Thank You Doctor Martin and Marina!

One Heck of a Doctor!

James Andrew Martin, M.D
Ophthalmologist

Doctor Martin truly is the consumate professional!
He gave very informative play-by-play descriptions throughout the procedure in excellent layman's terms; which banter helped me to relax immensely.
He should be recognized for his humanitarian skills and "bedside manner".

It wasn't long before I perceived we share like senses of humour, so when he asked how I was on my first check up how could I resist, "It feels like I got booted in the eye with a Doc Martin."

... and here's poor Marina!

Thanks for your wonderful help Marina, checking me out on my first trip to St. Joseph's Hospital.
Marina checked my eye and dilated it for my upcoming, preliminary exam with Dr. Harvey. After completing the notes in my file she asked me to follow her back out to the waiting room.
It was a very busy day with dozens of patients in the main waiting room waiting for her.
As we exited the examination room, I knocked my elbow hard on the door frame and yelled out. Marina turned around fast to see me rubbing my head in the doorway, pretending I had walked right into it.
I think she wanted to kill me when she realized I had duped her.
We've seen each other a couple of times for my followups and I believe she has forgiven me.

Expert Photography by Goomie

Update, July 24th, 2009

Sixteen Days Post-op, The Redness
in My Left Eye is Negligible

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The operation on my right eye was today. This was minor compared to the left one ... requiring laser work to repair two holes in the bottom of the retina. It took maybe ten to fifteen minutes and was painless, except for the mild discomfort while Doctor Martin used that shoehorn device again to access where he wanted to go … keeping my eye from blinking as he worked with the laser. It does feel like he is removing my eyeball. (If you are perusing this site for information and have not had the procedure yet, don’t read that last sentence.)
It seems my left eye, (now 16 days after the operation), experienced its best day of improvement. The gas bubble is approximately fifty per cent of its original size … so, as according to Doctor Abdul, is about one millimeter in diameter now versus its original two millimeter diameter size. Being half its original size, it seems there is less refracted light crossing my field of vision.
The best thing of all … another patient in the waiting room referred to people “our age” should not be experiencing eye troubles. Figuring him to be in his mid forties, I laughed and asked how old he thought I was. When he replied 45 it took every ounce of willpower not to jump up, run over and plant a kiss on his cheek! Yes, it is awful when people as young as us get those old age afflictions! Hahahaha
One patient in the waiting room today, a mechanic, had a tire blow up in his face the day before, sending a piece of steel into his eyeball. After emergency surgery last night, Doctor Harvey was not optimistic about his recovering sight in the eye. Meeting others in the waiting rooms, such as this chap with a very poor prognosis, makes me realize how blessed I have been to make such a great recovery. We should never take our health for granted!

Hardee Har Har!

Was at the pharmacy today and asked if they had eye patches.
Voila! .... $2.69 plus tax and I'm ready to go pirating.
The gas bubble in the left eye is refracting light coming into the eye, sending a ray of light for every light source up through my entire field of vision,. It makes reading, watching television or working on the computer very disconcerting.
When I walk through a store with banks of overhead fluorescent lighting there's a veritable light show dazzling my entire view.
By eliminating the use of my left eye things are back to normal; well half normal!
I'm not sure if I'm going to use the patch all day, every day ... we'll have to see if I can put up with it ... I can't even stand having a watch on ... so this is really annoying me.
Who said life is easy!!!

I got my sight back, so all else is trivial!

UPDATE: Wednesday, July 22, 2009, 3:00 PM

It's been a quiet couple of days between postings; not much to say. This morning I had my first check up with Doctor Martin in a week, with good results.

My left sight did not improve over the last week, which his associate, Dr. Abdul, confirmed during his battery of preliminary tests before I went in to see Doc Martin.

Abdul is exceptionally interesting and very candid about his own country. We had a short chat about his father in the air force before WW2 and his grandfather being the first doctor in Afghanistan.

It will take an estimated 40 days for the gas bubble in my left eye to evaporate. Since it deflects light like crazy ... I see rays of light which bounce off the bubble ... it will take awhile before I see clearly - it still looks like someone has smeared Vaseline on my eye .... but not as much this week. The bubble also casts an emerald hue on everything. At a previous appointment Doc Martin explained it will be 2 to 3 months before I fully recover my sight, so I did not feel bad this morning when I could not read the bottom line on the chart.

