2010 - Starting to get some answers

January - Had a CT scan following the MRI results from 2009 in preparation for my first appointment at the St Joe's Eye Clinic in Hamilton. Dr. J. Harvey, an eye surgeon specializing in oculoplastic, reconstructive and cosmetic eyelid surgery, with sub-specialty skills in the area of lacrimal, orbital and cosmetic surgery.

My MRI showed a mass on the right orbit, the CT indicated that the mass was centred on the right lacrimal gland. I was booked for surgery March 31st, to remove the mass and have it biopsied.

In January, I also attempted to return to work.  Managed to work a month an a half in a busy tax office as an assistant manager, but found the combination of headaches, vision issues and having a 3 month old baby at home was just too much.  February 27th was my last day worked.

Surgery was postponed to April 28th, 2010. Fortunately, it was a day surgery, I would be in at 11 am and ready to head home by 4 pm. The operation was pretty routine I guess, I was asleep the entire time so I can't say officially how it went. I did have some trouble waking up afterwards and I do recall hearing the nurses saying "let her sleep a little longer, she's got a baby at home" as I drifted between being asleep and awake.

Day after Surgery

Day after surgery, bandages removed

48 hours after surgery

A couple more terms/diagnosis came up resulting from the biopsy.

Tumefactive fibroinflammatory lesion is an idiopathic fibrosclerosing disorder occurring in the head and neck region. It is one of a broad spectrum of entities named inflammatory pseudotumors and, as the name suggests, it mimics a lot of diseases such as malignancies or infections.

Sclerosing orbital pseudotumor is uncommon. Due to unknown reasons, these tumors behave differently than other types of pseudotumor of the orbit. They grow more slowly, cause less pain, and are characterized by scarring (hardening of the tumor tissue).

Histopathology reveals large amounts of fibrous tissue.

Sclerosing orbital pseudotumor is not cancer. But, by local growth it can cause bulging of the eye (proptosis), double vision (diplopia) and loss of vision.

I certainly did have all of those symptoms in my right eye. Fortunately the surgery fixed the physical appearance, at least as far as the bulging and swelling around my eye. The drooping of my eye lid would continue along with the double vision and everything appeared to have a slight tilt similar to the image below. The picture below is a close representation.  In actuality, my vision appeared as if the foot on the right of the top A and the foot on the left of the lower A were touching while maintaining the angle shown.

CN IV Palsy Horizontal, vertical and Torsional
This is about the closest representation I can get to what my vision was like at the time.

Couple weeks or so post op.
Not winking, that's the limit I can open my eye

This led to additional aches and pains as I developed a tendency to tilt my head to counteract the visual information I was receiving. For the balance of the year and for 2011 I continued to see Dr. Harvey on a regular basis as he monitored my recovery and progress.

I had 2 eye lift procedures in attempts to correct the eyelid drooping as a result of the April surgery. 

A follow up MRI was performed and revealed that there was no further occurrence of the tumour. 

At this time, my official diagnosis was listed as orbital pseudotumour. My headaches continued to remain 24/7, varying in degree of intensity. Treated only with acetaminophen and ibuprofen.


On a more positive note, Rachel celebrated her first birthday October 23 with the help of family and friends.
  

Cousin Ethan helps Rachel with her mash cake! Happy Birthday to our little princess!

In Memory ~ Coco (1996- 2010)

2010 started out poorly for me not only medically but also emotionally. 

Coco (sitting up) and his sister Mokka

Coco was born August 14, 1996 and I was there to help him into the world as I also owned his mother Bubbles.  At 5 weeks of age, Coco was involved in an accident while playing with his father, resulting in an artificial cleft palate. This prevented him from being sold to his potential owners and instead he remained with my family his entire life which actually was a number of years longer than originally anticipated.

He was operated on at 9 months after getting his weight over 4lbs.  The vet attempted a closure of the palate, but by the time the surgery was performed, he had already learned to keep the opening between  his palate and his nose cleared. This meant that he also managed to clear the sutures that the vet had placed.  The end result was a reduction in the size, but a permanent hole remained in the roof of his mouth.

His disabilities didn't stop him though. Coco was a saucy and demanding little pup, earning himself the nickname "Little $hit".  If his food or water dish were empty and he wanted them filled, he would pick up his dish and toss it around until you filled it.  If he wanted attention and wasn't getting it immediately, he would make all kinds of noises, chattering and whining at you until you picked him up or made room on your lap.

Coco liked to steal things!
The soother belonged to a relatives son, picture taken in 1998

Coco and Rachel

When Rachel was born, he became her protector. If she was on a blanket on the floor, he was right there next to her. At times though, he did display a bit of jealousy. I remember a few times when Rachel would be snuggled up next to me and he would be standing on her pawing at the blankets trying to get in with us.  It was a good thing he never weighed over 5 lbs with the exception of preparing for his surgery.

In the picture here, he's actually a lot of fur, as he got older, it became more difficult to keep him trimmed down as it created additional stress on his breathing.  We believe the vibrations of the clippers created some problems with vibration in his palate.

On the morning of January 11th, 2010 we woke up to what we believed was Coco in the midst of a seizure.  Once again, we were faced with the difficult decision of having to say good-bye to a well loved family member.  He was also 14 years old.  Another loved boy gone but never forgotten.