My Vitrectomy

My Vitrectomy
By Ruth Wegman

Around Thanksgiving I noticed that a little paisley-shaped shadow danced along in front of me on the sidewalk. A few days later I noticed it again. Soon I clued in to the fact that it was there any time I looked at a light background. In December I was surprised to discover that the central vision in my left eye was blurry. Time to see the eye doctor! Distressingly, my eye flunked many of the optometrist’s tests. I couldn’t see all of the letters in a line of the eye chart at the same time. The one I focused on would disappear, so that it was only when looking past it that peripheral vision told me what it was. A retinologist appointment was scheduled immediately.
Dr. L told me that it wasn’t the macular degeneration I had feared, but a stage-one-to-two macular hole (stage three being most serious). He said it might improve on its own and to come back in a month. At the time I felt relief! I started doing two tests to observe progress. Every morning I checked the doorknob across the room. With my right eye it was clear; with my left eye, it melded into a dark shadow. The other test I did weekly focusing farther away. When I looked at a person, his head would appear to be a post sticking up out of a normal shaped body. Weird! After a month I was not surprised to be told the hole had grown to a definite stage two. As more weeks passed I noticed blurriness when anything came between what I was focusing on and my right eye. Ominous fuzz started to creep into my reading.
I began to educate myself on this age-related macular condition and its treatment, a vitrectomy. The procedure involves having the fluid removed from the eye and remaining face down during recovery. Yikes! I made the mistake of watching a vitrectomy on YouTube—not for the faint of heart.
Unwilling to accept this as my fate, I decided to get a second opinion and found another retinologist with good credentials. Dr. G took measurements and photos which were helpful in explaining the situation to friends. My right eye was 20/20, the left 20/50, and the hole was now stage three. Dr. G agreed exactly with Dr. L. The best chance of recovery was in the first six months; it had been over four. At this point my reluctance was overcome by the stronger commitment to vision.
The couple of days prior to surgery I felt stressed. My husband called it “anxioreah,” an apt term! All along, I didn’t really think I’d have to have the surgery. I’m in my mid-50s and hadn’t had surgery before. I’d never even heard of a macular hole or a vitrectomy, and I didn’t find anyone who had experienced either. It all seemed surreal. I expected to be rescued somehow, by circumstances, or by discovering some other kind of remedy, or by healing. Lots of people had prayed for this eye. But alas, when I awoke on surgery day, the door knob was still shadowy.

SURGERY DAY, April 2010
I arrived anxious but resolved. The friendly and supportive staff of “day surgery” eased my mind. In the traditional hospital gown, I received an IV in the back of my hand, monitors on my chest, and eye drops for dilation. Maybe half a dozen staff were in the prep room with a couple of other patients too. The anesthesiologist introduced herself. Dr. L verified that it was my left eye and initialed my face—haha! I asked him if he was on his game today and he assured me he was. In the surgery room I drifted off into “twilight sleep” and watched fantastic colors and movement.
I woke gradually in recovery and found a solid patch on my eye and tape across the side of my face. After post-op instructions (no alcohol, no making big decisions today, and keep face down), I was released.
By mid-afternoon I noticed the numbness in my face wearing off. My eye felt achy tired, like it wanted very much to be shut, but of course it was already shut. The tape felt tight. I wasn’t in pain, but took one of the Tylenol 3s because I wasn’t sure what to expect. That was the only pain relief used for the whole recovery.
Details of that afternoon and evening are vague. I had prepared by having on hand the face-down recovery chair and bed device, the special mirror for looking straight ahead, movies, large print and regular books, books on tape, crosswords and cryptograms from the newspaper, and healthy snacks. I had also taken a laptop computer, but found it difficult to use face down.
Sleepiness helped that night. I put my face in the face-down hole of the rented bed piece and slept 90 minutes before getting up to rearrange myself. It was like that all night. Every 90 or 60 or 30 minutes I’d wake up and move around. I managed to get about six hours sleep.

