Saturday, September 15, 2012

6th Nerve Palsy

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I have been meaning to sit down and write up this post for a while.  I doubt much of anybody will understand or care about it, but in the off chance some scared pregnant woman is searching the Internet for a personal story and not just medical documents, comes across this one and finds it similar and helpful, I'll be happy. 

In February, I lost the ability to use my left field of view.  I was 18 weeks pregnant with Daniel.  I was fairly healthy.  I wasn't overly stressed, aside from normal pregnancy issues.  I noticed a very slight jumping in my vision as I looked left one day while driving home from the store.  I thought my eyes were just tired, it was late and dark.  Two days later, I noticed that when I looked to the far left I saw two images.  Odd.  The day after that, in the span of just a few hours, the doubling moved from just the far left slowly across my field of view, so that when it stopped everything left of center even slightly was doubled.  I wasn't terribly disturbed by it.  I had no other symptoms.  If I had been experiencing other issues, I would have suspected a stroke, but I really felt fine.  I called the OB, who informed me to go to the ER.  I couldn't believe that I needed the ER.  So I, being much better able to diagnose myself, went to the urgent care.  Just to make sure.  That doctor spent 15 seconds with me and directed me to the ER.  Fine.

ER doctors do not appear to be comfortable handling pregnant women.  At least the ones I encountered.  The primary doctor who saw me was very nice, but very nervous.  I didn't realize it at the time, but they were all concerned that I had/was having a stroke.  It didn't make sense to me, but in retrospect I probably would have drawn the same conclusion, especially if I hadn't been able to know for sure that there were no other symptoms present.  The ER doctor consulted with the neurologist, who admitted me.  I stayed overnight.

The next morning I had a MRI.  And I waited.  The radiologist interpreted it as a stroke.  The neurologist disagreed.  I had bright spots on the MRI, which is a little disconcerting to see, but apparently can be caused by various things, some of which are not a concern.  One of the not so concerning causes of the spots is a history of migraines, which I have dealt with for many years.  The neurologist diagnosed me with an atypical migraine.  My head didn't hurt, so I thought it was odd, but it sounded better than a stroke.  He kept me another night and ran me through 8 grams of IV magnesium, which is the devil's drug, plain and simple.  It hurts like hell going arm hurt for a month after that.  I didn't have a headache before, but I did after the mag started.  Magnesium was about my only treatment option to try to dampen my nervous system to try to eliminate the theoretical migraine that wouldn't hurt Daniel.  Sadly, it didn't work.  I went home, and was told to report back if anything changed.

The official diagnosis: left 6th cranial nerve palsy, causing binocular diploplia (double vision).  The 6th cranial nerve controls the outside muscle of the eye.  If it stops working, the eyes cannot move together as they should, and in turn cannot focus together, creating the appearance of two images where there is one. 

It was a long road.  At first my brain just couldn't handle the change in vision.  No matter what I did, things were jumping around like crazy.  I was scared.  Tracking moving objects was impossible.  I was afraid to take my kids anywhere because I was afraid I would lose them.  I tried to cover one eye, but then my depth perception was gone and I couldn't see any better.  My brain finally started to learn to deal with it, but it was gradual and it took many weeks.  I was able to drive a little, but only when making right turns.  I had to depend on people to help me.  A lot.  It was HARD.  I slowly learned to manage the vision distortions.  I had lots and lots of prayer, and lots of support and help.  

After months of neurologist appointments, and lack of improvement, my vision finally started to correct.  From the center out, the doubling began to lessen, and finally, it was better.  I have no knowledge of what caused this to happen.  Palsies of the cranial nerves are common, and many times they are idiopathic and benign.  I'm not sure if it will happen to me again.  The OB claims that this was not caused by pregnancy, but the timing was a bit odd.  Daniel is perfect, there were no consequences for him or his health as a result of anything that was happening to me.  If you are pregnant and worrying about your baby, try not too.  Easier said than done.  Hopefully this story will help. 

Losing vision is terrifying, especially at first.  I was scared for a while.  I am beyond thankful that it has been restored.  I am hopeful it won't happen again, but it is possible.  For now I'm enjoying my healthy vision and trying not to take things for granted, because when something like that is taken it becomes very obvious how valuable a fully functioning, healthy body really is. 


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