Detached Retina (Part II)

Tuesday, June 10, 2008
I was up early today (actually I really didn’t sleep much last night) and I was really worried about the surgery. Every time I thought about them operating on my eye I just got more freaked out. Once I finished my bath and was dressed I sat down and tried to relax. I wasn’t able to eat anything – 1. because I was too nervous and 2. because I was told not to eat anything after midnight. Finally at about 7:45 Thomas and I headed for Albuquerque. I had to report to the Albuquerque Ambulatory Eye Surgery Center by 9:00. We arrived a little early and I got all the paperwork filled out. From then on it was just a matter of waiting. Thomas called his cousin Ruth and she and her husband, Chris were going to come and keep him company. Eventually, a nurse came to get me. I was taken to the preparation area for all the necessities before surgery. First stop was the bathroom. They wanted to make sure my bladder was empty so I was comfortable during surgery. I was put on a stretcher and made very comfortable. I would be on this stretcher all the way to the recovery room. The nurse asked lots of questions including what eye they were operating on. She put a dot on my forehead above my left eye and put a patch over my right eye so they couldn’t get to it. She checked my date of birth and a few other minor things. She took my temperature and blood pressure, ran an EKG, started an IV and put 12 drops into my left eye (4 drops each of three different medicines). After all that it was a matter of waiting again. After what seemed like an eternity I was moved to the holding area. Here the nurses again asked questions and checked things – all to make sure they were operating on the correct eye. The anesthesiologist showed up and explained all that would happen. He made sure to let me know that I would be aware of what was going on although I wouldn’t feel anything. At this point I was thinking – please, please, please just knock me out – I didn’t want to be aware of anything. He talked to me about mundane things like what I did for a living and how long I had been doing it. I realized at some point that whatever he was giving me was working – I seemed to be mostly out of it and I wasn’t totally understanding everything he was saying. Around this time I assume they started the surgery. I really don’t remember much but I was aware that things were happening in the area of my left eye. I do remember the doctor talking about laser and gas bubbles but that is about it. Today’s surgery was done by Dr. Reidy. Here is what he did . . .

Vitrectomy
Vitrectomy is an increasingly used treatment for retinal detachment in countries with modern healthcare systems. It involves the removal of the vitreous gel and is usually combined with filling the eye with a gas bubble (SF6 or C3F8 gas). Advantages of this operation is that there is no myopic shift after the operation. A disadvantage is that a vitrectomy always leads to more rapid progression of a cataract in the operated eye. In many places vitrectomy is the most commonly performed operation for the treatment of retinal detachment.

Scleral Buckle
Scleral buckle surgery is an established treatment in which the eye surgeon sews one or more silicone bands (bands, tyres) to the outside of the eyeball. The bands push the wall of the eye inward against the retinal hole, closing the hole and allowing the retina to re-attach. The bands do not usually have to be removed.

Once the doctor was finished he asked me if I was okay. Through the haze I told him I felt okay – just a little woozy. Shortly after that I was wheeled into the recovery room. The nurse checked my vital signs, asked me a few questions and finally sat me up into a chair. I drank a little water – my mouth was really dry. I was also having some pain but not enough to take any meds. My eye was completely bandaged and I was still a little out of it. The nurse removed my IV and then Thomas and I waited for the doctor to come talk to us about discharge orders. We only had to wait 5 minutes for the doctor. Here were the orders I was given:

1. Walk carefully, depth perception will be affected.
2. Resume usual diet and meds.
3. Percocet for pain as needed.
4. Face down position.
5. No car travel above 7500 feet – due to gas bubble.
6. Stop at La Bajada Hill for 10 minutes for pressure adjustment with gas bubble.
7. No vigorous or jarring activities.
8. Do not remove eye patch until next doctor appointment.
9. Do not get operated eye wet.
10. May do light reading and a little TV watching.
11. Follow up doctor appointment Wednesday, June 11, 2008.
12. Diamox for eye pressure once per day

I have to say that the professionalism of the staff at AAESC was incredible. Everyone was so nice, attentive, knowledgeable and caring. I haven’t seen that in a long time. The entire staff made me feel comfortable that I was in good hands.

Once we got home all I wanted to do was sleep. But remember I had to do it face down. So I got a couple of towels and arranged them so I could lay face down – it wasn’t very comfortable and I didn’t get to sleep. While I was trying to rest Thomas went and filled my prescriptions. He also made a phone call to get some equipment. There is a place in Albuquerque that rents chairs and tables that help to position you correctly so that you can maximize the benefits of recovery. Albuquerque Support Systems rents this equipment for one to two weeks. So we made plans for them to deliver what I needed the next day. Until then we were able to get a massage table that I could lay on. Thomas’ cousins, Ruth & Chris brought the massage table to us. That evening and night I only slept about one hour. Lying face down and being on my stomach was so uncomfortable – my back ached and my face hurt. Also my eye was killing me – I had about 6 out of 10 pain and on top of that I felt like something was poking me in the eye and it was burning. I was also having a little nausea. Thomas called the emergency number – the person that answered assured us that all of my complaints were completely normal and not to worry. She told me to take the Percocet and then talk to the doctor in the morning. So I made the best of it – I tried staying face down as much as possible but I had to get up a couple of times and walk around. Three Percocet and one hour of sleep later it was time to go to the doctor for my follow up appointment.

