No More Patch!

After about seven months of patch therapy, my three year old son now has two equally strong eyes! He was diagnosed with amblyopia back in May. When he first started wearing his patch he was so blind in his left eye that he ran into walls and couldn't do his wooden puzzles. Now his left eye works just as well as his right. I'm proud of him, and of myself because I was the one who had to make sure he wore the thing for two hours every day.

But now the doctor says no more patch! In a few weeks we'll go for a check up to make sure his eyes are still equal. Now I have to make sure he wears his glasses every waking minute, but that's easy compared to the patch.

And Now, For My Next Trick...

After submitting my very first full manuscript ever to be requested by anyone in the publishing industry, I thought I should take a short break before beginning my next project.

Four days was enough.

Yesterday I sat down and wrote out all the ideas I've had to date that I thought were good enough to become books. I picked the one I got the most excited about, and then spent the rest of the day happily dreaming up a whole new world.

In other happy news, my three-year-old went to the eye doctor yesterday and lo, his lazy eye is now reading 20/30 just like his strong eye! His vision is equal after only six months of patch therapy! Hooray! This month we're cutting his patch wearing time in half to see if it stays stable.

Catch Me, Mommy!

This morning I misbehaved at the eye doctor's office.

I was very good for the first forty-five minutes. I kept my three-year old quiet by reading to him and playing with the toys in the lobby. Then I got impatient. I got crabby. I had a book to revise and laundry to fold, for crying out loud!

With well practiced technique, I engaged in subtle passive-aggressive behavior. I let my three-year old run wild through the lobby. He tore around and around the big salt water fish tank as fast as his little legs would go. Then he did a dance for me on the front door mat. After that he played with the drinking fountain (one of the old ladies in the lobby was nice enough to inform me that he didn't really want a drink, he was just playing with it). Next he had fun trying to run away from me as I attempted to catch him and re-do one of his buttons that kept coming undone. Every time I started to feel a little guilty that we were terrorizing the office I remembered that my appointment time had been a whole hour ago. They deserved it!

When we finally got in to see the doctor she spent most of the five minute visit talking to her intern about making sure to write "no refills" on the prescription when the patient shouldn't have refills. This had NOTHING to do with my son since he doesn't take any medicine at all. I was happy to learn that his eyes are still improving, and I was very polite and thanked the doctor for helping my son to see better.

On the way out, two hours after we had arrived, I was hoping that there wouldn't be a spot for us in three weeks and we'd get to wait longer before we had to come back. No such luck.

Next time, Dad can take the three-year-old to the eye doctor.

Patch

At our last visit to the ophthalmologist (only one misspelling that time!) - which I can only hope was actually covered by our insurance - I found out that my three-year-old's eyes are not crossing as much as they used to. That's great news! The glasses are working.

When the nurse asked me to cover my child's left eye he read everything off the chart, both near and far. But then, when I covered his right eye he shook his head and pulled my hand away. When I finally got him to sit still and look at the eye chart, he couldn't tell a ducky from a birthday cake. The nurse asked him what he saw on the projection screen across the room and he said, "Fire!" I guess because of the light.

The ophthalmologist had a student ophthalmologist with her that day. She explained to him (not to me) that my son had (insert unpronounceable term as hard to spell as ophthalmologist) which simply means that his eyes had been crossing to compensate for the difficulty of focusing, and in order to avoid seeing double, his brain learned to ignore the left eye. The solution: an eye patch over the stronger eye, worn two hours a day, while the child does some activity involving vision, like television, computer games, puzzles, or books.

My first thought was, "That's not so bad." I am sorry to admit my second thought was, "There goes my writing time."

I already told you how much my son hated me covering his right eye with my hand. The patch was even worse. It was a clever little contraption that attached to his glasses instead of sticking on his face. He quickly learned how to pull it down just enough to peek over it so that it looked like he was wearing it even when it wasn't doing him any good. If I tried to read to him or do puzzles, he would hop up and run away, fling his glasses off in some hard-to-find location, and then come back. I decided to work him up to the full two hours instead of asking him to do it all on the first day.

It was uncanny doing puzzles with him the first time he wore his patch. Using both eyes, he could always get the pieces in the right place every time. With his left eye, he fumbled around and usually aimed the pieces about half and inch to the left. But now, at the end of the second week, he will wear his patch for about thirty minutes before he tries to dispose of it when I'm not looking, and he will point directly to pictures on command instead of off to the left of them. It seems to be working.

I'm supposed to go back to the ophthalmologist in two weeks. If I can get my referral extended. Hopefully she'll confirm my suspicions that my son's left eye is on the way to recovery, and she won't do anything that requires any pre-authorization I haven't got.

Insurance Adventures

I got a bill yesterday from the ophthalmologist (yes, it took me about five tries to spell that word). The bill was something of a surprise. It took me an anxious three weeks to get the referral, then it took me six weeks to get in for an appointment, and now apparently my insurance company won't cover the visit because prior authorization was not obtained.