Oh ya ... as an aside ... I played that old, old eye chart joke on Marina at St. Joseph's Hospital when she last checked me. Covering one eye and facing the chart I read out, "M A D E I N J A P A N". Maybe it's too old; she kind of ignored me, offering a very small hehe under her breath.

Since there are the beginnings of problems in my right eye ... a couple of minute holes at six o'clock for those keeping track and mapping my eyes along with the surgeon ... Doc Martin wants to nip those in the bud, so I have laser surgery on that one this Friday morning. (This is NOT major, so please, please, please ... no flowers.)

Martin has given me permission to lay almost prone at night now, but not below 30 degrees ... so we have reluctantly turned the furnace back on.

Also, I'm to limit my beloved gardening as yet, due to the continual bending over; plus refrain from full contact lawn bowling all together.

Overall, I am very encouraged by it all and glad that my prognosis is so good. There are others I chat with in the waiting room who are at risk of losing their sight, so I am extremely blessed with my own result.

Update, July 21st, 2009

The redness is almost non-existent, at least to someone unaware of the invasive surgery just two weeks ago.

Look at This American Propaganda!!!!

I just had a retina detachment and was attacked by a total of six doctors and had my eye sight restored, all for free under our health care system, within a day. It's all recorded here, day by day and even hour by hour.

Look at the propaganda being spread south of the border in this You Tube! No wonder their health care system is in such disarray!

Update: Friday, July 17th, 2009, 6:00 PM

Nine Days After
the Operation

It seems this could be the best day for improvement so far ... at least externally. As can be seen the redness diminished quite a bit overnight. I don't feel I look like a boxer, (well, I guess I am looking scruffy from sitting still).
Internally, nothing changes noticably from day to day. My eyesight still remains quite blurry and there is a tinge of emerald green to everything, due to the gas bubble sitting in my eyeball.

UPDATE: Friday, July 16, 2009, 3:00 PM

The last 24 hours has probably seen the most remarked decrease in my left eye's redness; now eight days since the surgery.

Update, July 15th, 2009

Saw Doctor Martin at his office this morning:
* The eye is healing fast.
* On the eye chart it is now at the legal minimum for driving, (how's that for an eye that was blind a week ago!!!).
* Have to stay still for one more week.
* Next appointment one week from today.
* Will soon repair two minor holes in my right eye retina.

* He agreed that it would probably be okay if a patient wanted to take two Tylenol 3's before my type of surgery. I told him it had hurt quite a bit and that would take off some of the sting. I wish I had!!!

As can be seen from these photos taken at 2:00 PM today, there is still some redness and very minor swelling. But look! The smile is there as good as ever!!! hahaha

Image Update: July 13th, 2009, 5:00 PM

Still lots of redness in left eye

Check Up, St. Joseph's Hospital, July 13th, 2009, 8:00 AM

This morning's check up with Dr. Martin and Dr. Shadra, the resident ophthalmologist at St. Joesph's, went very well:
* I was able to read down to about the 8th line on the chart.
* My eye was dilated with drops, and using that viciously bright light, Dr. Martin examined my whole eyeball, ("look up, more up, more to the right, good, now more to the right, not so much to the right, good, now down, further down, ....")
* Dr, Shadra also examined the gas bubble.
* Dr. Martin advised me to continue sitting slightly forward and to the left to keep the bubble in its place and to keep sleeping in an upright position, (which is so tough to do!).

Dr. Martin also explained how the retina reattaches. During the operation he froze the area behind the retina, causing scarring and swelling. This induces the body to repair itself, reattaching the retina as the gas bubble pushes the retina back into place.

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As an aside, Doctor Martin had explained last week during my followup exam that he enjoys his namesake, the British comedy "Doctor Martin" aired on the American PBS network.
Last night, Mar and I enjoyed seeing it for the first time, (Episode 4 from the first series).
One scene showed the TV doctor visiting a ranger at a remote station. The ranger was experiencing a post Bosnian war mental disorder and had developed an imaginary eight foot red squirrel friend named Anthony. He set a place at the table for him and was troubled when Doctor Martin ignored him during a meal.
So on arrival this morning I told 'my' Doctor Martin I had brought an eight foot friend, Anthony the squirrel. His expression was glazed like a donut for a few seconds ... until he caught on and we all shared a very good laugh.

