As a note, For those interested in learning more about gaining binocular vision later in life, I encourage you to read this fabulous book. This is what got me started down this road, allowed me to learn of the treatments available, and gave me some of the language and perspective to describe my recent experiences. Check it out -

Fixing My Gaze: A Scientist's Journey Into Seeing in Three Dimensions
by Susan R. Barry

http://www.amazon.com/Fixing-My-Gaze-Scientists-Dimensions/dp/0465020739

I will discuss this book more in future posts, but I would not be here today without the inspiration and influence of this book and its wonderful author, and want to make sure she gets her due.

Another lousy night of sleep last night. I even took a Sominex, and so this morning feel like a casualty of a Keith Richards after-gig party. I swear all the grandiose origin stories about the onset of a zombie apocalypse got it all wrong. If we all turn into the walking dead it will be because of a collective addiction to over the counter sleep medication. The. Worst.

I tried lots of relaxation exercises and such, and reinforced the truth I already knew about myself, in that I totally suck at quieting my mind. I don't even realize it when I'm wandering off my mantra until I'm half a mile down some mental digression wondering "how the heck did I get here?" I think meditation would be a good thing to work on. I've long wanted to, but always leaned on running and yoga to help me get square in my mind. I think I might try again to work on meditation. It would be good for me, especially at a time of mental upheaval like now.

In thinking about it, I chalk up my sleeplessness to a caustic cocktail of the following:

1) excitement in my brain about all the recent changes, plus my anxiety about wanting depth so badly (and tying it to a good night's sleep in my mind)
2) hangover from general anaesthesia
3) hangover from 5 nights of sweet juicy percosets post-surgery
4) lack of exercise

I will strive to work on 1 and 4, accepting that 2 and 3 will pass.

The presence of depth in my vision does indeed seem to be related to sleep. I only had it for a little while yesterday, and have not had it yet today. Yesterday, I was waiting for the bus, noting that I had no depth, and all it took was to look at someone's quirky yellow hat for a surge of nausea to take over. I then noted that the woman standing behind the yellow hat wearer was looming in that special way. I then enjoyed depth during my bus ride, and it went away by lunch. Oh well. I am getting better about my anxiety related to depth, especially upon reflection on what my surgeon said regarding further mental adjustments happening after I resume wearing my contact lenses. Even my super-snazzy Zeiss lens glasses distort my view, so I imagine that exacerbates my brain's confusion about its changing input.  It is what it is - the motto of the two thousand teens. I think if depth does go away I will seek out vision therapy to help bring it back. It's too wonderful to let go forever, and from what I've read there is plenty of evidence that vision therapy has helped people retain / regain depth perception. Here's to hoping.

But I am REALLY enjoying my lack of double vision. There is sometimes a teensy HINT of it still, but it's fleeting and most prominent when staring at a bright light, but most of the time my experience is of a single view. Since my left eye is still worse than my right, there is an area on the left side that is still a bit of a mystery compared to the right, but it is utterly GLORIOUS to be relieved of that constant annoying secondary image.

In an effort to jump-start better sleep tonight, I resumed my routine of running in to work today. Since my eyes are more light sensitive, that means I couldn't wear my glasses. Yes, I went commando. I've done it before so wasn't worried about it, and generally did fine. As I sit here, I feel INFINITELY better, and I will run home as well, and try to lift some weights tonight. Since I didn't have depth on the way in, running was a familiar experience, though I tried to take the lessons learned from having depth and imagine objects and people as discrete things the way I saw them with depth, and this actually helped. Also, now that I have more or less a single view, I found I could focus less on the details and more on the overall landscape. This made navigating the sidewalks actually easier, but I also found I reverted to my old methods at crosswalks and such. Given that I need to be super cautious, that's probably ok. But on one straight-away I tried to really zone out on my vision and cast a wide gaze, and was feeling good about it...

...until I turned my ankle. D'oh!

I was able to walk it off, and I note it is not swollen. I have a trick left ankle and have turned it countless times. But here I was trying to cast a wide view and getting tripped up by NOT focusing on the details in front of me. Oh irony, you mischievous strumpet.

