Welcome to the Hotels.com EyeOp XIV Report.  We’ll take you through the entire operation from warm-ups to the very end.  The patient walked in relaxed and comfortable, but lacking any fashion sense in a button down Tigger shirt, grey sweatpants, and sneakers.  At check-in, he was informed of a last-second audible that there would be no transplant on this day, just the cataract extraction.  Not flustered by the surprising news, he moved to the waiting area and went through the word scrambles as quickly as Eliz could read him the letters.  Then, his number was called.  It was time.

In the prep area, he relaxed while Lisa went over the plan and put some “face paint” above his left eye.  There wasn’t a flinch when she put the IV into his left hand.  After a brief meeting with the surgeon, Dr. Ayres — where additional “face paint” was added above the left eye and a reason was given for not being prepared to do the partial cornea transplant (if it wasn’t needed, the tissue would have been wasted) — Dr. Curtis came over to start the IV.  She remarked that the patient already looked relaxed and sleepy before starting the IV.

At 11:06 am, the players took the field.  The patient was so very comfortable, only spoke to the doctor once or twice and enjoyed “twilight” (minus the vampires.)  Within 30 to 45 minutes there was a pat on the shoulder from Dr. Ayers and it was off to recovery.  After a grueling victory, the patient celebrated was a cool cup of water and an apple cinnamon bar.  He was given last minute instructions (keep the shield on, don’t get water — or anything else — in the eye, take 12 eye drops per day, etc,) and put his chai (jewish symbol for life, not spiced Indian tea) necklace back on.  Three hours after arriving, it was time to go home.

The 1-800 Contacts Great Sight of the Day was everything outside!  The grass and the trees looked greener.  The buildings had depth and dimension.  Some signs on buildings could be read.  So far, so good.

So that’s how the Hotels.com EyeOp XIV Report would end.  But the healing continues.  This morning, on our way to the first post op appointment, I was able to see more signs on buildings and stores and read some advertising on buses.  At my appointment, the doctor said everything looked good and I was able to read some of the 20/100 line without the pinholes.  I was even able to read the A in the CAV8 (20/80) line with the pinholes!  The other good news is that I only have to wear the plastic eye shield to bed.  I can also resume ALL normal activities on Monday (until then, no heavy lifting, gardening, or other strenuous activities.)

I watched some of the Flyers and Phillies games tonight.  Wow!  I was amazed at how much I could follow the play in the Flyers game.  I could see the score and time left in the period without getting up off the floor (where I lay, propped up on my left elbow to watch TV.)  Even the Phillies game looked good, though it wasn’t in HD since we have Fios.  I could see the rain pouring down on Halliday…  I was disappointed we didn’t get to Jacob’s lax game before the rain came.  We were in traffic on 202 after our delivery in Wilmington.  My next chance at live sports is Jane’s softball game on Monday.

I am pleased with the results thus far.  I believe I’ll be able to follow a movie on the big screen.  Maybe we’ll try that next weekend.  I am looking forward to trying things that I haven’t been able to do for many years.

EyeOp XIV Report is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: cataract extraction, cornea transplant, Dr. Ayers, Dr. Ayres, Dr. Curtis, eye, face paint, game, Jacob, Jane, John Fecenda, Lisa, patient, post, time, warm ups, Wilmington, word scrambles

On Wednesday, I’ve got an appointment with my GP.  It was postponed from 10 Feb due to the little bit of snow we had (not to mention the lack of power and heat too.)  When I saw Dr. Rist on 9 Dec, she told me to lose weight.  Since then I’ve eaten only about 1500 calories per day.  On days that I did some physical work like shovel snow, move our store inventory, etc., I would eat more calories as a reward.  As of this morning, I am down 41 pounds.  I’m interested to see what she says.

Jake is spending the week living at school, something he will have to do for his junior and senior years at Westtown.  We dropped him off on Sunday and will pick him up this Sunday.  He was really looking forward to it.  Then, when we got there, he noticed a Super Nintendo game system (circa 1991.)  The seniors whose room he and his friend are staying in left them a note saying that they could play with the system.  We have a couple of games from the video store that Jake has always wanted to play, but we never had the system (well, we had it, but upgraded to something else before he was born.)  I’m worried that school work might not be first on his mind this week.  Eliz picked him up some candy from BJ’s the other day.  You know, BJ’s doesn’t sell anything in small amounts.  She got him a variety bag of candy bars (not the fun size, the normal size) and a bag with god know how many packages of Skittles in it.  He posted today on Facebook that he was selling the candy.  Prices were $.50 for candy available in the school store and $1.00 for candy not carried in the school store.  I’m interested to see what he does with the funds, though his intentions could be philanthropic.