DAY 2 April 29
My husband walked me to the 8:30 appointment. With a big brim hat and shades and my head down, I saw only sidewalk and floor. When we arrived, a nurse apologetically pulled off the tape and washed my face, gently scrubbing off tape residue, eye goop, and the initials. It felt great! Three kinds of eye drops were given to me and pouch of other useful items including a nice pair of sunglasses that fit over regular glasses.
The nurse asked me to open so she could put numbing drops in my eye to check the pressure. I was completely unable to open it naturally and had to use my hands. I could see only blurry light. The nurse held up an eye chart and asked what the letter was. I thought she was kidding. But no, she asked me to try harder to focus and brought it close. Ok. Maybe it’s a big letter E. “Good!”
Dr. L came in and I helped my eye open for his exam. Looks good, he said. I could hardly believe it when he reported that the hole had closed during the surgery. Amazing.

DAY 3, April 30
I got up early because I was uncomfortable. This became my habit compensated for with naps. Kept my eye shut most of the day again; it was a little goopy. With some effort it could open to a slit on its own. I started an interesting novel which helped me through the face-down time. Although I preferred reading (one-eyed at first), the CD version enabled me to switch to audio from time to time which was nice. If I dozed—face down of course!—during the audio, I could catch up with the book. Also got Mitch Album’s Have a Little Faith. Love Mitch!
I taped the hard patch back in place as instructed for the first day or two. My eye was a little goopy and it was easy to put a gauze pad under the patch. But I didn’t use it for long. For one thing, reading glasses didn’t fit over it. For another, it didn’t fit well into the u-shaped pillow, and finally, tape on my face was uncomfortable. So why bother, I thought. When my head whacked into on open cabinet door I had an answer. Hitting a couple inches lower could have been really bad! I decided protection was needed, especially given that I only had partial vision. I chose brimmed hats, figuring the brim would be a protective shield for bumps as well as a block for light from above. Sunglasses would work for outside. I often wore both.

DAY 4, May 1
Eye is able to open on its own. I can see blurrily. When it’s shut I’m still treated to all kinds of indescribable sights. It’s hard to keep looking down when friends come bringing food.

DAY 5, May 2
Opening wider. The face-down-recovery chair is good for providing variety of positioning although I can’t stay in it all day. I like the helpful forward-facing mirror that comes with it. And the selection of little pillows is very useful: u-shaped pillow, three smaller pillows for the face to accommodate glasses, an arms pillow, and two different sized chest pillows. I use them all, on the chair, on the bed device and on the couch. They’re more supportive than normal pillows and yet still comfortable.

DAY 6, May 3
I’m getting restless and think surely it must be Tuesday, but nope, still only Mon. I recruit whoever is available to take me for a walk every day—eyes protected and head down. My back aches some. A useful stretch is pressing shoulders down and back as if trying to get the blades to touch behind. Lying on my back for eye drops a few times a day feels wonderful!

DAY 7, May 4
Eye is open half the daytime now or more, but sometimes I shut it for a rest. Left eye vision has progressed from a line across the top of my sight field (above the line things being fairly clear and below the line underwater blurry) to a perfectly round bubble taking up most of the range of sight. The clearer vision is outside the bubble except for up very close. I was surprised to read small print on a bottle thru the bubble today. Wow! “When the eye is filled with gas, the vision is very poor. Patients can sometimes see better, though, while looking straight downward and holding an object just a couple of inches from the eye.“ http://www.retinavitreouscenter.com/procedures_vitrectomy.html?detectflash=false YES!

DAY 9, May 6
Finally back to the doctor. He says it looks good and I am released from 60 minutes face-down with 10 up to the reverse of that, 60 up with 10 down. And, although lying on my back is still forbidden, I can sleep on my side without worry, oh happy night! Also the frequency of eye drops is reduced. At first I flinched with each one, but after multiple times a day of multiple drops and multiple days, I barely feel them.

