do you see what I see?

One of the most common presenting symptoms of multiple sclerosis is optic neuritis. To quote wikipedia:

"Major symptoms are sudden loss of vision (partial or complete), or sudden blurred or "foggy" vision, and pain on movement of the affected eye. Many patients with optic neuritis may lose some of their color vision in the affected eye, with colors appearing subtly washed out compared to the other eye. A study found that 92.2% of patients experienced pain, which actually preceded the visual loss in 39.5% of cases"

Apparently, up to 50% of patients with MS will develop an episode of optic neuritis, and 20-30% of the time optic neuritis is the presenting sign of MS. As I know all too well, MS can somewhat slippery to diagnose at the best of times. Compared to symptoms as generalised and hard to nail down as numbness and pins & needles, it's really not too hard to understand why a sudden disturbance in your vision might be the thing that really scares someone off to their doctor and onwards to their neurologist.

...unless, of course, you've recently had your eyes cracked open and had corrective lens implants clipped onto the front of your irises..... in which case a blurring of your vision may not automatically have you reaching for your neurologist's phone number.

Since I had my eyes operated on in July 2008, I would say that my eyesight has been brilliant more than 90% of the time. I only say 90% because, although I don't regret the procedure for an instant, there have been one or two little niggles. The lens in my right eye is smaller than the lens in my left. The reason for this was that I needed a rigid lens in that eye to correct an astigmatism, and the rigid lens couldn't be rolled up before insertion like the other lens, and so needed to be smaller. Because it's smaller, in some light conditions my pupil approaches the edge of the lens and I get some leakage of light. It's not too much of a big deal, and once I got used to it, my brain basically tuned it out. But it's there. My right eye also seems to react more slowly to changing light conditions, meaning that my vision becomes slightly blurred when I move from very bright conditions to dimmer conditions, and once in a while my pupil seems to get "stuck", and takes a bit longer to adjust. Again, not a very big deal.... but it's there.

I also have an obsessive personality, and once in a while, my brain finds something tiny to latch onto to the exclusion of almost everything else. In the old days, this was things like the fit of my glasses or imaginary scratches on my lenses. Nowadays, sometimes it's my new eyes. Initially I fixated on some barely perceptible hazing that occurred in my left eye, caused by skin cells on the implant that my brain - if left to its own devices - would quickly tune out. When I finally let it go, the hazing quickly disappeared. In addition, once in a while, I'll notice that the correction of my right eye is fractionally less good than the correction in my left. I'll sometimes sit for a while, alternately closing each eye and comparing what I see. Then I'll realise that I have perfect vision with both eyes together, and perfectly acceptable vision even in my 'weaker' eye, and I'll get over myself and find something else to worry about.

So, with that in mind, you might understand why, when I start to experience more regular blurring in one of my eyes, I don't immediately assume that it is the onset of optic neuritis. Over the last couple of weeks, this is exactly what has been happening: the blurring in my right eye has been getting steadily worse. Where before it only happened from time to time, now it seems to be happening more regularly, and although my vision still tends to improve in brighter light, that doesn't now seem to be always the case. I've also noticed that, when blurry, my eyesight is less blurry at the periphery of my vision than it is at the centre. Not surprisingly, I've also been getting nagging tension headaches behind my eyes too. Of course, it's possible that it's still all in my head, or that there is some kind of mechanical problem with my implant.... but I've also started to come to terms with the fact that there might also be a neurological explanation.

I really don't know how I feel about that. Let's review the possible outcomes: if it's all in my head, I may well be crazy; if it's a problem with the implant inside my eye, then it could require surgical correction (or removal)....or it could be further neurological evidence that my MS is progressing.

What kind of options are they?

Well, one way or another, I guess I'll find out more on Friday - I've got an appointment go get my eyes checked up. It's a regular appointment that was originally supposed to happen in November last year, then in July and then last Friday, when I sat in a hospital waiting room for two pointless hours for my doctor to show up..... well, what kind of service do you expect when you go private? If the appointment does nothing else, it should help start the process of elimination.

Funnily enough, since the possibility occurred to me that this might be caused by something that is totally outside of my control and nothing to do with any choices I've made or how nuts or otherwise I may be, I've found the whole thing a lot easier to deal with.

Funny things, brains.

the future's so bright....

As I went out running this evening, I found myself squinting into the evening sun as I dragged my limbs, still aching from Sunday's 9 miler, around the Embankment. Why had I decided to run without my sunglasses on? I love wearing sunglasses and I almost never go running without them. I even have a pair that I use especially for exercise. It might have gone past seven by the time I set out, but it's not winter here just yet and there's still good daylight to be had long into the evening. What was I thinking? I almost never go anywhere without sunglasses. I'm very attached to my sunglasses.