Jane found her letters from Tabitha tonight.  Tabitha was conjured up when Jake literally lost his first tooth.  It either fell out onto the ground or he swallowed it with his lunch that day at Granite Run Mall.  He was disappointed because he was so looking forward to putting it under his pillow for the toothfairy.  That night, after he went to bed, I wrote a letter from Tabitha, a toothfair from the North American office.  I expected it to be a one and done sort of thing, but when he lost his next tooth, we was just as excited to get another letter as he was to get the money.  And of course, if you do it for one, the other has to have it too…  Jane actually got a letter or two before she even lost a tooth.  She would sometimes leave notes for Tabitha under her pillow.  Jane laughs at the letters now, but she had fun reading them tonight.  She said each one had a little education, like Sesame Street.  I also would include things that I thought would boost their confidence and nudges on nutrition.  One day I’ll post them or publish them.

It is amazing how easy 700 words comes off my fingertips these days…  So much for a short update.  More later this week on the retina appointment.

This and That is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: aunt jemima treatment, candy, day, Dr. Ayers, Dr. Garg, Dr. Rist, Jake, Jane, Jemima, nintendo game system, North American, PAM, retina specialist, school, Sesame Street, shovel snow, store, super nintendo game system, Tabitha, week

Again, I was unable to read any of it until I flipped the pinhole cover down.  Like magic, the E appeared.  I then said I know the next line is S and L, but I can’t see it.  She told me I was wrong.  What!?!  It’s not S and L.  Now I had to know.  I moved the pinholes all around until it was as clear as it was going to be for me.  I guessed O for the second letter.  Try again.  D!, I said next.  That was it.  The first letter (don’t ask me why I don’t read them in order) looked like it could be an O, G, or C.  I guessed G in hopes of it being the GD line.  No such luck.  C was my next try and that was it.  Kelly mentioned that this chart is made up mostly of similar letters that repeat often, so my usual deduction that I’ve got a one in 26 chance which increases with every letter doesn’t work.  I’m actually going to have to read them.

Once I was finished with the eye chart, Kelly took us to another waiting room, where Eliz read me the story of the Penn State mascot in a recent addition to ESPN magazine.  Before we could finish, we were called to see the doctor.  Dr. Garg asked me about my issues and mentioned that he had spoken to Dr. Pro about me.  He explained that even though my right eye doesn’t do much he still wanted to check it out.  Since my cornea is really cloudy and I have a pretty mature cataract in it, they would use an ultrasound to have a look.  He also explained a test they’d run on my left eye, to check for changes in the macular pigmentation.  Dye is injected via an IV (that’s iv, not roman numeral for 4) and pictures are taken.  After he mentioned the dye, I remembered that I had this test before.  The images are wicked.  Unfortunately, I didn’t have a flash drive on me to get the images.

I went into another exam room to have the ultrasound and then back to the second waiting room to wait on the angiography.  After a 10 minute wait, Tom called me back to have the angiography.  He took a couple of images of my eye before putting the dye in.  The dye made me feel nauseous for about a minute.  Tom took more images and left to give someone an OCT scan (which took him all of five minutes — about 1000x faster than mine took on Monday.)  He then came back into the room I was in to get two more pictures.

I waited in the angiography room for a few minutes until they called me to see the doctor again.  He explained what he thought was going on.  He increased my use of one drop to three times per day and added another drop to try and get the swelling down in the retina and cornea.  He suggested that I wait on having the cataract removed until I see him again in six weeks.

After three hours, we were out of there.  We headed down City Ave to pick up Jane from school.  She called me just before the ultrasound and said she wasn’t feeling well, which I knew when she left for school.  I also knew we’d be right down the street from her and could pick her up after the appointment if she couldn’t last the day at school.

After I spent an hour, or so, at home (at which time I found out my mom had gone into the hospital — more on that below,) we headed over to Viva Salon in Springfield.  They’ve been having a problem with a hydraulic base that was still under warranty.  We swapped out the bad base for the good one that has been in our car since the move and headed to my next eye appointment.

I had scheduled this appointment with John Ruffini, another NPHS alum, to talk to him about the cataract surgery (and before I knew of any retina issues.)  He had a look at my still dilated left eye and we discussed my options and the problems that could arise from taking out the cataract.  He also thought it was best to see how the eye reacts to the increased drops and new drop.  I have put off scheduling the cataract surgery because of moving the business and the fact that it could undo the partial cornea transplant.  My left eye has endured seven operations over the years, with another one imminent.  I’m tired of going through these procedures and the recovery with mediocre success.  The risk/reward factor isn’t great, though I would do anything to preserve any sight I still have.