DAY 12, May 9
My eye mostly stays open now; redness is almost gone. The distracting big bubble in front of me bounces and joggles whenever I move. Also I now notice little “bugs” that race in and out of my vision. What was that! I focus and it disappears. An apparition! Sometimes these tiny black floaters hover like fruit flies; other times one races across the counter like a spider. And then they all disappear.
I’m still taking it easy and trying to remember to put my face down a while every hour. I sent the recovery chair back.
DAY 15, May 12
Bla, bla, bla. I fear turning into a blob from lack of exercise. Bubble is shrinking daily, maybe hourly! As it gets smaller, the dark rim around it gets thicker. By evening, it’s so little and the rim so thick it’s like a black pearl. Also, this being the two week mark, I cut back the drops again as instructed.

DAY 16, May 13
My friendly little bouncing bubble companion is completely gone. I call Dr. L’s office and learn that yes, I can cut the green emergency bracelet off; yes, I can lie on my back; yes, I can go back to aerobics and strength training. Yea! Today’s other landmark is that I drove for the first time in two weeks.

DAY 21, May 18
It’s been a week since I stopped the opening drops, but my pupil is still dilated. I was light sensitive before, but with the pupil open it’s much worse. I’ve been wearing a brim of some kind, almost everywhere, inside and out. It’s hard on hair! Because of headlight glare I prefer sunglasses in the car even at night.
Day 25, May 22
I’m back to regular activities, even aerobics class—gently and wearing sunglasses. Hole in macula is obviously closed. It’s great to have central vision for the most part restored. To my relief, the pupil seems to be slowly, starting to work again. That’s the good news.
On the still-recovering side here are three results.
~Vision in the left eye is not as clear as the right eye, either up close or far away.
~I frequently, but not always, see floaters—about a dozen of them, tiny and dark black like freshly ground pepper. Sometimes they move with my eye movement and sometimes they seem independent.
~Finally there’s a three-lumped shadow to my far left. I notice it mostly when I first wake up or am near a light surface. It doesn’t bother me much.

WEEK 4, May 25
Back for my check-up today. Dr. L was pleased with the way the macula and everything inside looks. In reply to my anxiety, he assured me that although there’s a slight chance the hole could re-open nothing I do would cause that or can prevent it. I was disappointed to still be at 20/50, but he said vision can continue to improve over the next months up to a year.
I felt anxiety approaching this surgery, but it involved little discomfort and no pain. The visual entertainment that followed was quite interesting. To me the vitrectomy was worth it for the sight regained. I’m thankful.

on being one

We are not one person; we are many. If we were one, we would, theoretically be in agreement. But because we are many, we have many ideas and each likes his idea best. So there is discord at best and often conflict sometimes leading to violence at worst. Between Joe and Dennis for example. Between JB and TS. Between day shift workers and night shift. Sometimes between true loves Ruth and Steve. Between Jew and Arab, privileged kid and slumdog. Between God and Satan, God’s people (who are, btw, too often in conflict with each other) and the enemy’s people. Perhaps even between different voices in the same mind. But we are called to be one spirit as believers, with the graphic one-flesh picture in marriage as a model.

Not enforced communist, seven-of-nine, Orwellian, no-personality one, but one in harmony, purpose, and love, all expressing our individuality as we look to our same creator and redeemer, fight the same enemy, build the same Kingdom. Hmmm. August 18, 2009

Old Girl Learning a New Trick

For Father’s Day of 2008 Ellen got her dad a gift certificate for eBay through PayPal. After several months, I noticed Steve hadn’t used it yet, so I asked him about it. He’s not keen on shopping and didn’t want to take the time to figure out how to use the certificate. He told me to spend it as I liked.

I picked out a few books on line, but the seller didn’t accept PayPal. A few months later I tried again, being careful to go to eBay so I could use the credit. But then I was foiled by the whole bidding thing. I have never played with that and am not inclined to deal with it. Even when I asked the experienced and capable Audrey, somehow I still didn’t get the coupon spent.