The Gas in My Left Eye's Injected Gas Bubble

Bottles of C3F8 For Sale from a
Medical Supply Firm on the Internet

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At this morning's checkup, (which went fantastic!), Dr. Martin told me he used perfluoropropane (C3F8) in my eye.
I feel much, much better for knowing!

Update, Sunday, July 12, 2009 - 4 PM

* Redness slowly diminishing.
* Swelling around entire eye area almost gone

Update: My Gas Bubble Today ~ Sunday, July 12th, 2009

Found this excellent schematic
on the internet today

The top diagram shows the gas being injected directly into the back of the eyeball with a needle. This was definitely one of the more uncomfortable parts of my operation, but probably due mostly to the negative mental association of a needle being pushed right through my eyeball! My eye had been anesthetized locally, so any feeling was probably the pressure of the routine, not pain felt from nerves being traumatized by the needle.

The second diagram shows the gas bubble expanded.

As explained by Dr. Martin during the operation, the gas bubble would slowly expand. Has it ever! I'd guesstimate that it has expanded at least four or five times in size now, four days after the operation. It's quite the phenomenon to see ~ and how wonderful it is to see!!!

My bubble sits and shimys at the bottom of my left eye. It is opaque and a beautiful emerald green. Last night I looked out into the garden where we have a few dozen solar-powered garden lights ... they were all a beautiful emerald green when looking through my left eye only.

When I lean forward the bubble sits in the centre of my vision like a giant green drop of water impeding my eyesight. It's so unique!

Vision-wise overall, apart from the impeding opaque gas bubble, my sight has partially returned, albeit very blurry. I'd bet I could only read the "E" at the top of an eye chart, but last Wednesday I couldn't see out of the left eye at all, so I'll take it! My whole field of vision is back, full periphery included, but it still looks like someone has smeared Vaseline across the surface of my eye. I've noticed that writing across the TV screen, such as the by-lines on the bottom of CNN News, (hey ~ I was on that channel just to check my sight, okay!), is ripply or curvy. I'm supposing this is caused by the gas bubble.

Anyway, better get off of here and go follow the Doc's orders. He wants me to sit still for two weeks with my head slightly forward and tilted to the left. This holds the gas bubble against the detached part of the retina ... slowly pushing it back into place ... hopefully permanently!

Much of the Redness Disappeared Overnight ~ Images Taken Saturday, July 11th, 2009, at Noon

Q: Why did you frown when these were taken?
A: Because I took them myself.

The Gas Bubble is Expanding Fast ~ Friday, July 10th, 2009, 7:00 PM

Found these two great illustrations on the internet today showing gas bubbles injected into eyes.

Drawing showing the retina peeled away from the back of the eye with a gas bubble injected to expand and push it back into place.

An illustration of a gas bubble expanding.

The first illustation probably typifies the size of the gas bubble when it as first injected into the back of my eye; up against the detached retina.
Today, the bubble has expanded considerably!
In an upright position it sits in the bottom portion of my vision, out of the way. If I look down, it floats to the centre of my vision, taking up more than 50% of the field ... probably exactly what the second illustration above shows.

UPDATE: Friday, July 10, 2009, Noon

Two days less 6 hours after the surgery my eye is still very swollen, almost shut, but sight is quickly restoring.
There is mild discomfort due to the constant weeping of the eye, but no pain.
When I roll my eye around the attached muscles still tell me they had been stretched ... but that pain is also very dull now.

There is also a slight itch ... so there's a steady tendency to rub the eye ... I am going through a ton of Kleenex dabbing at it and soaking up the steady weeping, which also helps to relieve the slight itchiness.

Update, Friday, July 10, 2009 - 7 AM

Great News!
Although it looks like someone has still smeared Vaseline over the whole surface of my eyeball, sight has been restored to almost all of my eye ... so I assume that overnight the gas bubble expanded and pushed my retina back into place.
That is only 1 1/2 days after surgery!

Having lost all sight just three days ago in that eye it is very satisfying and gratifying to see out of it again.

