Saturday, November 4th, 2017

My Twitter feed is a mess. I have tagged more than a thousand people to follow and I think that by now I see scarcely a tenth of any one person’s tweets. I hardly ever see some of them at all because of the flood of pithy bon mots that roll by on the screen of my smart phone every day.

And yet, every once in a while, Twitter delivers something to my news feed that is totally unexpected and utterly pertinent. Yesterday it was this:

This, it turns out, is a scintillating scotoma, which most people describe as an aura they see before they get a migraine headache. I know a lot of people who get migraines and they sound like ghastly experiences; thank goodness I’ve never had one myself. In fact, I rarely get headaches. I see these auras from time to time, though, and they scared the hell out of me until just this last summer when I found out what they were.

The first time I saw an aura, about eighteen years ago, I was dressing in the dark in our bedroom in Misawa getting ready to go work a day shift. The aura began as a tiny spot of bright light in the center of my vision that looked a lot like the afterimage you see when you look straight into a bright light, then look away. I thought at first it might be a result of stepping out of the bathroom where I had the lights on, into the bedroom where the lights were off, so it didn’t alarm me at first, but instead of fading away as the afterimage of a bright light will do, it got bigger and began to shimmer, and after several minutes it filled most of my field of vision. I was so scared by it that I woke My Darling B and asked her to take me to the emergency room. By the time I saw a doctor the aura was gone. After I described it to him, he told me I’d probably experienced a transient ischemic attack, which is another way of saying I’d had a stroke! He said it was just a “mini-stroke,” though, and nothing to worry about.

Military doctors say crazy shit like this all the time. Sean broke his arm — a hairline fracture, no broken bones or anything sticking out of his arm — and to diagnose it, the doctor asked Sean to do a couple push-ups. On an arm he suspected was broken. Same doctor told me and a couple of the people I worked with that a lot of my problems were caused by drinking milk. So I wasn’t surprised when this doctor casually suggested I’d had a “mini-stroke” and it was nothing to concern myself with. Sure. Bet it happens all the time to lots of people. I’ll pay it no mind at all. Thanks, doc. Just gonna go down to the legal office now and make sure my will’s up to date. Toodles!

I saw an aura one more time while we were still in Misawa but I didn’t experience any other symptoms: no headache, no loss of feeling in any part of my body, no slurred speech, no loss of consciousness, nothing but the weird, shimmering light. I didn’t tell anybody about that one because, hey, it’s nothing to worry about, right? The doctor said it was just a teensy-tiny little strokette. I can brush these off no problem. Maybe it’s my super-power.

The next time I remember experiencing an aura, I was on vacation in California with My Darling B. We stopped at a restaurant for breakfast and were just approaching the cashier to pay our bill when I realized I couldn’t see the cashier’s face. The shimmering aura is impossible to see through until it expands to the outside of my field of vision. As we waited our turn to see the cashier, I realized I might have to tell B I was having another “mini-stroke” because I wouldn’t be able to drive if the aura didn’t go away. Luckily it expanded to the point that I could see though the center of it, so I got behind the wheel and off we went. I probably shouldn’t have — well, no, I shouldn’t have; no “probably” about it. I am just this stupid sometimes, but we were having such a good time I didn’t want to ruin the vacation with a trip to the emergency room.

I saw the aura one or two more times, but the next one I clearly remember came about a year or so ago as B and I were just leaving a yoga class. I had to ask her to drive because I wasn’t stupid enough to believe I could see though the aura that time. On the way home she asked me if I could remember what the doctor in Misawa said was causing the aura, and after we got home, she made me promise to see a doctor after she looked up “transient ischemic attack.” (Don’t look it up; it’s terrifying.)

So the next week I sat down with my primary care physician and described in detail what I usually saw when one of these auras came on: a spot of light, usually in the center of my vision, that expands gradually until it fills my field of vision. The light always shimmers in a colorful, cross-hatched pattern. I can’t see through the aura until it fills my field of vision, at which point it is usually C-shaped; I can see through the middle and the open arms of the C. There is a solid boundary around the outside of the light, but no definite boundary inside when it becomes C-shaped. The aura expands past my field of vision in about fifteen minutes, after which I can see normally again.

My doctor consulted with an ophthalmologist, who told us both I was experiencing a migraine aura. I said I didn’t get migraines, and he said it didn’t matter; some people see the aura but don’t get the headaches. I have never been so relieved by a diagnosis in my life. I wasn’t dying the thousand deaths of mini-strokes!

I haven’t seen an aura since then, but just the other day I saw a tweet from one of the photojournalists I follow on Twitter: “In the spirit of oversharing on social media, this is happening in my vision right now and it’s FASCINATING. I’ve watched a tiny flicker in my vision (both eyes) turn into a giant blinking rainbow snake made of triangles over the past 20 minutes … it’s horrifying but CRAZY TRIPPY in a way that mirrors on descriptions of religious visions.” He posted a link to a Wikipedia article that included a description which almost exactly describes what I see when I experience one of these auras:

Scintillating scotoma, also called visual migraine, is the most common visual aura preceding migraine … It may precede a migraine headache, but can also occur acephalgically (without headache).

Many variations occur, but scintillating scotoma usually begins as a spot of flickering light near or in the center of the visual field, which prevents vision within the scotoma area. The affected area flickers but is not dark. It then gradually expands outward from the initial spot. Vision remains normal beyond the borders of the expanding scotoma, with objects melting into the scotoma area background similarly to the physiological blind spot, which means that objects may be seen better by not looking directly at them in the early stages when the spot is in or near the center …

As the scotoma area expands, some people perceive only a bright flickering area that obstructs normal vision, while others describe seeing various patterns. Some describe seeing one or more shimmering arcs of white or colored flashing lights. An arc of light may gradually enlarge, become more obvious, and may take the form of a definite zigzag pattern …

It is oddly comforting to know that somebody else out there is experiencing the same thing I am. I mean, I knew other people were seeing this, because the doctor told me so, but to have somebody relate it to me, even if indirectly, made me feel better somehow.

It’s also somewhat more satisfying to have a real name for this phenomenon, instead of “migraine aura,” even if all it means in plain English is “shimmering blind spot.”

scintillating scotoma | 11:00 am CST
Category: daily drivel
Comments Off on scintillating scotoma

Comments are closed.