So, the period of adjustment continues, and will continue to do so for a while. My follow-up appointment with my surgeon is next tuesday, and I look forward to hearing about progress. The eye is a little less pink today.

I should add that people continue to be incredibly kind and supportive to me through this whole process in a way that is quite remarkable and wonderful. At work, at home and online. This part of the experience is one I came very close to avoiding altogether, as I was tempted for whatever reason not to be open about this experience. Probably self-consciousness. But I'm so glad I decided to be open about it, as it is shaping my worldview in a wonderful way, on top of everything else that is happening. Thank you all for your kindness and support. I'm really enjoying sharing this journey.

One week after surgery, there's still some pink in the eye, but people at work have to deal with me and this whole experience has turned me into Captain Overshare anyway, so here ya go -

So what the heck did they do to me anyway?

Since I've had some questions about it, and I can't sleep, and it's more or less officially been a week since surgery, I figured I'd provide a bit of detail about the actual procedure I had done neigh upon seven days ago.

The condition that I had - well, one of them anyway - is called strabismus, or a misalignment of the eyes. While this condition is annoying enough in and of itself, it can contribute to at least one of the other conditions I have, nystagmus, an involuntary jittering of the eyes. But more obviously, it causes a lot of confusion with my social interactions with people, as I regularly run into situations when people don't think I'm looking at them, or are confused by my appearance. I will get into the whole topic of living with my various eye conditions - and how they've shaped me as a person - in another post later this week. It'll be a doozy so it may take me a bit to complete.

The surgery I had done last week is alternately called "strabismus surgery", "eye muscle surgery" or "eye alignment surgery". I had it performed at the illustrious Massachusetts Eye and Ear Infirmary, though my surgeon was officially affiliated with Boston Children's Hospital, as it's much more common for this procedure to be conducted on children than adults. Typically they try to correct this kind of thing in childhood, but in my case they didn't, and my history with the medical profession related to my eyes is yet another blog post to come.

The specific procedure involves (good time to put down your lunch now) the following basic steps. First, a handy illustration:

No, nothing gory, but before you search for strabismus surgery on Youtube you REALLY should put away your lunch.

Anyway, the basic concept of strabismus surgery is to reposition the placement of the eye muscles so as to allow the eye to point in the correct direction. As far as this layperson knows, that involves the following:

1. slice through the clear outer layer of the eye (called the conjunctiva)
2. detach the muscles needed to align the eyes - my lazy eye drifted toward my nose, so they detached the muscles responsible for left-right movement, known as the "lateral rectus" as illustrated above
3. "loosen" or "tighten" the relevant muscles and reposition where they are attached on the eye to pull the eye in the right direction - in my case they "loosened" the lateral rictus on the inside of the eye (nearest my schnozzus grandius), and "tightened" the one on the outside
4. reattach the muscles to my eye in new places, allowing the eye to be aligned. They did this using dissolvable, adjustable sutures
5. stitch up the conjunctiva and send the poor sap on his way

Simple, right?

It does sound very brute-force in some ways, but remember this is being done on quite the microscopic scale by human beings with mechanical instruments. Steady hands indeed.

I was under general anaesthesia for the main event, which was actually the most nerve-wracking part of the whole affair for me. I am a wee bit nervous of being put all the way under, as I know it can have nasty side effects, not the least of which is not waking up, and I made the n00b mistake of reading up on general anaesthesia on the web, and anything called "medically induced coma" is not going to put my mind at ease. But statistically it's safe and so I sacked up and took the risk.

