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My mother was diagnosed with dry age related macular degeneration on her sixty second birthday in the spring of 2002. She was completely blind by 2010. She lived her last four years in a memory care facility in Cedar Rapids, unable to see my face across the room, unable to read the birthday cards I sent her, unable to tell which of her grandchildren was sitting in the chair beside the bed without asking them to speak first. She passed in 2014. Yesterday I turned sixty two. This morning I sat in the same kind of retinal specialist's exam room my mother sat in, and a specialist I had never met pulled up my OCT scan, pointed at the small yellow drusen deposits with the end of a pen, and said Jennifer, you have early dry AMD. I am looking at the exact same timeline my mother walked. I am not walking it. My name is Jennifer. I am a retired elementary school librarian. I ran the library at Harrison Elementary in the Cedar Rapids public school district from 1986 until 2019. I raised two daughters with my husband Tom on a quiet street in a quiet town and I drove my mother to her retinal specialist appointments for the last nine years of her vision because she needed someone who knew how to ask doctors the right questions without making the doctors defensive. I was that someone. I held her hand in the exam room. I filled out her insurance forms. I picked up her prescriptions at the Walgreens on Mount Vernon Road. I drove her home through the snow in January and through the thunderstorms in July. I watched my mother transition from a woman who read the Cedar Rapids Gazette cover to cover every morning to a woman who could not read the cover of the Cedar Rapids Gazette to a woman who could not see the cover of the Cedar Rapids Gazette to a woman who could not remember what the Cedar Rapids Gazette looked like. I watched her transition from driving herself to the grocery store to riding with me to the grocery store to sitting at the kitchen table unable to tell whether the mug in front of her was her coffee mug or her tea mug. I watched her transition from threading a needle to asking me to thread the needle to crying quietly on the couch because she could not remember what threading a needle felt like. I watched the entire nine year timeline. Start to finish. 2002 through 2010 through 2014. I was in every single one of her exam rooms for the last six of those years. I was the one who asked the specialist the hard questions she was too polite to ask. I was the one who ordered the audiobooks. I was the one who labeled the kitchen drawers with raised bump stickers. I was the one who wrote the letters she dictated to me to send to her own sisters in Des Moines. Yesterday was my sixty second birthday. My two daughters flew in for the weekend. We had cake at my house on Saturday night. Sunday morning I went to my regular eye doctor for an annual exam because my vision had been a little soft for about six months and I had been telling myself it was the small print on the volunteer shift catalog cards I still sign up for at the library even though I do not work there anymore. The eye doctor ran me through the usual tests, then she paused, then she said Jennifer, I want to send you to a retinal specialist this week. I want to rule out something. I sat in my car in the parking lot for about four minutes before I could turn the key in the ignition because I already knew what the word rule out meant. The retinal specialist saw me Monday morning. His name is Dr. Halvorsen. His exam room is almost identical to the exam room my mother used to sit in. Same blue vinyl chair. Same wall mounted OCT monitor. Same framed cross section illustration of a retina on the pale green wall. Dr. Halvorsen did the dilation, the slit lamp, the OCT scan. He pulled the scan up on the monitor. He pointed his pen at the small yellow dots on the image. He said Jennifer, you have early dry age related macular degeneration in both eyes. The drusen are early, we will monitor this, I want you on an AREDS 2 formula, come back in four months. He handed me a pamphlet for PreserVision. I sat in that exam room holding a pamphlet for a supplement that I have seen the inside of my mother's medicine cabinet for nine years. I sat in that exam room and I realized Dr. Halvorsen had just said the same words my mother's specialist said to her in the spring of 2002. The exact same words. Monitor. Four months. AREDS 2. PreserVision. The same pamphlet. The same shoulder pat. The same non answer about what happens next. The only thing that had changed in twenty four years of medical protocol was the year on the calendar and the name on the chart. Here is what I have not said out loud to Tom or to my daughters. I am not afraid of going blind. I am afraid of going blind the way my mother went blind. I am afraid of slowly turning into the woman I spent nine years driving to appointments and nine years labeling kitchen drawers for and nine years writing letters on behalf of. I am afraid of my daughters one day taking turns driving me to Dr. Halvorsen's office the way I took turns driving my mother to her specialist. I am afraid of my grandchildren learning to speak louder and slower to me the way my nieces and nephews learned to speak louder