I never got around to writing up what we did in mobility training on Tuesday and I wanted to really write up what today was like.

Tuesday was a review of the Sighted Guide method, and some more work on going through doors. And then we went over to work on some technique with the cane. Originally the first thing I was shown was just a cross body way of holding it so that there was no motion. On Tuesday we started with introducing a back and forth motion. That in and of itself is not that hard, though he said that sometimes it can be hard to for new users to keep the can arc within a shoulders width (the goal). If anything I'm overly cautious of going outside of that distance and don't move the cane far enough back and forth, but have been getting better. The more difficult piece is the rythmn of walking with the cane properly. The idea being that the can is moving away from the foot that is moving forward. This takes some time to process as there is a lot going on (at least for me). Making sure that you have the cane held properly and and your wrist in the right position, the can moving back and forth properly and then you have to walk. I was doing ok by the time we went back inside Tuesday.

Today we once again did some Sighted guide review and then back to the cane technique. Reviewing what we did last time and then adding in Contacting an object. After working on getting that properly, without a blindfold then I was to do it blindfolded. The "object" that I was contacting was the wall of a building, we were on a playground. What turned out the be the hardest part under the blindfold was that once I started at the wall and waled away from it and needed to turn around to walk back towards it to do the contact, making that 180 degree turn was difficult. Heck, at first even walking out straight from the wall was a little screwy. But, he showed me how to square myself with the wall so as to walk more straight away from it. Then using the way the sun felt make a better estimation of that 180 degree turn.

Today I also had on my hearing aids for mobility training, not sure if that was the best idea, but I did. It was kind of neat during the Sighted Guide review, except that I got a bit distracted by the sounds and missed some of the cues that something was happening (new inputs can be overpowering). But, then when we did the blindfolded work with the cane and the additional strain of the sound of the hearing aids it drained me pretty good. I was exhausted at the end of it. It was hard to focus and sort out all the things that were happening. I didn't have to think about the cane movement so much any more, but trying to walk with the cane with *NO* visual cues and all of the noise that I can't sort out so well (still working on getting some sort of directionality feel to the hearing aids).

I tried to explain to the instructor that the hearing aids are not a fix it to everything. I still can't follow what he is saying when I am blindfolded, though I get I catch words here and there. And even if speech was not an issue, I can't wear them when it is raining and this is Portland. There are other reasons for NOT wearing hearing aids, some of which are personal and simply choosing to not wear them that day or whatever. Sometimes you need a break.

Today was a bit different. We worked on the narrow passage, stairs and doors. Though, some of these required what normally would have been verbal communication between the Sighted Guide and the blind person. I made it pretty clear that I would not be able to follow verbal communication when not facing the the Guide AND blind folded. At one point I wanted to yell, "What part of DEAF don't you get!?!?!" Apparently he didn't have a set of tactile signs for the verbal communication so I made up some just get through the training. I'm really curious if there is a standard set of tactile signs for this sort of Sighted Guiding so that we can use them and I'll learn the correct ones if I work with someone else.

Today he moved at a much more rapid pace, it felt like running to me almost. When I mentioned that he just said that is because I've spent so much time slowing down to avoid falling and running into things that a normal pace seems really fast now. We went up the stairs and down them, that was different at first, but I got the hang of it. One of the things I figured out and is kind of neat now that I realize it is that I need to use more than my hands for finding things like the railings. I realized at a point if I used my hip and upper leg I could search a much greater area faster when trying to find the railing when I knew we were at the stairs. Some stairs the railing is right next to you and easy to locate. Some it is further out in front of where the stairs start, others it is lower to the ground, some it sits off to the side further. Even when you are paying attention to the marker of "last step" it is hard to not try and take one more.

I'm getting better at telling what where we are in that area based on how the ground feels under my feet, especially when we get back to the parking lot of the building, that parking lot is soft and flat like nothing else we walk on (and the building blocks the sun). I need to practice on the doors some more. Not so bad on the pull doors, but the push ones I had trouble with. Again it's a matter of finding the way to orient myself so that I'm in the right place to push on the door properly. It also looks like there is some timing involved here to not move forward too soon or too late.

