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!

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