I think there are two likely reasons for this attachment. The first is that, for thirty years of my life anyway, I wore glasses. I didn't get my first pair of prescription sunglasses until I was in my late teens. If you've ever seen the prescription sunglasses on offer as the "free pair" when you buy a pair of specs, you'll know that the choices are extremely limited and the styles generally unflattering. I began to wear contact lenses with greater regularity from my mid-20s onwards, and it wasn't long before I bought myself my first pair of proper sunglasses - a pair of Oakleys from a shop in Padstow. In fact, the very same pair that I still wear when I'm out running. I was thrilled with them and wore them almost as often as I wore my contact lenses. I've been wearing sunglasses like that ever since, even more so since I had my eyes done last year. It might be old hat to all you people lucky enough to have perfect eyesight, but the thrill of having a proper pair of (relatively) stylish frames with excellent lenses was like a revelation to me. It's a thrill that's never really worn off, and even though I no longer need to wear glasses or contact lenses, it's still the freedom to wear sunglasses when I want (along with the ability to see my watch on the bedside table) that gives me the biggest kick.

The second reason? I like the feeling that people can't see my eyes. Perhaps this is another fallout of wearing glasses for so long, or perhaps just because I'm a bit shy, but I like to hide behind my sunglasses: pretty much every pair that I own are big wraparounds with pitch black lenses. I can see out, but you definitely can't see in. Part of the reason I like to wear sunglasses when I'm running is that I want to keep the pain on the inside. I don't want anyone to see my eyes lolling about in my head as I drag my sorry body around the place, and somehow I think that sunglasses make the whole process look effortless. It's a bluff, but it's a bluff that somehow makes me feel better about myself and perhaps makes me run harder. A double-bluff, perhaps. Even if the only person I'm fooling is myself, then it's still worthwhile.

I might risk looking a bit of a prat walking around on a mildly overcast day, but I not sure I care. Lest you think I'm a complete moron who wears his sunglasses ALL THE TIME, I should add that I do have limits: the sun has to at least have the potential to show it's face, otherwise the sunglasses will stay at home. Even when the sun is shining, I will always take them off when I'm indoors and usually when I'm talking to someone. I'm not one of those people. At least I like to think I'm not.... maybe I am? I don't wear sunglasses to look cool, I wear them because it's still the thrill for me that I can wear the sunglasses that I want when I want to wear them. They make me feel free. It's a small freedom, I know, but I hope I'll never get bored of it.

Regular readers here will not, I'm sure, be surprised to hear that I like to spend my time fretting about possibly invisible scratches on the lenses......

not there....

Yesterday afternoon, I found myself involuntarily reaching out to push the glasses I no longer wear back up my nose. I suppose it's hardly surprising, given that I wore them for the best part of thirty years. All the same, it was still something of a surprise to find them not there as I reached out to adjust them.

I suppose this kind of vestigial feeling must be similar to that experienced by people who lose a limb, although presumably it's infinitely preferable to reach out for glasses that you no longer need than to look for an arm you no longer have.

Life without glasses is good.

one wave short of a shipwreck....

My recent brushes with neurology have shown me how much doctors know about the human brain, but also how much more they don't know. Technology means that we can now see inside the human skull, but any understanding of it that we do have is very much glimpsed through a glass darkly. Thanks to MRI scanning, I have seen what my brain looks like, but I don't feel any closer to understanding how it works. This has never been clearer to me than it is now.

About two weeks ago, whilst playing football, I noticed that the vision in my left eye was slightly cloudy. I tried to ignore it, but it's still a little less than two months since my surgery and my eyes will not have fully healed yet, so I couldn't really help but worry about it. Immediately after the first operation, I had been anxious that the quality of the vision in my left eye hadn't been as good as I had hoped, but as the weeks went by, it seemed to get stronger and stronger until the point where it was at least as good as my right eye. In turn, the vision in my right eye seemed to be a little more variable, and I was troubled somewhat by the way that light fractured as my pupil approached the edge of the smaller lens in dim light. After reassurance from the professor that my brain would learn to tune that out, I resolved to put my worries to the back of my mind and to just leave my brain alone to adjust to my new eyes. The cloudy vision was a bit of a worry, but I was determined that I wasn't going to just go running straight to the professor just in case my mind was playing tricks on me again.