As for the tactile signs that I used for the day. I used the sign for transfer, 2 fingers drawn across the hand in a sweeping motion, for when I need to transfer sides. When there are stairs, I didn't know what to do so I had him take two fingers and just tap them against my my palm twice, it reminded me of a variation of walking up the stairs. And for door I was at a complete loss for something that could be done in one hand and coped out and hand him simply lay the manual letter D on its side into my hand. Since the number of signs was limited this was ok.

I talked about the trouble of finding my bus still when there are a bunch of busses at the same stop and they gave a bok that has a bunch of numbers in it. The numbers can be flipped in a way so that you can make the number of the bus that you are waiting for. That way you can alert the driver of the bus or another person waiting to help you get the right bus. The numbers all have braille on them as well to help finding the right combination.

In other news VR sent the authorization to the audiologist for the hearing aids. The audiologist was nice enough to order them based on the promise of the authorization, so I'm glad that it was taken care of before they actually came in. Just can't wait for them to get here and go in for the fitting. My one interpreter was joking with me today when I got to class, she was out friday (the first day I was using the cane) and when she saw the cane said to me that this was new, "Got tired of falling and bumping into things finally, huh?" She's so funny.

It's been a long day.

Today was my first day of mobility training. I guess I should back up a step and say that I went to the intake appointment with the Independent Living Resources group that was made a long time a go. They are very nice people. In the course of the intake interview they said that it is great that things will be happening through OCB, but it seems as if it isn't happening quickly enough and they wanted to know if I would like to start mobility training with them until OCB can take over. I thought about it and said ok, then the woman called in the man who would be doing it and he said he could schedule me for the next morning (I was kind of like, "Woah, didn't see that coming"). They will also be helping me with learning braille, peer counseling, and advocacy when/if needed. They are able to get things started more quickly because they don't use a medical model of qualifying people for services. To be honest I don't understand the model, but will try to get a better understanding later. Parts of what went on were confusing without an interpreter that day.

So today was mostly about learning to be guided. It was kind of weird at first, but once you learn to trust the person doing the guiding it isn't too bad. Telling myself to trust Christopher and stop shuffling my feet was the hard part. But, once I did that I walked quicker. It was funny because he noticed that I was paying attention to his body language more I guess than most people, I could tell at one point that something was there that I should pay a little more attention to by his body language and I shuffled my feet and sure enough I found it. He showed me the way he moves his arms to indicate that we are at a curb or step and how to step up/down safely.

In future lessons we will work on things like when being guided, how to go through a narrow space and up/down stairs properly.

While I was given a cane today, the instruction for it was very rudimentary. But, enough to get started. I was shown how to open and close it safely and properly. And for use, just a very simply cross body method that involves no real movement of the cane. It allows for finding curbs and other things for now. He also showed me quickly how to use it help judge how far I was stepping down off the bus or finding the distance to the step onto the bus. He pointed out that if I stand with the cane in front of me while waiting for the bus the driver will see that and know to stop for me. That became very obvious when I used it today on the way home.

I used the cane on the walk back from the bus to the apartment and found that it does let me move a bit faster than shuffling my feet. And wondered how it much it will help once I really learn to use it. Someone tapped me on shoulder to let me know the light had changed when I was waiting to cross the street (this is a nice thing since I really can't see the walk lights and have to guess by other means).

It was just a first day, but while I didn't want to use the cane it is hard to say it didn't help.

On Monday I go back for more training and also will be doing some braille class. I've marked the keys to my dorm with a braille "I" and "O" for indoor and outdoor key, so I can tell the difference. It has helped a lot. Not that I know a lot of braille at this point, but have done some learning on my own, and they said I had a pretty good head start.

Guess that catches you up on that news for the day.

This isn't the greatest due to the OCR, but I hope it shows a few things.

