Sunday, July 15, 2012

Contacts To Cataracts (Part 5)

It may sound familiar, but as I said a few days ago, Oh My God!  This is so wonderful!

I am now 4 days post op on my right eye, and 2+ weeks post op on my left.  The only word that really comes to mind is miraculous.

There are only a few things I have to share about the second surgery.  First, I was asked by the doctor's office to change my surgery time from 8am to 1pm to accomodate a diabetic patient.  The woman was elderly and couldn't wait too long for her insulin and to eat.  I, on the other hand, was younger, more easily adaptible and not diabetic.  I agreed, but reluctantly.  Ayurvedically, I am a primarily a Pitta (blond hair, blue eyes, fair skin, a strong constitution) which means I get pretty cranky if I miss a meal.  I do better if I miss breakfast, but much worse if I miss or am late for lunch or dinner.  Through nobody's fault, they were running late at the surgery center (most likely due to patients needed additional recovery time), so my surgery time was bumped closer to 2:30pm.  I had last eaten at 6:30am.  I did not have an easy time of it due to being very hungry.  I developed a headache and was cranky.  I managed to retain my sense of humor and did warn the nurses I was not in a good mood.  All went well, and it was what it was.  The surgery was quick, and I got my cup of coffee right afterwards.  I was glad I had packed along a PB&J for the drive home.  If I had to do it again, I may have elected to say no to switching surgery times, or have considered delaying a week to accomodate a more urgent patient.  I don't know.  It seems silly now, this petty bitching, but at the time, it was a big deal to me.  I was hungry!

At my follow up visit the next day, less than 24 hours after surgery, I was seeing 20/30 out of my right eye.  My eye pressure was up, but I was told 50% of patients experience this.  The doctor gave me a drop to bring the pressure down.  I was released to drive and return to my regular routine, but still no heavy lifting or rubbing of the eye (which means still no eye makeup).

I came home and pretty much took it easy for the rest of the day.  My eye was still dilated and the vision was a bit fuzzy.  My husband had a headache, and so we spent the rest of the day just watching TV and hanging out.

When we woke up the next morning, I asked about his headache which was better.  He asked me how I was doing, and I looked at him quizically.  "Fine," I said.  "Why wouldn't I be?"  And then I realized - oh he's asking about my eyes.  I was seeing so well, I totally forgot I had even had surgery.

Now the one "bad" thing about the situation is that I'm seeing so well, I keep forgetting to do the whole "drops" thing.  So far, I've caught myself and haven't missed a dose, but I probably should be setting alarms on my phone to remember.  If I were working, I'm pretty sure I'd be forgetting all the time.

Right now, I'm seeing very clearly and crisply in my distance vision.  I drove yesterday for the first time.  The biggest thing I noticed is that my depth perception and peripheral vision had improved, and it was much easier to merge onto the freeway/highway.  I'm wearing "readers" that I bought at the drug store for computer and close up work.  I'd been wearing them along with my contacts before so I'm not surprised I need them now.  I can deal with it.

My next follow up visit is in 3 weeks.  At that time, we will see if I need anything stronger than readers, or if I am a candidate for monovision with one contact.  This is where you correct one eye for distance, and one eye for close up vision.  The brain then determines which eye to use depending on what you are looking at.  I had been corrected with monovision for many years, but stopped when I made the switch to soft lenses.  It's unclear (pun intended) whether this will work for me now, but I'm excited to find out.  I have as much trouble remembering where I set down my readers as I do remembering where I put my cell phone.

My bottom line here is this:  If you have cataracts and need or want surgery for them, DO IT!  You won't be sorry!  One of the best things I ever did for myself.

Wednesday, July 11, 2012

Contacts to Cataracts (Part 4)

Things I Wish I Had Known In Advance

What They Don't Tell You

Things They Told Me But I Wish I Had Really Thought Through On How It Applied To Me

This article is addresses the fact that there are things they tell you in advance, but you don't really comprehend until it is happening.  And then you think (or may think) - Oh Shit!

