More Treatment, With Occasional Digressions

I haven’t posted since last Wednesday, Gentle Reader, and I do apologize for the delay.

Thanksgiving was absolutely wonderful, as it usually is in my family in New Jersey. For approximately the forty-second year in a row (honest), I went to my brother Gerald’s house and ate really great food and sat around with the people I love. My sister and her husband were in from Tucson, my newest baby grandniece made her first family appearance, and a good time was had by all.

(Digression -- Saturday was another family day. I had come home Thursday night for treatment and work and then returned to New Jersey Friday night. The event was the scattering of my parents’ ashes at the Jersey Shore.

My father died in 1988 and my mother died less than a year later in 1989. They had wanted to have their ashes scattered at the beach, where they sort of met and where the family had spent it summers. In typical DeBenedette fashion, one thing led to another and we hadn’t gotten around to it.

My sister Susan finally put her foot down and insisted on doing this since she would be back East. She was the impetus for this finally getting done and I thank her for it. She even had a beautiful photomontage of my parents done, showing their wedding photo and a later shot of them. My brother Mike and I chose some readings and we were all set.

The only minor hitch is that we were all pretty sure that trotting onto the beach in New Jersey and tossing human ashes into the wind may be, if not illegal, at least frowned upon. So, we decided to keep the group small and the readings short.

Keeping the readings short was easy. Keeping the group from growing all out of hand was not. My parents had four kids, three of whom have spouses. Two of these children each have two children who are already adults. Two of those children have spouses and children. Already, we are up to a gaggle of people. Then my uncle, my mother’s last sibling, was invited. Then the news about this ceremony leaked (ahem, was mentioned) to a couple of cousins, who also wanted to attend. It ended up that we had seventeen people, including three children. This represented four generations, which was good.

We met at the beach. My brother Mike, who must have some experience on how to avoid being noticed by the law, said that we would do the distribution of the ashes and then the readings. He and my brother-in-law Rob went about halfway down a jetty and opened the boxes that held Mom and Dad and found that inside these boxes were nicely sealed tough plastic bags. Who knew? Mike got the bags open and bent and put the ashes into the water, and he and Rob came back to the beach. We read the poems and the prayer we had selected. It was beautiful. Then we all went out to eat.)

On Friday, it was back to treatment. Yes, the treatments are starting to get “same old – same old,” which is probably a good thing.

Actually, I am feeling nothing. So far, I am not getting any changes on the skin of my face, although I still have the very last vestiges of the black eye from hell, which might disguise them. I have not lost any hair. The thought crossed my mind that maybe the whole thing is an elaborate hoax and nothing is happening to me. Maybe I just lay on the table and the technicians start a buzzing noise and stand outside snickering.

Today, however, I finally noticed something: a smell. When the machine was buzzing, I smelled ozone, sort of an electronic “hot metal” smell. Dr. Kaul, who is Dr. Han’s partner, and Mike the tech said that some people report a smell like that.

Dr. Kaul said that I might feel more side effects this week because I will have five treatments in a row this week and next week. I now have something to anticipate.

Should I Feel Any Different?

I had my second radiation treatment today. Again, I lay on the table and got irradiated with x-rays and the general feeling was about the same as having nothing happen at all.

Today's treatment was the first that did not involve any simulations or marking or anything else. I got there a couple of minutes late, at around 8:50 a.m. (acccckkkkkk!! Morning) and was out of there by about 9:05.

I did put some moisturizer on the right side of my face. I am not sure why I did this, but I figured that maybe it would offset the dry skin/sunburn side effect I am supposed to get. I have also found myself tugging at the hair over my right ear, as if I am checking to make sure it is still attached. It is, but it won't be if I keep tugging at it.

And so it goes.

Tomorrow, I have a day off for Thanksgiving and then I get a third treatment on Friday morning. Then five treatments next week and five the week after and we shall see what we shall see. And with any luck, we will not see double.

Treatment at Last

I finally got a treatment today. It was a bit of an anticlimax, actually.

