Tuesday, December 16, 2008

NYC and the Eye Exam

We recently took a trip to NYC. My third time there and the most enjoyable. We went down on Sat morning and promptly headed to Katz' deli where we partook of some pastrami sandwiches and pickles. We then walked north to Union Square where we did some shopping and had warm apple cider. We then continued to walk and shop for the remainder of the afternoon. Dinner was at the Mesa Grill (Bobby Flay) where we had an amazing meal. Lots of southwestern flavors and spices. We had tamales with garlic and shrimp for an app. Lael had a honey glazed salmon and I had a spice encrusted pork tenderloin which was the best I have ever had. Nice and spicy. As sides we had another tamale with sage butter sauce, cilantro pesto mashed potatoes and a chile releno. The releno was very spicy and Lael couldn't handle it but I thought it was actually the highlight of the meal. You just don't get those at many restaurants. In the past I was never keen on visiting NYC as I found it overwhelming. We did the city at our pace and I am looking forward to our next trip. The hardest part will be to find another dining experience to match the Mesa Grill.

Makin's ojos (spanish for eyes)

Today I took Makin to the Animal eye specialists because her left eye has had a bit of cloudiness that I wanted looked at. I am still trying to digest all of the information and am thankful that Lael can understand the biology. It also doesn't hurt that Lael's dad is an optometrist!

Information from the visit is as follows:

Makin has intraocular inflammation (anterior uveitis) in both eyes which causes both pressures to be lower than the normal reference range and her internal health will be evaluated with blood and urine evaluations including evaluation for the three most common tick related diseases. With previous history of lyme is is possible that she has experienced the ultrastructural changes in the endothelial lining of the blood vessels in her eyes. Those changes can possibly cause leakage of proteins normally found in the blood stream to leak into her eyes even if the initial insult has been resolved. It is also possible that, based on epidemiology, that she has a current active infection that can cause of the bilateral anterior uveeitis.

The cloudiness in her left eye is the result of corneal endothelial degeneration. Essentially there has been a degeneration in the corneal endothelial cellualr anatomy which is causing a decreased surface area to volume ration of the endothelial cells causing increased corneal thickness which is causing increased refraction of light in the corneal tissues which appears blueish. There is no way to affect change of the damages cells as they are nerve related but we may be able to influence the physiology of the cells by altering the biochemistry of the fluid inside the eye with the combined use of Predisone Acetate and Flurbiprofen (apririn like med) as well as AK-NACL (ointment) to osmotically draw fluid from the surface cell layers of her cornea. If there is sufficient fluid accumulation it is possible for corneal ulcerations to occur.

Needless to say all of that information was tough to process. Makin is on four different meds, the three mentioned above and doxy. I am glad we made the visit although the check book isn't. Makin was great during the exam. When we had her on the table I thought she was squirming because she was uncomfortable but it turns out that all she wanted was to roll onto her side becasue there was an opportunity for three sets of hands to rub her belly! Silly, silly dog.

Makin will be on the meds for three weeks with a lot of attention spent on looking at her eyes to see if we are causing problems or discomfort. We then have a recheck scheduled to determine how she is dong. I feel a little bad for not being more on top of things but feel we are on the right track now. It is also a funny thing that both of the girls have more medical attention than Lael or I combined since we have gotten them. I think this is the normal case with our devotion to our pets. I wouldn't change a thing and only hope that we can do the best we can for them. They are definitely my buddies.

Again, a gratuitous picture. I think Tessa is smiling because she is snuggling Makin!


Jules said...

Very sweet picture. I am glad that the trip was so much fun. The food at Messa grill sounds amazing. My dh would flip for that meal.

Re: Makin's eyes....Is this something you will be able to stop progress of? Or do you not know until you recheck in three weeks? Sorry for all the questions.

Take a deep breath! I found it really overwhelming after Carmie was diagnosed with PRA. At least you have two excellent resources for info in your FIL and Lael.

Give the girls extra belly rubs for me, please.

Katrin said...

so sorry to hear about the eyes :-( Glad you had fun in NYC though!

Blue said...

Poor Makin! I hope the meds will get this under control.

I LOVE the photo of the girls.

Makin & Tessa (Lael and Neil) said...

They are hoping to be able to resolve the pressure thing in both eyes. The cloudiness is degenerative thing and is something we could not have prevented but are hoping to be able to slow down. We should be able to tell a lot more in three weeks.

Good news is that we can already see a change. Steroids are something of a miracle drug. Things don't seem to be bothering her at all (meds) and I think Makin likes the trade-off of eye drops for a carrot. yes carrots trump many, many treats. Silly!

Andrew Campbell said...

Neil + Lael: sorry we missed this news for a few days. Glad you enjoyed NYC... feel free to holler if you're coming down this way again. They may not be the Mesa Grill, but we have a few dining recommendations of our own.

Will be interested to hear how Makin's eyes turn out -- but in the meantime, we will be thinking warm, supportive, get-better thoughts.

best wishes

Kelly said...

Poor Makes!!