Most of the following is about the strictly inconvenient stuff and things to think about before you pick a surgery date.  I am so pleased with the results of my surgery that I would never think twice about recommending the procedure to anyone with cataracts.  The sooner, the better, you won't be disappointed.

1.  "The Drops" - I remember back when I was a teenager and my grandparents were having cataract surgery, they did a lot of complaining about the eye drops.  I assumed it was about the drops themselves.  After all, putting foreign objects, liquid or otherwise, in your eye is not a natural thing to do.  Jump ahead 45 years and I now realize that it is not the drops themselves, but the time it takes to do all of it.  Three separate drops, waiting 5 minutes between drops, means three 15 minute periods that you have to set aside each day.  And then you have to remember to use them.  That means taking them with you if you go out for the day.    Again, tres inconvenient, but worth it.  It's the one that I hear all cataract surgery patients complain about.  It doesn't sound like a big deal, but it can really screw up the day.  And on a personal note, I can't wear my contact in the non-surgical eye for the 3 pre-op days which means no driving, and difficulty navigating while walking - with or without bubblegum. And the drops do not end with surgery.  There are post surgical drops which you use for about a month.  Two bottles of each of the three medicines - one bottle for each eye to avoid cross contamination.

2.  "Make Up" - The instructions say no makeup on the day of surgery and the day after surgery.  Okay - no big deal right?  Also in the instructions is not to rub your eye for a week to 10 days.  The unsaid consequence is that it is difficult to remove eye makeup without rubbing your eye - so really, it is no makeup for 2 weeks, and then you have the other eye done and no rubbing (think make up) for another 10 days.  That's about a month without make up.  Be sure to check your vanity prior to surgery.  I'm lucky in that I am retired and my grandkids don't really care if I have make up on or not.  But remember to take this into consideration when scheduling your surgeries.  If you have a social event, or just going to work, and not wearing make up is difficult, maybe you just don't plan anything for those weeks.  As I said, in my case, it turned out okay, but if I were still a working woman, I would have been uncomfortable, and my vanity challenged.

3.  "Driving" - You might as well get a driver.  Not just for the day of surgery and the day after, but also the day before as you will be dilating your eyes with those dreaded pre-op drops.  Then the 2 weeks in between, depending on how much correction you need if you are near or far sighted, you may not be comfortable behind the wheel.  I had my contact lens for the non-surgical eye the first week after surgery, and so I was okay to drive, but I did use back roads and stayed off the freeway and avoided traffic.  The week of surgery, the drops start again and I couldn't wear the contact in that eye.  Another thing it would be good to point out in that follow up visit weeks before surgery.  Do you have a job that requires that you drive either in the course of the job itself, or just to and from work, you will need to take this into consideration.  I probably would have used my sick leave to take the whole week off, and if I had enough, I would have taken the week before the first surgery and the 2 weeks between surgeries off.

4.  "The In-Between Surgeries Time" - Contact lens wears definitely have the benefit here - at least for the first week in-between surgical dates.  You'll have your surgical eye which probably will be fine with much improved vision, and you can use your regular contact lens in the non-surgical eye.  The week of the second surgery, you are not supposed to wear the lens because of the four times a day eye drops.  It means one good eye and one bad eye.  Your depth perception is definitely off, and it can just be very hard to focus and see clearly, again depending on how much visual correction you require.  I was lucky because my husband and I are retired, so he did most of what needed doing in regard to watching our grandson four days a week.  I was relegated to snuggling and rocking during quiet time - something I do quite well anyway.

I had talked with my doctor about the challenge of navigating during the time between surgeries.  He said,  "Well, most people just deal with it and adapt short term to having one blurry eye."  I'm thinking, "But I have very special eyes....."  I was quite insistent about having the left lens removed from my glasses so I could read or watch TV easily.  The doctor humored me, and had the optician remove the left lens.  LOL - looking out the one lens glasses made me very sick to my stomach.  So not only did I look ridiculous, I felt terrible.  I should have just trusted that the doctor had more experience with this, and took him at his word that the brain (and the patient's attitude) just learn to adapt.  If I can do it, anyone can.

