Idiopathic: arising spontaneously, or from an obscure or unknown cause

Two days ago, completely out of the blue, my left eye went into revolt. It will no longer follow orders. Sure, it will open and close, and focus, and generally appears healthy, but it will not move – not like it is supposed to. I try to look at something, anything in front of me and what I see is TWO of everything. I try to look right, and more or less see one blurry image. I try to look left, and it’s like someone installed a kaleidoscope in my head. Looking straight on is just confusing. Two paths diverged in a wood – only, my feet are telling me there should just be one.

Like most people confronting terrifying physical maladies that appear suddenly without warning, I began this journey in denial…nay, complete ignorance that there was actually even a problem. I got up Thursday morning and my eye felt a little weird, but I put my contacts in as normal and went on about my day. On leaving my apartment, I began to notice that I couldn’t focus well on things that were very far away. What a nuisance. One of my contacts must be inside out or something, I thought. During the day, I would take each one out and inspect it, and put it back in, but did not manage to solve the problem. I found that by angling myself and looking slightly to the right at students, I could focus fairly well on their faces and ostensibly appear to be normal. I muddled through the day this way, and even had dinner with a neighbor after work as planned. Then, before bed I took my contacts out and realized to my shock that the problem was my EYES. I went to bed and hoped that a good nights sleep would put things back in order.

Friday morning I woke up….and it was worse. Now I could recognize that I was not having mere focusing difficulties, but rather seeing two distinct images that would not align. Double vision. I called my uncle, the optometrist. He was careful not to freak me out too much, but urged me to see a doctor. At one point, the word “stroke” was mentioned. I called my boss and told her. We were able to find an eye doctor across the street from my work, so I went in early to see if one of my coworkers could accompany across the street to translate. Walking to work was disorienting at best, though I know every step of the way well enough that there was no real risk of falling or getting lost. I tried hard to concentrate on the person walking 3 feet in front of me, because if I looked up, the floating people coming at me made me feel drunk, unstable, dizzy. Eventually I learned that closing one eye made the world stop moving so much so that I could keep up with it.

One of the teachers at work took me over and dropped me off with the optometrist’s office, but then had to go back to work to cover one of MY classes. Between the preliminary eye checks conducted by the ultra friendly Japanese staff, I was left to sit and wait for a bit, and couldn’t keep myself from crying. All of a sudden, one of my very favorite, most relied-upon senses was being compromised, and I had no idea why, no way to know if it would get better or worse, and could only wonder what horrible affliction my vision problem indicated.

The assistant manager from my office came and found me in this state. I would cry spontaneously several more times throughout the day. Next I saw a junior doctor of some sort – optician perhaps – who tested my vision and was the first to see the problem in action. He made me follow a flashlight, first right, then left. “Ah, soka!” he breathed, his face registering validation of the problem I was experiencing, but til now didn’t know if anyone else could see. I next saw a more senior optometrist. He was kind and even spoke a little English. He was able to tell me, with the aid of a dictionary, that the problem was with my abducens nerve. This is one of the 6 cranial nerves that control the movement of the eyes. Beyond that, he could tell me nothing concrete, but he suspected diabetes and asked me about any other symptoms, of which I’d had none except for a common cold. I was referred to a hospital.

My first experience at a Japanese hospital was a fairly nice one, despite the circumstances. I was referred to Tokai University Hospital, which I’m told is one of the nicer ones in the area, and handles the more serious conditions. Other hospitals here treat a number of patients who come in with colds and such. I’m told that this is partly because the Japanese language doesn’t entirely differentiate between hospitals and other minor care facilities, such as clinics or doctor’s offices, and partly because Japanese health care is socialized. Why NOT go to the hospital? Your tax dollars are paying for it.

Tokai University Hospital is large, clean, and extremely modern. Though I carried around a small file that seemed to have my name and appointment info on it, the doctors I talked with referred to computers for all of my medical information. You pay for most procedures or medicines at a computer kiosk like an ATM or airline check in machine. My blood pressure was taken entirely by a machine about the size of a toaster oven, and with no staff assistance whatsoever. The administrator pointed us to the machine, I stuck my arm in the cylinder, and a few minutes later a receipt with my vitals was printed out.

The hospital was both efficient and slow. I got a lot more done in one visit than I would expect at a hospital in the US, though I haven’t been to US hospitals enough to be qualified to compare. I came at 2pm, and was able to see a neurosurgeon, get an MRI and blood tests, go over the results of those tests with the neurosurgeon, see a neurologist after that, get more blood drawn, and collect a prescription all in one day. However, that one day took 6 full hours, with lots of waiting. We came in to the general info desk where my coworker turned over my referral letter and filled out a form for me. We were asked to wait. Then we were directed to neurosurgery. And asked to wait. Then we were shown to another seat directly outside the doctor’s room, where we waited for a bit longer. After seeing the doctor we went to have my blood drawn. And waited for that. Then we went back down for my MRI, but were told i had to (you guessed it!) wait – because you can’t have eaten within 3 hours of the test. We went upstairs so my coworker could have a pastry and I could be mildly jealous. She chose a bench looking out the window. We chatted a bit. I tried to determine whether there were 2 people or 4 people across the street walking their dogs. I settled on 3. i cried again and tried no to let her see it.

