UPDATE, Saturday, September 5th, 2009

About 14 hours after surgery

Bandage off, lots of bruising, about 36 hours after
surgery, eye quite painful, taking Tylenol 3's

Had day after surgery follow-up with Doctor Chaudary at 10AM, bandage came off. He said retina is well seated again but couldn't see too much because of cloudiness still there from surgery.

UPDATE, Thursday, September 3rd, 2009

Just a quick note to say I have not quit posting to this blog: to the contrary, I have not had much success, have had to stay still, that did not work, and so will be having my THIRD operation tomorrow morning.
As soon as possible, I will update this site completely and explain both my second and third operations to the fullest.
Thanks for your patience!
mike

UPDATE, Thursday, August 6th, 2009

The Vitrectomy

UPDATE, Wednesday, August 05, 2009

My Calling: Driving Hospital Staff Bonkers

Well it’s the day before my “emergency” operation at the Downtown Hamilton campus of St. Joseph’s Hospital. I have been relocated there from the King Street, Stoney Creek campus because the latter is on a two week vacation period; operating with a skeleton crew only. Everyone in their system is referring to my procedure as an “emergency” one. Whatever, it sure is making me feel like the important guy with the cigar in that old muffler commercial.
This morning I had to go in for my pre-op everything.
The first person I saw was the clerk who made a brand new hospital card and put together a file. Once I had verified the details on my new card, I was told to go to a waiting room. I had a sense that this was all going only too well! When things in a hospital seem ultra efficient, you JUST KNOW the boom is about to fall.
The wait wasn’t bad at all, and yes, I got smacked full in the face with the first passing of the boom. A clinician soon came to the waiting room and called my name, telling me to follow her.
When they call out your name in a crowded waiting room with an authoritative voice, isn't it just like getting called to Contestant’s Row on The Price is Right?!?!
I meekly followed her to a chair in the hallway where I was told to sit. She took my heart rate, (63), and blood pressure, (high because I had just walked a long hallway), but I guess I passed. On we went, down the hall some more. We soon arrived at a weigh scale in the middle of a high-people-traffic hallway and she told me to get on. I asked if I should remove all my clothes first to get an accurate reading, putting her on official notice that she was now being challenged. The Grand Tour continued! She then asked me to follow her once again, (evidently she had not read the chart that I am half blind), and took me to a height chart on the wall.
Why can’t they just ask for your height! I mean, I’ve been the same height for 40-something years and have always passed that question with quite a good and accurate mark! What's more, she failed! She was so much shorter than me ... that when she laid papers on my head they bent downwards against the chart, cutting at least half an inch from my official height.
On we went ... she next led me to a private room. Here she put me on an electrocardiogram machine. I guess I passed that one … she simply grunted as she pulled off the sticky things, painfully removing half my body hair, (they should give you a general anesthesia for that test!).
With that she instructed me to go back to the waiting room to be called upon yet again. Having toured what seemed to be half the hospital with that one tekkie, my mind was now busy formulating an efficiency report. If they put a weigh scale and height chart in with the heart machine they could process the patients twice as fast instead of giving each one a global-sized tour of the cavernous hallways of St. Joe's!

So back to the waiting room and to the same bunch of today’s contestants waiting to be interviewed, questioned, poked, prodded and tested. We had just begun trading war stories again when a lady in a very smart pink lab coat asked me to follow her. She even had her own office where we stayed put. She introduced herself and added, (no kidding), “I’m a registered nurse.” Impressed, but not wanting to outrank her about my actually being a rocket scientist, I simply replied, “How do you do, I’m a registered patient”. Her look indicated we had not gotten off on the right foot. I also felt that inevitable feeling of wanting to challenge authority.

And then the questions started! She should have simply gone page by page with me through Grey’s Anatomy. I could not believe how many diseases exist to man. She wanted to know everything about me. She seemed genuinely unhappy that she couldn’t find something terminal about me, so I decided it was time she was challenged too!
The Pink Registered Nurse had asked for my complete history of operations. Beyond a tonsillectomy as a 12 year old and a repaired Achilles tendon from trying to play sports to too old an age, that cupboard was bare. I waited until she was off that page and had shuffled that sheet back into the thick deck; then said, “I forgot an operation”.

Holy Operating Theatre! The look of triumph was telltale on her face. Her inquisition had indeed unearthed something sickly about me. It was evident in her eyes that I was no longer the Poster Child of Health I had tried to establish. I was setting her up ....

She finally and triumphantly found the sheet and scrolled with her pen downwards until she reached the box containing “tonsillectomy” and “Torn Achilles”, with their respective dates. Without looking up she asked, “What was your other operation?”
In the smallest little voice I could muster I replied, “Circumcision.”
For what seemed an eternity she just stared at the sheet, with no clue on how to proceed. She knew that I knew I had the upper hand here now; that I was finally in charge of this interview; that I had delivered the TKO.
After an eternity she meekly asked, “Can you remember when?”
Firmly and in control I replied, “Yes, it was on April 23rd, 1950”
“How on earth do you remember the exact date!” she whispered, trembling and now definitely in awe.
“Cause I was two days old!” I triumphantly ordered, as she penned in the date.

