deborahjross: (Default)
By the time of my second cataract surgery, I was readier-than-ready. I was so tired of not being able to see clearly out of both eyes, which made depth perception – necessary for driving, pouring water from a pitcher, etc. -- impossible. I was excited rather than anxious, an interesting way to approach eye surgery. My first surgery had been quick, painless, and even a little bit fun, especially the psychedelic lights during the femtolaser portion. The gap was only two weeks, so all the surgery prep was still fresh in my mind. By prep, I mean chatting with the anesthesiologist, starting antibiotic and steroid eye drops several days before, fasting the night before. I strongly dislike sedation and had asked to not be sedated the first time. In the past, it’s taken me a solid week to feel really clear-headed after receiving the drug they use. This time, I was able to tell the second anesthesiologist (a different one) how well it had gone and to reiterate my preference. Very often, patients don’t realize their opinions and prior experiences matter, especially when it comes to medication. Just because the “usual” protocol includes a specific drug doesn’t mean it is required. Often, there are alternatives with fewer of the obnoxious side effects.Read more... )
deborahjross: (Default)
in·ter·reg·numˌin(t)ərˈreɡnəm/. noun. A period when normal government is suspended, especially between successive reigns or regimes. An interval or pause, as in, "the interregnum between the discovery of radioactivity and its detailed understanding."

After cataract surgery on my first eye, I entered a bizarre period in which that eye had excellent vision at intermediate distances (computer screen, conversation) and the other was a total blur. I’m very near-sighted (as in -15 diopters), so there was no possibility of fusing images. So the world looks blurry and sharp at the same time, and I have to use parallax (shifting my head) for any kind of depth perception. Needless to say, I do not feel safe driving. Or pouring water from a pitcher, unless I can brace the lip of the pitcher against the glass – we found this out in a somewhat spectacular fashion.



One solution might have been to wear a contact lens in the nonsurgical eye, and I had worn hard or RGP (rigid gas permeable) lenses for over 50 years. But a couple of years ago my eyes, which had become drier over the decades, flatly refused to put up with contact lenses. I tried all sorts of lubricating drops, but was never able to wear my lenses more than a few (2-4) hours a day. If I did any work on the computer, that time dropped to an hour (people blink less often while staring at a computer monitor, hence increase in scratchy, red eyes). Finally, earlier this year, I lost one of my lenses. This has happened maybe half a dozen times over  the years. I looked everywhere (if you wear contacts or are close to someone who does, you know the crawling-around-on-the-floor routine) and eventually concluded that after I had cleaned them the night before, the lens had stuck to my finger instead of sliding off into the soaking solution. Since then, I had washed my hands and tidied up the counter area. So, no hope. I’d been wrestling with spectacles ever since.



My next idea, which friends have tried, was to pop a lens out of my spectacles, so that my nonsurgical eye sees through the remaining lens. Great idea, right? And it worked – so long as I covered one eye, didn’t matter which. When I tried to fuse the equally-clear images, however, my brain went nuts. It turned out the images were of sufficiently different sizes, too disparate for my brain to turn them into one. This might not have been the case with a person less near-sighted than I am. So, rather than putting a patch over one eye – toss a coin as to which one – I’ve been wandering around in this visually bizarre state.



Read more... )
deborahjross: (halidragon)
I had my first cataract surgery a few days ago. It began, of course, with fasting and the usual pre-op check ins. I'd already begun using antibiotic and steroid eye drops.* In addition, I used an eyelid scrub, a little moist towelette with a coarse texture, the night before. I don't wear makeup, so that wasn't an issue, and my hair is dry enough so skipping a shampoo the night before (they're afraid you'll irritate your eye) wasn't a problem, either.

The surgery took place in a surgical center associated with a hospital, and clearly it was cataract surgery morning. Nonetheless, I appreciated the care everyone took with me. The nurses were great -- but I think nurses are great, anyway. It takes me a long, long time to feel clear-headed after Verced, usually used as a sedative, so the anesthesiologist and I came up with a different plan. I'm old enough to remember the days when you got what they gave you no matter what you said. How wonderful to be listened to!

Once I was hooked up to an IV and my eye was dilated, it was time to begin. The first step was a femtosecond laser to break up the cataract and make an incision for its removal, at the same time correcting my astigmatism. This was not only painless, but an amazing light show. Gorgeous colors, flashing lights, snowflake mandala patterns...and the laser makes funny noises as if it's singing to itself.Read more... )

Phase two was the removal of my lens and implantation of the artificial corrective lens. After talking with my surgeon (and my financial advisers!) I opted for accommodative lenses, which should give me great distance and intermediate (computer, piano, social) correction. I'll still need reading glasses, which is okay.

This is the phase that disturbs most folks. They envision (excuse the pun!) pointy metal instruments coming at their eyes. I saw nothing but lights! The lights were not as entertaining as those produced by the laser, but they were quite benign. Before I knew it, my doc was saying it was over and was placing a clear, perforated plastic shield over my eye.

I spent a little while in recovery, not so much from the surgery as the anesthetic, and then my husband drove me home. The surgical center folks were adamant (a) that I not drive; (b) that I have someone at home in case of need. "Need" amounted to eating a light lunch and sleeping most of the afternoon. The next day I had a follow-up exam with the surgeon, who was very pleased by how everything is healing, and was allowed to take off the shield except for sleeping. Oh joy, I get even more eye drops four times a day!

I had thought that I'd be able to pop a lens out of my spectacles to correct the nonsurgical eye, but alas that didn't work. So I toddle around with one still-dilated eye that can see intermediate distances just fine -- far distance will come as everything settles and my eye muscles learn how to flex the lens -- and one utterly myopic eye. Needless to say, I can hardly wait for the 2 weeks to fly past so I can get my second eye done!