and slower to my mother. I am afraid of the specific domestic death that I watched unfold across a nine year timeline while I made casseroles and refilled coffee and held my mother's hand through eighty two monthly appointments. I am not afraid of the disease. I am afraid of the timeline, because I have already lived inside the timeline, and I know what every single month of it looks like. I got home from Dr. Halvorsen's office on Monday afternoon and I sat at my kitchen table with the PreserVision pamphlet and a glass of water and I did the thing my mother never did. I opened a fresh legal pad, and I wrote across the top of the page MOM'S TIMELINE in blue ballpoint pen, and I started listing every single date I could remember from the nine years. Diagnosis 2002. First magnifier 2003. Stopped driving at night 2004. Stopped driving entirely 2005. First white cane 2007. Moved in with me and Tom 2008. Fully blind 2010. Memory care 2011. Passed 2014. I sat there and I looked at that list and I thought, I am not writing this list for my own daughters. Then my sister Beth called from Des Moines and asked how the appointment went, and I told her, and she said Jennifer, go to the kitchen, the envelope I mailed you two weeks ago is probably still in the pile, open it. I had forgotten about the envelope. I walked to the kitchen. I opened the envelope. Inside was a stack of printed abstracts from Japanese and European ophthalmology journals, a highlighter-marked printout of a paper from a research group in Kyoto, and a sticky note from Beth that said "the macula is built every morning from what you put in the cup — read the highlighted parts first." The papers explained a mechanism nobody had ever explained to me or to my mother in any of the eighty two appointments I drove her to across nine years. The macula is the small central area of the retina where all sharp focused vision happens. The macula is protected by a layer of two specific yellow orange carotenoids. Lutein. And Zeaxanthin. They sit in a dense little layer right on top of the macula like a sunshade your body weaves from what you put in the cup every morning. Their whole job is to absorb the blue light and the oxidative stress that bombard the retina every waking second of every day of your life. Here is the part of the paper that made me stand up from my kitchen table and walk to the window. The body does not manufacture these carotenoids. It harvests them. From the plants you eat and the leaves you steep. After the age of fifty the daily intake from a standard diet falls below the rate the retina burns through them. The layer thins. By sixty, for most people, it is already significantly thinner than it was at forty. By sixty two, for some women with a family history on the maternal side, the layer can be dramatically thinner. Thinner pigment layer means unfiltered damage to the soft tissue of the macula every single day. The drusen deposits form. The scan shows yellow dots. A retinal specialist points at them with a pen and says the same words he said to your mother in 2002. And the pamphlet he hands you is for a supplement that contains a gram of vitamins and about the amount of lutein you would get from half a cup of spinach. I pulled up the research on my laptop at the kitchen table. The Macular Pigment Optical Density studies. The Kyoto catechin papers. The shade grown green tea carotenoid profiles. I read through abstract after abstract for about two hours. And every single one of them said a version of the same two sentences. The pigment layer can be rebuilt. And the catechins in a real whole leaf ceremonial tea, taken every morning, reduce the oxidative burn rate on the macula by a factor the AREDS 2 formula does not address at all. Not managed. Not slowed. Rebuilt and defended. You put the two carotenoids back through the plants you eat and the leaf you drink, and you put the catechin defense on top, and the macula pulls them in, and the protective sunshade thickens again, and the unfiltered damage stops landing on the soft tissue beneath it. My eyes are not going to go blind on my mother's timeline. My eyes are not broken. My eyes are undefended in the exact same way her eyes were undefended, because she never knew there was anything to defend them with, and I never knew there was anything to defend them with, and her specialist never told her, and my specialist has not told me. I spent nine years driving my mother to a specialist who handed her the same pamphlet every four months. I spent nine years filling out insurance forms for the same supplement that I now know was missing the whole second half of the defense. I spent nine years holding my mother's hand through a disease trajectory that might have been different if a single doctor in a single exam room had said the words "shade grown" and "ceremonial grade" and "one cup every morning" out loud in front of the two of us. I cannot get those nine years back for her. I cannot make her outcome different. I can sit at my kitchen table the morning after my own diagnosis and refuse to walk the same hallway she walked. My sister Beth had already ordered something for me because she knew Monday's appointment was coming and she knew what the word rule out meant too. The package was a small tin of ceremonial grade matcha