She was now almost a basket case. When she asked me how my hearing was I replied, "Pardon". That went right over her head like a Jumbo Jet on takeoff and she asked me again! Next, she asked how my eyesight was. Here I was sitting across from her, totally blind in one eye and registering with her for a vitrectomy eye operation; sporting dark sunglasses so huge I looked exactly like a pale Stevie Wonder.

Moments later she asked me to go sit and wait at the end of the hall for the interview with the anesthesiologist. I'm sure she was headed to the pharmaceutical department for a Valium hit and Prozac chaser. She had finally met her match!
Before long the anesthesiologist, Doctor Bilos, called me into his office. He was a very nice chap, wanting to know my history with anesthetics, allergies, possible current illnesses, and a host of instructions to follow before the operation. He made sure that I will be spitting out all the water when I brush my teeth tomorrow morning … I thought about it for a fleeting moment, but then decided not to go there! After all, he hadn’t told me he was a registered doctor.
So I’m home right now, half blind, and thinking about tomorrow’s operation, praying for the best.
Let’s hope so!

UPDATE, Tuesday, August 4th, 2009

St. Joseph's Hospital
Main Entrance
King Street Campus, Stoney Creek

-0-0-0-0-0-0-

My next scheduled appointment with Dr. Chaudhary was for 10:00 AM this morning and my operation is still tentatively scheduled for Thursday.
Before seeing Dr. Chaudhary, some preliminary exams and note-taking were done first by Marina the Clinician and then by Dr. Sharda, the resident opthamologist. Then on to see “The Big Boss” ….
At Sunday’s pre operation chat, Dr. Chaudhary had explained that I have to fast, solids and liquids included, from Wednesday at midnight.
So the very first thing, when Chaudhary asked how I was doing, and if I had any more questions and concerns, I explained how starved I was since I had been fasting since midnight for this appointment, as per his instructions.
He turned towards me and gave me a brand new look, a look of inquisition lying somewhere between ‘are you that dumb?’ or ‘are you pulling my leg?’ When he realized he wasn’t dealing with a deck of cards short of an ace he had a good laugh.
In fact I had two concerns, one for each eye. My left eye had gone completely blind the day before. Marina the clinician had just shone a very bright light into it and I had seen the barest of a flicker. Telling him my guess would be now 99.9% blind, I explained my layman’s fear that perhaps the retina had become completely torn, dislodged and irreparable. Thankfully, even before he looked under the microscope he assured me that it would remain attached at the base, towards the lens, and that the operation had not become more critical due to this advanced state of blindness.
My second concern was the increased number of floaters in my right eye, (as in the one and only good one I currently have). He confirmed my suspicion that these were the result of Saturday’s laser treatment and not a sign of a second retinal detachment. PHEW!!!
So all the worries I had harboured over the last two days were quickly negated by his explanations.
He took me over to a secretary who gave me the necessary forms I have to complete and take tomorrow morning to the Pre-Op department at downtown St. Joseph’s, the site of Thursday’s operation, (because St. Joseph’s, Stoney Creek is on a summer vacation schedule).
So much paperwork for Thursday’s operation! They want all my medical history!
Again! Why don’t they have a central computer system … it’s all over the province now … at my family doctor’s, plus the West Lincoln Memorial Hospital, (my annual examinations) and again at the St. Catharine’s General, (my ruptured Achilles tendon).
Also, I am beginning to wonder if they really do read all the forms? Perhaps under the listing of past medical history I should slip in that I once had a fallopian tube pregnancy, just to make sure they are on their toes….

UPDATE, Sunday, August 2nd, 2009

Had a 10:00 AM appointment this morning with Dr. Chaudhary. Sunday mornings at the St. Joseph Hospital Eye Clinic is a very quiet place .... he was seeing three patients while Dr. Adam was also in, seeing several more down the hall. There were no clinicians on duty, so both doctors were appointing examining rooms for the patients, applying the dilating drops, plus conducting all the other routines normally done in advance of their examinations.
What an exclusive club I have joined! Dr. Chaudhary explained that only 1 in 8000 people experience a detached retina. In our town of twenty something thousand people, that means only 3 of us have probably experienced it. My old neighbour and gardening buddy Don was one. So I have to wonder who the other lucky club member is?!?!
Chaudhary spent an incredible amount of time today explaining my particular case and the two options of repair he is contemplating for Thursday's surgery.
This morning's examination revealed to him that I have a giant tear. He was very candid and honest that this is not good news. Restoring my retina will be extremely difficult and there is a very high degree of risk for impaired sight complications subsequent to the procedure.

One major problem I may face is the slipping down of the retina like the wall paper it resembles. This causes warped central vision. The good news is my peripheral vision should be restored.

He also guaranteed me that I will experience a cataract on my eye as a direct result of the upcoming surgery, probably in the range of 18 months afterward.