So to wrap up my tips for dealing with the cataract experience:

1.  Check your schedule and make a plan for dealing with the drops.
2.  Think about your social and work plans.  If you are a woman, think about when, or if, you just have to wear makeup.
3.  Find a chauffeur.
4.  Be ready to have your vision disturbed, fuzzy or annoying during the weeks in between surgeries.
5.  Not mentioned above, but another consideration is the financial aspect.  Depending on the lens you are getting, there may be a large out of pocket (not covered by insurance including Medicare) expense.  For me, I did not need the toric or multifocal lens, so my out of pocket expense was limited to my deductible and the cost share portion.  A surprise was that the eye drops were not covered completely by my insurance.  I had about $130 pharmacy bill, for each eye, that was a surprise to me.  If finances are an issue, be sure to get the names of the procedure, and the CPT and ICD-9 codes from the surgery scheduler, and the medications that will be prescribed.  Then call your insurance carrier and check on what they will or will not cover.  Cataract surgery is generally a covered expense for most insurance carriers, but it's better to know in advance and not be surprised by a big bill.

Tomorrow is my second surgery date.  I'm a so "looking" forward to it.  Seeing well out of both eyes without correction will be a very big treat for me.  It will make camping easier, swimming easier, staying in strange unfamiliar places easier ---- not that I make a point to stay in strange places, but it will be great to be able to stay in a hotel room, or at friend's or relative's house, and be able to get to the bathroom in the middle of the night without having to grab my glasses.  Incidentally, that is a hard habit to break.  I still wake up first thing in the morning and try to grab my glasses.  It takes a few seconds for me to realize I don't need them anymore!  It's so cool!

Contacts to Cataracts (Part 3)

Okay - The only thing I can say about the surgery is OH MY GOD!  It is pretty darn close to miracle status, in my humble opinion.

Surgery time was 8:00am, with scheduled arrival at 7:45am.  The worst thing about it was not being able to have anything to eat or drink 6 hours prior to the surgery.  What, no morning coffee?  What's a Seattle girl to do?  The sip of water with the pre-op Valium was not cutting it.

I met the surgical nurse and the anesthesiologist.  Everyone asks the standard questions - name, date of birth, why are you here, which eye are we doing today.  All my questions were answered, and I was assured if I felt a coughing spell coming on, just to let them know and it would be fine.  The IV was inserted and I was given a little something more to help me relax.  The rest of it happened very quickly.  I saw some colored lights.  I could hear talking around me, but I really wasn't paying much attention.  The next thing I knew, they were walking me out to the waiting room, and giving me coffee!  My day was looking better already (pun intended).

Just when I was ready for my second cup of coffee, the nurse stopped by to go over post op instructions, and before I knew it, we were headed for the car.

My surgical eye was still dilated, and I did not have a contact lens in my non-surgical eye, so I expected things to be quite blurry.  I have a strong tendency to motion sickness, so I was keeping my eyes closed.  A few miles down the road, I decided just to open my eyes to see what I could see.  It really is hard to describe.  I was able to read signs on the freeway, and on moving trucks, etc., without glasses or contacts for the first time since I was 8 years old.  My husband said I was like a kid with a new toy.  I was reading signs right and left, totally thrilled already, knowing that my vision would improve even more over the next few days.

I spent the rest of the day at home, just taking it easy.  I did put my contact in my non-surgical eye so I could watch TV and read.  I had no pain, and no itching.  Dealing with the variety of drops I had to use was kind of a pain in the ass, but more on that in an upcoming posting.

At my follow up visit the next day, my vision was measured at 20/25.  I am so happy with the results so far.  So glad my sister-in-law, my daughter's father-in-law's wife, and a number of friends encouraged me to have this surgery. 

