Wednesday, December 3, 2014

Cataract Surgery #1

Yesterday I had cataract surgery on my right eye. I've known for 30 years there was one developing and finally came the time to get it fixed! During the time I was anticipating this surgery I did a lot of internet research and found a lot of information out there, but nothing written from the perspective of the individual having the surgery. So if  "gory" is not your thing read no further, but if you are curious I am sharing how these past two days have been. Today when I went back for a check I mentioned to my surgeon that I had found a lot of information with lots of different ideas about what one does before and after cataract surgery. I said all these differences made me think the rules/procedures are more art than science and my ophthalmologist agreed with me. That said, what I record about my experience is simply one experience.

The surgery was done at the Phillips Eye Institute in Minneapolis and my surgery could only be done on Tuesday, a day when right now no one could drive me. Great luck. There is a van that will pick up people if they live within 20 miles of the Institute.

For two days before surgery I was directed to place antibiotic eye drops in my right eye. Since I am a nurse I know how to do eye drops, but I found the way this antibiotic solution is packaged to be quite frustrating. The price of this made it like liquid gold and I didn't like wasting it with solution leaking out between the base of the bottle and the application tip.

The van arrived yesterday at 10:30 and we were away. I arrived at the Institute about 10:50. The first thing was to check in and sign some paperwork related to everything being billed. I was also given a pager.

I was to be at the Institute by 11:30 and was done with the check in due to my early arrival at 11:00 so I had a long time to "cool my heels" before anything happened. Meanwhile I could see a TV monitor that listed my doctor and I could see what he was doing.

About 11:45 the pager went off and I started the pre-op interview. Since this appointment was during the 2014 ebola scare, I was asked for the  third time if I had been out of the country during the last 21 days. This nurse also checked my temperature and blood pressure and put in a whole series of eye drops. Later in the day I was given a complete list of all the medications I had received that day.

I was given a plastic bag in which to place my purse and glasses case. We hung up my coat on a public coat rack. The plastic bag of personal possessions stayed with me at the foot of the bed.

In a few minutes I was taken into the pre-surgical area and asked to lie down on a gurney. Another nurse attached me to monitors for temperature, heart rate, and blood pressure. Then she tried to start an IV line; I warned her I had troublesome veins and I was right! It took a second try on the other hand.

The anesthesiologist came to speak with me and explained there would be a med given to give me  a 5 minute nap. He explained this was done to relieve the pain of needle insertions in my right cheek area to insert the meds for the block of any pain to my eye.

My doctor came to say I would still have a 30-45 minute wait but by this time I was quite relaxed. A nurse came and inserted the 5 minute nap med into the IV line. The next thing I knew someone was placing a white drape over my face. I could see shadows through this. I thought this was to protect my other eye from the bright lights needed to the surgery.

 I could hear music being played and people talking softly. I also heard the old lens being "vacuumed" out of my eye. I think this whole procedure took all of 20 minutes. I heard my doctor say, "you have a new lens."

Then the drape over my face was removed and I walked to the post-op room. I had a plastic eye shield over my eye -- only yesterday I didn't know what it was exactly, for it was totally covered by layers and layers of white tape.

The first question: What would you like to drink? This was a great question since I had nothing to eat after midnight and had nothing to drink since before 8 AM that morning. I asked for water and coffee which was promptly delivered and also got two granola bars to eat.

The nurse checked vital signs again and took out the IV line. She gave me some post-op instructions and also called my granddaughter, who lives with me, with the same instructions.

I was told I could bend or stoop, but not lift anything that weighed over 40 pounds. This rule will be different from many others one might read on the Internet from other health systems or doctors. I was told not to drive for 24 hours and not to make any serious decision for 24 hours.

I was escorted out the waiting room where I dug out my phone and used the camera to see what I looked like. I sent a text to a couple people saying I looked like I had lost the fight. The whole right side of my face was covered with white tape. The van driver brought me back where I was met by my granddaughter who had conflicting college classes at the needed times on Tuesday.

I really had no discomfort. Over the evening I could see some swelling may have come out of my cheek as the tape was a bit different and my glasses were setting just a bit differently over the tape mess.

I had a very comfortable night. I could begin to feel my eyelashes moving against the tape or the shield -- at least against something.

This morning we were at the clinic at 8:30. The technician removed the dressing, gave me more tape and returned the plastic shield. She checked my vision in both eyes. It was very obvious that the vision in my new right eye was much better and also it is much brighter. My left eye remains giving everything a yellow cast. The shoes I've been wearing lately really do have pink laces rather than orange as they looked to me.

The doctor reviewed everything and told me how to use eye drops for the next two weeks.I was told my vision might get better but that is should never get worse and it if did, call immediately. Also I was told I should not have any more pain than I was already experiencing, which truly is not much.

Now a few hours later my eye feels a bit like there is some dust in it. I want to rub it, but obviously shouldn't do that. The white of the eye is very blood shot and also the pupil is much enlarged.

My hand is a bit sore where the IV line was placed. My cheek does ache just a bit from the needle sticks. It is rather as if I had had a serious dental procedure yesterday -- but actually have cataract surgery is much easier than a lot of dental procedures.

Now I'm anxiously waiting the repair on my left eye later this month. My distance vision is much improved with just the right eye done, but reading fine print is a bit unbalanced and my glasses don't help very much.

An interesting thing that I learned from my tour of the net is that the type of lens replacement used today is a result of World War II. The first lens such as used now was inserted in Britain in the late 1940s. There it had been observed that the airmen who had experienced windshield explosions with fragments entering their eyes did not experience trouble. The acrylic didn't damage the eye nor did it deteriorate. And thus were the lens started that are used today. And my experience is far different than what I experienced in the 1960s when I was training to be a nurse. Then a person with cataract surgery was in the hospital on flat bed rest for 5 days with sandbags on each side of the head to avoid movement.

So I hope this post helps anyone contemplating cataract surgery. But remember it seems like every health system and every doctor has their own routine and this is simply a snapshot of one. 

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