So last wednesday about 10:15am I rolled into MEEI and got checked in. I hadn't eaten or drank anything since the night before (save a small cup of black coffee when I first woke up, which they allowed). I got a slick - pre-heated - patient robe (yes, MEEI is a 4-star affair) and sidled on up to bay number 1. I lay out on a gurney and a phalanx of nurses and other folks introduced themselves to me. Eliza was there too, and one of them, while attaching leads to my body, argued that I was too skinny and that Eliza needed to make me a massive dinner every night. I encouraged Eliza to take their pedigreed medical opinion to heart. At this point I started to feel weird again, because, well, I was mostly naked on a hospital bed with wires attached to me, able to hear my own pulse from a nearby machine. My surgeon came in (names suppressed as I haven't gotten permission) and very kindly reviewed the surgery with me and confirmed I was good to go, and seemed genuinely excited about the whole thing. I love her. Then they wheeled me down the hall a la so many episodes of taut medical dramas. This of coursed caused innumerable associations to references to "Dr. Allcome" and various other hyper-realized medical emergencies, but hell I was strapped to a board and ready for ignition so I wasn't going to let a lifetime of pop culture give me the heebie-jeebies now.

They parked me in the surgery room, which wasn't altogether different from bay number 1, and put a nice blue bonnet on my head. The anaesthesiologist came in, stuck me with an IV, and said that I would start to seem very relaxed. I noted that I did...

... and then next thing I knew I was awake again.

It was done. And I was surprisingly alert, and enjoying my new view for the first time. It was blurry as I had no corrective lenses, but I could tell right away that my double vision, that frustrating clash of imagery that I had become so accustomed to my whole life, was different. The world seemed more dome-like somehow, as I was getting a wider view out of even my good eye.

My surgeon came in and did some preliminary tests. They had put in adjustable sutures, and wanted to know how well the aligned the eyes, and whether some fine tuning was needed. I determined that I still had a bit of double vision, and that when they covered my left eye, then my right eye, then my left eye, my eyes did move to focus on a point of light, so clearly some tweaking was needed.

Here's where the real fun began.

First, they asked Eliza if she wanted to stay. She said she did. They next said they were not responsible for her passing out. I assured them that she is tougher than I am (I enjoy calling her "pioneer woman" as she clearly could have settled the West by herself), and they proceeded.

They did not put me back under. They put in some "numbing drops" (quotes deliberate), and attached to my eyelids what can only be described as "clockwork orange eyeclamps". They then reached in with their tiny instruments, undid the stitch in my conjunctiva, and nudged the sutures around. I had the sensation of my eye being moved around like you'd move a camera lens, an odd sweeping motion, independent of my right eye.

And there was another sensation - stinging white-hot pain.

But I channeled my inner yogi and breathed through it, because they had tiny instruments in my eyes. I told them it hurt like a mofo, and they applied more drops.

How was I not completely freaking out at this point, you may ask?

a. they had tiny instruments in my eyes and I was afraid to move
2. it hurt like hell and I was kind of focused on that
d. it was all oddly fascinating and I had quite the close-up view

After a few minutes, they assured me I was doing an awesome job, and closed me back up. The whole thing took about 5 extra minutes. All in all, that to me is FRIGGIN AMAZING.

I was able to relax for a few minutes as they watched me closely. My surgeon did some follow-up tests and we confirmed that the alignment was improved.

After a few minutes I looked over at Eliza, and noticed right away that the bedrail seemed to ... loom closer to me. "Something's different" I said.

I did not want to hope, but I had reason to believe.

I put my hands in front of my face, one in front of the other. The hand nearest my face ... loomed closer in a way it didn't before. I switched hands, and started to giggle.

"Something's different" I said again.

As I continued to giggle, the nurse looked askance at me "ok, you're starting to freak me out" she said.

"No, this is good! This is amazing!"

Again, I did not want to hope for this. I questioned what I was seeing, but all I can tell you is that right away, in that moment, it sure as hell looked like closer objects were viscerally CLOSER in a way they hadn't been before. I WAS SEEING DEPTH.

In a matter of minutes I was out of the bed, clothes back on, being wheeled in a chair back to registration. That wheelchair ride was amazing, as objects, walls, ceilings swelled toward me in a new and magical way. My brain was going "TILT TILT TILT" as it tried to process it all. I stared around at everything, awestruck.

The revolving doors were astounding. The world outside forever (hopefully) changed.

