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<P>So what does a major columnist for the New York Times write when
under<BR>threat of losing his vision?<BR><BR>OP-ED COLUMNIST. Am I Going
Blind?.<BR>By FRANK BRUNI. <BR><BR>They say that death comes like a thief in the
night. Lesser vandals have the<BR>same M.O. The affliction that stole my vision,
or at least a big chunk of<BR>it, did so as I slept. I went to bed seeing the
world one way. I woke up<BR>seeing it another.<BR><BR>This was about four months
ago, though it feels like an eternity. So much<BR>has happened since. I don't
mean all the tests and procedures: the vials<BR>upon vials of blood; the mapping
of major arteries in my neck; the imaging<BR>of tiny vessels in my brain; the
first injection of an experimental<BR>treatment (or, maybe, a placebo) into my
right, dominant eye, where the<BR>damage occurred; then the second injection;
and then, last week, the third...<BR><BR>I mean the rest of it. I went to bed
believing that I was more or less in<BR>control -- that the unfinished business,
unrealized dreams and other<BR>disappointments in my life were essentially
failures of industry and<BR>imagination, and could probably be redeemed with a
fierce enough effort. I<BR>woke up to the realization of how ludicrous that
was.<BR><BR>So I flailed on two fronts. I tried to grow accustomed, day by
disorienting<BR>day, to reading and typing with a thick, dappled fog across the
right half<BR>of my field of vision, which was sometimes tilted and off-kilter.
I felt<BR>drunk without being drunk, dizzy but not exactly dizzy.<BR><BR>I also
fought not to be angry and afraid, a struggle familiar to anyone with<BR>a
significant illness or disability. The fear arose less from what I'd<BR>already
lost than from what I might lose still. Over the next five years,<BR>there's a
roughly 20 percent chance that what happened to my right eye could<BR>also
happen to my left. I could go blind.<BR><BR>The odds are on my side. But the
stakes are enormous. So how am I supposed<BR>to process this? Where on the
spectrum of optimism to resignation -- of hope<BR>to dread -- do I position
myself?<BR><BR>?<BR><BR>On that first morning, several hours passed before I
accepted that something<BR>was seriously wrong. I figured that I was just
groggier than usual. Maybe I<BR>needed more coffee.<BR><BR>As I sat at my
computer transcribing a long interview that I'd just done, I<BR>repeatedly took
off my eyeglasses to clean them, convinced that the<BR>smudginess of my vision
was some streakiness on the lenses. When I finally<BR>gave up on that, I rinsed
my eyes with water -- to no avail. It was as if<BR>someone had deposited a blob
of petroleum jelly in my right eye and nothing<BR>would dislodge it.<BR><BR>The
next morning I visited my ophthalmologist, who for many years had kept<BR>tabs
on my run-of-the-mill astigmatism and fine-tuned my prescription so<BR>that I
saw 20-20 with each eye. He said that in this case I needed
a<BR>neuro-ophthalmologist. (I didn't know that such a specialty existed.)
I<BR>found one, Golnaz Moazami, who could squeeze me in a few days later,
and<BR>after three tedious hours of staring at or into charts and colored
patterns<BR>and sophisticated machines, she told me this, in a rat-tat-tat
fashion:<BR><BR>I had almost certainly experienced what is colloquially called
'a stroke of<BR>the eye,' whereby the optic nerve is ravaged by a brief
reduction of blood<BR>flow and thus oxygen. The name for this condition is
nonarteritic anterior<BR>ischemic optic neuropathy (N.A.I.O.N.), and it afflicts
perhaps one in<BR>10,000 Americans. But I'd need extensive blood work and tests
to rule out<BR>other possibilities.<BR><BR>This tends to occur after the age of
50. (I'm 53.) It typically strikes<BR>during sleep, when blood pressure drops,
and is sometimes associated with<BR>sleep apnea, diabetes, hypertension or the
use of pills for erectile<BR>dysfunction -- none of which applied to me. I was a
mystery.<BR><BR>I would be surprised, Dr. Moazami said, by my brain's eventual
adjustment.<BR>It would edit my right eye out of the equation so that my left
eye could<BR>guide me on its own, leaving me with entirely serviceable vision.