The biggest impediment now is the gas bubble doing the good work. I can see it very plainly ... it is like a large drop of water sitting at the bottom of my eye ... since sight is reversed ... it is of course at the top of my eyeball.
If I move my head this gas bubble reacts like a drop of water, quivering like a large drop of water.

My Eye at Midnight Tonight, July 9th, 2009, or About 30 Hours After Surgery

Still swollen and very red ... as you can see I am opening them as wide as possible ... accounting for my scary right eye ... and my left eye only half opens due to the swelling.
The muscles surrounding the eye are still store as a result of the invasive surgery procedures.

Sight and Progress Notes, July 9th, 2009, 4:30 PM

The eye is still swollen from the surgery.
As recommended by Doctor Martin, cold compresses are awesome ... the cold feels good and relieves the bit of lingering discomfort.
The eye is tearing a lot, so I'm constantly wiping my eye dry.
After any amount of sleep, I awaken to find it has caked on my eyelids and lashes, which has to be carefully wiped clean.
Very little of my sight has been restored. The curtain caused by the detachment is still there, so the retina is not yet back in place.
My sight is completely smeared, as if someone has coated my eyeball with Vaseline.
The in-house nurse is doing a crack up job, rating: 10 out of 10.

Mar's Update to Family and Friends, July 9th, 2009

Update: 09 July 09

This morning we saw Dr Martin again as scheduled and he is pleased with Mike's progress so far. Mike had a relatively good night all things considered and he is already trying to figure out how he is going to stay sitting for 18-21 hours a day for the next several weeks. This I take as a good sign. This morning his sense of humour was in full evidence as he mentioned to the staff that he felt he had been kicked by a "DOC MARTIN".

The swelling is obvious on the outside of the eye but the internal pressure is where they want it to be so that is awesome.

Hope everyone has a great weekend. Mike now gets a few days off for good behaviour until we see Dr Martin again on Monday at 7:45am. Not funny this getting up at 6:30 :)

Cheers mar

Glen Mullen, M.D.

Our family doctor, Glen Mullen, just called to see how I was and how the operation went.
How blessed are we!
How many family doctors would take the time to call you on your cell phone just to see how you are?
He's one of a kind!

My Update to Family and Friends, July 9th, 2009

Hey!

Not seeing well, so will be short and sweet.
Eye surgery yesterday at 6PM. It's day surgery so I had to go home to my fine nurse.
Attached photo was at followup this am. The image has been 'doctored' ... I look much worse in real life.
Go again Monday, then again and again I suppose. If it fails I have to go through it all over again.
Doctor Martin is awesome and is keeping a 'close eye' on my progress.
My symptoms were very advanced, I had gone completely blind in left eye ... so he did very intrusive procedures, (I know cause the lady before me was done in 1/4 the time!)
Sticking needles into the eyeball was the worst. Now I know what to wish on my enemies: rectum needles. Or is that rectal?
He also used a shoe horn-like devise to pull the eye out ... felt like right out of the socket ... but it wasn't really.
Those were the things I can tell you. The others would make you sick.
Doc Martin told me that in order to keep the injected bubble in place I must stay erect for two weeks. I asked him how much Viagra he could prescribe for that! He has my sick sense of humour, so we have become fast friends.
In fact, during the whole surgery we were babbling back and forth.
This morning when he asked how my first night at home was I said I felt like my eye had been booted by a Doc Martin. I had to help him up off the floor.
Not supposed to be on here long, so will bid adieu.
Thanks so much for all your kind wishes and prayers. I look forward to the envelopes of money in the mail. hehehe

Best,

mike

Nurse! Nurse!! Nurse!!!

First Followup with Doctor Martin, Thursday, July 9th, 2009

The Gas Bubble

Once your sight begins to return, one of the first things you notice swimming inside your eyeball is the gas bubble injected into your eyeball.
It looks like a ball of water, not unlike one you might see sitting on a leaf after a rain shower.
However, I noticed that I had two, not one bubble; pushing against each other.
On my first post-op check up Dr. Martin told me they would soon coalesce. They have.

My Eye at 3AM, or About Nine Hours After Surgery

I woke up at 3AM ... it was difficult getting used to sleeping in a sitting position ... and my eye had pretty well swollen shut.
The soreness was all but gone ... because the two Tylenol 3's had kicked in.