We'll see, anyway. Ugh, inadvertent visual pun #136. I had wonderful depth yesterday, but as you can see, I am not having good sleep tonight at all. I've already been up for a few hours and decided to just get up and write for a bit in the hope that would tire me back out. Off to go see if it worked. But I will remember that if I do not have depth today as a result, it is not a failure, it is not a sign that it is gone forever. It is likely a sign that I should get some exercise tonight, drink a glass of warm milk before bed and do my best to set myself up to sleep well so the brain can do the critical work of processing all the new input and be ready to take it all in the following day.

And in closing, I would like to say that my whole experience with Mass Eye and Ear was fantastic. The staff were capable, confident, and also KIND, which is a label that not all medical staff get to enjoy. They were cool, and what they did for me is nothing short of a miracle in my eyes (ugh, pun #137), and I am forever gratified for their services and in their debt. I want to give my surgeon a thank-you present when I see her next week. Is that inappropriate? I thought something nice like a gift card for a dinner for two or something. I'll figure something out. Anyway, the whole thing was really a great experience, and I was home with plenty of time to go pick up Lyra at school. Totally amazing, it may as well have been drive-thru.

day 7: back at work today. I took the bus in today, and enjoyed the full-depth experience on the way in. I still have it pretty much now as I sit here. The effect is starting to get more subtle when I do have it, so I think I'm more or less just getting used to it, or integrating it into my old-school view. It does still kind of come and go, and thus it being more subtle and less of a big-bang like it was day one is a bit confusing to me. If I ever have any doubts I can look down my shirt front to confirm whether or not it's there. And even that is not 100%. The bus was very cluttered and busy, and people who were close to me felt even more "up in my grill" as usual. I also again felt very boxed in, as the sides of the bus are much more prominent now.

One interesting note - I was standing by the back doors, and there's a bit of plexiglass right in front. As I looked out the side windows, I mistook the reflection of the door on the plexiglass for another window, due to the fact that I was interpreting depth from the reflection.

I have been wearing sunglasses outside as I am a bit more light sensitive now, and am thus wearing NO corrective lenses. It's quite remarkable that depth can come even without that correction - there's enough information (even with my really lousy left eye) for my brain to interpret depth.

Oh yeah, my vision stats when optimally corrected - 20/80 right eye, 20/200 left eye.

I do wear glasses like right now when reading, but I actually prefer to not wear them right now as I get my full peripheral view (improved since surgery) and depth is much more dramatic. My prescription is such that even with the super snazz Carl Zeiss lenses I splurged on in the last year (a third the thickness of my old-skool coke bottle glasses) the view is still a bit distorted. I will not be able to resume wearing contact lenses for a month, and apparently that will be another full wave of adjustment for my brain. But I reaaallly can't wait for that. I lurve my contact lenses.

I didn't have depth yesterday except for very subtle cues. I hadn't slept well the night before and was in my head about the whole thing yesterday, so found myself again very depressed and afraid that I had lost it forever. I know, I really need to get my head around that.

I talked to my surgeon yesterday, and asked her what to expect of depth and hearing in general. She said that retaining / obtaining depth from the surgery is in fact very rare, and the fact that I got it at all is a testament to the flexibility of my brain. I've always considered myself highly adaptable so this was good to hear. She did say that in cases where depth was obtained, she found that it did stick around, so that was very comforting. However she said there's not a lot of clear information about why and how the brain works to retain it, and she for one does not have a lot of faith in "vision therapy", though admitted that was a bit of a polarized debate, and she sat on one side. I'll discuss that in more detail in a future blog as it's pretty interesting. She did say that if I wanted to pursue vision therapy, that it would not hurt my eyes, so I should do whatever made me feel productive.

She also reminded me that my eye may drift a bit as it heals up, and that what I see today may not necessarily be its final position. However, she did also say that they were generally very happy with the position of my eye and that this surgery tends to have great durability. It is however also possible that my eye will drift back over time and that I might in fact need this surgery again. I sincerely hope that won't be necessary, but only time will tell.

