A Sit Down – with Dr. Jim Mayer

This post appears as part of a series called Sit Down – candid conversations with real people detailing their journeys and experiences with Vision Therapy.

A Sit Down – with Dr. Jim Mayer

Mayer profile

For the benefit of our readers, can you explain how you are involved in Developmental Optometry?

First off, I would like to thank you for this interview.  It is very kind of you and made me feel good!  I am involved with Developmental Optometry from the clinical side – both as a patient and optometrist.  I started the Agape Learning & Optometry Center in Thousand Oaks, California 30 years ago!  From the start we have provided Developmental Optometry and Primary Care services.  I went to school at the University of Wisconsin and Pacific University in Oregon.

What led you to Developmental Optometry?

As a youngster in rural Wisconsin I remember having very poor spatial awareness.  There was a game in which we would stand above a paper cup and drop pennies into it.  My penny often would ricochet off the lip of the cup!  I never understood why – I just thought I wasn’t good enough.

I began to wear glasses for farsightedness when I was approximately 5 years old.  My “penny scores” did not improve with the glasses!  Glasses did not seem to help every visual problem.  Our ophthalmologist patched my “good eye” continuously for 6 months.  When the good eye was uncovered, it had become “bad”.  Therefore the old bad eye was patched continuously for the next 6 months.  Yes, you guessed it!  The original bad eye had become “good” but after the patching it was now “bad” again!  Therefore this feeble attempt at vision therapy was deemed unsuccessful and I was left with a “bad eye” and no stereopsis.

As I grew older I became very involved with basketball.  It helped being tall for my age.  My glasses always seemed to be a target for opposing player’s hands and elbows!  I am not sure why my folks never suggested contact lenses.  Later in life I now understand how contact lenses can help developmental optometry cases.

I attended a basketball camp in which Jon McGlocken of the Milwaukee Bucks made 20 consecutive free throws with his eyes closed!  It impressed me when he discussed how important it is to know where you are on the court when on offense or defense – concepts of visual imagery were being developed.  I also read “A Sense of Where You Are” by the great Bill Bradley.  I learned that superior basketball skills can be learned with practice – much like deficit visual processing.

Our small town ophthalmologist moved away when I was 14 and our family began to see Dr. Ken Patterson.  He was a wonderful man and very patient.  He lighted a fire within me for conventional optometry.  At the time I had been interested in becoming an engineer.  After speaking with an engineer I learned that profession would be soon “extinct” because of the emerging field of computers!  Optometry became my passion.

All of these situations resulted in me being led to Developmental optometry.

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Why did you choose to attend Pacific University?

In a name, Paul Ranslow (at the time an assistant admissions director).  My family visited the school and he personally picked us up at the airport!  He showed us the campus, put us up at a hotel and took us back to the airport.  He was a wonderful recruiter – even though we were not from the western region.  I was the first from my family to attend college.  We visited several other schools but our hearts were with ol’ P.U.!!

Your practice, Agape Learning and Optometry Center, won an award from the Ventura County Star in 2013.  Can you tell us about it?

Aw shucks!  It was one of those reader’s polls.  Much like I say it is a good thing that our kids look like my wife, this award is probably because of a wonderful staff of caring individuals caring for great patients.  The two go hand in hand.  All I can say is a big “THANK YOU!!”

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In layman’s terms, how would you explain the difference between a Primary Care Optometrist and Developmental Optometrist?

Yikes, tough question!  Today I believe that most Developmental Optometrists are also Primary Care – and as we know, not all Primary Care doctors are Developmental.  As Developmental Optometry is progressing I am seeing more and more offices limiting their scope to this area.  However, it is still relatively rare.

To me a Primary Care specialist looks for ocular disease first and after it is ruled out will primarily investigate refractive problems.  Reading difficulties are seldom looked at very deeply.  Developmental specialists are oriented in first thinking how visual performance can be improved.  Nearpoint visual concerns are of paramount importance.  We look how lenses or prisms can be used.  Also, is vision therapy needed?  Ocular disease is investigated but not possibly as the main reason for the visit.

