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.

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