Monday, June 05, 2006

Indications

For "the record" (though shouldn't it be called "the CD" these days?), and for those of you who are coming to Stephan's epic saga in media res, here is a synopsis of how I got on this road to a diagnosis of MS.

On the evening of August 12th, 2005, while having dinner in Denver with an old friend, I noticed that I felt vertiginous if I tilted my head back. I didn't know what to make of this, and it wasn't a strong feeling, so I just filed it away under "pay attention" and went on with the evening. Over the next couple of days, however, the vertigo got stronger and became nearly constant. I also found that I had double vision whenever I looked far to the left, and, eventually, whenever I looked anywhere left of center. After a few days of constant vertigo, I also felt quite nauseous. Trying to focus on a computer screen or anything else close to my face increased the vertigo.

I was in Denver for a week-long work trip. I spent much of the time holed up in my hotel room, not in the vacation-having-fun kind of way, but in the if-I-sleep-at-least-I-don't-notice-how-awful-I-feel kind of way. I went into work on the days when I was really required, and stayed in bed the rest. Eventually, I had the brain wave to get some Dramamine, which broke the nausea and allowed me to work more effectively, but by this time, my double vision was in full swing. When I got back to Tucson, I saw a neuro-opthalmologist, my internist, my osteopath, my acupuncturist, and even my dentist for good measure, although that was a pre-existing appointment. The consensus I got was that the most likely explanation after a single episode was a virus, or an overreaction by my immune system to a virus. The ophthalmologist advised against getting an MRI at that time because MS was still only residually indicated, and even if the diagnostic image came back clean, just the mention of MS anywhere in my record would make me virtually uninsurable.

My double vision gradually cleared up over the following months, until, by December, my vision was basically normal again. But then in mid-April of 2006, I noticed slight vertigo one evening over at a friend's house, and trouble focusing in my right gaze the next day. So I went into the ophthalmologist again. He noted that now I had two events, separated in time and in space (my two visual symptoms came from different parts of the brain), so it was time to get an MRI. And that's where this blog picks up in the 5/5/06 entry.

Spinal Tap: Mission Accomplished

I had my spinal tap on Friday (2 days ago). It went smoothly, and I seem to be recovering well. I'll get my results in a week or so, and will pass them on then.

The experience itself was interesting. I had been hearing a number of different meta-messages about spinal taps. The good Dr. Imberly told me, and I believe her, that it is a routine procedure. Dr. Kate gave the same vibe. Various laymen, however, talked about it with a certain weightiness. I think I now have a better read on what this is about. When my doctor was prepping me for the procedure (which took only about 30 minutes total, from walking into the office to walking out), he said that I should expect to feel a certain pressure on my back. But if I were to feel a pain in my legs, he said, I should tell him at once and remain absolutely still. I imagine this is because it would indicate the needle was rather closer to the actual spinal cord than intended. So I think the mixed emotional messages I've been getting stem in part from the severity of possible side effects. If done carefully by a skilled doctor, the procedure should be routine. But if it goes wrong, the consequences may be rather worse than a bruise, or so I gather.

In any case, mine went fine. It did tire me out. Whenever I have blood drawn, even just a small vial like for cholesterol tests, I feel pretty weak afterwards. In this case, it was my cerebrospinal fluid that was extracted. I didn't feel weak afterwards, but I felt...knocked down. The comparison that came to mind was of floating in the ocean, and being bowled over by a wave. The wave is neither swift nor slow—in fact, it is almost gentle—but you are completely helpless before it. That's how I felt: gently, inexorably, knocked onto my back.

I've been resting, drinking caffeinated beverages, listening to music, playing video games, and taking painkillers. I think I'll probably go to work tomorrow and be just fine; at worst, I may leave early. For now, it's off to make a little more progress in Dragon Quest VIII.