It has been 2 weeks since that surgery, and my vision is amazing.  Tomorrow I have the other eye done, and I can hardly wait!

Tuesday, July 10, 2012

From Contacts to Cataracts (Part 2)

The Unexpected Hiccup:

I like to think of my actions and reactions not as part of a problem but rather as part of a solution.  When you first inquire about cataract surgery with your ophthalmologist, you will probably be given a packet of information to review, and be asked to return for a follow up visit to discuss that information and the various options.  Also there will be non-invasive tests to measure inside your eye to help determine what type, size, and correction of replacement lens will be needed, a pre-op visit, the surgical date, and a post surgical follow up the day after surgery. 

My story didn't happen in that order.  I share the information here not as a criticism but as a learning experience, because what could have happened would not have been good for me.

First of all, statistically I believe I am much younger than the average cataract surgical candidate.  Of course, I forget that I am 58 now, and that 58 is closer to 60 than to 50, but still, on average, I believe I am younger than most who have this type of surgery.  And I wear contact lenses, which I am guessing most of the candidates do not.  I make this guess because all of the literature I read and the FAQ/information sheets I received did not mention contacts in relation to patient instructions and post op information.

Let's start with the initial visit.  I was having my annual eye refraction, and I brought up the fact that I was bothered more and more by my cataracts.  The doctor gave me literature to review, and said we would talk more about it at my follow up visit.  Because I had asked about cost differences between the various lenses (regular, toric for astigmatism, and multifocal which are akin to trifocals), he had me talk with his surgery scheduler and financial planner.  She gave me some surgery dates and I said okay to the financial terms.  The next thing I knew, I was scheduled for a pre-op visit.  I went home and reviewed the literature.  I called the office and asked to have an appointment to discuss options before my pre-op visit.  The receptionist insisted all this would be handled at my pre-op visit.  I hung up, thought about it and called again.  I asked to speak to the surgery scheduler this time, and asked about the follow up visit to discuss options.  She also told me all my questions would be answered at the pre-op visit.  I still was not sure this was the correct procedure.  I was missing that 2nd visit to discuss options.  Unfortunately I could get no one to listen to me.  Long story made somewhat shorter, I went through the series of pre-op testing to determine what measurements would be needed for my new lenses.  The information that didn't get passed on to me was that I was not to wear my contacts for 2 weeks prior to the test.  Had I been able to schedule the follow up visit, that information would have been shared with me.  As it was, I called before my surgery date with a medication question, and it came out that I had been consistently wearing my contacts except for the day of the tests.  I then received an emergency call from the doctor himself, cancelling the surgery because the measurements were not accurate, and the lenses that would have been created would not have worked for me.

I'm most grateful that this all came out before the surgery date.  I was frustrated because now the surgery was delayed 3 weeks, 2 weeks to be out of my contacts before testing, and an additional week to do the calculations and make the lens.  I should just have trusted my gut in the first place because I knew I was missing a step along the way. I had made plans revolving around these surgery dates and my daughter had to revise her daycare coverage.   The office was all quite apologetic about the experience, and I made suggestions about how this could be avoided with future.  There should be a section for contact lens wearing patients in the FAQ handout that mentions being out of the contacts for 2 weeks prior to testing,  and a simple question asked by the technician who did the testing confirming that contacts had not been worn for 2 weeks, would have avoided the mistake, and prevented a possible malpractice situation.  I hope they will apply these suggestions.

The next thing that happened was that I came down with a cold.  In the pre-op visit, I was warned to be sure and let the office know if I got sick.  I fought this cold with everything I had - from EmergenC, to grapefruit seed extract, to acidophilus, to Airborne, and when it finally got beyond the natural treatments, I pulled out the Sudafed and Robitussin DM.  I was pretty much over it (although it had taken 2 weeks), and was just dealing with the residual cough.  There was a lot of praying and affirming my perfect health going on. Because I believe all things happen for a reason, I began to question if this surgery was right for me, or if this surgeon was right for me.  I spent some time in prayer and meditation asking God to guide me.  I felt very calm about the procedure and the doctor, and felt guided to go ahead as planned.  Still I was a bit anxious and really, really, really did not want to cancel and reschedule yet again.