There was<BR>even a possibility that I'd get some vision back.<BR><BR>But there
was a much better possibility that I wouldn't. There was nothing I<BR>could do
-- no diet, no exercise, zilch -- to influence the outcome. Worse,<BR>the
'stroke' revealed anatomical vulnerabilities that meant that my left eye<BR>was
potentially in jeopardy, too, and there was no proven script for<BR>protecting
it.<BR><BR>Certainly I should drink plenty of water, especially before bed,
because<BR>dehydration causes or aggravates blood-pressure dips. Probably I
should take<BR>a baby aspirin daily, to promote blood flow. Possibly I should
avoid high<BR>altitudes, where oxygen is thin. Mostly I should pray.<BR><BR>I'm
not good at religion. I'm better at drama. I called Tom, my partner of<BR>more
than nine years: 'Would you still love me with a cane and a bad habit<BR>of
bumping into things? I called three of my best friends: 'I'm fat, I'm old<BR>and
now I'm a Cyclops. Do you think there'd be interest in the movie rights?<BR>I
called my sister: 'You have to give me your dog. But first you have
to<BR>retrain him as a companion for the blind. My phone soon ran out of juice.
My<BR>body was pumped full of it.<BR><BR>An estimated one million Americans are
legally blind, meaning that their<BR>corrected vision is no better than 20/200.
A few million more have<BR>life-altering vision impairment. Just a tiny minority
of both groups were<BR>born that way. The rest lost their sight after seeing
perfectly well. They<BR>almost always got some warning, followed by a period of
waiting and dread.<BR><BR>Macular degeneration. Glaucoma. Diabetic retinopathy.
These are more common<BR>culprits than N.A.I.O.N., whose obscurity helps to
explain the lack of<BR>progress in treating it. There's no huge market of
potential patients for<BR>drug companies to profit from. No deep pool of test
subjects to study.<BR><BR>Dr. Moazami confirmed that I had N.A.I.O.N. a week
after our first visit. On<BR>some people, its impact is subtle; they lose only
peripheral vision. But the<BR>central vision in my right eye was compromised, in
an unsubtle fashion. When<BR>I use that eye alone, I see the cloudy contours of
things, and the nearer an<BR>object is, the thicker the clouds are. I can tell
that a paragraph is here.<BR>But I can't make out a single word.<BR><BR>'This is
bad, isn't it? I asked Dr. Moazami.<BR><BR>'This is bad,' she answered, then
added, after an awkward pause: 'I'm sorry.<BR>I have nothing to offer you. But
wait, there was one thing: a clinical trial<BR>of an experimental treatment, and
she could tell me how to get into it -- if<BR>I wanted to go that route. I did.
So I soon added a new, time-consuming<BR>dimension to my already busy life. I
became an ophthalmological guinea pig.<BR><BR>Ever looked at pictures of an
optic nerve? I've appraised a Louvre's worth<BR>of them. And I can't get over
how fragile it seems, this slender thread, fed<BR>by about a dozen minuscule
blood vessels, that tethers the back of the eye<BR>to the brain and alone
decides whether you get to see the setting of the sun<BR>or the rising of a
soufflé?.<BR><BR>'I consider optic nerve damage the holy grail of solving
blindness,' Neil<BR>Miller, a professor of ophthalmology, neurology and
neurosurgery at Johns<BR>Hopkins University's medical school, told me. 'If you
have somebody who's<BR>virtually completely blind from cataracts, we can cure
that. Corneal damage?<BR>We can cure those patients. We can help a lot of
patients with retinal<BR>disease. But there is really very little that we can do
to restore vision<BR>that's damaged from optic nerve disease.<BR><BR>Rudrani
Banik, one of the neuro-ophthalmologists who monitor me during the<BR>clinical
trial, told me to think of the nerve and its surrounding sheath as<BR>'a cable
within a pipe. My pipe, she explained, is a quarter of the normal<BR>size, so if
the nerve swells -- as nerves do when bereft of oxygen -- it's<BR>more likely to
press up against the pipe and be hurt. 'Everything is<BR>congested,' she said.
