High On Hope and Optimism!

It's been two weeks since our trip to Ohio, and I think it's about time I get around to sharing all about it!  The weeks since the trip have been so chaotic that this is the first time I've sat down at the computer.

On her first ever flight!

Our trip was only three days long, but two of those days were FULL days of flying.  On the way there, we flew from San Francisco to Charlotte, North Carolina and from there to Akron, Ohio.  We started our day that morning at 3:00 a. m. and did not get into our room at the Ronald McDonald House in Akron until 7:00 p. m., our time (10:00 p. m., Akron time).  And the way home was an even longer trip!  Most of the other passengers told us what an angel Makayla was and told us how well behaved she was, but I have to give my husband and myself a huge pat on the back.  We had a whole bag of tricks we cycled through, endlessly, to keep that tired little girl happy.  She was pleasant, because we worked HARD to keep her that way!  Since she is not a napper, we could not count of her sleeping through it.

I had to wonder if it would have been less annoying to listen to a baby cry for a few hours, or to hear me sing the ABC's over and over and over and over again!

By the time we got to Akron, our appointment with Dr. Hertle was just 12 hours away, so we quickly ate some dinner the at the Ronald McDonald house provided us, and got ourselves to bed.  Unfortunately, since Makayla has never slept anywhere except her crib, and next to her brother, she woke up after about five hours and did not go back to sleep...but she seemed happy, and does really well on little sleep, so Joey and I pried our eyes open with McDonald's coffee and made the best of it!

We got to Dr. Hertle's office a little early (I am so grateful to have a husband who is as habitually and ridiculously early, as I am), and they took us in right away.  We met with a nurse and a resident doctor first, and we told them all about our experience so far with Makayla's Nystagmus and the doctors we've seen.  We told the nurse that the first ophthalmologist we saw, met with us for no more than 15 minutes.  He told us that Makayla had Nystagmus, and there is nothing we can do to treat it, and she will have it all her life..."and whatever you do, don't Google!" (glad I didn't follow that advice or I would have never found Dr. Hertle or the amazing people on Facebook's American Nystagmus Network!)  The nurse's jaw dropped to the floor and she promised that we would get more information about Makayla's Nystagmus, and how we can help her and treat it, over the next couple hours, than we have gotten in the last year and a half, from five doctors.  She was right.

During our appointment, They did an Eye Movement Recording on Makayla.  The test confirmed what we have been telling Makayla's doctors all along, that her right eye is not as strong as her left eye.  He called it Esotropia, which is a type of Strabismus.  Basically, she has a "lazy eye".  This is common in patients with Nystagmus. This test also provided the doctor with a lot of other information about Makayla's Nystagmus, like how quickly her eyes move and the pattern in which they move.

He was also able to confirm that the lower field of Makayla's vision is where her Nystagmus is the quietest, and where her vision is best.  This is her "null point".  This is another thing that Joey and I have been trying to tell doctors.  Yet they have insisted that she does not have a null point.  It seems that Makayla's null point is not as quiet as some other patients with Nystagmus, so they have simply told us that she does not have one.

After the Eye Movement Recording, we attempted to do a Visual Evoked Potentials (VEP) test.  Unfortunately, by that time, our sleep deprived little girl had enough.  They sent us back to our room for a nap and some lunch and we tried again a few hours later, but to no avail.  However!  Thanks to my fantastic binder of Makayla's medical records, the we were able to provide the doctor with a copy of a report from a VEP that Makayla had in September of 2011 at UC Berkely, thanks to a research study she was accepted into with the help of her Vision Therapist (have I mentioned how much I love these ladies?!).  Dr. Hertle said the results of that test were very good, and would be enough for him.

Finally, the doctor dilated her eyes and after his examination talked to us about the possibility of Makayla being albino.  This wasn't the first time we've been asked by doctors if she was albino.  As I understand it, most, or almost all albinos have Nystagmus (interestingly enough, I watched a documentary on albinism during my pregnancy, and learned about it's correlation with Nystagmus, AND that it was helped me identify Nystagmus in Makayla when she was only a few months old).  Obviously, Makayla is very fair, and has blue eyes.  We have not had any genetic testing done to determine if Makayla is Albino, but Dr. Hertle found a lack of pigment in Makayla's retina and noticed mild transilumination (light reflecting back) in Makayla's iris.  Both of these are commonly found in someone with Oculocutaneos Albanism (OCA).

We've been told by a couple of doctors now, including Dr. Hertle, that getting insurance to cover seeing a geneticist can be impossible, and that because not all of the markers for albinism have been identified yet, we could get a "negative" on a test, but still not be able to rule of the possibility of albinism.  Although more information is always better, knowing with certainty if Makayla is albino, does not change anything as of right now.  I am still very curious about all this albino talk and looking into getting some more answers.

We were very excited to hear that Dr. Hertle has a plan for treating Makayla.  Starting this weekend, we will begin "patching" to strengthen those weak muscles in her right eye.  We actually don't think Makayla is going to tolerate wearing a patch on her eye, so Dr. Hertle gave us dilation drops for her left eye, which will blur the vision in that eye and force her to use the right eye.  We will do that over the next two to four months and then go back to Ohio for surgery to fix the strabismus, and move Makayla's null point to the center of her vision.  We are currently waiting for a call from Dr. Herlte's scheduler for our exact surgery date.

The doctor thinks this surgery will be very helpful and improve Makayla's vision.  He said that she has only a very slight astigmatism, so if we can improve her Nystagmus enough, she may be able to see very well.  After this surgery, we will go back and See Dr. Hertle again and redo all the testing to gauge her improvement.  Based on the results, he may want to do a second surgery, or start getting Makayla into contacts.  The contacts will help to slow the movement of her Nystagmus, and straighten out the alignment of her eyes (if there is any strabisum not fixed by the surgery), and will also be tinted to help with her light sensitivity (also a symptom of OCA).

We are so glad that we make the difficult trip to see Dr. Hertle.  We have so much more information now, and a plan to help Makayla.  We have so much hope and optimism for her future!