I have always tried to combine the two as taught to me by my mentor, Dr. William Ludlam.  He was an amazing optometrist – I miss him!!

The efficacy of Vision Therapy is often questioned by parents and other professionals.  Some have even stated that Vision Therapy is “quackery”.  As a doctor, how do you manage this idea?

Personally I try to minimize it but I will acknowledge it.  In seeking help for a visual condition, a patient must have faith in what can be provided.  We have so many tools today with the Internet and wonderful books on what Developmental Optometry can provide.  I am old enough to realize I can’t help everyone.  I will provide resources when the subject comes up but I would rather spend more time discussing what CAN be done.

Strabismus surgery tends to be a polarized topic within Developmental Optometry, at times referred to a a travesty conducted by our counterparts in Ophthalmology.  Others view surgery as a valuable resource if timed properly.  Do you feel there are times this type of surgery warranted?  As a doctor, where do you draw the line?

I am a firm believer in what Developmental Optometry can provide.  As a patient, I am very happy that my parents did not proceed with strabismus surgery when “patching” therapy was not enough.  Heck, getting my tonsils out was enough for me!  Who really wants strabismus surgery for their child?  No one!!  We must be better communicators of what we can provide.

We have all heard stories of patients having multiple strabismus surgeries – three, four, five or even more – and in some cases the patients are worse off after surgery than when they started.  Do you think there will ever be a day when “fixing surgery with more surgery” will be the exception, rather than the rule?

Possibly, if the decision makers (moms) learn more about what we have to offer.  That is why the great communicators in developmental optometry are so important.  It reminds me when my wife had a vomiting problem.  A drug was initially given.  It did not work.  Another drug and continued vomiting. Of course, another drug with the same result.  Finally the physician acknowledged a side effect reaction from a different drug he had her on and the vomiting stopped!  Doing the same thing over and over and expecting a different result will not get the job done.  Things will change as others understand how powerful vision therapy is.

Why do you think Ophthalmology is generally so opposed to Vision Therapy?

My perspective on this has changed since my wife suffered multiple health issues over the last couple of years.  Generally physicians are trained to treat medical conditions with surgery and medication.  Alternative strategies are generally not as accepted as we might think.  I am seeing this at the hospital in which my wife now resides.  Medication resulted in daily vomiting as a side effect for approximately ten months.  Rather than remove the medicine because that side effect “has not been seen before”, my wife was given various antiemesis medicines.  These did not work but the hospitalist continued to try the same thing over and over!

Generally accepted therapies such as occupational, physical and speech are used in the the setting my wife is in but not to their full extent.  This has surprised me.  Alternative strategies such as hyperbaric oxygen and acupuncture are rarely acknowledged.  In fact, the hospitalist for my wife actively tried to dissuade me from trying hyperbaric oxygen.

Therefore I guess we should not be too surprised that ophthalmology does not praise vision therapy with loud applause.  They do not learn about it in their schooling.  It does not fit their models.  They tend to not examine successful vision therapy patients, only the unsuccessful ones!

Things are slowly changing, primarily because of wonderful authors and communicators such as Drs Leonard Press, Robert Sanet, Sue Barry, Penelope Suter, Garth Christianson, John Griffin, Ken Gibson, Harry Wachs, Dominik  Maino, William Padula, Ken Lane, David Cook, Lori Mowbray, Patrick Quaid and Larry Lampert.  Also a big thanks to Robin & Jillian Benoit!

All of us must continue to learn and provide excellent vision therapy.  The tide is changing, albeit not as fast as we would like.  Patience will win out in the long run.

carol

In September of 2011, your life changed significantly and almost overnight.  Can you explain what occurred?

Yes Robert, you are correct.  My wife, Carol (age 50 and in good health), experienced a thyroid storm and the start of menopause at the same time.  No one knows exactly why.  This resulted in atrial fibrillation of her heart and, finally, a diffuse loss of blood flow to her brain (stroke).  A 24 hour coma occurred.  She was in the hospital for one week and back home.  Everything seemed fine.  She was tired but she was moving and talking as before.