First, there was more simulation work, this time with these lead shields that were created to narrow the radiation field down so that it was just hitting what needed to be hit. The shields were these large pieces of shiny metal material. They were about four inches thick and there were ovals cut out of them. They looked like they had been cast and then machined into shape
I asked Erica the tech if they were lead and she said they were a blend of lead and something else so that they were not so heavy.

Today’s simulation did not take half as long as yesterday’s, for which I am grateful. The back of my head is still sore from yesterday.

After this was done, they led me down a hall and past a large heavy metal door and into the treatment room. There were signs all over the place about “dangerous radiation.” Along one wall was a rack of various lead shields like the one made for me.

I asked Dr. Han what kind of radiation I would be getting. She said that it was a high-energy dose of X-rays, higher than that used to diagnostic imaging.

I lay down on the table and was bolted in. They had some interesting music playing, sort of modern big band and Dixieland jazz. My kind of stuff and I felt good about that.

I was told to keep my eyes closed but to keep looking straight up. This was hard because after a while, you can’t tell where you are looking when you have your eyes closed.

The machine buzzed for a while. Erika came in and changed the shield and left. The machine buzzed again and it was over. During the buzzing, I tried to feel something. Was there any sensation to this? I felt like my sinuses were having some pressure, but I could not tell if this was my own imagination. I felt nothing, really.

So much for that.

I go again tomorrow and for another 11 times. This may actually get boring.

Hey folks, add comments. (Corrected)

I get the idea that some of my friends and loved ones have no idea what a blog is. This is because many have e-mailed me and asked, "What is a blog?" (You just can put much past me, huh?) This is a blog, which is short for web log and it is an interactive diary of sorts.

Note the word "interactive." You can add comments at the bottom of each entry. You click on the little word marked comments and you can read what other people said. Then you can add your own edifying, amusing, interesting, and intelligent notes and ideas to my deathless prose. Tell me what you think. Tell me whatever you want and the rest of the world at the same time. Add your own favorite prednisone war story if you have ever taken it. Whatever. Be my guest.

(In an earlier version of this post, I had said to click on the envelope with the arrow. That is what you use to email this blog to other people. You are of course, perfectly welcome to do this, but that is not how you add comments. Sorry for the error.)

The Woman in the Plastic Mask

The treatment today turned out not to be a treatment at all. It was another planning session.

I got clamped down into a simulator that took x-rays every way from Sunday to make sure that Dr. Han’s plan for treatment would hit all the parts that the radiation needs to hit and miss as much of everything else as possible.

For those of you who are technically minded, Dr. Han is going to treat me with 2080 centiGray of radiation divided over 13 sessions.

Today’s session was long and uncomfortable, unlike an actual treatment, which will be only about 15 minutes long. The headrest that my head fits onto is comfortable for only about the first 5 minutes or so. Then this spot on the back of my head started to get sore. Then it really started to hurt.

Dr. Han modified the pig head by removing some of the mesh around my right eye, the eye that is being treated. They wrapped the edges of the mask with adhesive tape and readjusted the tape when I said that the edges were tickling my eye.

When the x-ray camera (or whatever it is) was overhead, I could see a reflection of myself in it. I could make out the mesh mask and the eye cut-out. It reminded my of Dumas’ “The Man in the Iron Mask,” except that I am a woman and it is plastic and I am not the pretender to the throne of France and the Musketeers are not coming to the rescue unless I buy a candy bar.

I held still quite well, however. I put my mind into a sort of zen state and let it wander around. Still, the mask was tight and the head rest was just starting to drive me crazy when Erika, the tech today, said that we were done.

Then I took the mask off and took one look at myself in the mirror. I had a wonderful mesh imprint all over my face. I looked liked I had kissed the front grill of my car for a prolonged period. Or maybe someone had been carrying me around head down in a plastic mesh onion bag.

Tomorrow, I go again. Again, I will get clamped into the simulator because Dr. Han wants to take some X-rays with some lead blocks in place that will also block radiation from parts where we do not want it to hit. However, I have been promised that the simulation tomorrow will be short and that it will be followed by a real treatment.