A week later, though, and the cloudiness was still there... perhaps worse... and I could now feel a nagging sense of pressure behind my left eye too. I hadn't been given a handy fact sheet that might tell me what to expect from the operations, so I felt I had no choice but to email the professor and ask for advice. He emailed me back fairly quickly and told me that he would have expected my vision to have settled by now and that I should make an appointment to see him on Monday - yesterday. The wait for the appointment was only a few days but I found it difficult: I was really starting to struggle with my left eye and was finding it hard not to panic about what could be wrong. I resisted the urge to google, but my mind started to dwell on doomsday scenarios: what if the pressure in my eye was dangerously high? what if the lens needed to come out? what if? what if?

The day of the appointment itself I found myself able to put most of this from my mind because I knew I was seeing the professor that evening, but the vision in that eye seemed worse than ever and I developed a headache behind my eyes. I was nervous. The clinic was chaos, as usual, with twice as many patients as scheduled appointment slots, but as I had been slotted in myself, I felt I could hardly complain. I waited an hour and was then called in for the reckoning. The professor tested my vision in both eyes, he carefully and silently checked the pressures and he examined both the surface of both eyes and my retinas. Then he sat back and he gave his verdict: all the empirical evidence pointed to nothing being wrong. My vision was normal in my left eye and better than normal in my right, as it had been when I last saw him; the lenses were attached well and the pressure was good. There was perhaps a thin layer of cells on the stickier surface of the left lens, but this would have been there since the operation that inserted the lens and would be invisible to me. All good news, but why was I seeing a haze? Why was my vision cloudy now when it had been clear before? The professor had no answer, except to say that everything looked extremely good to him.

There are only two possible conclusions I can draw from this: the first is that the professor, one of the most eminent specialists in this field in the world, doesn't know what he's talking about and has missed something that is affecting my vision, or my brain is playing tricks on me.

It must be the latter.

As we drove home, I was both relieved and depressed: relieved because my eyes were okay, but depressed about the tenacity of my brain in hanging onto a haziness that probably wasn't really there. It occurred to me that the haziness had started to bother me at about the same time that I was starting to stop being bothered by the fracturing light in my right eye. In other words, my brain was tuning out one thing and fixating on another, or perhaps it simply inventing something to fixate on.

As you might imagine, this is really difficult to come to terms with. C. wondered if I had substituted fretting over my glasses for fretting over my implants, and she's probably right. But the fact that this is likely all in my head does not make it any less real to me or the symptoms any less bothersome. The bigger picture is great and I'm still really pleased that I had my eyes done and I've been delighted with the results. If I could go back in time, knowing what I know now, I'd make the decision to have it done all day long. I'm not so naive that I don't realise that if it wasn't worrying about my eyes, my brain would most likely still be fretting about the fit of my glasses or the scratches on my lenses or God knows what. I might still be fretting now, but at least this way round I can see the clock when I wake up in the morning. Of course, if I could stop my brain doing this, then I would stop my brain doing this. Apart from anything else, it is incredibly tiring and I just wish it would stop.

I'm actually pretty stress resistant: I don't really let the pressures and strains of the office bother me, and I am well able to take other assorted crises in my stride. It's the little things that really get to me, and frankly I'm beginning to realise that the obsession with little things is probably a manifestation of problems that I'm having elsewhere in my life. Quite what those problems might be, I don't know, but I do know that, whatever they are, I wish they would bloody go away so I can think about something else for a while.

Meanwhile, I've got some more drops for my eye (placebo, anyone?) and I'm trying desperately hard not to think about my eyesight in the hope that my brain will turn its laser like (over-)analytical focus onto something else less bothersome.

My analytical frame of mind is probably my greatest asset. Turns out it's something of a curse too, and that I'm a mentalist.

It's enough to drive you mad.

they do run run...

On Thursday, I received a hefty blow to my ankle.

By Friday, my ankle had blown up and I could barely walk. An X-ray revealed that it was not broken, but ligament damage would mean that I would have to rest it up for a week or two.

I'm due to go skiing at the end of January, and because I'm obviously going to need my ankle in full working order for that, resting up and giving it a good chance of a full recovery seems like simple common sense to me. Why on earth would I want to do anything that would slow down my rehabilitation and might jeopardise all that outlay on a skiing holiday? Why risk it?

