior to that, they are most likely not going to develop them at all). The tests aren't bad, you just have to put your head in a little box with one eye patched, stare at a particular location--the computer tells on you if you don't--and push a button whenever you see the flashing lights.
Emily
Cheri - 02 Aug 2007 00:32 GMT >> x-no-archive: yes
>> I have to have two more appts. for visual field testing, because >> pituitary tumors often compress the optic nerve, but he said I have >> absolutely no signs of retinopathy or macular degeneration. That is wonderful news Susan. I'm very happy to hear that.
Cheri
Will, T2 - 02 Aug 2007 00:34 GMT >He responded that my blood glucose spikes probably caused that and I >told him that I don't have them, that my bg stays in a narrow range, [quoted text clipped - 5 lines] >pituitary tumors often compress the optic nerve, but he said I have >absolutely no signs of retinopathy or macular degeneration. So far, so good, Susan.... it is really good news about your retina health! Let's just hope thre is no other problem with the optic nerves <fingers crossed>
Will, T2
John - 02 Aug 2007 03:41 GMT > but he said I have absolutely no signs of retinopathy or macular > degeneration. > > Susan Good for you! That's wonderful news.
John C.
BlueBrooke - 02 Aug 2007 07:30 GMT >x-no-archive: yes > [quoted text clipped - 17 lines] > >Susan Excellent news, Susan. Here's hoping for more . . .
 Signature BlueBrooke T2/D&E/June 2005 May 2007 A1c 5.5 Oct 2006 A1c 5.8 Jun 2005 A1c 6.8
Billie - 02 Aug 2007 11:41 GMT Good for the retinopathy and macular degeneration.
Interesting about the Cushing's and the optic nerve. The testing I had done last year (forget the name) did show some optic nerve damage, but my ophthalmologist was not concerned right at that moment, but keeping a close eye on it. Visual field shows loss of vision for the lower inside part of my left eye, along with a general loss of peripheral vision all around that eye. The right eye has not been affected equally so.
Anxious to hear how your tests come out. I'm trying to keep up with all your Cushing's info. I do not go jumping to have tests performed, but with the brain lesions from last years mri, and with the info I've gleaned from your experience, I am seriously considering asking about a repeat mri to see if anything has progressed, or if there is any possible pituitary involvement. They've all (four docs) been very vague about the atrophy and lesions.. It was bothersome to me because I've always had normal brain mri/scans, and then all of a sudden these lesions showed up.
Have you, or anyone else, had any head mri that showed atrophy? It just seems like there was a specific time that a lot changed for me, and I am very curious.
Billie
"Striving for a world without Myasthenia Gravis" Myasthenia Gravis Foundation of America http://www.myasthenia.org Muscular Dystrophy Association http://www.mda.org/disease/mg.html http://www.mda.org/publications/fa-mg-treatment.html Myasthenia Gravis Association UK http://www.mga.superbuilder.net/mgaforum.html
: x-no-archive: yes : [quoted text clipped - 17 lines] : : Susan Susan - 02 Aug 2007 15:12 GMT > Have you, or anyone else, had any head mri that showed atrophy? It just > seems like there was a specific time that a lot changed for me, and I am > very curious. Billie, pit atrophy isnt' typical; usually, there's tumor and adrenal thickening or additional tumor from being overstimulated by the pituitary. Often, MRI fails to capture pit tumors, which can be hard to find on film if they're behind or below certain structures. Something else; radiologists miss more of them than they dx. They read mine as normal. The neurosurgeon at M.D. Anderson suspects it's one large tumor wrapped around both sides of the pit; the neurosurgeons compare actual pits to films all the time and are the only ones to read these correctly.
Abdominal C-T for adrenals with iodine contrast turned up my thickened left adrenal. Other tests really can't be run while you're still on steroids.
HTH,
Susan
krom - 02 Aug 2007 12:20 GMT Thats great news on the no signs of retinopathy or macular degeneration! Fynnt how shocked doctors are when you tell them you have tight control.
KROM
> x-no-archive: yes > [quoted text clipped - 17 lines] > > Susan Alan S - 02 Aug 2007 13:03 GMT >he said I have >absolutely no signs of retinopathy or macular degeneration. Some times "no" news is wonderful news :-) Good to hear.
Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraltraveloz.blogspot.com/ latest: Mossman Gorge in the Daintree Rainforest http://loraldiabetes.blogspot.com/ latest: Self-Testing and Type 2 Management
Frisbee® - 02 Aug 2007 13:07 GMT >>he said I have >>absolutely no signs of retinopathy or macular degeneration. > > Some times "no" news is wonderful news :-) This is why I stopped seeing my opthalmologist.
Loretta Eisenberg - 02 Aug 2007 13:44 GMT Susan, I must have missed that post about cushings syndrome. I never heard of it before. I hope it is treatable.
great that you dont have macular degeneration
Loretta
Susan - 02 Aug 2007 15:15 GMT > Susan, I must have missed that post about cushings syndrome. I never > heard of it before. I hope it is treatable. > > great that you dont have macular degeneration > > Loretta Thanks, Loretta.
Susan
Tim Shoppa - 02 Aug 2007 14:32 GMT > He responded that my blood glucose spikes probably caused that and I > told him that I don't have them, that my bg stays in a narrow range, > even after meals. I told him "I don't eat starch, period." > > He said: "That's the way to do it!" :-) I've been to lots of opthamologists over the past 25 years for checkups, and the good ones are always at the leading edge of knowing diabetes treatment methods.
It's also must be a little sad for them because they see directly so much in the way of diabetic complications and retinopathy is one of the earliest and most visible. It's hard to see tiny tiny blood vessels inside someone's foot but they can look straight into my eyes.
Tim.
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