Pig Heads and CT CDs

When we last left our heroine, me, she was scheduled for a planning session at the radiology clinic, for be followed by a special CT. This turned out to be a hoot.

First, I must explain that I am a night owl. I do not do mornings willingly or well. The planning session was scheduled for 9 a.m. on Nov. 14. I actually got there on time. Anyone who knows me understands that this was a miracle of the first order.

The first order of business was getting this mask thingy made. I was told that I would have a piece of plastic placed over my face that would mold to it and would help in keeping my head still for the treatments.

I was laid down on a table and my head positioned on a clear hard plastic head rest. The mask started out as a flat piece of white plastic with holes in it. The plastic had been warmed up to soften it and it was quickly placed over my head and pulled all the way down in back to where it would be fastened down to the head rest. As it was cooling, Dr. Han pulled up on the area around my nose a bit and did the same on the part over my eyes to give me room to blink.

Then she and the two techs started doing various things, which may or may not have included taking measurements. They attached pieces of tape to the mask and made marks of various kinds. At this point, Dr. Han mentioned that I might lose some hair over my right ear near the eye. Damn.

But the good news was that I would probably not need a tattoo. One way that radiologists ensure that the radiation is hitting the right spots is to use one or two tiny tattooed dots as markers. It looks like I will not need a tattoo.

(Digression: I mentioned to my brother Mike that I might need a tattoo on my face and he told me to get one of the big tribal kind, one like what Mike Tyson has on his face. Do I have to explain that my brother is my older brother?)

After about 15 minutes of my laying there and them doing various things, they started to take the mask off. Uh-oh. Some of my hair had molded into the mask and was now caught. Releasing the mask was a bit painful and slow because of this. So, I have already lost hair to this whole procedure.

Now I took the mask and the head rest with me to the hospital. I was going to have a CT scan done with my head clamped in place just the way it will be during the radiation treatments.

The mask is now a long odd shaped piece since it goes well past my head to reach the head rest. As I was carrying around, I was trying to figure out what it reminded me of. When I handed it to the tech at the hospital, it finally came to me. It looked very much like the head of a pig.

“Does it look like the head of a pig to you?” I asked as I handed it over.

“Yes,” she said. “Wow, it really does. Isn’t that odd?”

“But it is molded to my face!!!!” I started laughing uproariously and the tech decided to walk away from the crazy lady. Sensible woman.

The CT got done and I was handed a CD of it. I took the CT CD and brought it to the radiology clinic and went home.

I am now due to have my first treatment on Monday, Nov. 21. Do stay tuned.

Diagnosis and Decisions

Once I got home after the biopsy, I basically vegged out for two or three days. I had to put a cold compress on my eye four times a day, but that was about it for treatment.

(Digression: I went to Blockbuster to rent the entire extended play editions of The Lord of the Rings. They were missing the first one, so I settled on The Matrix Reloaded and The Matrix Revolutions. I fell asleep during both of them. Twice for each.)

The results of the biopsy came in the next week: dacryolimus adenitis (AKA dacryoadenitis) mixed with idiopathic orbital inflammation, both of which probably due to an autoimmune problem. Somewhere around this point, Dr. Della Rocca noted that I did not have lymphoma, which I had not even known was in the running as a diagnosis. So, this was good news.

But it is an autoimmune inflammatory condition. In other words, my own body is attacking itself. How lame is that? The system in my body that is supposed to repel boarders and keep outside disease-causing agents at bay is attacking me on its own. Biological treason!! Unfortunately, I cannot fire my immune system and hire a new one.

The usual treatment for this is prednisone, which I was already on at the whopping dose of 60 mg a day. Prednisone was not only causing enough side effects to drive me crazy (OK, drive me crazier), it was losing its effectiveness. Not to mention the fact that it is really bad news to be on prednisone for long periods of time.

Dr. Della Rocca strongly suggested that I undergo radiation therapy to tamp down this immune response. The radiation would cause the condition to go into remission, I would get off the prednisone and, yes, everyone will be happy.