Wednesday, June 11, 2008
My appointment was at Eye Associates in Santa Fe at 8:20 with Dr. Mark Chiu. I wasn’t feeling all that good. I was tired, my eye had a lot of pain (4 out of 10) and I was still nauseated. Dr. Chiu examined my eye and the first thing he said was that there was still fluid behind the retina in the lower part of my eye. He also noted my eye pressure at 31. Upon hearing that there was still fluid behind the retina I felt this overwhelming disappointment come over me. I had just gone through this major surgery (which for me was very traumatic) and it didn’t seem to have worked. The doctor told me to relax and he gave me some meds and more instructions to follow and I was to return on Friday, June 13 for a follow up. Here were my instructions ;

I was to continue my face down position as much as I could tolerate. Take my Percocet as needed. And put eye drops in my left eye three times a day (Atropine, Pred Forte, Zymar). I also had to put Istalol drops one time a day and take my Diamox one time per day for my eye pressure. I was also to wear an eye shield at night to protect my eye.

So I returned home disappointed but resolved to follow the instructions to the best of my ability. Amanda from Albuquerque Support Systems delivered all the equipment I needed to maintain the face down position. I received a Seated Support with pads, a Bed Support with pads and two reverse view mirrors. I was happy to receive this equipment because it made the face down position a little more tolerable. So once all the equipment was positioned and Amanda left I put myself in the Seated Support. It was pretty comfortable and with the reverse view mirror I was able to watch TV and that helped to pass the time. Unfortunately the Bed Support was not as comfortable. I found myself in the same predicament as the night before – uncomfortable and unable to sleep. Again I only got about an hour of sleep. My back was really bothering me – I realized that I very seldom sleep on my stomach. I continued with all my meds including the Percocet for pain – both for my eye and my back.





Thursday, June 12, 2008
Today was extremely boring!!!!! I maintained my face down position as much as possible alternating between the massage table, the seated support and the bed support. My eye continued to bother me (3 out of 10 pain) and I continued with my all my meds. The nausea had subsided quite a bit but my appetite was not very good - I ate very little today. I also got very little sleep. I was anxious for my appointment in the morning to see if there had been any changes.

Friday, June 13, 2008
I arrived for my appointment at 8:30 at Eye Associates. I was seeing Dr. Reidy today. He did the usual examination and informed me that there was still fluid behind the retina. He said he thought that by today all the fluid would be gone. He also told me that sometimes more than one surgery has to be done and he felt this might be the case for me. He wanted me to continue with all the instructions and to come in again Monday, June 16 for another check up. My eye was feeling better, the pain had subsided but apparently it wasn’t healing. I was so disappointed and decided to really follow all the instructions until Monday and hope for the best. I really wasn’t looking forward to another surgery.

Saturday, June 14, 2008
Another boring day! Just hanging around – going from my seated support to the bed support to the massage table. Having trouble getting comfortable. Although I didn’t have any eye pain today I was still uncomfortable. And since I am not able to do anything all I did was worry about having to have another surgery.

Sunday, June 15, 2008
Today was pretty much the same as yesterday. I feel pretty good, just uncomfortable being in the face down position. And again all I did was worry about the possibility of surgery.

Monday, June 16, 2008
Today my follow up appointment was with Dr. Wyant at 8:00. I can tell you I wasn’t very optimistic. All signs pointed to another surgery. And since I had been thinking about it all weekend I was concerned that another surgery wouldn’t help. I felt like I had followed all instructions to the best of my ability. If the first surgery hadn’t fixed the problem and if following all the instructions hadn’t helped what would the purpose be of putting me through another stressful and traumatic surgery. I didn’t feel that I could do any more than I had already done. So after the doctor completed his exam he confirmed my fears. Another surgery would be necessary. He tried to explain that it was nothing I had or hadn’t done – it was just the nature of the injury. I have to say that at this point I was really freaking out. I really didn’t feel like I could endure another surgery and another two weeks of all those limitations for nothing. I kept telling the doctor that I just couldn’t do it. He spent over 30 minutes with me explaining that this is the way things go sometimes. He noted that I was too young and healthy to just blow off my eye. He had every confidence that the eye would be fine. It was just that sometimes patients needed more than one surgery. He asked if Thomas was around and he wanted the two of us to talk about it. So Thomas came into the office and the doctor left us alone to talk. There really wasn’t much of a discussion – Thomas felt that we needed to just do it if the doctor thought it was necessary. So with a very heavy heart and much fear and concern I agreed to the second surgery. It was scheduled for 10:00 the next morning with Dr. Wyant at the AAESC. My concerns and stress level have skyrocketed and I have trouble relaxing the rest of the day. I decided to ease up on the face down position since I had to have the surgery again and that helped me to get a little sleep tonight.

* I will continue with Part III beginning with the second surgery. It may take me a week or two to get it posted.

Detached Retina (Part III)