Four days after getting home she suffered another diffuse stroke.  This time she was in a coma for almost one month.  It was a very scary time.  The medical care at Kaiser during this time was outstanding and we will be forever indebted.  It was first thought she would come out fine but she didn’t.  After one month she became more alert but her arms and legs were contracted.  She also could not carry on a conversation.  She was able to mimic very well at that time.  Medical personnel felt she would always need help breathing, would never be able to move or eat (she had a stomach tube).  They gave me the option to stop feeding her after 5 days.  I declined because I felt God could have taken her and He didn’t – how could I?

She was transferred to a subacute facility about 35 minutes from our home.  She is still there  – 33 months later.  Today she moves her legs up and down.  She can sit erectly in a wheelchair for periods of time.  She does not have stomach or oxygen tubes.  She can roll in bed to her right.  Her left arm is contracted at the elbow and shoulder.  Her right arm contraction has lessened but she can not grasp effectively with her hand.  Writing or keyboard input is not possible yet.  Verbally she will respond to high frequency sentences about 80% of the time.  For instance we will say, “A penny saved, is a penny ____”.  Carol will usually say, “earned”.  She will respond positively by winking or opening her mouth.  She seems to be remembering better.

This experience has been life changing but it is what it is.  Carol is still with us and slowly getting better.  I love the Irish proverb, “A good laugh and a long sleep are the two best cures for anything!!”

As your wife’s condition has improved, you’ve tried many “alternative” treatments including Acupuncture and a Hyperbaric Chamber.  Can you explain why you chose these routes, as well as the benefits of these and other treatments you’ve tried?

Western medicine did an amazing job in saving my Carol’s life.  I am so thankful.  Nevertheless Western medicine has more difficulty with chronic issues.  It made sense to me that Carol’s acquired brain injury may heal better with therapies which improve circulation.

Early on we were providing syntonic filters (thank you Mary VanHoy!) and iLs music therapy (approximately 250 hours to date). We also attempted various vision therapy procedures for visual attention.  This worked well in the hospital setting when Carol still had a trach and stomach tube.  Long wheelchair rides in the California sun of several miles have been also done – these are meant to decrease inflammation in her brain.  As Carol improved I added Play Attention neurofeedback and Interactive Metronome.  These therapies help with concentration and motor control.

Nutritionally it has been difficult because of the hospital setting but we have gradually added a number of nutritional supplements such as omega-3, alpha lipoic acid, coEnzyme Q10, L-Acetyl Carnitine and others.  Along this vein Carol is drinking alkaline water to lessen the acidity from the brain inflammation.

Hyperbaric oxygen therapy was done in a monopod last summer for 50 hours.  I began it because Carol became mute in the spring of 2013.  This was difficult because it took about 5.5 hours out of every week day.  The facility was about 50 miles from the hospital.  This therapy resulted in better brain blood flow also.  Her right arm is no longer contracted because of it!

Currently Carol is experiencing the Bio Energy Synchronization Technique.  This treatment is meant to relax and balance her brain.  It also helps her to image and visualize a positive result.  It is intense – 2 hourly visits per day, 7 days per week.  Carol has put in approximately 150 hours as of this date.  Carol’s ability to hold her head erect has improved tremendously with this technique. It is also helping her attention and concentration.

Overall Carol is improving slowly from a devastating diffuse brain injury.  She appears motivated and works hard.  It has taught me what patience means.  Her health is our priority.  It always seems impossible until it is done!!

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As you’ve shared so much of your life on Facebook since your wife’s stroke, your strength and positive attitude in the face of adversity is something far beyond inspiring and incredible.  You seem to take it all in stride and continue moving forward.  Is this something you work on or does it come naturally?

Thank you Robert!  For me a saying comes to mind: “Those who leave everything in God’s hands will eventually see God’s hand in everything.”  There is a reason all of these things are happening.  However it is too big for me to understand now.  I must have faith and understanding that my Father wants the best for me, my wife and family.  I am at peace with that as best I can be.  It is tough now but there are actually a lot of good things that have come from it – I love God, Carol and the kids even more than ever before!  I know it sounds crazy!!!