So why was it that by Sunday I was chafing at the bit to get out and do some exercise? My ankle was still bruised and pretty sore, but I was now able to get around quite a lot more easily, and my attention inevitably began to focus on wondering whether or not I could get away with going for a swim or something. Thanks in the main to a series of extremely disapproving / withering looks from C, I somehow found the strength to resist that urge and spent the day sat on the sofa watching the telly and reading the papers. I know that's how Sundays are supposed to be spent, but I really found it a struggle. My weekends are generally planned around my exercise routine: a run on the Saturday and a swim or something on the Sunday. Everything else is worked out around those two immoveables. This weekend was different: the last proper exercise that I have done was that game of football on Thursday evening. Under normal circumstances I would have done another 3 sessions since then (swim - run - swim). I'd probably give myself Monday evening off, but would be back out again over lunch on Tuesday for a run, another swim on Wednesday, football on Thursday, swim on Friday.... and so on.

I may have got a perfectly sensible excuse for not doing all this exercise, but the net result of missing out on those 3 sessions is that I feel fat and lazy. It's ridiculous, I know, but that's absolutely the way that I feel about it. I look at myself in the mirror and I imagine that I can see myself getting heavier and I'm desperate to do something about it.

By almost anyone's measure, I'm pretty skinny already, and my metabolism is stoked up so high that I could presumably stand to rest for a few days without putting on so much as an extra pound. For whatever reason though, I do not see it like that: when I look in the mirror I do not see the thin, bony man with the sticky-outy veins and the hollow cheeks that everyone else seems to see. When I look at myself, even though I can easily count my own ribs, I only ever see the bits that wobble and I imagine them getting bigger and bigger the longer I look at them and do nothing. As a result, I feel compelled to exercise, and when I do exercise, I feel compelled to flog myself. I don't like to weight train, I like to run. I only swim because I need to do something that helps to stop the muscle wastage in my upper body that the WTs are causing and because it stretches my back out; it always feels like a fairly gentle form of exercise to me, and is therefore a bit unsatisfying. Only running really gives me the feeling that I am working hard enough - nothing else makes me sweat so much or makes my muscles ache so much. That's the one exercise that really feels as though it's doing me some good. It hurts, and pain is good.

I haven't exercised since Thursday and I'm facing up to the fact that I realistically won't be able to anything much until next Saturday at the earliest.

The very thought of it is driving me mad with frustration.

Crazy, I know, but that appears to be who I am.

I think maybe I might try a swim tomorrow night.

six foot six and a hundred tons

I think I might be addicted to exercise.

It's not that I particularly enjoy exercise per se, it's that I feel so awful if I don't exercise; if I don't get my fix. A typical week for me has six days of exercise: a rest on Monday, a run at lunchtime or a game of football on Tuesday (and sometimes a run after football), a swim on Wednesday, football on Thursday, a swim on Friday (the pool is pleasantly quiet on a Friday evening), a run on Saturday and another swim or run on a Sunday. If I miss any one of those days, then I feel fat and lazy.

In spite of my bad neck, I've managed to play a game of football and go for a couple of runs so far this week, but because I've missed a couple of days, I feel fat and lazy. I was actually away in Telford today and there was no possible way that I could have done anything, but in my head this is no kind of excuse - it's just a day missed.

Like I say: it's an addiction. Or is it an obsession? Or is it both?

Missing a day's exercise also seems to leave me feeling a bit tense: it's brilliant for clearing the mind. No exercise equals a cluttered mind. It's surprising the things that work themselves out in your head when you are trawling up and down a swimming pool or running alongside a river, not to mention the number of earworms that drift onto my internal jukebox.

So it seems I depend upon exercise psychologically and psychiatrically as well as physically.

Frankly I'm amazed I give myself one day off a week.

It hasn't always been like this though.

I know you might not think it to look at me, but I eat like a horse and I feel that somehow if I don't exercise hard, then I will stop being able to eat what I want. This is partially true: after a very active life at school, I slowed down a lot when I was at University and - when an increased beer intake is factored in - I put on quite a lot of weight. I'm tall and have broad shoulders, so I carried this pretty well, but the simple truth is that I was about five stone (70lb) heavier than I am now. I never really set out to deliberately lose all that weight, it just kind of happened. I started to exercise more and to eat better (I think mainly because I began to cook for myself a lot more and discovered that I liked fruit and veg more than I liked a burger and chips). The final clincher was a nasty bout of bacterial food poisoning that seemed to affect my body's ability to process some types of food.... add it all together and the weight just fell off.

...but somewhere along the way I got hooked on exercise. It's not a habit I want to kick particularly, it's just that I'm not sure it's healthy being quite this obsessive about it.

It's in my nature, I suppose, and there are certainly worse habits I could have acquired.

Soap operas for starters.
Meteorology.
Chess.
Blogging.....

That kind of thing.

anonymous call; a poison pen; a brick in the small of the back again

I lost a pen yesterday.