Things I don't understand exactly. What inferior cupping mean? The loss of tissue sounds concerning. I don't under stand the Cup to Disc ratio, but googling seems to say the ratio should be smaller.

At the end are plain scans of the visual field test. I don't understand any of what is written, and there are pictures. Click on the images for a larger view.

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Wearing: 2 months
right eye: -7.OO +2.75 x O92
left eye: -6.5O +2.25 x O96

VisuaI acuity:
0cc: SneIIen - isolated
right eye :2O/2OO
left eye :2O/2OO
BEO: 2O/2OO

Nsc: BEO: 2O/2OO @ 5 inches
Ncc: BEO: 2O/4OO

Ncc:
Prima: 12-14XT'
Downgaze:
NPC: Can not converge

Dsc: ortha
Nsc: 2O X(T)'

Optic Nerve: slightly greyish and less nervous tissue: inferior ring is thin OU. Cup/disc ratio O.6 to O.7 OU

IMPRESSION:
1. lntermittent exotropia
2. Myopia
3. ? Optic neuropathy -- change in optic nerve cupping over the past two months with loss of nervous tissue and inferior cupping.
4. If there is no optic neuropathy. then will need to consider ERG to evaIuate retinal function particularly with night
vision problems. No signs of RP presently (optic nerve pallor. retinaI vessel attenuation, pigmentation)

Left Eye

Right Eye

They think they found the reason I have such a difficult time with converging my eyes together. There is a severely reduced field of vision, something I never noticed. And some questions about night vision surprised me as well, apparently all of this is related. There was a noted decrease in the amount of optic tissue, and it greying. So, now I have to see a neuro-opthamologist. That appointment isn't until the middle of next month, which makes me concerned over the fact that she will order more tests (most likely a CAT/MRI brain scan) will take time and then waiting for another appointment with the NO.

There was enough information for the doctor to help me get mobility training, right now with glasses my VA is at 20/200 and I was unable to decypher the test about the field of vision other than to know that they said it was greatly reduced. Retinitis pigmentosa is the suspected cause, but there are a lack of classic indicators (hence the need for more testing).

It is frustrating that the doctor would not do what was needed to get some help with mobility.

My eyes are still iritated and oozing stuff. There was also white stuff (skin?) that was attached to the one driving me nuts because it felt like it was scratching my eye. My RA pulled it off with some tweezers, it was attached but came off easily she said,

Guess it is time to move up that next eye doc appt,

It turns out that rubbing my eyes after the contact with the peroxide may have led to what is now infections in both eyes. There is defenitaly bacterial infections and they suspect viral as well. I have anti-biotics for the bacterial and there is little the can do if it is also viral. If things don't improve in a day or two, I need to go see the eye doctor again. Even with my glasses I couldn't read the eye chart at all this morning, but that could be a result of how stressed out I am with the infections and irriatation.

I hope this week gets better, really.

Wasn't really feeling well this morning so didn't get to go swimming, between the GI issues and my ear ache. So after the bath, decided to put some hydrogen peroxide in my ear to help with the ear ache from swimming. Well, the cat decided about that time to attack me from behind and I managed to get the hydrogen peroxide in my eyes. I paniced and rinsed as best I could before trying to get help. In the process of trying to find someone to help, locked myself and ID out of the apartment, so had to go get someone to let me back in. Then went to student health services and then flushed out my eyes better and sent me to the hospital. Well, the street car I was on got blocked by a badly parked car and was delayed over 15 minutes on the way to the hospital. Then I went to the clinic rather than ER to keep costs down. They simply photo copied a page out of the home care book, said keep ice on it for a while, take tylenol and if it isn't better in 2 days come back. The nurse never even looked in my eyes.

To say the least it has been a long day. My eyes are burning something fierce. Everything is even more fuzzy than usual. And I am trying to not just cry.

Found this while doing searches. Thought it was a joke then realized the site was really advocating for fixing vision without glasses.

See full article on throw away glasses (note it is dated 1923).

It is quite amusing until you realize they aren't kidding.

May post other stuff find in other posts, this one just stuck out.