A Sit Down – with Dr. Susan Daniel
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. Susan Daniel
For the benefit of our readers, can you explain how you are involved in Developmental Optometry?
I had my first eye exam when I was 17 years old. My basketball coach noticed that I always trapped the ball when trying to catch it and I would hit my opponent on the head, rather than block their shot. He thought maybe my vision might be to blame. My optometrist diagnosed me with intermittent esotropia, diplopia, and high astigmatism. I was able to wear toric contacts, which helped me see better clearer with each eye, but I still saw double and had to close one eye to look at the board.
When I started looking into what I wanted to do as an occupation, I researched optometry and set up two internships during the summer- one at a low vision clinic in Sacramento and one at my hometown optometrist’s office. Although I liked the one on one attention of working with low vision patients, I was unaware that behavioral optometry even existed until my first year in optometry school at SCCO. Luckily, as a first year student, I was treated in the vision therapy department for my double vision, which made school much easier! In my clinic rotations, I favored developmental optometry, since I loved seeing the significant impact on a person’s life with the use of lenses, prisms and therapy.
In 1992, my husband, Dr. Christopher Davis, and I started our practice in Carlsbad, CA. We had one exam room and a very small vision therapy room. Although I mainly practiced general optometry with some in-office and home vision therapy for visual efficiency cases, it wasn’t until 1999 that I changed my practice to devote my time to treating patients with neuro-developmental disorders. Due to the growth of our practice in treating this population, we expanded to two larger offices and brought in two amazing developmental optometrists, Dr. Camilla Dukes and Dr. Karen Love, 5 vision therapists, and a student optometry extern to our practice. I am a member of the AOA, COVD, and OEP organizations and on the executive board of NORA.
In the year 2000, the movie Erin Brockovich told the true story of how contaminants were released into the water of a small town in Southern California between 1952 and 1966. You have an interesting connection to this story. Can you explain?
Unfortunately, my family lived on the PG&E (Pacific Gas & Electric) compressor station camp in Kettleman, CA when I was in 1st -3rd grade. We were highly exposed to hexavalent chromium, which was in our water. The contaminant was initially used by PG&E as an anti-corrosive in the pipes, but was found to be carcinogenic. Instead of cleaning up the toxin, PG&E falsified the water reports and did not alert people in the area that they were drinking toxic water. When we lived on the camp in the 1970’s, the contaminant was dispersed in the air that my brother and I played in and in pools that we swam in. My brother survived late stage Hodgkin’s Lymphoma as a young adult and I acquired my strabismus, sustained significant hearing loss, and developed an autoimmune disease. Because of Erin Brockovich’s investigation into the cover up of the toxin by PG&E, the lawsuit that took 20 years to resolve was the largest environmental tort case ever settled in the United States.
As an adult, have your challenges continued?
Although my vision is now awesome due to VT and LASIK, I continue to struggle with my hearing loss, as I am not able to wear my hearing aides successfully due to a plastic allergy. I am able to lip read, but I have difficulty interpreting people who have an accent, when I am in groups of people who are speaking at the same time or when I am lecturing and cannot see the person who is asking a question. I am unable to hear anything behind me, so I startle easily when people come into my view and I tend to talk very loud.
Do you feel these challenges have made you a better doctor?
Interestingly enough, I had a professor in college who wrote on my letter of recommendation for optometry school that I would not be a good doctor because of my hearing loss. I hope that I have proved him wrong! I definitely feel my hearing challenge has had some benefit to me as a developmental optometrist. Since my main understanding of language is with non-verbal communication, I enjoy working primarily with patients who are unable to communicate verbally, such as those with cognitive impairments, autism, TBI, stroke and other neurological and developmental conditions. I have been able to modify my examination procedures to better communicate with my patients by using the techniques that have helped me compensate for my hearing loss.
Because I startle and feel anxious when I don’t know what is expected of me because I am missing what people are asking of me, I am sensitive to the hypersensitivity and the anxiety that my sensory sensitive patients feel and I explain and demonstrate every procedure and test before performing it.
