Sixth Nerve Palsy and Hypertension

This is the best definition I found in the internet as it is simpler and not so technical:

A sixth nerve abducens palsy makes the eye turn medially, giving the eye a “crossed appearance.” This esotropia is worse when attempting to look toward the side of the lesion.

Abducens palsy can be caused by vasculitic processes like hypertension and diabetes. It can also occur in the setting of high intracranial pressure. A subtle abducens palsy can often be seen in cases of pseudotumor cerebri.

Last second Saturday of January this year, my husband, while in the car suddenly exclaimed, "That girl crossing the street is double." I was shocked to hear this and asked him if he was dizzy or feeling anything bad. He replied he was okay and was not feeling anything bad.

At home, he told me that early morning at around 4 am that day he was astonished that he was having double visions when he turned on the TV in our room. He never mentioned anything but only that noon when he fetch me from work. He refused to be brought to the hospital until the following Monday as my daughter was in panic already when I got home because the cross-eye look was already gotten very obvious.

My husband consented when I suggested that we go visit his cousin doctor who lives in the neighborhood. When his cousin doctor saw his eyes, I saw the look of panic and concern in his eyes and immediately told us to go the emergency room of a particular hospital so off we went.

The initial finding was mild stroke. His left and right eyes have 20/20 vision. The doctor had it dilated to see the back of the eyes and they were all good. No problem with the eyes was seen only that the left eye is not moving together with the right eye. It stops at some point to the left. A CAT-scan was suggested and the first set of medicine was given for the distribution of oxygen to normalize.

Apparently, high cholesterol was found to be the culprit for the hypertension. His blood pressure rose to 180/110 that time. Laboratory tests were done and aside from the high cholesterol, high sugar reading was also seen. His tests are ongoing.

My husband is currently on medication. His LDL (bad cholesterol) was what was found to be high. We were told that the condition will be back to normal within 6 months to a year. It will self-heal but husband has to watch his diet and take the medicines religiously. The blood pressure has to be monitored, too.

Cholesterol is a type of fats produced by the body and can be acquired from eating meat, dairy products, poultry and fish. The body system needs cholesterol to function normally but too much of it that build up in the arteries can be the cause of heart attack.

Cholesterol is mixed with the protein that flow in the blood stream, a combination called lipoprotein. The two lipoproteins that are main carriers of cholesterol are the low-density lipoprotein (LDL) and the high-density lipoprotein (HDL).

LDL is also called bad cholesterol. This is what brings the cholesterol from the liver to the other parts of the body. Most of the times LDL is build up along the walls of the arteries. If the LDL level is high, this can cause coronary artery disease (CAD), heart attack, or stroke.

HDL, on the other hand, is called good cholesterol. They help clean LDL cholesterol in our blood stream and bring them back to the liver to be disposed. The increase in HDL can help to lessen the risk of heart diseases.

There are also what are called triglycerides. These are another type of fats see in our blood stream. High levels of triglycerides can be harmful also to our hearts.

There is never such a thing as the right time to have the cholesterol level checked but men from 45 years old and women from 55 years old should have their cholesterol levels checked.

1. Food intake must have less fat, or with less or no saturated fat.
2. Look for low-fat diet workshop, or consult a dietrician to lower fat intake up to 30% or lower.
3. Eat two (2) to three (3) servings of baked or broiled fish once a week.
4. Eat more soluble fibers that can be derived from fruits, dry beans, peas and oats.
5. Exercise everyday, this increases HDL level.
6. Stop smoking. Smoking is bad for the heart even if your cholesterol level is low.
7. Work to loose weight. Weight loss from 2.5 to 4.5 kg can lower your LDL while increasing HDL.

During the first times with the condition, my husband had bouts with headaches because he was not used to having double vision. Having to have limited movements because of it also can cause depression or frustration, and this is what we were trying to avoid from the very first time it happened. It is a good thing that the kids are cooperative, too.

My husband found a way to solve the problem. He put a black paper on the second lens of his sunglasses and stopped covering his left eye with gauze and plaster. It was more comfortable for him to wear a pair of sunglasses with the left lens covered than have it plastered. The headaches were gone probably because of this solution, or he may have gotten used to it now.

During the first week, he tried not to move around and get tired. Today, he had been slowly helping around the house despite being physically challenged (I forgot to mention that his left body was not moving normally and was affected by stroke when he was 23). This is the latest mild stroke he had apart from the first two major strokes.

It is important to let the patient feel loved and that he is being taken care of. It is a blessing that the instance did not require a surgery but it is important to be there always for the support that the patient needs. It is not easy to feel 'useless' because of this condition so the loved ones have to be there. Friends can also help so let the patient socialize and do the same things they do if they can and is not detrimental to the condition