After leaving John Ruffini’s office, we made a delivery in Holmes and stopped by a salon in Milmont Park to look at a styling chair that needs replacing.  We returned home at about 4:00 pm and had an alarm company tech waiting to convert our system.  It took him about two hours (the whole story will have to wait for another time.)

We were finally able to head to Riddle to visit my mom.  She went to the hospital at around 8:00 am this morning because she was having shortness of breath and chest pains.  The doctor wanted to keep her overnight for observation.  She seems to be okay, though uncomfortable because of the shingles.  We are hoping to pick her up and take her home tomorrow.

A Long Day is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: 1964, C.  I, cataract, chart, congenital glaucoma, cornea, Dr. Ayers, Dr. Garg, Dr. Pro, Dr. Ruffini, Eliz, espn magazine, eye, Holmes, Jane, John Ruffini, Kelly, L.  Now, Media, Milmont Park, nether providence, Penn State, penn state mascot, Providence, Queen, queen of babylon, retina, retina specialist, Riddle, room, Rose Garden, Springfield, Strath Haven, StrathHaven, swelling, Teavana, Tom, Viva Salon, Wallingford, wills eye

Dr. Pro recommended a couple of retina specialists at Wills Eye, who also have an office at the Pagoda Building in Bala Cynwyd.  It was too late in the day to get an appointment today, so I’ll call them tomorrow and set something up.  I’d like to get something quickly to stop further decrease in my vision.  I already have an appointment with my local ophthalmologist, John Ruffini, on Friday and will discuss the scan, my options, and the cataract (which was the original reason I made the appointment.)

Time to See a Retina Specialist is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: appointment, bala cynwyd, call, cataract, congenital glaucoma, cornea, cornea transplant, Dr. Ayers, Dr. Pro, Dr. Ruffini, eye, iop, John Ruffini, late in the day, retina, ruffini, swelling, wills eye

I get called back and the “nurse” (she is more than a helper, but I doubt she is a nurse — please correct me if I’m wrong) puts up the eye chart.  I see the big E (20/400,) but not the SL (20/200.)  She drops the pinhole thingy over my eye and after some searching for the perfect pinhole, I see the SL line.  The OPLB line looks like some black blobs and I can’t make any of the letters out.  The “nurse” says, “Oh, that’s not so bad.  It’s only one line less.”  Really?  So if you are driving down the street, you don’t think seeing a sign with letters about 12 inches tall would be much easier to see than the sign with letters about six inches tall?  I’ve wasted a ton of money on signage then if it’s not that different.

After waiting an unusually long time to see Dr. Ayers (a total of about an hour fifteen minutes,) he finally came into the room.  We exchanged pleasantries and then discussed my eyes.  I told him about my left eye and not seeing as good as I had been and I am now having greater difficulty reading on the computer.  As I put my head into the applanation tonometer (the machine with the blue light on it,) I mention that my right eye is bothering me.  He took a look at the right eye and mentioned things like corneal edema, bullae, and some other things to the “nurse” who was writing everything in my chart.  I kind of knew that I had some bullae (small, fluid-filled blisters ,) because I’ve had sinusitis and been on antibiotics for the past two weeks.  (This is the third time I’ve had sinusitis in the last four months, could it be the mold at the store?)  The problem with the bullae now though is that when they pop, the pain isn’t going away and any kind of light brings additional pain.  I thought I might have an infection in the eye.  Doc said no and to use this stuff called Muro 128, which is basically a kicked up saline solution.  It also comes in a gel that I usually use.  I suppose I could also go to the kitchen and throw some salt in my eye…

As he checked out my left eye, he noticed the “folds” straight away.  He then said the “folds” are Haab Striae and I’ve had them for a long time.  He then (tried to) show me the sketches he’s done of my eye at every visit.  He realized I couldn’t see it and told me each one has them (the striae) there.  He said my eye looks good.  My IOP was eight in the left, 16 in the right.  Wow, so everything is good!  I am so relieved.  But wait, I can’t see as well.  There’s got to be something going on.  I do have a cataract in there, but the doc says he doesn’t think it is time to remove it.  Besides, by taking that out, it may wreck the endothelia that was transplanted in December.  Dr. Ayers says, “But we could just do another one.”  He said I might be able to 20/70 or 20/80!  Of course he said I’d get to 20/100 by doing the endothelial transplant.  I guess I’ve got to wait more than 42 weeks after the surgery to get there.  He doesn’t think the cataract is the problem though.  Dr. Ayers then adds, “Whatever it is, it’s not an easy fix.”  House!  HOUSE!  Where the hell is that guy…  Oh, he’s not real?  I thought that show was one of those reality shows.

