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Greetings, fellow readers. I've been looking forward to making this post for quite some time now -- we're going to pick back up from when I went on disability and review the treatments I have tried since, catching up to where I am today. I'll document how my symptoms have changed as well; again, I'll save the psychological side of my journey for future posts. Let's get started!

I officially began my short-term disability leave in early November 2021. Suddenly having so much time on my hands and so few distractions was both a blessing and a curse; I finally had time to dive in and start pursuing treatments, but I was also now focused on my symptoms 24/7 and realized just how bad things had gotten.

A week or so into my leave, I managed to be seen by one of the few well-rated neuro-ophthalmologists in my city. He listened to my case carefully and referred me to a local retinal specialist to rule out any physical issues with my eyes. After the testing came back clear, I returned to his office to receive an 'official' diagnosis of visual snow syndrome, and he suggested I seek out neuro optometry for a post-concussion-aligned visual therapy regimen.

Following my doctor's orders, I found one of the few neuro-optometrists who specialized in vision therapy for 'visual snow'-like cases. This unfortunately involved weekly travel to Plano, TX for in-person evaluations and therapies.

Honing in on my case's similarities to traumatic brain injuries, I found a promising local institution specilizing in rehabilitation from 'post-trauma vision syndrome', a common set of symptoms experienced by individual suffering TBIs. After a lengthy evaluation and diligent note-taking as I told my story, the team at this institution prescribed me a pair of glasses with lenses customized based on my peripheral vision's dysfunctions issues with visual overstimulation.

At this point I was by far at my worst symptom-wise. The 'visual snow'-related symptoms, i.e. static, afterimages, halos, were not a big concern. Rather, my vision had become so blurry and distorted that I had a hard time seeing just a few feet in front of me. I felt dizzy and disoriented 24/7 and felt this constant feeling of head pressure and lightheadedness. I was wearing sunglasses all the time; trying to navigate outdoors (or even indoors) without them would me feeling overwhelmed and sick for hours. My brain had lost the ability to comprehend things I was looking at; everything looked 'off', and people's faces looked morphed and blurred.

Aside from the visual issues, I had developed strange shooting nerve pains in my hands, feet and arms, which would randomly begin pulsing without any obvious trigger. The left side of my body would randomly go partially numb and I'd feel pins and needles in my extremities. Several times the numbness spread to my tongue. I began feeling strange pressure-like sensations on my face, specifically on my cheeks, forehead, and even inside my mouth. It seemed like these symptoms would flare up after being stimulated past my brain's threshold, especially after attempting a walk without sunglasses or trying to use a screen.

The best way I could describe my situation was surrealistically terrible.

While visiting these specialists, I was also hard at work finding medications, supplements and activities I could do at home to aid in my recovery. It was pretty clear that I was stuck in a hyper-stimulated state; aside from my visual snow and tinnitus, essentially any combination of motion, light and sound would make me feel panicky.

My first voyage into the world of medicinal treatment involved meeting with a psychiatrist and discussing anxiety-reducing drugs, hoping they would help with my symptoms and general stimulatory overwhelm. After trying Zoloft, Lexapro and Remeron with severe side effects, I found I was a very poor responder to potent pharmological psychiatric medications. I decided to tackle this side on my own.

I became something of an armchair neuroscientist and learned about the complex neurobiological underpinnings of stress and anxiety, and what kinds of supplements could help calm down my brain. My research brought me to a collection of supplements and medications which had been shown to be effective anxiolytics without documented severe negative side effects. Below are a few I began taking:

• Bacopa Monnieri: an herb which helps upregulate neural GABA(A) receptor density, allowing the primary inhibitory neurotransmitter GABA to have a larger effect..
• Emoxypine: a chemical derivative of vitamin B6 which increases the binding affinity of GABA at receptor sites.
• Etifoxine: a prominent European anxiolytic which serves as a positive allosteric modulator of GABA(A) receptors, similar to benzodiazepines, but without a quick development of tolerance and withdrawal effects after cessation.
• Kava Kava: a popular herb with GABA(A) potentiating effects.

I began attempting to revamp my lifestyle to live as stress-free and relaxed as possible. Getting massages, taking baths, practicing yoga at a local studio, and getting into meditation. I took meditation to the next level in fact, purchasing a FocusCalm portable EEG to monitor my practice. I combined all this with some light exercise and lots of time outdoors.

By the end of November, I was beginning to see very slight signs of improvement. I could function indoors without the use of sunglasses, a lot of the physical symptoms had mostly subsided, and on one remarkable evening my vision shifted from horrific distorted bluriness to something much more tolerable, although almost more intense and high-definition than normal. I have no idea if it was the medication or lifestyle changes, but the improvements were noticeable.

In early December I had my initial consults with the neuro-optometrists who would begin leading my visual therapy and lens-based rehabilitation. I began flying weekly to Texas for vision therapy, flying back to my hometown to be with my family during weekdays, and returning home on weekends. I was flying more than my friends working in forward-deployed consulting roles, which is saying something. Despite typically loving travel, it was completely overwhelming.

In early January I managed to get admitted by the TBI rehab center called CognitiveFX based out of Provo, UT. I stayed for a week and a half and underwent extensive vision, vestibular, cognitive and psychological therapies. CognitiveFX is known to be the penultimate 'concussion bootcamp' program, and I did have a great experience with all the therapists I worked with. The program uses an fMRI to evaluate pre-therapy and post-therapy brain activity, advertising a high proportion of patients seeing better test results on the second scan. My first fMRI showed slowed 'processing speed' and 'distraction suppression', which supposedly is common in post-concussive patients. After my grueling week of therapy, I was bewildered to see my second scan show severely worse results. One of the chief neuroscientists explained that it could be attributed to fatigue as I had just done some cardio prior to the scan. Nonetheless it was a disappointing close to the week, and I can't say I saw any remarkable improvements from the program.

Later in January I began seeing a functional neurologist just a mile from my condo who had experience treating concussions. I began seeing him three times a week, undergoing visual therapy, vestibular therapy, and some more innovative treatments including TMS and neurofeedback. This ended up being a huge blessing; the neurologist was able to take over managing my vision therapy, and I no longer needed to travel to Texas every week. By early February I was established in a new routine, wearing my specialized lenses and seeking treatment at my functional neurologist's practice while attempting to figure how to navigate my strange new world.

I also began the transition to long-term disability in mid-January. This proved to be a much bigger headache than short-term disability, which was handled purely by my employer; I had to work with an insurance firm which required a great deal of correspondence and paperwork. Luckily, however, once completed, this would eliminate the stress of having a forced return-to-work timeline, letting me focus on healing without worrying about paying the bills.

Aside from a few small details, this brings us to where I am today. I'll make a post soon documenting the symptoms I'm currently facing in as much detail as I can, as well as the additional treatments I have on the horizon. Next, however, I'm planning on doing a deep-dive into the psychological side of my illness and how I've been able to cope.