Wednesday, November 28, 2007

Katie # 2 -- Stick to your Guns

One of the reasons it was so important for Katie to keep her glasses on was the great discrepancy between the vision in her good eye versus her dermoid eye. The minute she got glasses it was easy for anybody to tell that, just by looking through her lenses -- the right eye was essentially window glass, but the left eye tipped anything you looked at through it by about thirty degrees. How Dr. O could correctly choose her prescription when she couldn't say anything but "gah!" is beyond me, but he obviously knew what he was doing. But even with glasses, because one eye could see much more easily than the other, she ran the risk of developing amblyopia, in which the good eye takes over and does all the work, and the bad eye essentially goes blind even though everything works. The brain just learns to ignore the "bad" signals.

One-eyed vision has all kinds of ramifications; it means no depth perception, which can make driving impossible. (I loved the test Dr. O had to see if Katie had depth perception. It was a set of pictures [I remember specifically a very ugly bug] which were "stereoed" with the double layer plastic stuff. He would ask Katie to pick something up, and if she tried, that meant binocular vision -- depth perception. Even babies don't try to pick up flat pictures off paper!) Because Katie pulled her glasses off so much, part of her prescription was to have her right eye covered for a certain number of hours each day, forcing the dermoid eye to do all the work. This is usually done with an adhesive eye patch, but Katie (surprise!) HATED having something pasted to her face. So since her glasses were already secured to her head with Croakie and tape, we covered the right lens of her glasses instead. It was a lot easier to make sure her glasses were on than to have her constantly picking at the tape. I do have a picture of "Katie the Pirate" dressed up by her siblings and neighborhood friends. When I get time I will scan it so I can upload it for you to see.

At our very first visit with Dr. O, when Katie was two days old, he mentioned surgery to remove the dermoid. It wouldn't correct her vision, he informed us, but having it removed for cosmetic reasons would save her a lot of grief once she started school. I think he was envisioning what I call the "little kid with glasses" personality -- shy, uncertain, expecting to be teased. We have known a few of these -- one of my cousins, and a good friend of Maggie's, and some others. But the surgery would be costly, and we were between insurances when Katie was born.

[We are some of those people who contribute to the "millions of people with no health care" statistics that get bandied about, especially in election season. When you are self-employed, as my husband was by this time, you simply can't afford one of the low-co-pay, covers-everything policies that most people seem to think they deserve. Sometimes we have been without insurance, but never without health care. We just paid out of pocket. The total cost for a midwife assisted home birth was about two months premiums for the covers-everything-with-maternity-rider policy we had considered.

One of the things probably nobody considers when deciding to self-insure is the medical costs associated with a "major birth defect". We were assured that that's what Katie's dermoid was. Now we have seen major birth defects. One of Rosie's childhood pals was born with no nerves to her intestines. She has been in and out of the hospital so many times her parents have lost track, and finally a couple of years ago received a multi-organ transplant that is letting her be an almost-normal college student. Somewhere in this process she hit the lifetime limit on her parents' insurance (I think it was a million dollars) and since then has had to rely on Medicaid. But a cosmetic defect on an eye is not in that class. If we have to deal with a major defect, I'll take a dermoid.

I also don't mean to put down people with no resources, obviously. It's just that counting people like us in the statistics is cheating.]

Since we didn't have the money for the operation upfront, we asked Dr.O if postponing it was possible. He agreed that it was, and that frankly it was a rare and possibly dangerous thing (since the operation could damage the eyeball to such an extent that Katie might be blind in that eye anyway.) But he still felt that psychologically Katie would be better off having the operation before she went to kindergarten and kids started to tease her. So we kind of left it there.

Meanwhile, stubborn, opinionated, feisty Katie was growing up. She had a very independent turn of mind, and was (and is) quite self-sufficient. Once, due to a head-counting error, (we were giving our five neighbor kids a ride, along with our six) we left three-year-old Katie at church in the after-service coffee hour. When we got home (only about 7 minutes away) and discovered our mistake, we sped back, only to find Katie in conversation with somebody or other. She hadn't even noticed we were gone!

By the time she was four, and we paid one of our last visits to Dr. O, he could see it too. This kid wasn't going to be traumatized by teasing! In fact, she told us that during her first week of kindergarten some little boy said to her, in an obnoxious sort of fashion "What's that funny pink thing on your eye?" Katie looked him in the eye, (you could see this by her stance as she told the story), and gave him the four-year-old version of "It's a dermoid, idiot, want to make something of it?" As far as I know, that was the last time anybody tried teasing her about it.


Jen said...

Can't wait to see that picture!

blog nerd said...

i just found out you were doing this...this is great! again you are my hope--I'm 34 with one child and always wanted 6 children. it's still possible!