It’s Not Cuckoo Bananas, But It’s Not Good Either

It has been a busy week, so I haven’t had a chance, until now, to post an update on last Fridays appointment with Dr. Garg, the retina specialist.  Unlike two weeks ago when I went to the glaucoma doc, this appointment was lacking most of the nonsense.  By the end of the appointment, I wasn’t any closer to an answer than I was since late April.

The appointment started with the typical questions from a tech about how my vision was doing, if I was experiencing any pain or discomfort, etc.  Then it was time to read the chart with my left eye.  The E was not a problem.  The next line, C and D, I could see, but if I didn’t remember it I might have said G instead of C.  The next line, which I now know is DHN, I couldn’t see.  With the pinholes, I was able to make out the H.

She moved on to my right eye.  Good news there, I can still tell if a light is off or on if it is a foot or less away from my eye…  Yippee.  She then put, or should I say shot, drops into both eyes.  God only knows how many, but it was sure more than one of each.  One is to numb the eye to get IOP (pressure) readings, while the other was to dilate my eye.  While she was doing this, she left the chart on, so I continued to try to read it.  She then used a hand-held device to get the IOP (Dr. Ayres calls this device a glorified random number generator.)  IOP was nine in the left and mid to upper 20s in the right.  The previous week at my glaucoma appointment, it was eight in the left and 13 in the right using the standard device (the one that you put your chin in, press your head against the bar, and look at the blue light.)

She waited a minute or two and then tried to get another number on the right eye.  Meanwhile, I’m still trying to read the 20/100 line on the chart.  She then said I was cheating by continuing to attempt to read the line.  Eliz didn’t like what she said and asked how I was cheating if I was just trying to read the chart.  While the lady answered Eliz, I had my hand in front of my eye, trying to simulate the pinholes while still trying to read the line.  Hey, if you don’t want me to keep trying, shut the effing thing off!  As we got up to move to the next exam room, I glanced behind the chair where the chart is bounced off of a mirror and saw that the line was DHN.  Now maybe that was cheating.  How would that help me though?  It’s not like I could get a drivers license for reading the 20/100 line.

In the next room, Dr. Garg came in and asked some questions and then had a look.  He then told me that the only thing left to try were injections in the eye.  Before we try that though, he wanted to get another OCT scan to make sure the risk/reward was worth the attempt (actually, attempts, as it would take several injections over the course of a few months for it to work.)

Tom gave me the OCT scan a few minutes later, then we headed to another exam room.  After a minute or two, Dr. Garg came in and had a look at the scan.  He said that it wouldn’t be worth trying the injections as there was only a 15% chance of them helping me see better.  At that point, I said, “Okay, so there isn’t really anything you can do for me?”  “That’s right,” he replied.  He told me I could come back in five months (why?,) or sooner if I was having any other problems.  He did tell me to make sure that I see him, Dr. Ayres, Dr. Pro, or Dr. Ruffini frequently to get IOP readings.  Seems like ‘roids that I take 2x per day in the left eye could cause the pressure to rise.  Maybe it’s time to see Dr. House, Dr. Riviera, or Oscar Goldman…

So while my vision is not cuckoo bananas (a technical term Dr. Garg used at my last appointment in June,) it’s not good either.  So what do I do now?  Some days, my vision is better than others.  Today, for example, it sucked big time (I suppose that is a technical term I picked up somewhere along the way.)  Maybe I’ll see a little better tomorrow.  I’m not holding my breathe (but would if it would help…)

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Surgery No. 14 is Set

Over the past 10 days, I’ve been to three different doctors.  I’m starting to feel like my parents.  The most important of the three was two days ago.  My appointment was with Dr. Ayres, the one who did the partial cornea transplant (DSEK) in December 2008.  He thought that the cataract I’ve had in my left eye for sometime could be the culprit in my steadily worsening vision, but he sent me to Dr. Garg, a retina specialist, to rule out a retina issue.  Dr. Ruffini also thought I should consider having the cataract removed.

I was not looking forward to another surgery on my left eye until things started going downhill in July.  The problem was, none of the doctors knew what was causing the problem.  The cataract didn’t seem much worse than a few months earlier, if at all.  After going from one specialist to another, it was determined it wasn’t a glaucoma issue or a retina issue.  Lets just hope it is the cataract that is the issue.

I’m having the cataract removed on 15 April (so I guess I’ll send our taxes in early…)  There is also a possibility that I’ll have another DSEK (endothelial transplant.)  The donor endothelia will be in the OR, just in case.  Evidently, removing the cataract risks damaging my now 70 year old endothelia (along with the other common risks associated with this in most people and specific risks for unique individuals, such as myself, with other eye issues.)

I am disappointed that I have to wait that long for the surgery.  I joked with Dr. Ayres that I was ready to have it yanked on Wednesday.  I’m sure I have been less than pleasant to be around at home.  Tonight, I was home alone while Eliz, the kids, and a few of Jane’s friends went to see Alice in Wonderland — I miss going to the movies.  My frustration level is high and it takes me so long to do many basic things.  I am so ready to get the cataract out, it is hard not to get excited.  I’m trying to temper the excitement, since it only leads to disappointment after the surgery (at least after the last three.)

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A Long Day

It has been a long day.  It started off with a trip to the retina specialist at 8:30 am.  We were a few minutes late, so only had to wait about 10 minutes in the waiting room.  Eliz had a cup of tea from the Senseo (or similar) machine, while I brought my own (my favorite Teavana mix: Queen of Babylon and Rose Garden Rooibos.)  I was called back into the first exam room, where I would (try to) read the eye chart and go over my eye issues.  Kelly asked about any of my eye problems and then noticed we were from Media.  She said she grew up in Wallingford.  When Eliz told her we did as well, she mentioned that she graduated from Strath Haven in 2002.  I told her I graduated from Nether Providence and Eliz from Strath Haven and Kelly asked if I went to school with her mother since I was born in 1954.  I laughed and asked if I looked 55…  I guess if there’s going to be a mistake, that one isn’t bad at all.  She corrected my birth year to 1964 and we moved on to the eye chart.

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.

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