'Anatomically, we call it a disc at risk. I hate to<BR>use that term because it
scares patients.<BR><BR>For the first month after my diagnosis, I'd catch myself
absent-mindedly<BR>rubbing my eyes, as everyone does, and terror would sizzle
through me. Had I<BR>been too rough? Was my congested nerve still O.K.? During a
run through the<BR>park, a gust of wind blew dirt into my left eye, and I
panicked: I couldn't<BR>allow any injury to it. I no longer had a
spare.<BR><BR>Nights were worst. If the left eye were going to quit on me, it
would<BR>probably do so then. I quaffed two, three, four glasses of water just
before<BR>my head hit the pillow. Superstitiously, I also took my baby aspirin
then.<BR>If I somehow forgot to do either, I bolted out of bed, no matter how
close I<BR>was to sleep, and made amends.<BR><BR>Then, in the middle of the
night, when my bladder screamed, I hesitated<BR>before opening my eyes. What if
I'd had another 'stroke'? It was the same<BR>every morning: a stab of suspense,
then a gale-force sigh of relief. I could<BR>still see.<BR><BR>And I can still
see. The oddity of my situation -- the emotional riddle --<BR>is the distance
between the manageability of my current circumstances and<BR>what tomorrow could
bring. For the moment my handicaps are minor. I read a<BR>bit more slowly than I
did and frequently get a pinched, deadened sensation<BR>behind my eyes. My typos
have multiplied. My texting is a joke.<BR><BR>But extra determination and care
compensate for most of that, and I've<BR>learned that the best response to
weakness is strength: Prove to yourself<BR>what you can still accomplish. I had
a column due three days after I woke up<BR>to my newly blurred vision. I wrote
it on time -- and kept to my usual pace<BR>from then on.<BR><BR>I cut bait on
just one of four speeches scheduled for the subsequent months..<BR>I devoured
more books, not fewer, partly on the theory that I should take<BR>advantage of
my vision while I had it, but also to train and reassure<BR>myself.<BR><BR>On a
visit to Washington, D.C., I had a drink with a friend who works for<BR>David
Tatel, a distinguished federal appeals court judge there. I filled him<BR>in on
my odyssey and assured him that I was O.K., except for my anxiety<BR>about the
future -- about my independence, my competence. I'm a writer, for<BR>heaven's
sake. Explain how I do that without sight.<BR><BR>'If this hits my left eye,' I
said to my friend, 'it's game over.<BR><BR>'Why? he asked, then told me that
Judge Tatel was blind.<BR><BR>Tatel, 75, welcomed me into his chambers a few
weeks later.<BR><BR>He was given a diagnosis of retinitis pigmentosa when he was
15 and informed<BR>that he would someday lose his sight. He coped by not
dwelling on that. He<BR>went to college and law school. He married and started a
family. Then,<BR>around the age of 31, his vision began a sharp decline that
would end in<BR>blindness six years later.<BR><BR>He and his wife, Edie, had two
of their four children after that point. He<BR>adapted to his disability; his
workplace adapted to him. Various digital<BR>advances -- in particular,
text-to-speech technology -- helped hugely. 'I'm<BR>really looking forward to
self-driving cars,' he laughed, emphasizing that<BR>innovation is transforming
the lives of people without vision.<BR><BR>Of course he has regrets. In a speech
last year for the Foundation Fighting<BR>Blindness, he noted that while family
members have become 'true audible<BR>artists,' describing everything that they
pass on nature walks, 'I still<BR>can't see the clouds and flowers and potholes
myself -- or my wife's<BR>beautiful white hair. He believes that he knows what
his grandchildren look<BR>like, from the sounds of their voices and his memories
of their parents, but<BR>he can't be sure. 'Have I created it? he
wondered.<BR><BR>That same afternoon I met Peter Wallsten, 45, the senior
politics editor for<BR>The Washington Post. When he was in his early 20s, he
learned that he had<BR>Stargardt disease, a juvenile form of macular
degeneration that eroded his<BR>vision over the ensuing decade. He works on an
enormous screen that shows<BR>letters in a gigantic font, and he listens to
writers' stories and does some<BR>of his editing by dictation.<BR><BR>'This is
the important thing to remember: It's not your brain that's<BR>affected,' he
told me. 'It's your eyesight.<BR><BR>He added, 'There are things much harder
than this.<BR><BR>Harder than this: A friend of mine was recovering from a
stroke before the<BR>age of 60. Another friend was grieving the death of a
39-year-old spouse. A<BR>mother in her mid 40s was questioning whether a rare
cancer that she had<BR>battled for years was really and truly defeated.<BR><BR>I
found myself taking inventory of the obstacles and upsets that people I<BR>knew
were dealing with. There were children with autism. Parents with<BR>Alzheimer's.
