Tuesday, May 15, 2012

Cataract Surgery - Part 2

It's been a few months since my Cataract Surgery - Part I post, and life has gotten in the way of me completing this post, the intention of which is to inform people of what can happen instead of the perfect vision one expects.  Here is my story, too long for some I'm sure, but not long enough for those considering this surgery.  It ain't always what it's cracked up to be, so BEWARE!

From perfect calm going into surgery to near panic afterwards, I dared not wait for my one week appointment to see what had gone wrong. While my near vision is vastly improved (I can read without glasses with the left eye), I am seeing a shadow behind each letter, and everything at a distance looks foggy. Distant tree tops look like big green blobs. There's a haze over everything. The clinic was closed on Monday so I got in Tuesday afternoon. I was put thru a bunch of tests, and the Doc says my surgery is healing perfectly, I've got 20/20 vision in that eye, and "What are you, just a big cry baby?" I was taken aback but didn't say anything more than "No, I just don't know if what I'm experiencing is normal. Ya'll don't tell us what to expect."  After the doc left the room, his nurse explained that my eye may be staying dilated longer than some people's. Everything will be fine as soon as the pupil closes back up and muscles re-trained (therapy to come) to flex the flexibile Crystaline lens I opted for (and paid $2500 extra for since insurance only covers the static lens). Apparently, my old lens was stiff so the muscles have gotten weak. It could take up to 3 months for maximal vision to be realized, the tech explained.

So I'm going into a trial this weekend, not distraught, but miffed that there are so many things the doctors don't bother to tell you beforehand. It would only take them a few minutes to allay a patient's concerns. But since they don't, I'm sharing my experience here for anyone else out there who might benefit.

The incisions nowadays are very small, because the lens comes folded over "like a taco", they said. They slip it in then flatten it, so no stitches are required. You're not allowed to bend over for about 3 days, I guess so it doesn't fall out. HA! You have to sleep with your head propped up, or on the side away from the surgical eye for a few days, too, so it doesn't dislodge. HA! HA! Can you just see yourself waking up on the wrong side and your lens is lying on your pillow! OOPS!

Oh, I could say more. Like, a lens is nothing more than a thing. A replacable thing. They make an incision in the lens pouch, suck out the old one like, they tell me, "sucking a grape out of its skin", insert the new. The lens insurance pays for are inflexible lens, set for either close up or distance, your choice. You still need glasses for one or the other. The Crystaline Lens is flexible but not covered by insurance, though they aren't much more expensive. Go figure.

Then there are what they call the "hinges". "The muscles of the eye have to re-attach to the hinges", they say, "then the muscles have to learn to bend and contract the lens according to what you are focusing on". All the years of going blind, the muscles have weakened. They require rehab. They don't tell you that ahead of time!

Then there are the eye drops. An antibiotic, 1 drop 4 times a day. An anti-inflamatory, 1 drop 2 times a day. Both of these begin 3 days before surgery, both sting, and my insurance co-pay was $120. After surgery, another anti-inflamatory is added, 4 times a day, for . . . . . they didn't say how long. I'm still dropping them in. Guess that's right.

For those considering this surgery, here are even more details:

The surgery is painless. The first round of drops sting a bit for a few seconds; there's a stick when they put in the IV drip in your hand, and you have to fast from midnight to the following morning after surgery, but that's all. Recovery takes only a few days before you're good to run and play, however it takes up to 3 months and several checkups, and maybe a lasic correction, before you're done. They don't tell you that until afterwards.

Starting from scratch, you have to get an eye exam to see if you qualify, and if so, you must schedule the surgery within 3 months. Then, you have to get a signed permission from your Family Doctor attesting to the Eye Surgery Center that you are in good enough health. Since I have no family doctor, I had to get a physical! Fortunately, I've been in process of getting thoroughly checked out as I turn 65, with an assigned doctor sending me here and there for lab tests, and explaining the results to me. She signed the form.