My conversation with her really reinforced the fact that this whole adventure is in fact a process and not a big-bang. She said there will be another round of adjustment when I resume contact lenses, and that it may take weeks for my eyes and brain to sort each other out anyway. So I will try again not to get depressed or anxious, and accept that this all will take patience and time to figure out. I also remind myself that I am exceedingly lucky that this works at all. It has been hard for me to wrap my mind around, as the acquisition of depth DID feel like a big bang - BOOM, it was THERE. And then in the days following, it's come and gone and gotten more subtle, and the uncertainty has caused me some anguish and struggle. It is very hard to have something so miraculous come and go. I wasn't ready for it and I haven't handled it well. But I must maintain perspective. I have people in my circle who are dealing with REAL uncertainty in their health, where things do not look good and they need to exert strong mental and emotional effort to remain calm (or so I imagine). And here I am struggling between the uncertainty of things being more or less awesome. I don't presume to know what these people in my life are dealing with in terms of this real uncertainty, but I definitely have a bit more empathy for the position that they are in, and how important it is to maintain a sense of perspective and strength. I also don't want to start a pity party, or diminish other peoples' true problems with what kind of feels like navel-gazing in some ways.

I realize in the end I am focusing the least on the most apparent and obvious benefit of this surgery - the fact that I can lock eyes with someone and really lock eyes with them. That is what brought me into the surgery room in the first place. The rest will take time to sort out, and I am coming to a place of acceptance for that.

On the other hand, I went to a yoga class yesterday and the instructor said "oh, a friend of mine had that surgery last year and now he's driving!" and all i can say to that is "bwahahahahahahahaaaa". As a note, my balance is still really wobbly and I got light-headed a few times, but I really wanted to go to CHILL OUT, and that helped. I had a great night's sleep last night and things are looking much brighter today, literally and figuratively.

This is going to me my last direct-to-facebook posting, as I have indeed started a blog to track this journey over time, since it will clearly be an ongoing thing. I will update facebook when there's new posts to show, but I hope you will all join me for the ride.

Now it's time to STFU and GBTW. :)

and today... originally posted to Facebook

Day 6

Good morning! Four more glorious hours of depth yesterday. Got out for a while to enjoy the lovely day and marveled at the beauty of tree branches, and the volume of space between trees. Buildings seem taller, trees seem taller, but power lines seem to hang lower and more ghastly than before. The sensation of people standing distinct from the background reminds me a little bit of a video game - when you're used to 2d platformers, then getting into your first 3d environment like Grand Theft Auto, which I've played for a total of like 10 minutes, but I remember marveling at how each individual person was their own entity, not just decoration on the background, but somehow more distinct. I'm not really a gamer but I keep saying things like reality is the ultimate 3d simulation. So dumb, but the language is limited.

I don't have a lot of new discoveries from yesterday, just building upon what I knew before, and in the hours between depth I'm trying to relax and remember what it was like. I did not sleep well last night, so I wonder if I am rested enough today to have it come back during what appear to be the golden hours of 10am to 2pm. But in general what I really marvel at is the fact that I'm surrounded by the same stuff as ever, the world is the same world as it was last tuesday, but I have the blessing and opportunity to see it all so differently. Something new and marvelous has been added to the world that I knew, making it again magical and amazing to behold. This is not an exaggeration.

 My eye is a little less red today, and discomfort has decreased to the level of "contact lens in too long". My energy, despite a lousy sleep night, is starting to come back and I am antsy to exercise. But I am home again today because my eyes do still get tired very easily and I cannot read for very long. I am observing also that my nastygmus - the involuntary jittering of the eyes, is absolutely more stable now. That too is miraculous. I'm a lucky guy. I hope everyone gets to have an experience so amazing.

My single biggest bit of advice from this experience - ALWAYS GET A SECOND OPINION. Doctors are generally well-trained and capable, but are as subject to bias as anyone else. Don't let one person, however knowledgeable and pedigreed, steer critical decisions of your health and well-being. After many years of my eye doctors telling me there was nothing they could do for me, I even DID get a second opinion by going to Mass Eye & Ear in the 90's, and they said I was fine with my other doctor. But thanks to Sue Barry, author of "Fixing My Gaze", for reigniting my curiosity of how I could change my situation, and for MERSI (mersi.com) for their optimism and enthusiasm toward treatments. Have a great day everyone. Hopefully there will be more new observations tomorrow.