We went back to the MRI area at the appointed time, but were told it would be another half an hour. Then we were shown inside….to another waiting area. This time in a random hallway where no one seemed to be assigned to the task of coming to fetch us or near enough to even know we were there. Eventually a nurse who had passed by a few times decided to check on us and got us into the room where the MRI was actually located. We sat down again. To wait. “New chair.” I said to my co-worker. She laughed. There were two massive, bank-vault like metal doors in the room. They had giant numbers painted on them that reminded me of some sort of landing bay in a star trek ship. To add to the ambience, the automated entry door to the room and the nurses’ spiffy mandarin collar uniforms looked very futuristic as well. (The neurosurgeon wore scrubs, a white coat, and crocs, just like you would expect). I was eventually taken in and laid on the MRI platform, where my head was strapped down tight and covered with a sort of cage. I was handed a rubber squeeze ball for any emergencies and then mechanically glided into the circular machine. I was warned that it was loud, but the sounds this machine makes are completely incongruous with the idea of an advanced computerized magnet that can take pictures of your brain. There is a bizzarre assortment of knocks and thwacks, drumming like a nail-gun-hitting metal, and various other mechanical grinding and humming sounds.

On the left is the Tokai University Hospital nurse's uniform, fresh from the bridge of the USS Enterprise. Spiffy, no?

The neurosurgeon (who, by the way, was alarmingly young looking and very cute), showed me the pictures of my brain and told me there was nothing wrong with them at all. With double vision, they suspect 3 major causes: head trauma, such as from a fall or accident, which I had not experienced; vascular causes due to diabetes, which my blood test had ruled out; and tumors, which would have showed up on the MRI but didn’t. So, the good news is, I don’t have cancer or diabetes. The bad news is, they don’t know why this happened.

I was dispatched to the neurologist next. He told me more or less the same things (through my co-worker/translator), but at the end he began clicking through a wide range of different windows and cells on his computer to assemble a prescription for me. I asked him how he could be certain that I didn’t have diabetes, as I had become convinced that was my fate. After all, both my parents are diabetics, and I had had to pee 5 times already that afternoon, as if my body was conspiring to prove that diagnosis. He showed me a number on my blood test results which were apparently fully normal and nowhere near the diabetic range. I was sent to get more blood drawn. Not sure why. Then we paid for the visit and my prescription at a little computer kiosk. it came to 25,000 yen – roughly $300. Pretty good, I think, for seeing 2 doctors, getting 2 rounds of blood tests, and an MRI. Though it is unsettling to have a major medical problem when far away from friends and family, I am so glad that it happened when I had good health insurance coverage. My self-funded, “hit-by-a-bus” coverage that I carried in the US would not have gotten me so far. I had a $5,000 yearly deductible to meet on that plan before any coverage would kick in. I don’t know what the going rate is these days, but I’m pretty sure the MRI would have eaten a big chunk of that. After about another 30 minutes of waiting outside a pharmacy window that appeared to be closed and deserted, someone eventually emerged with 7 – SEVEN – envelopes of medication for me and my mysterious eye affliction. We returned to my work – mainly so that my co-worker could report back and so that I could get better translation of the information that came with my medicines.

My coworkers have been so great about this. My poor manager was scrambling all morning to get my classes covered – either by the other teachers present who had free hours, or by calling in part timers. Yet, when I saw her this evening, she was upbeat and cheerful, and seemed concerned about my problem. The other teachers who’d had to cover for me didn’t seemed stressed by it, and instead talked happily about getting to talk with my students. I missed my students. I was sad not to have the chance to talk with them myself – especially since I won’t see most of them again until after the new year. And then of course, there is the assistant manager who stayed with me for 8 hours of waiting today – first at the eye doctor, and then all afternoon and evening at the hospital, with a cheerful and supportive demeanor the entire time. This experience sucks, but I could not ask for better people to go through it with. Not one person acted the slightest bit put out by having their entire schedule disrupted, and suddenly having to do more work due to my issues. This is a far cry from a previous place I worked back in America, where my boss made me feel every inch of the inconvenience I caused by asking for 2 days off to attend my Grandmother’s funeral. Here, in this supposedly more rigid, conservative place, everyone has been so kind and warm the whole time.

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