Switching gears a bit, your son Matthew has Autism and although many children with Autism are born with neurological deficits, this may have not been the case for Matthew. Can you explain?
Matthew was born full term without complications in 1997 and he developed normally in his first few months of life. After his DPT shot at 4 months of age, he immediately developed nystagmus and lost his ability to push up and roll over. Later, we found we had video documentation that showed his motor skills were normal the day before his shot and was lost the day after. He received physical therapy and regained his motor abilities and began speaking his first words, but when he received his MMR and other vaccinations at 12 months old, within a few hours he had a series of non-febrile grand mal seizures that left him with significant frontal, parietal and temporal lobe brain damage. He lost all motor and speaking ability. The amount of mercury that he received in his immunizations that day exceeded the safe dose for an adult by 200 times. His measured mercury levels were 16 times what is known to cause brain damage.
Dr. Andrew Wakefield, whose study connecting vaccinations and Autism was retracted by the Lancet journal, maintains his findings have been “grossly distorted” and that there truly is a relevant connection. Since your family has been living with this possible connection for some time, where are your feelings on this issue?
Dr. Wakefield’s study found a unique type of enterocolitis in patients with autism. The paper did not link vaccines to autism as the media suggests. However, there have been multiple subsequent papers that have shown gastrointestinal disease after the MMR vaccination in children with autism. Even the vaccine injury compensation fund has paid out claims that show a link of vaccines and autism. My opinion is that there are many causes to the behavioral characteristics of autism, including genetic predispositions and environmental triggers, including vaccines. I personally know of hundreds of children that have had the same reaction that my son had to their vaccinations that led to serious gastrointestinal and immune dysfunction and autism. There are studies that seem to prove a vaccine-autism link and studies that prove no link, so it is up to each individual to decide on there own. But since 1 in 68 children are now diagnosed with autism, it is an important subject to investigate.
You have taken admirable steps in improving Matthew’s quality of life, and many of those treatment options now have a place in your practice. Can you tell us about these things?
When Matthew regressed into autism, he was extremely ill and was on medications for his recurrent seizures, severe gastrointestinal issues, immune dysfunction, bacterial, fungal, parasitic and viral diseases. He had failure to thrive and was not responding to his family or his multiple therapists. He was not able to sit up, babble or interact with his environment. My husband and I were in the dark as to alternative ways to help him.
Everything changed when Matthew was two years old. I had a young patient with autism who was on a special diet and supplements and was recovering from many of her symptoms of autism. Her parents directed me to websites and parent support groups that led me to the treatments that would ultimately help my son heal. We put him on gluten and casein free, GMO free, sugar free and low oxylate organic diet and various supplements. Within a few weeks of starting the diet, his rashes and yeast infections disappeared and he was beginning to notice that we were in the room.
Over the years he has received numerous treatments that have all been helpful (some more than others) including occupational therapy, physical therapy, speech therapy, cranial sacral, chiropractic, ABA therapy, Pivotal Response Therapy, music therapy, oral motor and feeding therapy, hippotherapy, Relationship Development Therapy, Rapid Prompting Method, Floortime DIR, neuro-feedback, PECS, Dynavox and iPad Proloquo2go Assistive Communication Technology, Auditory Integration therapy, the Sensory Learning Program, Interactive Metronome, Reflex Integration Therapy, Syntonic Phototherapy, Essential Oils, InfraRed Sauna, Chelation therapy, Hyperbaric Oxygen, Herbal treatments, Homeopathy and Intra-venous immunoglobulin treatments.
I always say it takes a village to help raise a child with a disability! I am forever grateful to the awesome therapists, teachers, doctors, mentors, parents and friends who have helped our family. I love my autism family- wonderful parents and kids who share our journey. We are bonded by our experiences, frustrations, and joys of progress- no matter how small.
