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Medical Forum / Diseases and Disorders / Diabetes / August 2007

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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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