richard a keener

Hello and Thank You for taking the time to read this long post about my
Monocular Diplopia problem which I've had for about a year and a half now. I
could certainly use any feedback or suggestions.

It seems I will have to go outside my insurance plan again to find a
doctor who is willing to take a "trial and error" or "process of
elimination" approach to find the cause of my diplopia, at my expense of
course which is fine with me. Writing the below summary of my problem has
made me conclude that I either have a fungal, bacterial or spirochete
infection. I guess this post could be considered long and if you have the
time please read my story and let me know what you think either by post or
email. All comments are welcome...


Patient personal information:
1. A 45 year old Caucasian male, 5'10", 170 lbs. No other health problems.
Never smoked. Do not drink alcohol or have done any drugs.
2. Live on a small farm in the St Louis Missouri area with (2) horses, (1)
pony, (4) dogs, (4) cats and (6) chickens.
3. Work as a computer ****yst at a sedentary job. I enjoy what I do for a
living.


Description of problem:
1. Bilateral Horizontal Monocular Diplopia. With each single eye I see a
second clear image slightly offset to the side. This is the same for both
eyes individually and together. For an object two feet away the second image
is about 1/4 inch to the side. For an object 50 feet away the second image
appears to be about 1 foot to the side with respect to the distance.
2. Difficulty concentrating. I zone out very easily.
3. Neurological pains lasted for one month and then faded.


History of events leading up to diplopia: Whether or not they may be
related....
1. January 1996 Injury to tailbone during a fall. In bed for two
days with a 102 degree fever immediately after the injury. It was two years
before I could sit back on my tailbone without yelling out.
2. Spring 1996 Woke up with bloated stomach, did not eat for a
week. X-ray is normal. Dr. thinks it's just an infection.
3. June 1996 Intestinal cramps and diarrhea begins and
continues through 2001. Dr. tests for H. Pylori, negative result. Diagnoses
me with stress.
4. Fall 1996 Had a Root C**** done. A controversial topic
these days.
5. 1998 - 1999 IBS. Intestinal cramps are strongest for these
two years as I search for food allergies as a cause.
6. 2000-2001 Intestinal cramps gradually become less severe
as I cut back on the vending machine candy and Mountain Dew.
7. Summer 2001 Spider bite on forehead, took 6 months before it
started to heal and left a 1/4 inch crater. Probably a Brown Recluse. Zinc
Oxide cream really did the trick.
8. Summer 2001 Dug a tick out of my back. No rash or fever. It
healed very quickly.
9. Summer 2001 Swallowed one of my mercury amalgam fillings. That
left seven remaining.
10. Winter 2001 Showing symptoms of depression. Poor sleep habits,
cannot concentrate. Fatigue.
11. Spring 2002 I noticed the double vision and started my journey
of seeing many doctors.


Tests performed with Normal results:
1. MRI of whole head. No tumor or MS lesions
2. Blood tests; acetylcholine, ANA, RPR, SED RATE, TSH, T-4, Lyme
disease, Western Blot. All normal.


Physicians seen:
1. Primary. Ordered MRI. No problems seen. Referred to Neurologist.
2. Neurologist. Ordered blood test and he didn't see a problem. He said I
was getting better since the neurological pains had faded.
3. Ophthalmologist. Didn't see a problem with my eyes.
4. Neuro-Ophthalmologist. Two lengthy visits. Could not find a cause for
Diplopia. Good vision otherwise, I might need reading glasses soon.
5. Infectious Disease. Ordered western blot with normal result. He saw
no cause to further investigate. Recommended Yoga classes.
6. Primary. Said there was nothing more he could do for me. He had to say
it three times before it finally sunk in I was being dumped. Was I a
liability? He recommended a psychiatrist.
7. New Primary. Prescribed Doxycycline for possible tick co-infection. No
reaction or improvement. Recommended a Homeopathic doctor might help.
8. Homeopathic doctor. Prescribed Metronidazole, Iodoquinol and
Praziquantel for possible parasite infection. No effect. Recommended I have
my 7 mercury amalgam fillings replaced, which I did. Did 9 DMPS IV
chelation treatments along with DMSA capsules for Heavy Metal toxicity. No
change in vision or concentration problem. Doctor now doesn't think mercury
is the cause of my diplopia. He wants me to have my root-c****led tooth
pulled as it may harbor an infection. I won't do it. Tell me what the
infection is and lets kill it and if it comes back then I'll consider
pulling it.
9. New Primary. He thinks we've tried everything and I should learn to live
with it and focus on improving my symptoms of depression. Now I really am
depressed...