Speaking to my dad about the appointment last night, he said, “What are they gonna tell you?  They can’t fix it, it is the way it is.”  I should have listened to him.  I’d have saved a few hours and the copay.  Not too bad for a guy that only spent two weeks in high school.

I’d like to thank Ken for transporting me to my appointment.  Since Ginny and Scott aren’t with us at the store, we don’t have coverage for Eliz and I both to leave store.  Between the mold, the economy, and my vision, it might be time to get into something else.

Everything Looks Fine… is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: applanation tonometer, appointment, cornea specialist, corneal edema, Dr. Ayers, eye, fluid-filled blisters, Ginny, glaucoma, glaucoma specialist, Haab Striae, I, infection, ken, line, Mold, muro 128, nurse, saline solution, Scott, sinusitis, the economy, time, visual acuity

After about 10 minutes, we were called back.  Christy asked about any problems, pains, etc.  She wrote down everything I said.  Then it was time for the eye chart.  Big E, that’s all I saw and even that wasn’t clear.  I could barely see that there were characters on the next line.  20/400, just like at the glaucoma study and Dr. Ruffini’s office.  Christy then flipped the pin holes down.  I saw the next line (CD, 20/200) and a letter from the next line!  The C& D (from the 20/200 line) showed up just like those ballplayers at Ray’s cornfield did for Mark.  For fun, she shined a light at my right eye.  I saw the light…  Hold the applause, please.  Dr. Pro wasn’t quite ready to see me yet, so back out into the waiting area.  We’re back to reading recipes like it’s 1999.  Sad thing is, I would have been able to read those recipes back then…

After five minutes or so, we went into another examination room.  First in was Dr. Katz, who, I believe, is doing a Fellowship at Wills.  He was very friendly and joked with Eliz and I.  He checked the IOP in both eyes (18 in the right and six in the left.)  He also looked around both eyes and mentioned that he saw the “button” in my left eye (the new part of the cornea that was transplanted last December.)  Dr. Pro came had a look and asked Dr. Katz for a quick evaluation while he (Dr. Pro) continued to checkout my eyes.

Dr. Katz stated that he got an 18 for my right eye, but didn’t know how accurate that was.  Dr. Pro said that it is hard to get a good (accurate) reading from that eye because of all the problems with it.  The cornea is thick with some scarring and there is a cataract that is pretty mature in there as well.  He then tried using a different device to get the IOP in the right eye.  From what I saw of it, it looked like one of those digital cooking thermometers.  Since the numbing drops were beginning to wear off, it didn’t feel too good being jabbed into my eye.  Dr. Pro said that the numbers were all over the place and that some of the readings were around 30.  (Perhaps my eye was simply picking the Powerball or MegaMillion numbers for the next drawing.  If Dr. Pro isn’t there for my next appointment in January, I’ll know…)

Dr. Pro then talked about the fold in the left cornea.  He told me to call and give Dr. Ayers (the cornea doc) a heads up.  He also told me to take the Pred Forte drops four times per day until I see Dr. Ayers at the end of this month.  He told me he didn’t know the cause for the fold and if it could be repaired without surgery.  Dr. Ayers would be able to tell me more.  Dr. Pro then began discussing my right eye.  He said it might be time for a trab.  I asked him why.  He thought the pressure was kind of high and I did have some vision in that eye and we should try and save it.  I mentioned that I had been told in the past by Dr. Wilson and Dr. Starer (R.I.P.) that any glaucoma surgery should be accompanied by cataract removal and a new (okay, actually it’s used, but new to me…) cornea.  I was a bit surprised by the suggestion of the trab recommendation.  My eye has very little pain usually (though, at that moment I could still feel where the meat thermometer was jabbed into it.)  Saying that I have some vision in that eye is like saying the homeless guy sleeping on the street with 18 cents in his pocket has money.  Is it true yes.  Is the sight meaningful?  No.  I then mentioned to Dr. Pro that I would be game for any type of experimental surgery on that eye.  After some additional discussion, Dr. Pro told me he just wanted me to know my options.