from a company called PiPi Tea. I read the description online the night the appointment happened. Whole leaf. Stone milled. Shade grown in Kyoto. Cold processed to preserve the catechins. Roughly one hundred and thirty times the catechin concentration of a steeped bagged tea. The two carotenoids the pigment layer is built from, delivered intact in the whole ground leaf. Plus the EGCG catechin the research identified as the oxidative defense. Ninety day money back guarantee. One small scoop every morning, whisked into hot water, before my coffee. I started the first tin the next morning. Week two. I was standing at my front window watching Tom shovel the driveway and I realized I could see the edges of the neighbor's mailbox numbers clearly across the street. I had not been able to read mailbox numbers at that distance in at least eight months. Week four. I sat at my kitchen table with a hardcover copy of Marilynne Robinson's Gilead that I had started in August and set aside in September because the print was getting harder to follow. I picked it up. I read three chapters straight through without the magnifier. I put the book down and I cried into a dish towel for about five minutes because Gilead is my favorite novel and I had been quietly preparing myself to stop finishing novels the way my mother had quietly prepared herself to stop in 2005. Week six. I drove myself back to the retinal specialist for an early voluntary follow up. I did not tell Dr. Halvorsen what I was drinking. I just said I wanted a check in. He did the OCT scan. He read the image. He read it again. He asked the technician to run it one more time. He looked at me and said Jennifer, the drusen appear smaller than they did on Monday of last month. He said that is unusual in such a short window. He said keep doing whatever you are doing and come back in four months. Week eight. I sat down at my kitchen table with the legal pad I had labeled MOM'S TIMELINE and I turned to the next page and I wrote across the top of it MY TIMELINE. Below that I wrote Week 1 Started PiPi Tea Matcha, Week 6 Drusen Smaller, and a long empty column of blank lines going down the page. I am going to fill those lines. I am going to fill them with dates that do not match my mother's dates. There are two timelines available to me right now. In the first timeline I take PreserVision the way my mother took PreserVision, I come back every four months, the drusen get bigger, the specialist patiently repeats the same words he has said to a thousand other women like my mother, and I slowly turn into the woman I drove to appointments for nine years, and my daughters learn to drive me the way I learned to drive her. In the second timeline I whisk one small scoop of matcha into hot water every morning before my coffee, I fill in the blank column of MY TIMELINE with dates that belong to me and not to her, I read Gilead to the end, I drive myself to every single appointment, and the nine year hallway I watched my mother walk through becomes a hallway I do not have to enter. I cannot give my mother back a single day of the nine years. I cannot rewrite the memory of sitting at her bedside in the memory care facility holding her hand while she asked me who was sitting in the room. I grieve for her specifically, because every single night since the Monday appointment I have thought about what might have been different if somebody had said the words shade grown ceremonial matcha out loud in her exam room in 2002. But I can tell my daughters right now, before their clock even starts, what those words mean and why they matter. I can tell my sister Beth. I can tell my two nieces in Des Moines who are already in their late fifties. I can tell you. I can tell you right now, while your mother or your father or your aunt or you yourself still have time to put the pigment layer back before the timeline starts. Here is what I want you to understand. Every single morning between today and your next appointment is a morning your pigment layer is either rebuilding or thinning further. There is no pause. The timeline runs whether or not you are looking at it. The appointments you have scheduled with your specialist are going to come, and they are going to be either conversations about monitoring or conversations about progression, and the difference between the two is whether you put the two carotenoids and the catechin defense back before the scan changes. My mother never got to choose. I get to choose. You get to choose. I do not care what they wrote on your chart or your mother's chart or your grandmother's chart. You can do something. You can give your macula back the two carotenoids it is built from and the catechin defense that keeps them from burning out, in ten seconds a morning with a small whisk and a cup of hot water. You can do it with a ninety day money back guarantee in your pocket, which means if nothing moves on your scan and nothing changes in your reading, you get every penny back. The link Beth sent me is here: https://shop.pipitea.com/mca/gr/sp Go read the description. Look for the words *ceremonial grade* and *whole leaf* and *shade grown*. Those are the words that were missing from every exam room I sat in with my mother for nine years. I am not walking her hallway. Do not walk it either.