There are some folk who don't see the gem inside my rough exterior who might consider me a hot head. To which I say a hearty "bite me". But let this opinion be a caution that within this blog may lurk items of a venting nature or perhaps those which might be considered a rant. So be it. Proceed with caution. You have been warned.

Friday, January 14, 2011

Eye Surgery Processing - A Poke in the Eye Part 2

Disclaimer: These two posts aren't necessarily meant to be either a rant or humorous (and maybe none of my others are either in spite of intention). Wikipedia states: "In the United States, age-related lenticular changes have been reported in 42% of those between the ages of 52 to 64, 60% of those between the ages 65 and 74, and 91% of those between the ages of 75 and 85." If you manage to live to the age of 52 or better, the chances of your dealing with this problem are better than even. And since age-related cataract is responsible for 48% of world blindness you do definitely want to deal with it. So this topic is by way of alleviating a little stress for anyone facing this in the future.

And now, on with the narrative.

The presurgical physical not having revealed any contraindications I dutifully showed up at the out patient surgical center at the appointed time. Here's where the process could use some improvement. Very like airlines, the outpatient center had me show up two hours early. During that two hours they verified my personal and insurance information (10 minutes) and did a minimal surgical prep (20 minutes). For the other hour and a half I sat around and waited. This is akin to airline practices except there's no stop and grope at the entrance. I don't have a clue why it takes 30 minutes to get you processed and yet you have a 1 1/2 hour wait beyond that. I'm not sure about anyone else, but during this period the thought that someone would soon be shoving a sharp instrument into my eye got my adrenaline going pretty good. After 1/2 hour in the waiting room post sign-in ritual, when I was called back to sit in the little room with the curtain and have my vitals checked, the nurse remarked that my blood pressure was up a bit. You think?! Then I got into a surgical gown (allowed to retain trou but no shirt) an IV started, many eye drops administered and settled in to wait for another hour.

Whenever I'm on the receiving end of an IV I always wonder how people that do this many times a day, day after day for months, maybe years, can still be inept at it. I have great ropy veins that you can see from across the room with one eye closed, yet on this occasion the nurse might as well have been using a 3 penny nail to get the IV going. There was pushing, twisting, withdrawal and skewering before she was finally satisfied. To my credit, although there was tooth grinding and white knuckling of the gurney rails, I managed to refrain from any imprecations or violence. In the aftermath of the entire process the next day the most annoying after effect was a big irritated bruise at the IV site. Yet a week later on the visit for the other eye, I was looking the other way and didn't even notice when a different nurse got the IV on the first try. Different people have differing skills. Let the nurse that has trouble starting IVs specialize in taking histories or something else with no pain potential.

During the hour of waiting I was visited by the surgical nurse, the anesthetist, the anesthetist's assistant and the surgeon. They all looked at my chart and then asked me which eye we were supposed to be doing. Every one of them asked that - and then the surgeon took a marker and scrawled his initials above the right (not left) eye - which was also the right (correct) eye. In my presurgical anxiety state this made me think that they would not take so much time verifying this if at some time someone had in fact performed a procedure on the incorrect eye. A sobering thought. And while we're on the subject of presurgical anxiety, I've got an IV in my arm, how about a few milligrams of valium or something to keep me from pondering everything that could possibly go wrong?

But finally the surgical nurse came for me and I went shuffling down the hall in my paper booties with my IV stand. Once in the operating room the lethargy of the last 2 hours suddenly turned to practiced efficiency. Up on the table, warm blanket applied, arms strapped down (people sometimes involuntarily try to protect their eyes while under anesthesia), EKG monitors leads applied, head taped securely in place and as I feel the onset of warm fuzzies I realize the anesthetic has been administered. Soon I am aware of some activity taking place near my eyes and realize that I am going to be awake for this. Then I realize that I don't care. Next thing I know I can feel some slight pressure in the general area of my eye. Again I don't care. Whatever this anesthetic is, it's very effective in keeping me relaxed and motionless. The combination of the topical anesthetic in the eye drops and whatever is administered by IV combine to keep me perfectly comfortable and relaxed. After reading up on the procedure I realize that a lot is going on up there but subjectively it seems to be over in minutes and soon a perforated metal shield is placed over my eye, I am helped into a wheel chair and rolled out into the recovery area. Half an hour later I am being driven home by my wife who tells me I was in the OR about 30 minutes. I have a minor headache over the eye later but a couple of Ibuprofen knock that right out.

The next day I return to the center for a follow up. The surgeon looks into my eye, pronounces it doing well, I am relieved of the eye shield and given directions for anti-inflammatory and antiseptic eyedrops for the next two weeks and told to wear the eye shield at night for the next week and sent home. The following week, after a check up with my regular opthamologist the procedure is repeated on the other eye with much less anxiety now that I know how simple it is. Three weeks later I get my new glasses that tweak my astigmatism and provide close vision correction and I see better than I have in years. In fact my distance vision without glasses, although not perfect, is now better than it was with glasses prior to the procedures.

As with any surgical procedure, complications are possible but I had no complicating factors like glaucoma, my surgeon has a national reputation and has himself developed several advanced procedures and the staff and facility of the out patient surgical center were top quality. In the future there is the possibility that the rear of the lens capsule could become somewhat opaque but this is correctible by laser.

Every once in a while everything comes together and works out right. This was one of those times. Considering that most of my life is filled with annoyances of one kind or another, I felt this experience was worth retelling.

1 comment:

homercat said...

I have followed your adventures in eye horrification with much interest, as genetically we are almost identical. And I am NOT looking forward to this. On the other hand, your humour and resolve have made me less apprehensive. Still I say, DAMN those genes! I don't want nobody pokin' my eye! So glad this has worked out so well for you, and that also gives me the warm fuzzies that it won't be so bad when I have to deal with it. Keep on mendin' on, eh?