Paul update - Day 27

Day 27 – Tuesday 9 December

Today was spent at the ARI but the timing of the appointments meant there was a lot of hanging around. Paul’s first appointment was at 1000 so the ambulance picked him up at about 0930 and since only one of us could go in the ambulance with him, I drove up in the car.

His first appointment was with the cardiologist who did an echocardiogram to try and get to the bottom of the heart problem he suffered whilst in the hospital. We were relieved to hear that his heart is structurally normal and his racing heart beat is down to the “wiring” which is basically what they had originally said, but this has confirmed it. Apparently this is quite common in teenagers and might right itself or, if not, can be treated.

The other appointment was not until 1400 and was with the ophthalmologist to investigate his double vision. It turned out that the ophthalmologist that saw Paul lives in Alford and we vaguely know him – small world! Basically he said that the problem Paul has is common with head trauma: he has damaged the nerve which supplies one of the muscles controlling his left eye, so one of his eyes is higher than the other - hence the double vision. The ophthalmologist spotted it straight away as Paul was subconsciously tilting his head to try and correct it. Also, normally the brain fuses the 2 images together but Paul is also struggling to do this so he has a bit of a double whammy in that he has double vision both side by side and up and down, so it was quite difficult for him to explain exactly what he was seeing. He has been given a prism lens to stick on to his normal glasses and this temporarily corrects the problem; once he has recovered he will no longer need it but it could take a few months for his vision to return to normal.

If anyone is interested, he has damaged his Trochlear nerve which, apparently, is the fourth cranial nerve. (Eh?) The ophthalmologist says he has “stunned” the nerve and it should recover in much the same way as your leg recovers when somebody gives you a dead leg, so he doesn’t believe the damage is permanent. A Google search brings up some interesting articles but his is one definition:

Trochlear nerve: The trochlear nerve controls the superior oblique muscle of the eye, one of the extraocular muscles, the muscles that move the eye. Paralysis of the trochlear nerve results in rotation of the eyeball upward and outward (and, therefore, double vision). The trochlear nerve is the fourth cranial nerve. (The twelve cranial nerves emerge from or enter the skull as opposed to the spinal nerves which emerge from the vertebral column).The trochlear nerve is the only cranial nerve that arises from the back of the brain stem. It follows the longest course within the skull of any of the cranial nerves.”

This appointment finished about 1500 but the Ambulance didn’t arrive until after 1700 so we had more hanging around and were quite late back in the end. He had missed supper but one of the nurses managed to find him something so after he had eaten, he was very tired and settled down to watch Race to Dakar on DVD before falling asleep.

It was good for him to get out and about in the fresh air today and sitting in his wheel chair has probably helped build his stomach muscles and make his body stronger, but it was a long and tiring day for him (and us!).

Thanks again to everyone who is sending him texts; he enjoys reading them but it is taking him a while to reply so please be patient!