More medical fun

I’ve been pre-occupied lately with more medical stuff. Some of it is the same old stuff with some new developments, and some of it is new.

First, the old stuff. I had to go back to the gynecologist for a check on all the shenanigans earlier this year. The timing was fortuitous, since after I had set the appointment I started bleeding again and could talk to her about that odd occurrence. With my levels of estrogen and progesterone being pretty much non-existent when tested in April this was unexpected, so now I get to have the endometrial biopsy. Hooray (not). At least this doctor believes in good drugs. I took some misoprostol last night to “prep the area,” and was instructed to take a hydrocodone before I arrive at the office. My neighbor and friend is driving me to the doctor’s office, so I won’t be a hazard to anyone on the road.

I don’t expect that there will be any problems found with the biopsy, but it’s recommended to make sure my bleeding isn’t caused by something bad. When I told the doc that I haven’t had any hot flashes in a couple of months, she said it was likely my ovaries produced some extra estrogen for a while, which is why this happened. Sadly, the hormonal pendulum seems to be swinging back the other direction because I’ve started having a few little hot flashes during the night and evenings. (I wonder why they happen so much more often in the evening? I’ll have to ask the doctor.)

The really shocking thing I’ve been working on absorbing is that I was diagnosed with a form of glaucoma called angle closure glaucoma. This all came about when I went in for what I thought would be a routine eye exam not quite two weeks ago. I had been experiencing some redness in my right eye, and had noticed that the eye was looking a little odd, but I didn’t imagine it was anything serious.

The optometrist told me that the intraocular pressure in my right eye was very high, that I needed to use some drops over the weekend to reduce the pressure, and to come back on Monday when another doc could evaluate me for glaucoma. I tried not to worry about it over the weekend and used the drops as prescribed. When I went back on Monday the second doctor repeated all the tests and referred me to an ophthalmologist, where I was seen later that day. Two doctors examined me there and that’s when I was given the diagnosis and told I needed laser surgery to correct it. The drops were working to reduce the intraocular pressure, so I needed to continue those for another week until the surgery could be scheduled.

Yesterday was the big day, and after a laser peripheral iridotomy, I now have an extra hole in my iris. It’s been amazing how quickly the procedure has worked to get my eye looking normal again. Due to the pressure, my pupil was distorted and the iris looked bigger in my right eye than my left. Within a few hours the pupil shape and iris were looking closer to normal again.

Unfortunately, I’ll never regain the vision I lost in the eye. The vision loss seems to be mostly peripheral, and I can’t say I really notice it very much. I’ve apparently had this angle closure issue for “a while” now, so the vision loss has happened slowly enough that it never triggered any alarms for me. After the laser procedure yesterday the doctor told me that the reason I have the angle closure issue is that I have plateau iris syndrome: the shape of my iris makes the drainage angles in my eyes very narrow and easily blocked. If the iridotomy alone doesn’t work, I’ll need another laser procedure to widen the angles. I’ll also need to get the left eye fixed, too, so I can minimize any vision loss in it.

I’ve been getting my eyes examined every year since I have a vision plan as part of my employer benefits. However, this issue of narrow angles is apparently only recognized when there is a special exam called a gonioscopy — which isn’t part of a standard eye exam — performed. I’m making a list of questions to ask the doctor during my follow-up visit, and I’ve also already let my sister know about this since plateau iris and glaucoma seem to run in families.

The lesson here is to get your eyes checked every year. And if you have any history of glaucoma in your family, you may even want to request a gonioscopy to confirm if you have narrow angles. If I had been diagnosed with the plateau iris condition sooner I could have had iridotomy years ago and perhaps saved more of my vision.

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