It wasn't an especially nice or an especially expensive pen, but I liked it. It was a blue/black gel pen that I bought in Muji for less than a pound. I liked writing with it and I was sorry to discover that I had lost it somewhere. At the first opportunity I will buy another one.

...and then in my first meeting of the day, I noticed that the guy sitting next to me had a blue/black gel pen from Muji.

I supressed my instincts to decry him as a thief and instead tried to shrug and accept that it wouldn't really be that surprising if someone else had the same pen as me. He could have bought it himself, after all.

...and then he picked up the pen and carefully read the sticker on the side, as though seeing it for the first time.

It doesn't mean anything. Deep breath. Deep breath. Concentrate on the meeting.

... and then he opened up his notebook and started to draw a couple of lines with the pen, examining the nib carefully each time, as though trying it out for the first time.

IT'S MY PEN! HE'S GOT MY PEN!

It cost me less than a pound.

He could have his own or he could have found mine lying around on the floor somewhere and picked it up. It doesn't mean anything. I lost the damn thing and I'm going to buy a new one.

So why do I still find myself to be mildly annoyed?

and it burns, burns, burns....

I nearly washed my wedding ring down a sink last week.

Anyone who has seen the pictures of me at the wedding struggling to force that same ring over the broken knuckle on my ring-finger will realise just what this means: it means that after something like 4 months since that fateful game of basketball, the swelling in my joint is finally going down. Mind you, I didn't have much time to celebrate this fact as the sinks at work don't have a grill over the plugholes (no, I don't know either), so I had to act pretty fast to avoid the need to go and fetch a plumber.

Later on that same day, I was shaking my hands after washing them, and the ring flew off my finger, requiring some quick reactions to catch it before it sailed across the room.

Clearly time for an adjustment then.

This is actually a visit I have been putting off for a while. I have been doing this partly because I know that the swelling in my knuckle will go down gradually, and I didn't want to get the ring adjusted once, only to have to take it back a month or so later. If I'm totally honest though, the delay was also equally due to the fact that I am mental: I had become fascinated by the way that my once shiny and new ring was wearing... to the extent that I was almost worried about getting it back from the jeweler, all perfect again, only to have to go through the pain of watching that perfection disappear, one scratch at a time.

Yes, I realise that this is irrational.

Yes, I realise that it is entirely inevitable that something I wear on my finger is going to get banged and scraped and a little bit bashed (which is one of the reasons I opted for a platinum ring in the first place, as it's harder than gold).

Yes, I realise that all I have to do is to get the ring polished once in a while - which if free, by the way - and it would all be as good as new again.

I know all of this, and yet it was still virtually inevitable that I was going to fret about this -- anyone who knows what I am like with my glasses (amongst other things) would have been able to predict that. And I did fret, right from the first moment that I looked at the ring in its box, before I had even put the damn thing on, and saw some tiny surface scratches caused by the initial polishing. Once I started wearing the ring, there was no holding me back. I think I'm looking at my ring in almost every single one of those photos.

Perhaps "fret" is too strong a word. I think "mesmerised" might be better. I simply found it fascinating. I'd never worn a ring before, so I was acutely conscious of it on my finger and of every knock that it took in the course of a normal day. I just wasn't able to equate the things that I did with the marks that were appearing on my ring.

Of course, after a while I started to get used to wearing it, and I stopped looking at it quite as often. I still looked, naturally, but I think that the ring stopped looking scratched (bad) as much as having character (good). So, not only was I now getting reconciled to this, but I was even tentatively starting to like the way it looked.

And then I got the ring re-sized (it was made 4 sizes smaller) and it came back all shiny again, and I was facing up to the prospect of scuffing it up all over again.

As it happens, I haven't really had any time to worry about that as something else has come up.... quite literally. It's been quite hot here over the last few days, and the higher temperatures coupled with the process in the jewelers of trying on sample rings for size and taking them off again, putting my own ring on as it was being resized and taking it off again... all of this has combined to irritate the joint in my finger to such an extent that it has swollen up again. Not so much that the ring was compressing my finger, but enough that I couldn't get it on and off without a struggle. The best thing would therefore be to leave it well alone, but as my finger continued to swell, I couldn't stop myself trying to see if I could still get the ring off, irritating the joint more and more each time I tried.

In the end, I have had to take the thing off entirely and will have to wait a few days to see if the joint goes down again (now the ring is smaller, it no longer fits on the finger of my right hand either).

And you know what else?

I was just putting the ring back in its box, when I noticed a mark......

Gah!