My Eye at Approximately 11PM, or Five Hours After Surgery

Mar's Post Op E-mail to Family and Friends

08 July 09

Hi Everyone,

Apologies off the top for sending a group email in reply to your warm wishes and prayers but it has been a very stressful few days and we need to be back at the hospital to see Dr Martin at 7:45 in the morning (Thursday). We so appreciate your concern and what I have done is copy and pasted the email I sent out to our kids a little while ago (Wed 08 July)

We want to thank you for your wishes and prayers for Mike's surgery today. We were to be there for 5 and Dr Martin ran a little late at his office so got to the hospital later than expected.

Mike went in at 5:37 and was done about 6:10. Hopefully all went well altho looking at him one would think he had run into the back of a truck at 100km/hour.

He was one brave patient as Dr Martin kept asking him if he was ok since it is a pain Mike described as green --blue and white searing light. He said there was no let up and he talked to try to focus away from it. Anyhow he is still in pain but I gave him a tylenol 3 that does not seem to have done much for him yet but hopefully will take the edge off at least.
I dropped him at home and then went to pick up his eyedrops at AJs. He is to take them in his left eye 4x a day BUT Dr Martin wants me to put them in 4x tonight.

Mike is not allowed to go horizontal for 2 weeks and cannot fly for a month (no plans there at least). He is in our room in my lazy boy as he wanted darkness and he can listen/watch tv as a distraction. He can get up and walk around as he feels like doing that but just cannot lie down.

We are to see Dr Martin again at 7:45 tomorrow morning back at St Joe's and we are on the way at least to recovery of his sight hoping everything goes according to schedule.

I hope everyone stays healthy at your end and stay safe. Enough stress for a while at this end.

One thing Mike did say coming home in the car was that he hoped no one had to go thru what he did and we know many people do every day.

In case anyone wants to know more details of the procedure it is pneumatic retinopexy surgery and you can see it online. Perhaps too much info for some I agree.

Take care all and thanks again for your love for Mike
mar

The Operation: Pneumatic Retinopexy, Wednesday, July 8th, 2009 ~ 5:37 PM to 6:10 PM

There were two of us in the waiting room at 5PM, the time designated by Doctor Martin ... he was coming to do both of us at St. Joseph's Hospital after he closed his office for the day in Hamilton. I have wondered if he ever goes home!
The other patient was Elizabeth from Stoney Creek. She was a bundle of nerves so Mar and I engaged her in steady conversation, trying to get her mind off of the impending operation.
Her retina had not dislodged as much as mine and her procedure was going to be simpler and easier ... all done by laser. It didn't help me when I heard her groaning out load through the door with the odd muffled scream thrown in ... especially knowing my operation was going to be more invasive!!!!

Within 15 minutes the door opened and Liz came out fast, grabbed her husband and left in a hurray. My turn.

Settling into the "barber chair", Doctor Martin applied an instrument to hold my eye open. It proved to be discomforting, but not painful.

Here is the exact procedure as explained on another website, (LINK):

Pneumatic retinopexy is an effective surgery for certain types of retinal detachments. It uses a bubble of gas to push the retina against the wall of the eye, allowing fluid to be pumped out from beneath the retina. It is usually an outpatient procedure done with local anesthesia.

During pneumatic retinopexy, the eye doctor (ophthalmologist) injects a gas bubble into the middle of the eyeball. Your head is positioned so that the gas bubble floats to the detached area and presses lightly against the detachment. The bubble flattens the retina so that the fluid can be pumped out from beneath it. The eye doctor then uses a freezing probe (cryopexy) or laser beam (photocoagulation) to seal the tear in the retina.

The bubble remains for about a week to help flatten the retina, until a seal forms between the retina and the wall of the eye. The eye gradually absorbs the gas bubble.

The operation, though quite quick, was very painful. Doctor Martin did say I was a good patient, asking several times if 'that had hurt' and wondering why I was not flinching. I explained I was "compartmentalizing the pain" ... that I had severed my Achilles tendon years ago and that pain had been extreme ... so I was remembering that pain instead, minimizing the current pain on hand. Hey ... whatever works!

BUT TO OTHERS ... I believe two Tylenol 3's should be ingested an hour before this procedure, if allowed by the surgeon!!!! It did hurt enough to warrant them!!

