Me And TED And Dr. KPC":
A True Story Of Vision Lost & Found

This is a brief recounting of how, thanks to the caring and expertise of Dr. Cockerham, I went from someone with bulging eyes, double vision and a compressed optic nerve whose life was on hold, someone too disabled for 18 months to even seek employment, back to being a detail-oriented technical writer who enjoys seeing straight and the life around him.

Bloody Eye At The Dentist Office

In March 2006 I arrived at my long-time dentist office for a routine cleaning. Both the dentist and the hygienist, noting my left eye looked somewhat bloody and was twisting outwards, insisted I have Urgent Care check it out. I had also noticed, and been disturbed by, the appearance of my left eye but since no actual vision changes were yet apparent I'd been stubbornly ignoring it.

Urgent Care took a blood test and referred me to a good local opthamologist. The blood test came back showing hyperthyroidism.
Not only that but the CT scan that the opthamologist had me take showed proptosis/exophthalmos (bulging eyes), another classic attribute of Grave's Disease, also known as TED (Thyroid Eye Disease), or Grave's Opthamology.

Vision Lost

Within a couple months I acquired two other miserable, and classic, Grave's Ophthalmology characteristics: double vision (strabismus) and a compressed optic nerve in my left eye. A difficult 11 week regimen of taking Prednisone© stabilized the situation but didn't improve it. There was still a noticeable loss of vision in my left eye too; it saw with maybe 70% of the brightness and clarity with which my right eye saw.

More than a year was to go by wherein my life stood still. I was unemployed, on California Disability, felt alone and miserable and was treading water. Reading was difficult and painful; using the PC likewise. I only did some lightweight editing, replied briefly to email and watched TV. I was also becoming a burden and a drag on my roommate. Walking to and from the ocean at West Cliff was the one big consolation prize.

I went through various stages of denial and then had an important realization: no matter how bad I wanted to, I would never see as well as I had, or in the way that I had, before developing Grave's.

I saw my ophthalmologist regularly, every four weeks at the most. He ran tests which showed that the vision in my left eye wasn't worsening but, not being an expert in Grave's Disease himself, referred me to specialists at Stanford for consultation on what might be done to improve my vision.

He also brought up Orbital Decompression surgery, noting that it was the one treatment that would likely have me seeing best "five or ten years down the road" and that, though it was a major surgical procedure, I was "young enough to recover."

I met with a neuro-ophthalmologist at Stanford in January 2008. She instructed me to occlude (cover) my left eyeglass lens with scotch tape in order to ease the disconcerting affects of the double vision. Occluding one eye did provide some relief but my existence, visual and otherwise, remained just that, an existence, and uncomfortable.

The neuro-ophthalmologist noted that, given the degree of my visual impairments, something would eventually need to be done; she mentioned surgical options as well as radiation treatment. I was reticent to explore the surgical options until I'd checked out the other, less invasive, alternatives so a referral was set up for me with Stanford's Radiology Department to see if radiation treatment, which could remedy the compressed optic nerve, was appropriate. I eventually decided to pass on the treatment because it wouldn't address the bulging eyes and double vision, only the compressed optic nerve.

A few months later my life was still on hold and I overcame my misgivings about surgery enough to at least arrange an initial consultation regarding it. I met with Dr. Cockerham for the first time on the day before my 52nd birthday, May 12 2007.

Vision Found

Dr. KPC had only to examine me briefly before informing me that I was a good candidate for the definitive treatment -- the Orbital Decompression surgery I'd been hoping to avoid. She unequivocally stated that this surgical procedure was the only treatment that could, and would, address all three of the visual impairments that Grave's Disease had left me with: the proptosis, the double vision and the compressed optic nerve.

I first agreed to schedule the surgery within four weeks, noting how miserable I was. But then I got cold feet and put off scheduling it. Fortunately for me, Dr. Cockerham didn't let me off the hook! I received a follow up phone call and an email from her with two direct statements that were to change my mind, and my life, for the better:

"You have a compressed optic nerve. You need surgery." and "You'll never regret restoring your vision."

The Orbital Decompression surgery took place at Stanford in August 2007. It eliminated the bulging and fixed my compressed optic nerve. The recovery was neither easy nor brief but going through with the Orbital Decompression was the key to me getting my life back to live. Within a few days of the surgery, my brain and my entire being experienced a profound and tremendous sense of relief at no longer having a pinched nerve painfully transmitting inadequate visual signals to my brain. Not only that but I could see properly out of my left eye again and the bulging was gone too!

"Trouble with you is The trouble with me Got two good eyes but we still don't see..."

-- Casey Jones, words by Robert Hunter, music by Jerry Garcia.

I still had double vision however, as Dr. KPC expected would likely be the case. In early October 2007, I had successful strabismus surgery (a brief outpatient procedure), again performed by Dr. Cockerham, this time at Dominican Hospital in Santa Cruz. My eyes began to fuse shortly thereafter, no more double vision. Fun! Another few weeks of inexpressible post-surgical relief ensued and I still give daily thanks for, and never take for granted, the blessing of being able to see straight.

So today, thanks to the surgical expertise of Dr. Cockerham and Dr. Winston Vaughan, the sinus surgeon who teamed up with Dr. KPC to do the Orbital Decompression work, and to Dr. Cockerham's insistence that I not deny myself definitive treatment, I'm back on my feet and chasing technical writing contracts in Silicon Valley.

Recent Observations Of A Dental Hygienist

The other day Mia, my friendly long-term local dental hygienist, glad to see the vibrancy back in me after its long absence, observed: "Yeah, you were just treading water there for a while." Another day I stopped in at my regular opthamologist's office to say "Hello" to a couple members of the office staff. Rosalie looked me over and noted "Now there's even a gleam in your eye!"

Thanks for listening and, if you're having Grave's Opthamology issues, I hope my experience encourages you to pursue the definitive treatment offered by Dr. Cockerham.

Alan Mark Levinson
Technical Writer / Editor
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