I guess that obtaining a referral is not the same thing as obtaining prior authorization. If I'd known I needed to do that I would have filled out paperwork, sent faxes, driven across town, donated blood, whatever it took! WHY DIDN'T SOMEONE TELL ME!

When I called the insurance company I found out that the doctor's office was supposed to obtain the prior authorization. However, I'm the one who signed the paper that says if the insurance decides not to cover it, I have to pay. I haven't got the doctor's office side of the story yet - I intend to go in and talk to them in person.

In the Ploo!

When my two-year old came in from playing out back, I asked him where his glasses were. He had them on when he went out, but not anymore.

"In the ploo!" he said.

"In the pool?"

"Yeah."

"I wouldn't put it past him," my husband said.

One of my two-year-old's favorite pastimes is standing at the pool fence and throwing rocks, toys, sidewalk chalk, and whatever he can find into the pool. We got the gate key and went out to look. Sure enough, after my husband had fished up several rocks, he netted the glasses. They were in the ploo. Our two-year-old has been banned from playing on the back patio until further notice.

I wasn't sad about him being cross-eyed and needing glasses until I saw a video of him taken about a year ago. There he was, cute baby face, two blue eyes staring at the camera, both straight on. It made my heart ache. He looks so different now. I find that when I look at him I'm drawn to focus on the eye that is not looking at me, and it gives me the impression that I don't really have his attention. I do hope he grows out of it.

Mommy, I'm Done With Glasses

Last Monday I took my almost-three-year-old to the optometrist. About six months ago I began to see him go cross-eyed. Over time it became more obvious until three months ago I took him to the pediatrician. Due to the complexities of modern health care, the pediatrician had to refer me to an optometrist, who then had to refer me to a pediatric optometrist. After two weeks of calling to make sure all the referrals were properly faxed, I finally learned that the only pediatric optometrist on my HMO is semi-retired and comes to her office on my side of town only on Mondays. The first time she could see my son was eight weeks away.

Now, eight weeks later, in the exam room at last, I sat with my son in my lap while the optometrist ran through a battery of tests. She used prisms to check how much his eyes were crossed, and then had me cover each of his eyes in turn while she tried to get him to track a stuffed toy across his field of view. All the while she kept saying, "Oh yes," in a very serious tone of voice. That made me nervous. Oh yes what? Oh yes, this kid is really messed up?

"So that left eye can turn out, it just doesn't want to," she cooed at my child after she had finished her last test. "He's a little cross-eyed," she told me.

"Well, I'm glad I'm not going crazy. When I first noticed, I started asking all my friends, 'Does he look cross-eyed to you?'" It was true. He crossed his eyes so slightly at first that I wondered if I was imagining it.

They put some eye drops in his eyes and told me to go out and wait in the lobby while his pupils dialated. We had been at the office for almost two hours already, and the child was not about to sit still. I tried to keep him from terrorizing the tropical fish and running out the front door. When I thought I could not take it any longer, they called us back for the last test.

"Oh yes," the doctor said again as she shone her light though a lens and looked in my child's freakily dialated eyes. "He's far-sighted. He needs glasses." She rattled off the prescription to the nurse. Then she explained, "There's an equation in the brain stem that relates focusing to eye alignment," she told me, "If we can correct the focusing, the alignment should go back to normal. Hopefully, with glasses, he'll grow out of it before he's twelve. There's an eighty percent chance the glasses will do the trick."

"Thanks," I said, wondering how I was going to get a two year old to wear glasses. The doctor did not offer any suggestions. I know I should have asked, but I got busy chatting with her about her life and her career and why it is that blue eyes look blue--I've always wondered that.

When I got to the eye glass shop I wished I'd asked. Trying out frames was a disaster. My son would hardly leave them on long enough for me to see how he looked. Finally he tore one pair off and flung it across the room, sending it clattering under the service counter. We were done.

"I don't know how I'm going to keep them on him," I told the woman who was helping me.

"Most kids keep them on once they get their real lenses in. They like being able to see," she assured me.

I was skeptical about this until we went to pick up the glasses. When my son got to try them on his eyes grew big and round with astonishment. He glanced around the room, startled and surprised. A little bubble of joy welled up inside of me. My child could see! I never knew that he couldn't, but now he was seeing the things that were close to him clearly for the very first time in his life.

For the first three hours, he kept the glasses on. I thought my worries that he wouldn't wear them had been completely unfounded. Then he came up to me while I was typing at the computer and handed me his glasses. "Mommy, I'm done with glasses," he declared with decisive finality. I guess he decided that being able to see up close without crossing his eyes was not worth having those things on his face.

A few minutes later, I gently hooked the glasses back on over his ears. He wore them for a while, and then, "Mommy, I'm done with glasses." I thanked him and set them aside, waited a few minutes, then said, "Time for glasses," and put them back on. He accepted this, wore them for a while, and then brought them to me once again, "Mommy, I'm done with glasses."

I know that in a year or so I'll be able to reason with him, but for now I'll just be grateful he hands them to me instead of flinging them across the room.