You have to decide whether to have the standard lens put in (that insurance covers), or the Crystalin lens, which costs $2650 per eye, out of pocket. In any case, you have to begin a regimen of eye drops 4 times a day for 3 days prior to the surgery -- one an anti-inflammatory, the other an antibiotoc. Even with insurance, these drops cost $125! OUCH! And doing anything 4 times a day, on schedule, without fail, is a strain. Thank god for my I-phone's wonderful alarm system.

You are required to have someone come with you to drive you home. They have to stay in the waiting room the whole time -- can't leave. No problem, as John was with me and brought his book. With surgery scheduled for 7 a.m., you are told to fast after midnight. I was told I could have black coffee, water, or unsweetened tea over at the eye center a few weeks earlier, so I made myself up a big cup and walked into the surgery center with it. They asked me if I had been drinking it, I said yes, and they had a fit, saying "Who told you that?", I was NOT allowed coffee or anything but water. I would have to reschedule, or I could wait until 9 a.m. and could NOT leave the waiting room in the meantime.

I had received a letter in the mail a few days prior to surgery saying they were going "paperless in compliance with new laws" and would I please go online and fill out my forms there. I did that, then saw no need to bring my folder of papers along, then they couldn't pull up my online papers and I had to fill them all out by hand anyway. Good thing the surgery was pushed back!

It all worked out. About 8 they began putting drops in my eyes to dilate my pupils, and moved me and John into a dark TV room, where we sat back in recliners and watched an I Love Lucy DVD. Every so often someone would come in and add more drops to my left eye. I've never found Lucille Ball funny, just loud, obnoxious and silly, but there must have been a sedative in those drops or I was more nervous than I thought, because I found both her and Desi hilarious! I was sorry they came to get us at 9.

John stayed behind. They laid me on a gurney, fully clothed, shoes on, with a hair net over my head and footies over my shoes. The anesthesialogist stuck an IV in my hand, nurses added more drops to my eye, I told jokes, and we all chatted and laughed for about 15 minutes, It felt like a party. Then the anesthesialogist said he was beginning the drip but I'd remain awake and aware, they wheeled me what seemed like a few yards out of the room into another one. When I got in there I asked "How long before the surgery", and they said it was all over! HUH! I don't remember a thing.

They sent me home with dark sunglasses for outside, an eye patch to wear at night, and instructions not to bend over or lift anything heavy for 48 hours, not to cook, to sleep on my back, and keep up with my eyedrops as before, plus a new one, for a week. No computer work for 24 hours.

I was to come in the next morning for a checkup, which I passed. That's when they explained that it could take up to 3 months for complete healing to take place and I might need to schedule a lasic correction at some point. I passed the test with flying colors, though. All seems perfect at the moment.

There was some sensation of gravel in my eye the first few days. Also a sense of eye strain. My eyelid wanted to stay shut the first day so I let it. It was like looking thru vaseline, with a violet haze. The next day the world looked blue instead of the yellow tint I'm used to. Like those new blue headlights I despise, or those white light lightbulbs that make everything, including people, look garrish. My depth perception is a bit off. I reach for something but it's still half an inch away.

So, here I am 2 months later and the left eye has made NO IMPROVEMENT. I am extremely sad, disappointed, and angry. I had scheduled the second eye for 3 weeks after the first, but I cancelled that until the left eye started feeling like my own. It still doesn't. While I'm not in any sort of pain, after 11 days I am still a tad disoriented and have slight headaches behind both eyes. My reading glasses don't work any more. The left eye doesn't need them, the right eye can't see without them. So I read with one eye shut depending on which one is tired. For distance, I use mostly the right eye. The new eye has horrible distance vision.

Just for the hell of it, I Googled "cataract surgery"+Alternatives, and the first page that popped up said "Cataract Surgery Obsolete" and goes on to describe what cataracts actually are, how they form, and drops that dissolve them within 6 months. That made me feel like crap. So shitty, in fact, I can't finish this post. I feel like a fool for not checking out alternatives to begin with. Me, the gal who has preached "alternative medicine" for years. What a fool I am.

Sorry, I can't write any more on this topic right now. I'll try later when my thoughts aren't so scattered and I'm not so upset. . . . . . . . . see Cataract Surgery - Part 3, finally written in March 2013.

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