 I finally just called the doctor's office to report my condition, and was told that as long as I didn't have a fever, it should be okay.  I was relieved to find this out. The surgical nurse called me just to go over procedure and told me that if I was still bothered by the cough or even a runny nose, they could give me something for it.  Also, if I felt like I needed to cough, all I had to do was tell the doctor so he could move his instruments.  I felt reassured.   I do wish they would have defined "sick" ahead of time.  To me sick includes common cold and beyond.  They were more worried about fevers and increased white blood cell counts indicating infectious disease.  I don't know if I would have reacted any differently.  Nothing I did as a result of this bump in the road was really a bother, other than my worrying, but I countered that with prayer, which certainly didn't hurt matters any and did help calm me down..

So, it was a go for surgery the next day.  I was relieved, excited and just a itsy bit anxiou.

Monday, July 9, 2012

Recipe Collection: Low Fat/Low Calorie Cole Slaw

I love mayonaise.  It is my condiment of choice for most everything.  In my attempts to stay with a lower fat, lower calorie eating plan, giving up the regular cole slaw that I make with generous amounts of mayo was not one of the highlights.  Asian style slaw is fine in some cases, but nothing replaces creamy coleslaw with fish or barbeque.

I found this receipe at www.sparkpeople.com.  It was submitted by a user named KLAYZEE.

Number of Servings: 8
4 cups shredded cabbage
.5 cup Kraft Light Mayonnaise
1 TBS cider vinegar
2 TBS skim milk
1 TBS splenda
pinch of black pepper
    Mix together. Makes approx 8 1/2-cup servings.
    Nutritional Info
    • Servings Per Recipe: 8
    • Amount Per Serving
    • Calories: 60.8
    • Total Fat: 5.0 g
    • Cholesterol: 5.3 mg
    • Sodium: 128.4 mg
    • Total Carbs: 3.5 g
    • Dietary Fiber: 0.8 g
    • Protein: 0.8 g

I did add 1 tsp of dill weed to this recipe, and only 1 tsp of Splenda (actually, I used Truvia) and 1 tbsp of 2% milk.  It does need to sit in the refrigerator for at least 30 minutes. 

Considering I used low fat mayo, it was pretty darn good.  Even my husband said it was pretty good, and he is not a fan of low-fat anything.  If I had to choose between not having cole slaw due to the fat content, and having this recipe with the low fat mayo - I choose this recipe.  I think next time I will try some celery seed/salt instead of the dill.  And I may cut back on the vinegar a bit to see if I can omit the Truvia.

    Sunday, July 8, 2012

    Life Purpose

    Back in my "past life" of being a professional psychic/intuitive/spiritual counselor, I was taught that the 3 most popular topics I would encounter in doing readings were health, love life and life purpose.  My experience has taught me that the answers are the same for all three:

    1.  The only constant is change.
    2.  Trust your gut. 

    Today's topic is Life Purpose.  It came up because of something I read this morning.  I went back to see what it was that prodded me to write on this topic, and danged if I can find it.  Perhaps it was just during my meditation time, while I was trying not to chastise myself for my sorely missed writing schedule, that I began to think about how our "purpose" changes from time to time.

    I believe our primary purpose here on earth is to love - to show love, to give love, to be love, to vibrate loving energy.  It only stands to reason that in order to embody that love, we need to love what we are doing.

    When I first started working, I knew I wanted to work in the medical field in some way, shape or form.  I did many things in this area from working in a hospital as a ward runner (fancy name for the bottom of the food chain in a hospital wing), a receptionist in a doctor's office, a transcriptionist, a lab assistant, medical claims assistant, and finally medical office management.  I enjoyed my work, was happy doing it, until one day I knew it was time to move on.