Some people may prefer to go ahead blind at this point, (I know, a very, very, very bad pun), but I want to fully know what to expect and the next options available if this second operation proves to be unsuccessful. Opthamologists have a huge bag of tricks and there are in fact more options. Dr. Chaudhary explained that each successive detachment and repair increases the odds for poor or no sight.

He discussed this Thursday's surgery at length, officially called a "Vitrectomy".
There are two main options on how he will hold the retina in place once he proceeds under the microscope.
But first, he will do some damage control, removing existing scar tissue via laser.
This microsurgery is performed with a very powerful microscope. He explained that modern ones have a good depth of field.
For this surgery he will use miniature instruments placed into the eye through tiny incisions in the sciera, (white part of the eye).
This is not the optimum approach of attack, but the safer of two possibilities. The best approach for working with the instruments is directly through the front of the eye after the removal of the lens, but the actual lens removal is last resort, probably the approach if this second reattachment is unsuccessful.
On Thursday he will remove approximately 90 per cent of my vitreous gel. It will eventually be replaced naturally by the body's own aqueous fluid.
If he fills the void with a C3 F8 gas bubble, his preferred choice, that will slowly evaporate, my eye filling the void by itself.
However, another replacement for the vitreous gel, and one that I understand holds the retina more firmly in place, is the use of silicone oil. The problem with this method is the necessity of yet another operation to remove this oil.
Once the operation is concluded, they may or may not allow me to go home. There are still routines to be decided. He does not know as yet if general anesthesia will be used. On my arrival they will be inserting intravenous in the event they will.
After the operation my head positioning for one week is paramount. I wish they'd just set it in a vise! I am not one to stay still ...
One in eight thousand people ... I would gladly give this up to someone else in the seven thousand, seven hundred and ninety-nine member group!
My next and last appointment with Dr. Chaudhary before I go under the eyeball knife is on Tuesday at 10:00 AM.
Anyone out there performing miracles?

UPDATE, Saturday, August 1st, 2009

L to R: Dr. Robert Adam, Dr. Varun Chaudhary et Moi

Dr. Chaudhary and Myself

Dr. Chaudhary and Myself

Dr Adam, left, consulting with Dr Chaudhary. That's me in the chair wondering how the heck the Montreal Alouettes could have blown that football game on Thursday night.

-o-o-o-o-o-

Dr Adam phoned this morning at 9:00 AM to confirm my appointment at 11:00 AM with himself and ophthalmologist Dr Chaudhary at St Joseph's Eye Clinic in Stoney Creek.
After introductions, Dr. Chaudhary spent a lot of time examining me, explaining that he could see the retina was torn in three places and had collapsed once again like wallpaper. He had one interesting reason why a retina may detach in the first place, and perhaps what has happened to me.
The eyeballs of short-sighted people, (those who need corrective lens to see distances ... like me), change shapes in a fashion that stretches the walls on which retinas are attached, causing tears to and detachments of the retina.
Chaudhary signified my personal case has become much more major, that my eye is doing what it is supposed to do when fighting off a foreign intrusion. The doctors do not want my body to be so aggressive in its fight to block the retina from reattaching itself to the back wall.
To complicate matters, the gas bubble injected in my first surgery had broken up and some little bubbles had become trapped between the retina and the back wall of my left eyeball.
Chaudhary moved both my eye and head around in an abundance of positions and managed to dislodge a couple of the small bubbles trapped behind the retina.
He then examined and did a small laser opertion on my right eye. He had detected a small tear in its retina.
Due to summer shut downs, the eye clinic is now closed for two weeks, however, due to the seriousness of my redetachment, I will be scheduled for an operation this week using staff on call for such situations.
Chaudhary had me scheduled for another pre-op examination tomorrow morning ... Sunday ... making me wonder if ophthalmologists ever take days off! (Actally, he was in Italy when I had my original reattachment surgery with Dr. Martin.)
My reattachment surgery is tentatively scheduled for this Thursday at St. Joseph's at James and Charlton Streets in Downtown Hamilton.
Unfortunately, Chaudry explained that there is no guarantee that I will get my vision back but that is secondary to their main goal of restoring the retina to where it belongs so that I do not get a series of major complications that can result if it is NOT in the proper place ... although most of those complications are in the 1% range.
I'm currently taking anti-inflammatory drops four times daily and dilating drops, because if the pupil is open it helps to push back the retina in the right direction. I have had to keep my head up and slightly to the left all day. Tonight I have to either lie on my stomach with my head down or sit up with my eyes down and forward for about 4 hours. Sleeping tonight I have to lie on my right side with my nose in the pillow to maintain the right position for the bubble still in there.

IF YOU ARE PRONE TO QUEASINESS STOP READING HERE.
On Thursday Dr. Chaudery will be performing a "Virectomy". Under local freezing they extract about 90% of the the vitreous gel, (which fills the eyeball), and replace it a C3 F8 gas bubble.
One benefit of having all the liquid removed ... most of the floaters are probably removed too!
Dr. Chaudhary was very candid with me, explaining that a retina which has detached several times can result in ambulatory vision, or less.

Update, July 24th, 2009

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

----------------------

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!

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.

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.

----------------

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.

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.

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.