It says something about prednisone and its side effects that radiation seems like a great idea in comparison.

Dr. Della Rocca said he would consult with Dr. Farquhar and find a convenient radiation oncologist who was familiar with treating the eye. Said physician would have to be in my health plan, I noted. I was expecting to have to schlep down to Manhattan for umpteen days in a row, almost certain that one would not be any closer. This would have meant a 1.5 hour drive, 20 minutes of prep time, 15 minutes of treatment, and another 1.5 hour drive or about four hours out of each day. Ick.

Dr. Farquhar came across with some good news. He highly recommended that I see Dr. Kyung Han in Mahopac, who fits all the requirements: she is convenient, knowledgeable about treating the eye, and in my health plan. Hallalujah!

It turns out that Dr. Han is also very nice and a warm human being to boot. I met her on Nov. 11.

I was most concerned about the side effects of the radiation, namely hair loss. I have only two good body features and one of them is my hair. I had put off getting a haircut because, why spend money on hair that was going to fall out? Dr. Han assured me that I would not lose my hair. She said the most serious side effect would be a risk of developing a cataract in that eye. I pointed out to her that that was a side effect of prednisone, so it didn’t make too much difference. She said I would develop a sun-burn like reaction on my skin around the eye. Big deal.

(I have very little vanity. Maybe I should go out and buy some?)

Dr. Han explained that she would have a planning session with me and then send me directly to Hudson Valley Hospital for a CT scan. Then she would decide whether to treat me in 10 sessions or 15 sessions. It would be the same total amount of radiation either way. Ten sessions would have a higher incidence of side effects, but a lower risk of a relapse, while 15 sessions would have a lower incidence of side effects, but a higher risk of relapse.

She really impressed me when she gave me a big hug as I left. Nice lady.

Snappy Answers to Stupid Questions

So what kinds of dumb things do you hear when you are walking around with a world-class, Olympic-medal caliber black eye?

What happened to the other guy? My answer: We are waiting for the coroner’s report.

Who did that to you? My surgeon, and I had to pay him for it.

How did you get that? I saved the free world, but I can’t tell you more than that or I’ll have to kill you, too.

However, usually I answered seriously, that I had had minor surgery on my eye and had bled a lot.

Actually, many, many people were very sympathetic. Customers at the store, especially my regulars, have continued to ask after my health. One little girl at the store was extremely solicitous. She wanted to make sure that it didn't hurt and asked me at least three times if it did. Very sweet. Another regular, Mary Jane, gave me a prayer card and put me on the prayer list at her church.

The eye, as you can see from the photo, really looked bad, but did not hurt too much. It was more of a dull ache.

How to Make God Laugh

To continue our story: When we last left our heroine--me--I had agreed that a biopsy of the tissue behind my eye was needed and we scheduled it.

At this point, I thought the procedure would be a needle biopsy. They would stick a large needle behind my eye and suck out a little bit of whatever is back thereanalyzese it, and everyone would be happy. Well, I would not be ecstatic, but I figured that they would give me enough drugs to make me happy.

Oh no, Dr. Della Rocca said. "I have to make an incision in your eyelid and go back there to get a bit more tissue than that." He showed me the tip of his little finger to let me know how much was coming out. I asked him if he could do an eyelid lift on both eyes while he was at it. He said no. He also nixed a tummy tuck.

The biopsy would be done at New York Eye and Ear and it would be a same day procedure. Get there in the morning and go home that night, or this is what I was assured. The date was set for Oct. 21, a Friday.

I went home and alerted my freelance clients to what was coming up and went to the bookstore and alerted them. At this point I thought I would need one or two days of recovery time before coming back to work, and everyone would be happy.

Finding someone who would drive me down to Manhattan and then back home was going to be a problem, however. All the people who had time to do it did not want to drive in Manhattan. Those who would drive in Manhattan could not make it that day.