Next, some months later again, our credit card number got stolen (another story), so when I decided to attack the certificate spending today, the first thing I had to do was figure out how to update the credit card info to the new number for both eBay and PayPal. Turns out, that’s not done. The old card has to be removed and a new one entered again. Ok. Then, on to eBay. I found, as AJ had showed me, that some purchases have a “buy it now” option, so those are the ones I looked for.
Finding what I wanted, a new hardback copy of Teach Like Your Hair’s on Fire, I held my breath and put the coupon number in the PayPal spot in the eBay shopping cart. Amazingly, this time it worked! Only fifteen months late! Yea!

But there was some money left. I also really wanted Physics for Future Presidents (check this guy’s website--http://muller.lbl.gov/ ), but the lowest price on eBay was $27. Half.com had it for $17. Half.com apparently does not accept PayPal. I bought the book anyway—on Half—for Steve from Ellen. He’ll love it!

But I still had the left over credit. I wanted to use it today while I’m remembering the process, so then my job became findng something on eBay with a buy it now option which accepts PayPal and totals $9 cost including shipping. Some frustration followed as I looked at various knick-knacks, but finally I went back to books and snagged another one with a total price + shipping of $8.45. Whew! I think I can let that last fifty-five cents go. :-] Thank you, Ellen!

New Baby

On April 16 I was privileged to help Holly through the birth of her sweet little daughter Esther Angel. I'd set up an appointment for the two of us to take a tour of the childbirth facilities at Carle that Thursday morning. She went into labor while we were there and we never left! The babe was born at about 8:30 that evening. If I'd known, I would have taken some music and focus photos for Holly and some snacks for me, but somehow we made it through. Mom and baby doing great!

funeral arrangements

None of us know when something is going to happen which will change our lives forever. Take our friends Mike and Holly. Saturday everything was fine. They were so happy and excited over their pregnancy. Although the financial future looked a little scary, they were hopeful. Married for two years, they had found real love at last. This totally included Holly's teen son who strongly bonded with his step-dad. It would work out somehow. That was Saturday.

Sometime after midnight Mike got up feeling really bad. Holly went to make him some tea and heard the fall. Mike had a heart attack. 911! CPR! EMTs! Rush to the hospital! All to no avail. He was gone. All the light and laughter and Latino virility that was Miquel evaporated, gone to be with Jesus. And Holly and David were left with phone calls asking about organ donation. It was so unreal. It was really too drastic and too startling to be true, right? Some mistake. Some dream.

But no, as the day wore on friends came to sit with them. The organ donation people called again. Decisions had to be made about the body. The body. Yesterday that very same body had seemed the essence of Mike. Now it was only the body, lying in the hospital morgue waiting for some word that various parts could be harvested.

Mike had wanted that. They had talked about it; he had checked it on his driver's license. It was his wish, so it had to be done. And yet how could Holly release those eyes that had looked at her with so much love. His heart valves, bones, skin. It was too terrible to think about and yet it was his wish.

After the long slow day there followed a trip to the hospital where only Holly's tears and the official's compassion allowed her and David, after much delay, to finally be able to see that beloved body again to say goodbye. It wasn't easy.

Now there are so many more decisions for wife and son to make. Which funeral home? What will the veteran's benefits cover? Cremation or not? How will they ever pay for all of this? How will they live? How can they raise this little unborn child, Mike's child who will be born fatherless?

This has been my last two sobering days.

Injured puppy

Sad to say, Jesse's six-pound friend Moose was injured while they were playing together today. I wondered if Jesse was being too rough, but Moose's mama thought things were going ok. Suddenly, when we weren't looking, the little doxie started to yelp in distress. From the look of things, we think maybe her front leg was dislocated. :-[ They left here for the vet, so I"m waiting to hear what happened.

Recommended by Ellen

I've been after Ellen to start a family blog, but she has finally persuaded me to just try it myself. Pretty scary for an old timer, but here goes. When I was trying to think what to call it, the snoring dog here beside me was all I could focus on, thus the Jesse's Family title.

Events of the day include my sidster's shoulder surgery. Charles writes that it went well and they're back home, although the doc reported she has serious muscle and bone deterioration there and will have to have the area somewhat immobilized with a sling for eight weeks.

In other big news, Anne and Anthony leave for Germany on Saturday!

All for now.