Notes: July 7th, 2009

My sight this morning was unchanged: the curtain is blocking about 1/3 of my vision.
Phoned Dr. Shadra's office and rescheduled for Thursday.
Took Mar for her tooth repair early and was home before 10 AM.
All of a sudden I realized my sight was now impaired by 2/3, so called Dr. Glen Mullen's office, our family doctor. His nurse put him through and when I described my symptoms he asked me to come in immediately.
At his office he took me in right away. He took one look and called St. Joseph's, telling them they should see me immediately, not on Thursday as re-scheduled earlier today by myself. He hung up and told me to be there in 20 minutes!
Called Mar on my cell as I left Dr. Mullen's ... told her the urgency ... and she said to pick her up on the way by.

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There were at least 30 people in the waiting room at St. Joe's!!!! I had to take a number.
After a couple of hours Marina, a sight technician, called me in for initial testing. Poor Marina. Her day is out to the waiting room to get another patient, test them on an eye chart, check eye pressure, dilate their eyes for a doctor's exam, etc. etc.
When Marina was done and was leading me out of this testing room, back to another waiting room, I decided to spice up her day. I walked into the wall. Boy! Did she panic! I thought she was going to kill me when she realized I had "punked" her.

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I was soon being examined by Doctor Harvey, the same surgeon who had fixed Ruth's inturned eyelashes a few years ago. In minutes he was calling a opthamologist, Doctor Jim Martin, telling him I definitely had a detached retina and should be seen immediately.
On leaving, Dr. Harvey assured us that Martin is one of the best in his field.

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So off to Wentworth Street South in Hamilton to see Doctor Martin. There were as many people waiting to see him as there had been to see several Doctors at St. Joe's!
Mar and I had some great conversation with several patients as we waited to see Dr. Martin.
I was finally called in to first see another Doctor, an associate of Martin's who did some preliminary tests. He also photographed both eyes before we left ....

Dr. Martin examined me and scheduled me for an operation for 6PM at St. Joseph's tomorrow evening, explaining it was imperative to repair it soonest, before more damage ensued.

He then "mapped" the damage to not only my left eye, but also the right. The right also has two small holes in the retina which require fixing in the near future.

Mapping is quite invasive. He used a metal device which felt like a shoe horn and he went all around the eyeball prying it to maximize his view. It felt like he was taking my eyeballs right out of their sockets!

While mapping he used a very bright light. It flashed extremely bright in my eye, alternating through hot white to very bright and beautiful blues and greens.

Martin explained his procedure all the way through, plus of course fully about detached retinas. For me, his detailed descriptions and narratives helped to relieve the tension and discomfort caused by the "mapping". The result: I have two tears in the retina between 11 and 2 o'clock, (a good position for an operation), plus two holes at the bottom of the retina, or near 6 o'clock.

Notes: Monday, July 6th, 2009

There was no answer at Dr. Peeker's office this morning so I decided to go over to the Emergency at West Lincoln Memorial Hospital.
I was attended to by Dr. Joan. She could not see anything wrong so set an appointment to see Dr. Shadra at St. Joseph's Hospital in Hamilton for Tuesday morning.
Whoops!
Mar reminded me she had a dental operation the next morning so back to Emergency. They called but St Joe's was closed. They gave me the number and told me to simply re-schedule at 8AM tomorrow.

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I estimate I've lost about 1/3 of my sight ... that has been a constant for two days.

Notes: July 4th to 5th, 2009

On Friday the 3rd and Saturday the 4th I noticed a small, dark, curved black spot across the whole bottom part of my left eye's vision. It very slowly increased until 1/3 of my vision was blocked.
My family doctor, Glen Mullen described it best back to me ... it was like a curtain was slowly being drawn up over my vision.
Unknown to me this was the second symptom that my retina was detaching.
When queried a few days later by Doctor Martin he asked if I had seen an increase in the "floaters" that have been in my vision for a couple of years.
(My optometrist, Dr. Peeker, had explained the early floaters to be the blue pigment in my eye breaking away and floating ... but that they would eventually settle and disappear.)
Dr. Martin's prompting reminded me that there had been a marked increase in these floaters several weeks, maybe months ago. If I had known, I would have detected this as an early sign that my retina was going to detach.

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Being the 'long weekend", I decided to be patient and wait for Dr. Peeker's office to open on Monday.