Financial crises. Career disasters. Addiction. Abuse.<BR><BR>And that was merely
the stuff at the tip of my nose, in plain sight. How<BR>much else lurked beneath
the surface? Show me someone with a seemingly<BR>unbroken stride and unfettered
path. More often than not, he or she is<BR>hampered and haunted in ways that you
can't imagine.<BR><BR>And despite my eye disorder, I'm in clover: economic
security; access to<BR>good health care; a durable relationship with a man whose
face will delight<BR>me for as long as I'm able to gaze at it, after which his
voice, which I<BR>also adore, will do. What I'm going through is what everyone
endures as the<BR>years accumulate and the wear and tear starts to show. It's
aging writ vivid<BR>and large. I'm bumping up against my limits. The trick is
figuring out when<BR>to focus on them and when to look away.<BR><BR>I increased
my disability insurance. I deleted Machu Picchu, with its high<BR>altitude, from
my bucket list. I carved out the necessary hours and showed<BR>up for every eye
appointment. The third injection was my last, and there's<BR>no meaningful sign
that the treatment is salvaging my devastated nerve, as<BR>it's meant to. But
it's too soon to reach any conclusions. I'll be under<BR>observation for eight
more months.<BR><BR>And I'll try to put N.A.I.O.N. out of mind, apart from the
water and<BR>aspirin. Joseph Lovett, 72, a filmmaker whose 2010 documentary,
'Going<BR>Blind,' chronicles the slow worsening of his vision from glaucoma,
told me<BR>that his best counsel was that 'you cannot spend your life preparing
for<BR>future losses. It disrespects the blessings of the here and now.
Besides,<BR>everyone lives in a state of uncertainty. Mine just has funky
initials and<BR>fancy medical jargon attached to it.<BR><BR>I'm no longer fit
for summits, but I crested a modest hilltop on a run a few<BR>weeks ago. I
wasn't after the view, but there it was, the Hudson River, gray<BR>and wavy and
magnificent. I could see upstream. I could see downstream.<BR>Lucky, happy me: I
could see for miles and miles.<BR><BR></P></DIV><!--~-|**|PrettyHtmlStart|**|-~-->
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<DIV style="FONT-SIZE: 1px; COLOR: #fff; CLEAR: both">.</DIV></DIV><img src="https://s3.amazonaws.com/msv5/images/spacer.gif" width="1" height="1" alt="Web Bug from http://geo.yahoo.com/serv?s=97359714/grpId=1468595/grpspId=1705007709/msgId=12109/stime=1519565437" /> <BR><img src="https://s3.amazonaws.com/msv5/images/spacer.gif" width="1" height="1" alt="Web Bug from http://y.analytics.yahoo.com/fpc.pl?ywarid=515FB27823A7407E&a=10001310322279&js=no&resp=img&cf12=CP" />
<DIV style="HEIGHT: 0px; COLOR: #fff">__,_._,___</DIV><!--~-|**|PrettyHtmlEnd|**|-~--><!--~-|**|PrettyHtmlStart|**|-~-->
<STYLE type=text/css>
<!--
#ygrp-mkp {
border: 1px solid #d8d8d8;
font-family: arial;
margin: 10px 0;
padding: 0 10px;
}
#ygrp-mkp hr {
border: 1px solid #d8d8d8;
}
#ygrp-mkp #hd {
color: #628c2a;
font-size: 85%;
font-weight: 700;
line-height: 122%;
margin: 10px 0;
}
#ygrp-mkp #ads {
margin-bottom: 10px;
}
#ygrp-mkp .ad {
padding: 0 0;
}
#ygrp-mkp .ad p {
margin: 0;
}
#ygrp-mkp .ad a {
color: #0000ff;
text-decoration: none;
}
#ygrp-sponsor #ygrp-lc {
font-family: arial;
}
#ygrp-sponsor #ygrp-lc #hd {
