Detached Retina (Part III)

Tuesday, June 17, 2008
So today I had my second vitrectomy. Even though I had already been through the surgery and knew what to expect I was still extremely nervous and anxious. The thought of having my eye cut again terrified me. My surgery was scheduled for 10:00 and we arrived at Albuquerque Ambulatory Eye Surgery Center about 15 minutes early. After getting all the paperwork out of the way it was just a matter of waiting. I was nervous so I decided to just sit and stare at the floor and take deep breaths. I wanted to be relaxed when they called for me. Eventually the nurse came for me and took me to the prep area. She did all the things she did last time – blood pressure, temperatue, EKG, started an IV and then put drops in my eyes. The wait for the actual surgery was longer this time. I was in the prep area for a good hour before they took me to the surgery area. One thing that helped me today was that it was the exact same staff as the first surgery. There was a lot of comfort in the familiarity of faces. The staff had done such a great job the first time that this made me feel a whole lot better. They got me prepped by covering my right eye with a protective patch to make sure that they operated on the left eye and the anesthesiologist started to put me under. I don’t remember much about the surgery although I was aware of something going on. I do remember the doctor talking about silicone oil at one point but wasn’t sure what it was all about. Today’s surgery was done by Dr. Wyant. Click on the photo below to what he did.

Silicone oil
Although the majority of uncomplicated retinal detachments can be corrected with standard surgical methods, a small percentage of patients develop severe retinal scarring which does not respond to ordinary treatment. Some of these patients can be helped by the use of silicone oil to fill the vitreous cavity of the eye. Silicone oil is a clear inert liquid which may help hold the retina in place after it has been surgically repaired. Although in some cases silicone is left inside the eye for many years, most surgeons prefer to remove the silicone oil approximately four to six months after surgery, unless the threat of retinal re-detachment is great. Removal can usually be accomplished as an outpatient procedure. Silicone oil removal may help avoid potential complications of silicone oil, which include corneal clouding and glaucomaI also remember the doctor asking if I was okay and he stated that he was done and would come talk to me in the recovery room. Once in the recovery room the nurse checked all my vitals, sat me up into a chair and gave me some water. This time around I didn’t feel as out of it, the pain wasn’t as bad and I wasn’t nauseated. The nurse then went and got Thomas and we waited a few minutes for the doctor. He explained that he used the oil instead of the gas bubble thinking that it would be better this time around. He also told me that the oil would have to be removed later on. My discharge orders were pretty much the same as last time with a couple of minor changes. We didn’t have to stop at La Bajada since I didn’t have the gas bubble and I didn’t have to worry about car travel above 7500 feet. 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 vigorous or jarring activities.
6. Do not remove eye patch until next doctor appointment.
7. Do not get operated eye wet.
8. May do light reading and a little TV watching.
9. Follow up doctor appointment Wednesday, June 18, 2008.
10. Diamox for eye pressure once per day.

Again, the professionalism of the staff at AAESC was incredible. I felt so comfortable that I was being taken care of true professionals and it made the ordeal more tolerable.

Since I had all the equipment I needed for the face down position I was ready to do what the doctor told me. When we got home I went straight to bed. I felt so tired. I rested for a couple of hours and when I woke up Thomas made me some dinner. Later my eye really started hurting so I took some Percocet and went back to bed. I was anxious for my appointment the next day. I really was hoping for better news following this second surgery.

Wednesday, June 18, 2008
My appointment was at Eye Associates in Santa Fe at 8:00 with Dr. Mark Chiu. I wasn’t feeling very good this morning. I was tired and my eye had a lot of pain (6 out of 10). Dr. Chiu examined my eye and I was so relieved to hear that the retina was flat and completely attached.. He also noted my eye pressure at 28. I was so happy at this point. Now I could follow the doctors orders with some optimism for the overall outcome. The doctor gave me some more meds and more instructions to follow and I was to return on Friday, June 27 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, Zymar) and I had to put Pred Forte in my eye every hour for inflammation. 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.

This time when I returned home I felt so much better. And I vowed to be a model patient and stay in the face down position as much as possible – I didn’t want bad news when I returned on June 27. My eye was still hurting so I took some Percocet and went to bed. When I woke up the pain was much better but still there (3 out of 10). I could tolerate it so I didn’t take any more medicine. All in all I was in better spirits and seem to be able to tolerate all the restrictions a little better,

Thursday, June 19, 2008 to Sunday, June 22, 2008
I am lumping days together now since the days seem to be about the same. They are pretty boring – almost all I can do is watch TV. The doctor did allow me more time reading and working on the computer. I did still have pain but it gradually got better and by Sunday it was gone except for just some general discomfort. I have been using this time to journal all of this and I have had plenty of time to think about all sorts of things. I won’t tell you about all I have been thinking about because I think you may all get the feeling that I may be losing my mind.

Monday, June 23, 2008 to Thursday, June 26, 2008
So, by far, this week has been my best. First, I didn’t have to have any more surgeries. And second, because some friends came to visit. This really helped to lift my spirits and deter some of the boredom. On Monday, Diane stopped by with iced coffees and we just sat and chatted. For those who know us, we have been known to have days slip away from us while we drank coffee and talked. It was nice to have some distraction from the face down position and the TV. Then on Tuesday, Diane and Peggy came by for a visit and brought lunch with them. Lunch was from my favorite sandwich shop – Mucho’s – I had a New Mexico BLT – my favorite sandwich. I really enjoyed the visit and was glad they took the time to visit me. And finally on Thursday, Diane and Chris came for another afternoon visit. It was relaxing and a welcomed relief from me being alone during the day and just thinking about my eye. Diane worried that the visits were making me tired – she was right – but that was okay. I have all day to sleep and rest so I didn’t mind being tired from the visits. All I can say is I am thankful for good friends. It has also been nice to get phone calls from family and friends that don’t live nearby. I enjoy the phone conversations because they also help break up the monotony.

This week has also been better with pain – it has subsided and all I have now is occasional discomfort. The one big issue I have is with light. One of the drops I use is to dilate my eye. So my left eye is constantly dilated and the light really bothers it – some days are worse than others. I do use an eye patch or sunglasses to help but there are days when it doesn’t matter. The other problem I am having is my sleep. I sleep at odd hours. Sometimes I can sleep through the night but more than not I end up getting up because it is hard for me to sleep on my stomach. So I end up taking naps whenever the mood hits me. All in all I am feeling better. I do have worries and I am looking forward to my doctor visit tomorrow and hoping for good news.

Friday, June 27, 2008
ABSOLUTELY FANTASTIC NEWS! My retina is still attached and looking good. The doctor seemed very happy and I was estatic. Everything is looking up. The doctor lifted the face down position. So now I can sit and sleep in whatever position is comfortable for me. I still have to take it easy. I am still limited in my activities and can do nothing strenuous. I think I can live with this if it means that my retina stays attached. There are other issues that will need to be dealt with but all that is on the back burner until the doctors are totally satisfied that the retina has healed into position. So I will just do what I need to do and think positive thoughts.

* Since there is really not much going on now I will just post updates as things change. So if I don’t post you can assume all is well.

Detached Retina (Update #1)