As we were waiting to checkout at the front desk, Eliz mentioned that my attitude had changed when he talked about surgery on my right eye.  I asked her if it was bad and she said that I was not disrespectful, but she could tell I wasn’t happy.  I wasn’t happy at all.  I still didn’t know what the problem was with my left eye and didn’t really care about how we can make my right eye minutely better.  I was extremely disappointed and frustrated.  When I got home that night, I began searching for answers on the fold.  I posted some questions in one of the yahoo groups I belong to, hoping for an answer.  As of this writing, I’ve got nothing yet.  I’ll keep you posted…  The best thing to come from the appointment, besides the recipes, was the fact that I didn’t notice any kids waiting to be seen.

Glaucoma Specialist is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: appointment, c amp, Christy, cornea, Dr. Ayers, Dr. Katz, Dr. Pro, Dr. Ruffini, Dr. Starer, Dr. Wilson, Eliz, eye, eye chart, family gatherings, glaucoma, glaucoma specialist, I.  He, magazine, Mark, pin holes, R.I.P, Ray

I had also hoped to stop by ASB (Associated Services for the Blind and Visually Impaired – asb.org) tomorrow, as they are just across Walnut Street from Wills Eye.  I didn’t hear back from them, so I don’t know if we stop in.  I don’t get a chance to get out of the store too often, so we’ve got to make the most of it.  Jane and Margaret are covering for Eliz and I tomorrow, by the way.  I will post tomorrow or over the weekend on how he appointment goes.

Wills Eye Tomorrow is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: appointment, asb.org, Associated Services for the Blind and Visually Impaired, black eye, clouding, cornea, cornea specialist, December, Dr. Ayers, Dr. Pro, Dr. Ruffini, Eliz, endothelia, eye, glaucoma specialist, Jane, Margaret, ruffini, specialist, tomorrow, Walnut Street, wills eye

The tech asked how my eyes were feeling and if I’ve had any problems lately (good and not really unless you count the elbow Eliz landed on my left eye last night.)  He then asked if I was seeing any better and I responded by reciting the eye chart down to the 20/60 line.  Since he hadn’t turned on the machine yet, he knew my memory was still good.  I was a little worried when he turned the machine on.  I saw the E, but not clearly.  I also had trouble seeing the S in the SL (20/200) line.  If I didn’t know it was an S, I don’t think I would have been able to guess what it was (though there are only 26 letters in the alphabet and usually no duplicates on a line, so I knew it wasn’t an L.  I could also eliminate other letters that are not rounded, like A, K, X, H, E, F, I, M, N, T, V, W, Y, and Z.  Now I’ve got a one in 10 chance.  Is that seeing or guessing?  I told the tech my concerns.  He handed me the eye cover with all the pinholes and told me to try that.  Within 10 seconds I could see the S.  When I was rattling off all the lines before he turned the machine on, he said there were alternative lines on the machine, made up by numbers.  I asked him to go to those so that I could see if I actually could see anything there.  He put the largest line up, which was the 20/100 line.  Without the pinholes, I saw five black blobs.  With the pinholes I was able to spot the 7 all the way on the right.  I was pretty excited.

Dr. Ayers came in shortly after.  He had a look and told me things looked pretty good.  The only concern is that my IOP was six.  It has been fluctuating between six and eight for a few years, but has been at six for quite some time.  I asked if I could go swimming and was told I could.  I also asked if I could wear goggles.  Dr. Ayers advised me not to wear the goggles that the swimmers in the Olympics wear, but to use those that are larger.  Fortunately, I already own a pair of AquaSphere goggles, so I’m good to go.    Dr. Ayers told me to cut back on the Predforte to only Mondays, Wednesdays, and Fridays as he didn’t see any signs of rejection going on.  I’d like to be off the ‘roids at my next visit in October.  The cataract is still not ready to come out.  The amount of vision I’d pick up by having it removed isn’t worth the boatload of risk (it could wreck December’s surgery, as well as destablilize the eye as far as the glaucoma is concerned.)   That finished up my appointment and we were good to go.

So, the bottom line is that I was pleased with what Dr. Ayers told me.  I can do whatever I could do before the surgery (swim, lift heavy things – though, the heavier I get, the less I seem to be able to lift, etc.)  Still waiting on something/someone to fix my badly damaged optic nerve…

Almost Eight Months is a post from: ICantCU.com | © 2009, iCantCU.com. All Rights Reserved.

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Post tags: 26 letters, ayers, Dr. Ayers, eye, eye chart, left eye, line, machine, pinholes, surgery, tech