All I Want for Christmas is No More Auras

(Title image: Photo by Brian Suh on Unsplash)

This was supposed to be a post for USA residents about how to find some harmony during the Thanksgiving holiday amidst the tensions brought by relatives with strongly differing views of the world. Such disagreements are always a possibility when families get together, but likely even worse this year.

But, no. Instead, I’m sitting here wearing sunglasses in a darkened room as I plink out this post.

Remember those shimmering scythe-shaped mosaics (auras) that I wrote about intruding on my vision some weeks ago? The ones that are associated with ocular migraines, but in my case minus any headache? Well, they’re still happening and with greater frequency.

Depending on which of my healthcare professionals you talk to, they either want to (1) wait and see how things progress or (2) shove me into an MRI tube ASAP.

And me? I really want to not be dealing with this issue. After seven years of putting a lot of space between my cancer diagnosis and the present moment, I am getting stressed by the possibility of this being something quite serious. And all I wanted was to enjoy the upcoming holiday season.

But I’m getting ahead of myself. Here are the details: I’ve now had seven of these episodes in about two months—I’m not even sure when the very first one was. After the last one (which was the second of two last week), I left a message with my ophthalmologist.

However, it was my oncologist who happened to call a few hours later, completely coincidentally, to give me unrelated scan results.

So, since I had him on the line, I told him about the auras. He sounded sad. And you know what? You never want your oncologist to sound sad, especially when they’re usually so good at being neutral when delivering news.

And then my ophthalmologist called back late that afternoon, urging me to see my primary care doctor as soon as possible and also schedule an appointment with her for the next day.

Next day, I snag a morning appointment with my primary care provider, explain the situation and the fact that I have no other symptoms other than the auras. Her take: this is very weird, yes…but it’s a hard sell to get this to qualify for an MRI at this time, even with the frequency. With my consent, she wanted to wait for a little bit and see whether the auras continued.

Or, I guess, until my head exploded or something.

Find a happy place, find a happy place, find a happy place…
(Photo by serjan midili on Unsplash)

When I saw my ophthalmologist that afternoon, she was extremely concerned and incredulous that an MRI wasn’t the first course of action. I could tell that she felt waiting was a bad idea.

But ultimately, she acquiesed to the notion that we’ll wait, although she’s sending a synopsis of her findings to my primary. She instructed me to take excruciatingly detailed notes the next time one of these auras occurs

And if you’re still reading this far down and are convinced that my goose is cooked, maybe it isn’t. Sure this whole experience is stressing me out. But there are far too many confounding variables present to resign myself to the fact that I’ll be getting my head shaved again soon…variables which I might be writing about in a future post…

…or I’ll be talking about my ride in the MRI tube and subsquent diagnosis.

But for now, I’m going to rest my eyes in a darkened room and think of silky fur on a contentedly purring kitten.

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For everyone in the USA, have a wonderful Thankgiving with your lovely families this Thursday…and let’s all try to keep it civil.

Maybe It’s Okay To “Overreact”?

After cancer, overreaction may be called for.

So it’s Saturday and I’m sitting in my general practitioner’s waiting room, having been able to secure an emergency appointment. That morning I started seeing light flashes (photopsia) in the outer periphery of my left eye. Very weird, sudden and striking, like little comets whizzing up and down along the curvature. I know I shouldn’t immediately rush to the uncurated internet for information, but who can resist when you need answers fast? After a quick search I saw some of the possible causes, including retinal detachment and Vitreomacular Traction Syndrome (VMT). My symptoms were pretty spot on as I realized I had some significant floaters in my eye too, more than usual.

Further reading pointed to aromatase inhibitors (the estrogen-squashing medication given to breast cancer patients with hormone positive tumors, after they’re done with surgery/chemo/radiation) as a potential contributing factor. As explained on the American Society of Retina Specialists’ website: VMT syndrome is most common in older adults and women due to age-related vitreous changes and vitreous liquefaction associated with declining post-menopausal estrogen levels, respectively. 

Great. I am taking the aromatase inhibitor, letrozole. And so far, it’s been highly effective in dropping my estrogen/estradiol to basement levels. Like, 80-year-old granny levels. Except that I’m 54 years old.

I do NOT want to wait on getting my eyes checked out! I learned from cancer that procrastination turns an easy fix into prolonged treatment.

So now I’m waiting to see whether what I experienced really does have to do with my unnaturally-low-for-my-age estrogen, or if it’s nothing to worry about. My GP’s office couldn’t do a retinal scan, but as soon as I get approval from my insurance, I’m jumping on the first ophthalmologist appointment I can get.

Before cancer, I would have brushed the symptoms off as just some passing oddity. I doubt I would have taken action unless the symptoms had persisted, and even then, it might have taken weeks. I wasn’t primed to react.

But now, while I am *not* panicking, I’m also not waiting. Like it or not, cancer taught me that when it comes to worst-case scenarios, the worst is a distinct possibility.

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If this does end up being VMT syndrome or similar, and if it can be reliably linked to medically-induced estrogen suppression, I’ll be deciding between risking loss of eyesight vs. risking the return of cancer.

But maybe it’s nothing.