March 31, 2013, originally posted to facebook

Happy Easter, Happy Passover and happy sunday to all. Now on to myself!

 Day 5: another new experience - talking about myself so much. Not used to it. I don't think I can keep it up forever, but since all this is too exciting for me not to share, and since the wonderful encouragement continues, I will stoically find a way to muster on! *cough*

 Anyway, I had four glorious hours of depth yesterday. It's suggesting itself a bit this morning so I want to make this update brief to take advantage of what appear to be the golden hours. It seemed to go away when I had a nap yesterday and never came back, but I'm keeping the faith and have rounded the corner in terms of my attitude toward it. This is all miraculous.

A few notable observations:

 - a fried egg looks like the surface of the moon

 - being in the car is a different experience. The frame of the car seemed much closer to me, and I felt much more contained than previously. I wonder if I will experience claustrophobia from this. I don't tend to suffer phobias, and seeing as that my biggest childhood fear was being in a house fire and my house burned down senior year, you can say I'm more afraid of having a phobia than anything, as it will inevitably come true. I'm phobiphobic.

 - my venture outside yesterday was to look at an open house (our 3-year epic journey to buy a house in the Boston area is another sadsack blog for another time) and found incredible challenge navigating the other visitors and actually trying to have a critical eye on the house. I got quickly overwhelmed, and felt much more comfortable standing in one spot and letting folks walk around me. We didn't make an offer

- however, having depth made navigating a space easier in some ways. Before, it was much harder for my brain to prioritize objects in a room, especially in motion. The thing in the foreground had the same importance as those in the background, even with the secondary cues available to me. I tend to look at one thing, then another, then another, then another, then figure out how to move. This makes things like grocery shopping during busy hours incredibly stressful. I'm looking at you, Market Basket. I know, that place is stressful for everyone. Anyway, when I see with depth, I have much more of an idea of the relative position of objects in the room, and more helpfully, the space available between those objects. I can plot a course more easily, and I can prioritize objects more effectively. If the depth sticks around, I think eventually this will make navigating spaces much much easier to do. My understanding is that people with binocular vision tend to fix their gaze wide when navigating a space, or driving or riding their bike, taking in the whole scene and understanding their place in it as opposed to focusing on details. I have had great trouble with this to date, and am sincerely hoping that I can learn to do this.

- points of light seem much brighter, and I have a sensation that the photons are flying at me. I have no idea what that's about. That might also be because both eyes are focused on the same spot, thus maximizing the light that comes from those spots.

 - sometimes the depth feeling strikes me like a shimmering. The object is not quite solid. I expect this is the brain figuring stuff out.

 - even when I don't have depth, I often have a consistent low-level nausea, especially when I'm concentrating on an object. I assume that's my brain continuing to figure things out

 - it is very weird to talk about my brain as a separate entity from myself, but here we are.

 - water in motion is so gosh-darned fascinating I could stare into the sink for hours. Pouring water or coffee is very cool too, it really seems to stand out

 Other than that, I'm out of percosets, but thankfully the pain is subsiding to "discomfort". My eye is back to looking fire engine red, but thankfully no crustiness. Until today I could really feel the sutures in there, like sand under the eyelid, but I have gotten used to it and don't think about them anymore. I have some interesting exercises to do, and folks are very kindly referring to people who could help me I will chat with my surgeon tomorrow and find out what she sees as next steps. I have a checkup with her next week. Hopefully by then I will be cleared to wear my contact lenses again and then things will really rock. I'm contemplating going back to work tomorrow, but my eyes do get tired very easily so I wonder how it will be to be back staring at a monitor all day. I will have to take frequent breaks. Good excuse to get up from my desk and go hassle people in person. We'll see how today goes. Anyway, for those celebrating today (or this week), have a wonderful holiday. Everyone else, get outside, looks like a good one in the making. Love and more soon.