Possible causes:
The Merck manual lists the following six possible causes for Monocular
Diplopia, when you have ruled out the eye lens. I also listed what I have
done for each possibility.
1. Virus Infection
2. Bacterial Infection
3. Fungal Infection
4. Parasite Infection Metronidazole 250 mg , 3/day for 21 day
Iodoquinol (Yodoxin) 650 mg ,
3/day for 21 days
Ulrta Parex (Wormwood) 500
mg, 3/day for 20 days
Praziquantel (Biltricide) 600
mg, 2/day for 2 days
5. Lyme Disease Doxycycline 100 mg, 2/day for 15 days
6. Heavy Metal Toxicity 9 DMPS IV treatments and DMSA capsules
500 mg, 3/week for 12 weeks


More info:
Most Ophthalmologist will probably tell you that Monocular Diplopia is
caused by a problem with the lens. Well I want to tell you about a vision
incident I just had a week ago that I think proves, to me at least, that the
lens has nothing to do with my Monocular Diplopia.
I'm sure there's a medical description for my experience but I couldn't
find it in my short search of the web so I'll have to describe it.
About once a year or less since my ****s I would see white jagged lines
or small triangles forming a semi circle. This image is bright white and I
cannot see through it. It starts as a small semi-circle in the middle and
gradually grows outward and eventually fades after about 30 minutes. I have
always attributed this to physical stress. I am very familiar with this
since I have seen it at least once a year for 30 years. What's interesting
about it this time is the image of the semi-circle is now a double image. I
sat in a dark room with my eyes closed watching this image grow and all the
while it was a double image.
I'm sure this image is generated somewhere behind the lens and the lens
has nothing to do with it. Perhaps someone can correct me if I'm wrong but
this seems to rule out the lens and possible the eyes as well.


What could it be?:
Heavy Metal Toxicity: I endured two months of painful dentistry work
and six months of IV chelation, which my insurance wouldn't cover, with no
improvements in vision or mental capacity. But that's OK since it allowed me
to definitely rule out Heavy Metal Toxicity as a possible cause, and my
teeth look a little better without all that metal in my mouth.
Parasite Infection: It seems that I have also ruled out parasite
infection as well with all the prescriptions I've taken. What do you think?
Lyme Disease: I'm not convinced that Lyme has been ruled out since
I've read that some people have tested negative from a blood sample but
positive from a spinal fluid test. I did take the Doxycycline for two weeks
so that may rule out the tick bacterial co-infections but I still think I
need to check the spinal fluid for the Borrelia burgdorferi spirochete.
Living on a small farm I have definitely had a good exposure to ticks over
the years.
Fungal infection: Could the tail bone accident have punctured or
damage some part of my GI tract that allowed an infection to start, allowing
yeast or bacteria outside of the GI system? I must confess to a very high
chocolate and sugar diet during those years. I also had a red spot about the
size of a dime on my nose for the last three years until I recently did a
food allergy elimination diet and found that I had problems with sugars or
anything sweet. I cut sugar, milk, corn and the vending machine out of my
diet and within six months the spot my doctor said was permanent...
disappeared completely. I guess we are what we eat...


What am I going to do next?:
I need to find a doctor that will take a "trial and error" approach to
finding the problem for my diplopia. It seems every doctor I have seen is
reluctant to order potentially unnecessary test. Who are they afraid of, me,
the insurance company, a medical board? The problem is obviously in my head
so why hasn't anyone done a spinal tap to look for a problem? OK I've
vented... I didn't mean to ridicule the people I'm asking for help.
All right, here's my action plan. 1) Take Diflucan for a possible
fungal infection. Diflucan does a better job of passing the blood brain
barrier, or so I've read. 2) Spinal tap to look for Borrelia or other
infections. 3) ****tail of antibiotics to kill anything it can. First)
Find a doctor that will help me with this action plan.

If you've read this far, thank you for your time. What do you think of
my plan? Do you have any suggestions or comments?

Thank You,

Richard Keener

email: keeners@swbell.net