It is amazing to open my eyes in the morning and have (one of them) see clearly. Also, the brilliance of the colors astonishes me. I had no idea how much my cataracts "grayed out" colors. I feel like Dorothy, stepping from black and white Kansas into Technicolor Oz.


*My doctor's protocol; yours may have a different one.
deborahjross: (halidragon)
As part of my preparation for cataract surgery, I’ve begun talking with my eyes. Or rather, talking to them. I say, “Eyes, something exciting and perhaps a bit perplexing is going to happen to you. But don’t worry, it’s like a hip replacement. It’ll help you see even better than before. I’m going to make sure you are safe (antibiotic eyedrops) and comfortable (steroid and anti-inflammatory drops). And we will have such fun seeing bright colors and sharp detail for many years to come.”

They don’t have a lot to say in response. But…

A week or so ago, I started dreaming about the surgery. It was the usual showing up without clothes or without having attended class or without having memorized your lines. In this case, I arrived at the surgery center, having forgotten I was supposed to fast. There was much hoo-ha and calculation of what I had eaten how long ago.

This last weekend, I drove our van down to LA to help my older daughter move in with us. The drive down was in daylight and the only visual problem I had was seeing the street signs while looking for hotel and then her apartment. But (for various reasons, you know the drill) we did not get started back until 7 pm. I am normally an early-to-bed person and ended up consuming as much caffeine as I usually do in a year, I’m sure. I was painfully aware of how stressful and difficult night driving has gotten to be. Almost all the freeway driving was in darkness. I have never appreciated trucks so much – all those lights made them easy to discern, much more so than the lane markers. Daughter and I took turns leading as we caravaned along, too.

I could imagine my poor eyes saying, “We’re trying, mom! This is the best we can do!”

“I can’t ask for more, eyes. I’m going to get you some help real soon now.”

So now I am taking my pre-op eyedrops four times a day. Fortunately, I’ve been using lubricating drops for so long, I’m used to putting drops in my eyes. After surgery, I’ll add two more. I have to wait two minutes in between each medication so it doesn’t wash out the one before. Other surgeons may have different protocols. I’m observing this one meticulously. I’ll be taking these for a while, because I’ll still be on some of them when it will be time to start full doses prior to the second surgery.

I am considering dubbing this season The Summer Of The Eye Drops.
deborahjross: (croning)
With my diagnosis of cataracts (in both eyes), I began to consider my alternatives. The simplest, which is to do nothing and rely on eyeglasses for increasingly inadequate visual correction, was not very appealing, especially since lens replacement surgery was now “medically necessary.” Medicare, like most insurance plans, covers only the bare minimum: a single focus (“monofocal”) artificial replacement lens, usually for distance, with the natural lens being removed and the new one inserted by scalpel. Monofocal lenses give most people excellent distance vision, although they do not correct for astigmatism, and usually require the use of glasses for reading and intermediate distance work.

These are not the only lenses available. Lenses can be toric (astigmatism correcting), or can correct for more than one distance. Multifocal lenses can provide a full range of vision (or so the literature says), including presbyopia, the difficult in reading that comes with age, but they can also result in halos around street lights and other visual difficulties at night. They also don’t come in all powers of correction. Accommodative lenses can correct for distance and intermediate vision, which means that glasses may be needed for reading; they flex like a normal, healthy lens. Who knows what new developments are yet to come?

Then there are choices as to how the surgery is done, the traditional scalpel, or femtosecond lasers. The benefits of the laser are that it is more precise and it can correct mild astigmatism at the same time. (Astigmatism arises when the cornea is shaped like a football instead of a soccer ball, resulting in multiple focal points; in pain speech, everything, near or far, is blurry.)Read more... )
deborahjross: (Deb and Cleo)
I'm not one to agonize publicly about my weight, my food preferences, how much I did or did not exercise on any given day. Really, who wants to read that? Suffice it to say that I have wrestled with said issues my entire adult life, mostly with some degree of success. I'm overweight but not obese, and I have a good fitness level (actually, for my age and not being an athlete, a very good fitness level). As I've gotten older, my motivation has shifted away from vanity to health/energy. There's a strong family history of Type 2 diabetes on my father's side. He was only a year older than I am now when he died of a stroke secondary to his diabetes.

We have learned so much about not just how to treat Type 2 diabetes, but how to prevent it. Exercise, exercise, exercise. Weight control. Healthy eating. (I'm sure not smoking is in there somewhere, but that's never been an issue for me.) Fortunately, I've always found some form of exercise I love, whether it's dancing, running, martial arts, weight lifting, hiking, yoga... So I'm not diabetic, not even an abnormal fasting glucose level, normal total cholesterol, but I do have high triglycerides and low HDL (and an "apple" shape) - all of which are markers for metabolic syndrome, the precursor to Type 2 diabetes.Read more... )
deborahjross: (Deb and Cleo)
More fascinating news summaries - the role of the X chromosome in sperm production, the average penis size, how writing about an abusive experience seems to help women survivors, sex addition (not), PTSD and prior trauma, and more. Check it out!

News Roundup: July 2013 - Open Minded Health
deborahjross: (Default)
From a friend who's a public health professional:

If you are not already signed up with Flu Near You, please consider it. Each week they send you an email where you check off any symptoms of flu you had in the previous week. It takes only a few clicks, and you can view the incidence and location of symptoms in your area. This way they will have real-time information about flu epidemics.

Go to https://flunearyou.org/ to register.
deborahjross: (Default)
Web MD reports a study that shows a woman's blood cholesterol changes with her ovulatory cycle. If your doc has urged you to begin medication for high cholesterol, you might want to be re-tested. Source was The Journal of Clinical Endocrinology and Metabolism.

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Deborah J. Ross

May 2017

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