My church, St. Andrew's Episcopal Church in Brewster, came to the rescue. Rev. Terri stood up and announced that I needed a ride and could anyone do it? Immediately, Lori Beninson, a new congregant stepped forward and volunteered. Lori is an EMT in New York City and said she was working in the city anyway. She could drop me off and pick me up that evening after I got release and everyone would be happy.

The saying goes that the easiest way to get God to laugh is to make plans. Based on these plans, God wet his pants and snorted milk out his nose.

I had packed an overnight bag just in case and brought two books, some knitting, and a good attitude. I also decided to play it safe and I went through my wallet and removed all but one credit card and I left my cell phone at home. These were such smart ideas that they came back to bite me later.

Lori picked me up at 6:30 in the morning on the day of surgery. We had a fun chat on the way down. The best part was that we switched cars in the Bronx to Lori's official EMT vehicle, which had lights and a siren. No matter how much I begged, she would not use them, however.

She dropped me off at New York Eye and Ear and came in and found out what time she should be back to pick me up. She gave me her business card and wished me well.

My surgery had been slated for 11 a.m., but by the time I got to the hospital, it had already been moved to 1:30 p.m. So I got dressed in pale blue hospital pants and top and a robe and was directed from place to place. They gave me a locker to store my stuff. This locker was about the size of a number 10 envelope and I had a tough time stuffing my overnight bag into it. I and the rest of the ambulatory surgery patients looked like guests at a really boring pajama party.

I got checked out by a nurse and a doctor, but it was pretty much hurry up and wait. I had my knitting. I finished reading The Historian by Elizabeth Kostova. I was happy.

Finally, at around 3 p.m., I get led into the operating room and put on the table. I was singularly not nervous, almost preternaturally calm.

My next coherent thoughts involve Dr. Della Rocca leaning over me and telling me that I have to stay overnight because I bled a lot. Lori is standing next to him telling me that I have to stay overnight. I argue groggily with both of them. They win.

Dr. Della Rocca explained that I bled more than expected. He had actually closed up the incision and had to reopen me and remove a clot. Because of the bleeding, he placed a drain in the incision, a short tube to the outside with a test tube hanging off it to collect blood.

By 7 p.m. that night, I was settled into a room and realized that I was not sure how I was going to get home the next day. I remembered that Lori had said something but I could not remember what.

I was out of it, but awake. At one point I was talking to the family of the lady in the next bed about how hungry I was. They nicely gave me a piece of fried chicken that they had brought in. Hey, I was on prednisone. I was hungry, OK? I even ate the dinner that had been brought up for me, a tray of food that may have been floating around that hospital for the past 15 years. It was meatloaf, but it could have been used as a roof shingle.

Around 8 p.m. I got up to go to the bathroom and saw my face. My upper eye lid was a bright blood red. My lower eyelid was, I swear to God, green. I could understand the red. But how on earth did Dr. Della Rocca do that green? I looked like the Italian flag. And there was a test tube hanging off the side of my face, for that added textural interest.

The next morning I was feeling better. I was not in any real pain but my face was tender to the touch. I woke up to find Dr. Della Rocca sitting next to the bed taking notes. He examined me and decided to remove the drain, which he did with a quick yank. That was about the worst pain that I experienced. He also said that I could go home that day.

But how was I to get home? I called Lori and left a message. She called me back and told me that she was at a workshop on Staten Island and that she could pick me up around 4 p.m. That sounded good, but I then found out that unless I was out by 1 p.m., the hospital would charge me for a second overnight. I tried calling several friends and relations, but didn't have anyone's phone number with me, because I had sensibly left my cell phone at home. I ended up taking a car service home, which involved the driver stopping at my house to allow me to pick up my ATM card,which I had sensibly left home, and then driving me to the bank. It worked.

When I got home, my cats greeted me in their usual where-the-hell-is-the-food manner. There were several messages on my machine asking how I was.

I took a photo of myself for posterity. I wanted to have a permanent record of the worst black eye I had ever seen.

I shall continue this story and eventually catch up to the present, I promise.