Your children seem to share your strength and inner fortitude.  How have they managed since your wife’s stroke?

The entire situation is tragic and very challenging.  Our daughter (Jalyn) was 10 and son (JJ) 12 when Carol developed her health problems.  Initially the kids and I would cry every Saturday morning for 3 hours.  It was tough.  Nevertheless God has blessed me with fantastic children.  They have always been optimistic for Carol’s recovery.  They have learned how to cook, clean the house and clothes and be positive. They are thriving under very difficult circumstances.  In the long run they will be better people for it.

Lastly, you seem like a fantastic husband, father, doctor and friend and through the course of researching this interview you have become quite an inspiration for this chair.  I’m sure many of our readers will feel the same.  Can you tell us who some of your inspirations are both within and out of Developmental Optometry?

Wow, thanks again for your kind words!  They are truly inspirational for me!  Of course my biggest inspiration is Jesus Christ.  He is my Father and I realize He wants the best for me – no matter what happens.  Everyone will go through at least one tragedy in their life.  He has been and will be my Rock for a number of difficult times in the past and future.  I praise and think of Him daily.  A prayer buddy through a number of trials has been Dr. Paul Rousseau – a man with a gentle and loving heart.  Drs Todd Wylie and Mary Van Hoy also bring a large smile to my heart.

Along these lines are a number of Facebook buddies such Tom Lecoq, Robin Benoit and Ruth Villeneuve along with Drs Susan Daniel, Bill Plewes, Gerard Gibbons, Paul Brand, A.J. DeVivo, Jason Clopton, John Abbondanza, Judy Kandel, Neena Gabrielle, Nancy Torgerson and Carole Hong.

I am always inspired by the amazing creative minds of Drs Leonard Press, Paul Harris, Dominick Maino, David Cook, Kelly Knueppel, Lori Mowbray, Lynn Hellerstein, Brenda Montecalvo, Graham Erickson, Dan Fortenbacher, Brad Habermehl, Samantha Slotnick, Randy Nelson and Diana Ludlam.

Finally I often think about my mentor, Dr. William Ludlam.  He allowed me to observe in his practice and work in vision therapy when I was young.  Dr. Ludlam gave me my start – thank you! I was afraid of him at times because he was such a giant in our field.  He lives on in my mind and many others as a great developmental optometrist.  Dr. Ludlam had so much energy and a razor sharp mind.  He set the standard for clinical excellence.  I wish he was still around to see how far developmental optometry has progressed.  I believe he sees it daily from his perch in heaven.

mayerfamily

Some Closing Thoughts – A great thanks to my new friend, Dr. Jim Mayer, for this interview.  I “met” Dr. Mayer about a year and a half ago on Facebook, and have been in complete admiration ever since. His positive attitude and dedication to his family in the face of adversity is truly an inspiration. Please join me in wishing Dr. Mayer, his wife Carol, and their beautiful children, the absolute best! 🙂

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Posted on May 16, 2014, in Sit Downs. Bookmark the permalink. 9 Comments.

  1. Thanks as always for these candid insights, Robert. I was emotionally drained after reading this, and as much admiration as I had for Jim and Carol, it rose to an even higher level. We are so privileged to have colleagues like Dr. Mayer in our profession. Phenomenal inspiration.

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  2. Thanks for the “Sit Down” Robert!

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  3. Bob and I have you and Carol and your family in our prayers, Dr. Mayer

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  4. Jim, thank you for your candor and openness in sharing your personal stories. Your own back-history in optometry is fascinating. Your strength and character with the challenges your family has faced with Carol’s health problems are a source of awe and inspiration. I am so moved by your devotion to your practice in parallel with your devotion to your wife and children.
    And, I am humbled by the personal nod. Thank you for that.

    Prayers of love and light to you and your family as you continue to bring healing and inspiration to those you touch.
    -Samantha

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