margin: 10px 0px;
font-weight: 700;
font-size: 78%;
line-height: 122%;
}
#ygrp-sponsor #ygrp-lc .ad {
margin-bottom: 10px;
padding: 0 0;
}
#actions {
font-family: verdana;
font-size: 11px;
padding: 10px 0;
}
#activity {
background-color: #e0ecee;
float: left;
font-family: verdana;
font-size: 10px;
padding: 10px;
}
#activity span {
font-weight: 700;
}
#activity span:first-child {
text-transform: uppercase;
}
#activity span a {
color: #5085b6;
text-decoration: none;
}
#activity span span {
color: #ff7900;
}
#activity span .underline {
text-decoration: underline;
}
.attach {
clear: both;
display: table;
font-family: arial;
font-size: 12px;
padding: 10px 0;
width: 400px;
}
.attach div a {
text-decoration: none;
}
.attach img {
border: none;
padding-right: 5px;
}
.attach label {
display: block;
margin-bottom: 5px;
}
.attach label a {
text-decoration: none;
}
blockquote {
margin: 0 0 0 4px;
}
.bold {
font-family: arial;
font-size: 13px;
font-weight: 700;
}
.bold a {
text-decoration: none;
}
dd.last p a {
font-family: verdana;
font-weight: 700;
}
dd.last p span {
margin-right: 10px;
font-family: verdana;
font-weight: 700;
}
dd.last p span.yshortcuts {
margin-right: 0;
}
div.attach-table div div a {
text-decoration: none;
}
div.attach-table {
width: 400px;
}
div.file-title a, div.file-title a:active, div.file-title a:hover, div.file-title a:visited {
text-decoration: none;
}
div.photo-title a, div.photo-title a:active, div.photo-title a:hover, div..photo-title a:visited {
text-decoration: none;
}
div#ygrp-mlmsg #ygrp-msg p a span.yshortcuts {
font-family: verdana;
font-size: 10px;
font-weight: normal;
}
.green {
color: #628c2a;
}
.msonormal {
margin: 0 0 0 0;
}
o {
font-size: 0;
}
#photos div {
float: left;
width: 72px;
}
#photos div div {
border: 1px solid #666666;
height: 62px;
overflow: hidden;
width: 62px;
}
#photos div label {
color: #666666;
font-size: 10px;
overflow: hidden;
text-align: center;
white-space: nowrap;
width: 64px;
}
#reco-category {
font-size: 77%;
}
#reco-desc {
font-size: 77%;
}
.replbq {
margin: 4px;
}
#ygrp-actbar div a:first-child {
/* border-right: 0px solid #000;*/
margin-right: 2px;
padding-right: 5px;
}
#ygrp-mlmsg {
font-size: 13px;
font-family: arial, helvetica,clean, sans-serif;
*font-size: small;
*font: x-small;
}
#ygrp-mlmsg table {
font-size: inherit;
font: 100%;
}
#ygrp-mlmsg select, input, textarea {
font: 99% arial, helvetica, clean, sans-serif;
}
#ygrp-mlmsg pre, code {
font:115% monospace;
*font-size:100%;
}
#ygrp-mlmsg * {
line-height: 1.22em;
}
#ygrp-mlmsg #logo {
padding-bottom: 10px;
}
#ygrp-msg p a {
font-family: verdana;
}
#ygrp-msg p#attach-count span {
color: #1e66ae;
font-weight: 700;
}
#ygrp-reco #reco-head {
color: #ff7900;
font-weight: 700;
}
#ygrp-reco {
margin-bottom: 20px;
padding: 0px;
}
#ygrp-sponsor #ov li a {
font-size: 130%;
text-decoration: none;
}
#ygrp-sponsor #ov li {
font-size: 77%;
list-style-type: square;
padding: 6px 0;
}
#ygrp-sponsor #ov ul {
margin: 0;
padding: 0 0 0 8px;
}
#ygrp-text {
font-family: georgia;
}
#ygrp-text p {
margin: 0 0 1em 0;
}
#ygrp-text tt {
font-size: 120%;
}
#ygrp-vital ul li:last-child {
border-right: none !important;
}
-->
</STYLE>
<!--~-|**|PrettyHtmlEnd|**|-~--><!-- end group email --></DIV></DIV></DIV></DIV></DIV></DIV></BODY></HTML>