One intervention in particular had a significant impact on Matthew’s life. In 2004 I took him to Colorado to participate in the Sensory Learning Program- a 12 day in office and 30 day total program that incorporated auditory, vestibular, and visual input, including Syntonic Phototherapy. At that time, my son was 7 years old, completely non-verbal, just learning to walk, unable to recognize his sisters and challenged with constant perseverations. On the 12th day of the Sensory Learning Program, my son pointed (which he had never done before) to a picture of a circle on a placemat and said, “circle.” It was the beginning of language for him! We now offer the sensory program as part of our vision therapy at our office.
In addition, my experiences with implementing various behavioral therapies with Matthew have taught me behavioral and communication strategies and modifications that maximize the vision therapy success of our patients with sensory and behavioral challenges.
I have a special place in my heart for the Neuro-Optometric Rehabilitation Association, as the multi-disciplinary organization has taught me so much on how to look at the entire body, posture, behavior, etc. and using optometric tools and therapy to make a positive changes in the patient.
Matthew is now 16 and attends a special day class in high school. He is still minimally verbal but is able to communicate to us on his iPad. He loves girls (like most boys his age), hugs and kisses, and enjoys puzzles, music, swimming, riding his bike and hanging out with his family. Matthew’s life has impacted his older sister Rachel’s decision to become an occupational therapist.
TACA (Talk About Curing Autism) is an organization near and dear to your heart, in fact, your practice is currently working to help TACA raise money. Can you tell us about your connection to TACA, and if people want to help in your fundraising efforts, how might they do so?
Our local chapter of TACA has given my family amazing emotional support and education on treatments. 100% of the money raised goes directly to the families in need. TACA has a mentoring program that links new autism families with a family that has navigated through the aspects of raising a child with autism. There is so much to learn- what to know about IEP’s, what’s covered by insurance, how to access and pay for various treatments, how to find autism friendly teachers, tutors, doctors, therapists, dentists, hair cutters, respite care, recreational and meaningful work programs, etc. TACA provides support and care during natural disasters and catastrophic events, such as the recent San Diego fires that displaced many autism families such as my own. They also provide scholarships to those who cannot access life changing treatments and educational conferences due to lack of funds.
For as much as you may have learned in optometry school, life itself seems to have taught you so much more about not only treating a patient, but treating a person. If given the opportunity, what advice would offer new graduates on how to find a balance between these two concepts?
Most of what I’ve learned about optometry came after optometry school! It’s important to keep an open mind as to new treatments and ideas that may not have been taught in school. What I love about developmental optometry is that we are not just looking at and treating eyeballs, we are taking into consideration the patients’ environment, nutrition, activities of daily living, social skills, family support, educational goals, etc. when making recommendations and developing a treatment plan. Because I get to spend so much time with each patient, many have become my friends and mentors as well. I am fortunate that I get to block my schedule so that each patient does not feel rushed. I want each child to feel that I care and that I’m not going to do anything that is scary.
Lastly, both you and your husband Dr. Chris Davis, are two of the most positive, loving, and warm people I’ve ever met, and it is always a treat to see you. Given the many hurdles you’ve faced in your life, what is your secret to maintaining such a positive and loving attitude?
Thank you Robert- I enjoyed working with you when we were both early in our careers. You have a gift of writing and I really look forward to reading your blogs.
Everyone has their own unique challenges and their own interesting story. We have a choice to dwell on the negative or celebrate the positive in each situation. Making the choice to be positive is not always easy and I lean on my faith, family and friends to keep me going! In a way, I’m lucky that my patients are as encouraging to me as I hope to be for them. I am truly blessed to have four terrific children- Rachel, Liz, Matthew and Elaina, a loving and patient husband, and an awesome profession.
Thank you for the opportunity to share my story.
Some Closing Thoughts – A great thanks to my friend Dr. Daniel for taking the time out for this interview. I first met Dr. Daniel in Reno, NV at COVD’s Annual Meeting in 2000 and as she mentioned, I worked in her practice for close to a year after moving to San Diego. Her love for her family and compassion for her patients has always been such an inspiration, and it is truly an honor to call her my friend. Please join me in wishing Dr. Daniel, her husband Dr. Chris Davis, and her entire family, the absolute best! 🙂