Me in October, 2004 

Our Story Until Now, a Recapitulation

I am starting this blog today, but my right eye has been giving me trouble off and on for some time. This blog will give me a chance to tell people what is going on, and perhaps save me from having to repeat the story from the beginning for everyone.

This blog will also give me a chance to keep a running record of what has been going on in my life, because the last year has made me think I am Job in drag.

To introduce myself, I am Valerie DeBenedette. I am a 51-year-old woman living in New York State. I am a medical writer and part-time bookseller. My writing has appeared in many places, most of which you have probably never seen, but which include magazines, newsletters, newspapers, websites, and one book (Caffeine, Enslow Publishers, 1996, buy yours today at BarnesandNoble.com). I have written about almost all areas of medicine, as well as food, people, current events, and travel. Most notably for this account, I have written extensively on ophthalmology. I also work as a bookseller, a job that is an enjoyable way of getting health benefits.

My hobbies include reading, knitting and cracking jokes. I was born and raised in New Jersey and currently live in New York State north of New York City near the Connecticut border. I live with two cats. I used to live with a man, Bernie Cullen, but after 20 years of a good relationship, he passed away in his sleep on February 27, 2005. You can find out something about him at his blog, http://www.charlesjccullen.blogspot.com/, which he started only a month before he died. Everyone says that they want to die in their sleep. No one ever wants to be the other person in the bed, which I must say was an interesting and educational experience. But I do not begrudge Bernie the chance to die so peacefully.

Back to my eye: In general, my health has always been good, outside of being hypothyroid, overweight, and prone to cracking too many jokes. But in late November or early December 2003, I noticed that my right eye seemed to be coming forward. I looked at it, decided that I was imaging it, and ignored it for a couple of weeks. When you stare at your face in the mirror for too long, anything starts to look weird and I chalked it up to my overactive imagination.

Then, it seemed to be getting worse. My eye didn't feel different, and my vision was fine, but I felt like the eye did not shut all the way, as if an eyelash was stuck between my eyelids and preventing a good seal. My upper eyelid started to look a bit swollen. I looked as if I was rather startled, but only on one side of my face, a marvelously cockeyed look but one that I did not want.

So, since part of my writing usually comes down to telling people to see their doctor, I finally went to see my general physician. He took about 15 seconds worth of a look at the eye, said it was very swollen, and immediately told me that I needed to be seen by an ophthalmologist. Almost all of my doctors are in the same building, which is nicely convenient, so I took myself upstairs to the ophthalmologists’ office.

I got an immediate appointment with Dr. Allan Farquhar, who practices with his father, Dr. Hal Farquhar, and with Dr. Steven Facchina. He said I needed a CT scan to see what was going on and then took a pressure reading on my eye. My intraocular eye pressure was 41, which is about twice what the normal reading is.

He started me on eye drops to lower the pressure and oral prednisone. The CT scan showed that some of the tissue behind my eye was swollen. The swelling could have been the eye muscles or the other tissues that surround those muscles, which includes tear glands and little pockets of fat.

Dr. Farquhar’s exam also shows that I have some double vision at the edges of my visual field. Something in back of my eye is interfering with how the muscles move. However, I have really good muscle control on my eyes. I can move them independently of each other (a trick that has freaked out every ophthalmologist I have shown it to), and the double vision is not really noticeable to me.

With this kind of inflammation, one possible diagnosis is Grave’s disease, which is a swelling behind the eyes associated with hyperthyroidism. (This is what Marty Feldman, the much missed comic actor had that made his eyes bug out.) But I am hypothyroid. But I was told to see an endocrinologist to check out my thyroid levels to see if that was a factor. The endocrinologist noted that there are rare cases of Graves’ associated with hypothyroidism, but that the thyroid is probably not causing my condition.

Dr. Farquhar also wanted me to see another ophthalmologist, Dr. David Della Rocca, who is in practice with his father, Dr. Robert Della Rocca. (I have told both pairs of doctors that I intend to find and consult with a mother/daughter set of ophthalmologists someday.)