    I took on a position as an administrator/office assistant for a spiritual teacher who taught psychic development classes.  I also had a part time counseling and hypnotherapy practice.  This was also very rewarding work.  I was able to meet many wonderful people, counsel and assist people on their spiritual journey.  I enjoyed this work very much....that is until I didn't.  Time to move on again.

    Next step:  Retirement.  Now those who are retired know that there really is no such thing.  You find yourself doing stuff that you enjoy, that occupies a good deal of your time, and doesn't pay nearly as well as your "regular job" did, if at all.  You are far more busy once you retire than you ever were while working.

    I had about six months of "retirement" where I spent a good deal of time writing and researching for a novel I intended to write.....and still intend to write. 

    Then grandchildren happened.  Following my heart, my joy, my love - I've been devoting most of my time to my grandkids.  I still enjoy writing, but I enjoy my grandkids more.  My gut instinct is that right now, this is my life purpose - to care for them, to guide them, to inspire them, to teach them, to love them. 

    At some point, I will go back to writing more than just an occasional blog entry, but right here, right now, my life purpose is to be a full time grandma!  Can't you just feel the love?

    Saturday, July 7, 2012

    From Contacts To Cataracts (Part 1)

    I was about 13 years old when I got my first pair of contact lenses.  This was back in the days before disposable lenses, soft lenses, or even gas permeable lenses.  They were hard little pieces of plastic.  They snapped easily.  They popped out of your eye if you looked suddenly in one direction, or if the wind came up and just swooped them off the surface of your eye.  And they hurt like hell when you first put them in.  In fact, there was a breaking-in period.  I wore them for 1 hour a day for a week, then 2 hours a day for a week, then gradually moving up to to 10-12 hours a day - 16 if I was lucky and used a lot of Visine.  But it was a miracle as far as I was concerned....to be able to see so clearly.  OMG - what a difference.  I knew I would never go back.

    In my early 50s, I developed a case of Grave's Disease (hyperthyroidism) and the tell tale sign was my bulging eyes.  I looked a bit like Luca Brasi getting strangled in The Godfather.  For whatever reason, in Grave's Disease, the immune system thinks there is something wrong with the area behind the eyes and sends in "healing" T-cells.  The T-cells accumulate there to "fight" the alleged infection.  As more and more cells gather, the push the eye balls forward in the eye socket, giving that bulging eye appearance.  When that happens, the shape of the eye changes, and contacts no longer stay on the eye.  I was forced to go back to wearing my glasses full time.

    Eventually Grave's Disease runs it course, but I was pretty miserable during the 5 years I dealt with the process.  I had to have radiation to the back of my eyes to destroy the T-cells, and I was on long term Prednisone to take down all the swelling, plus the medication to correct my thyroid function.  To correct the damage done by the T-cells, I had to have orbital decompression.  This is where they scrape some of the lower orbital bone away so the eye will fit back into the socket.  Then came strabismus surgery.  The eye muscles were extended and stretched out and my eyes wandered off to the side giving me double vision and a very odd appearance.  The blessing after those surgeries was that the skin was stretched out too, so I got myself a lid lift, a "necessary medical procedure" because the skin was drooping into my field of vision, and therefore it was covered by my medical insurance.  Yay!

    All during this process, I used spiritual techniques I had been taught over the years, including but not limited to, prayer, affirmations, a gratitude journal and a wish list.  On my wish list was an entry for 20/20 vision without the use of contacts or glasses.   I had the beginning of cataracts for years, but it did not effect my vision enough to warrent surgery.   Well, the long term use of Prednisone contributed to my cataract formation, and surgery was scheduled.

    Nowadays, opthalmologists are able to replace the cataract lens with a vision correcting lens.  It is a bit link a permanently placed contact.  My dream and intention of having 20/20 vision without the daily use of glasses or contacts is now possible.