Dr. Della Rocca says that we could do a biopsy, but that because treatment would be the same in any case—prednisone, we could skip it. A biopsy procedure would involve him going behind my eye and taking a bit of the tissue there for analysis. This idea is greatly unloved by me, so we skip the biopsy.

However, all tests were sort of inconclusive. The diagnosis that everyone decided on was idiopathic orbital inflammation (IOI). Idiopathic is Latin for “We don’t know what the @#$% is going on.” Orbital is the area around the eye and eye socket of the skull. So, I have a diagnosis that says nothing.

So, I spent Christmas 2003 on prednisone.

Ahhhh, prednisone!! The bane of my existence. Prednisone is an important and useful drug. For those of you who do not think the Physicians’ Desk Reference is light reading, it is a powerful anti-inflammatory drug that controls inflammation better than almost anything available. It also has a list of side effects longer than your arm, many of which have been making my life weird.

Side effects of prednisone are many and varied. It makes you hungry. I will eat anything that does not move out of my reach fast enough. It gives you indigestion like no one’s business. I sometimes feel like John Hurt must have about five minute before the alien burst out of him in the movie of the same name. This means that you also eat to keep the acid monster at bay.

Prednisone plays with your head. High doses of prednisone can cause depression, paranoia, hallucinations, or euphoria. Mood swings are my problem. You can walk up to me and say hello and even I do not know how I will react. It also makes me feel jittery.

Long time use of prednisone causes cataracts, osteoporosis, and a general weakening of the tissues. It also weakens your immune system making you more susceptible to infections.

You also cannot just stop taking prednisone. You have to slowly wean off the drug, which may take a week or two depending on your dose.

And just to add a little bit more misery, prednisone is God awful tasting. Just swallowing the pill leaves a disgusting bitter taste in your mouth.

I spent that Christmas sort of euphoric. I was just happy in general, which was fine by me.

The swelling went away (although my eye was still slightly forward of where it should be) and all was right with the world.

But about six months later, the swelling came back. Back to Dr. Farquhar and back on prednisone. Down comes swelling and I come off prednisone.

During this time, I also experience a bout of iritis, which is an autoimmune inflammation of the iris, the colored part of your eye. Unlike my other eye problem, this was painful. My eye was incredibly sensitive to light and I looked like I was using tomato sauce as an eyewash. This was treated with prednisone drops and I got to avoid the oral stuff.

Christmas 2004. December brings another case of eye swelling. With each recurrence, the double vision gets a little worse. I am developing a thickening of the conjunctiva of the eye that is noticeable, too.

By this time, the amount of prednisone needed to beat the swelling back is between 60 and 80 milligrams a day, which is a honking big dose of prednisone. Again, I become euphoric. At least I think I am euphoric. Actually, I am manic. I will laugh at anything that short of a compound fracture.

By now, even when the swelling is under control, I have some double vision at the edges of my vision. But sometimes in the morning, I have about a half hour of double vision that does away.

So, 2005 commences and the periods between the swelling are tending to be shorter and short. I bat back and forth between Dr. Della Rocca and Dr. Farquhar’s office for a bit. For a while, I just ignore the eye and stay out of the way of my doctors because I just put up with the eye. I have been under a lot of stress this year and for some of that time, the eye has been the least of my worries.

But one day in late fall, I wake up and I cannot uncross my eyes. My eye is quite swollen. I take myself to be seen by Dr. Facchina, who says that there is no infection and that since Dr. Della Rocca saw me last, why not have him look at it.

I schlep down to 14th Street to the New York Eye and Ear Infirmary in Manhattan and see Dr. Della Rocca. He points out that the eye is no longer responding to prednisone and that maybe a biopsy is a better idea now. We schedule the biopsy.

The only thing good about this day is that New York Eye and Ear is across 14th Street from the New York Knit Café, where I can buy yarn and have a cup of seriously good coffee. When the going gets tough, the tough buy yarn.

I shall break this off here, gentle reader, and allow you to get on with your life. I shall continue the saga of my eye, with photos and descriptions of the black eye from hell in my next installment.