PONOGRAMS

 

Ponograms:

1-24  The First Twenty-Four
25-48  The Second Twenty-Four
49-72  The Third Twenty-Four
73-xx  The Fourth Set


49  Pure Michigan
50  Ah, Youth
51  Unlikely Friend
52  Golfballogy
53  PCNEWS
54  Before/After Squared
55  Hawaiiana 1
56  Hawaiiana 2
57  Hawaiiana 3
58  A New Outlook
59  Hawaiiana 4
60  Crash Dummy
61  Dogs, Boards, Kids...
62  Photographic Treasures
63  Hawaiiana 5
64  My Comb is Crooked
65  Call Me A Doctor
66  Hawaiiana 6
67  Home for Christmas
68  Led By Words
69  Pono Bowls
70  Poppy Tour
71  An Invitation
72  Wunderkammer I

HOME


A NEW OUTLOOK

As usual, I took a number and filled out the form.  The DMV was not very busy so I only had minutes to wait.  We took care of the paper work and the clerk turned on the box for the eye test.  I was shocked when I looked in and had trouble making out the letters.  The clerk was very patient with me, hinting that there were no two of the same letters on a line and that I should move my head around to see better.  Somehow I passed and received a two-year driver’s license renewal.

I had a regular appointment scheduled in just a few weeks for my yearly eye exam, so I looked forward to discussing the situation with my eye doctor.  She had previously indicated that I was developing cataracts but that they probably didn’t need attention yet.  The new exam showed that the cataracts were increasing, but she was still able to correct my vision with glasses.  I was left with the feeling that attention to the cataracts would depend on my discretion.

Driving in Maui is not very challenging.  I don’t think there is a road where one can legally exceed 50 or maybe 55 mph!  I’m familiar with most of my destinations and I really don’t drive that much.  So I made a plan to test the effectiveness of my vision when I traveled to California and Michigan in the spring.  High speeds and unfamiliar routes would provide the challenge I needed.  I guess you’d have to say I failed miserably!

On freeways, the signs were not quite readable until it was too late to react.  In residential areas the street signs were either too small or of such cryptic fonts that I couldn’t make them out.  I got lost several times.  It didn’t take long for me to decide that my eyes needed attention before my next driver’s license renewal.

Upon return from the mainland, I simply went back to things as they were, but readable signs kept getting closer to me.  Finally I got the notice for my annual eye check so I bit the bullet.  Instead of keeping the regular appointment, I asked to see the cataract surgery specialist.  He did an evaluation and agreed that it was time.  I was put in the pipeline for “cataract extraction with intra ocular lens implant”, commonly called “cataract surgery”.

This list illustrates the pipeline.  The dates are only significant to show the amount of time between appointments

2011-11-08 Cataract evaluation

2011-12-27 Measurements of both eyes for new lenses

2011-12-27 EKG – pre-op requirement

2012-02-01 Surgeon – pre-op for left eye

2012-02-08 Surgery on left eye

2012-02-08 Primary – check heart rate (anesthesiologist’s request)

2012-02-09 Surgeon – post-op (found abrasion on left eye)

2012-02-13 Surgeon – post-op II (to make sure abrasion was healing)

2012-02-27 Regular eye doctor – test of left eye

2012-02-27 Surgeon – check left eye/pre-op for right eye

2012-02-29 Surgery on right eye

2012-03-01 Surgeon – post-op

2012-03-20 Regular eye doctor – test of both eyes post-op

2012-03-20 Surgeon – check of both eyes post-op

2012-04-10 Primary – check heart rate (anesthesiologist’s request) and regular 6-mo

The pre-op appointment a week before surgery for the left eye consisted of a final look at the left eye, an interview with questions about history and general health, instructions leading up to the surgery, and prescriptions for eye drops to be collected from the pharmacy and started the Sunday before surgery.

On the day of the surgery I was to arrive fasting since midnight, had to have arranged for delivery and pickup (no driving allowed), and had to allow for about 2 hours at the clinic.  As you might expect there was an interview, more paperwork including an inventory of possessions, and a verbal walkthrough.  I was installed in a bed in pre-op, vital sign monitors were hooked up, and the usual IV was inserted (TKO).  A series of eye drops was started with a couple minutes between each drop.

While the drops were administered, the anesthesiologist came in, said normally the procedure is done without anesthetic, but that I could have some if I wanted.  I declined.  My vitals monitor was making noises and he watched for a while.  He was concerned that my heart rate was low (35) and he ordered meds to speed it up a bit and also made arrangements for me to see my primary after the surgery to investigate the low rate.

The last “drop” before surgery was a sticky jell smeared all over to numb the eye.  The surgery was almost anticlimactic – it took about 10 minutes!  I could feel liquid sloshed across the eye a few times, but the knife and other tools were barely perceptible.

The next day I drove to the clinic for post-op, wearing the big honking wraparound glasses and closing my left eye most of the time.  I felt like there was a toothpick under my eyelid.  While I was led to believe the visual improvement would be almost immediate, I felt like I was looking through smoke or a thin white sheet.  There was a veritable blast of light, but not much detail.  I had trouble seeing the eye chart.  The surgeon looked me over and found a “scratch” on the eye!  He said that would cause what I was seeing.  That was a Thursday.  He was off on Friday and the weekend, so he scheduled a post-post-op for Monday.  By Monday it had cleared a bit, but I was really reluctant to have the second eye done.

As we talked about it, I came to understand that what he called a “scratch” was really an extensive abrasion.  That made a little more sense to me, but I told him that I wanted to give it a week or so before committing to the next surgery.  I promised to give him my go/no go one week before the next surgery.  As time went on, it cleared completely and I sent an email and called his nurse to indicate that I was ready.

 

 

Eyechart

List of eyedrops

 

^^ I’ve had “a couple” eye drops (more like a couple hundred)

 

 

<< I’ve seen a few eye charts (but every time I try to memorize they change the chart)

Eye charts and the paddles to cover one eye and the paddles with little holes were a common feature of my doctor visits.  I estimate that each eye endured well over 200 eye drops over this period, with nearly 200 self-administered.  The listing above is one page of the record of drops on one surgery day.  The little bottles are the prescriptions for home use.

I started out feeling lucky if I could get the drops somewhere on the proper side of my face, but soon got so I could find the mark most of the time.  One of the drops had to be used for only two weeks.  The other prescription had to be used until it was gone.  It wasn’t until the bottle was almost empty that I realized dripping it on my cheek meant it would run out sooner – of course I didn’t do anything with that knowledge (consciously).

 Wraparound eyeglasses

 Eye shield

 

 

Wrap-around sun protection

Shield for protection while sleeping

After surgery the affected eye was supersensitive to light.  The wraparound shades did a good job during that period – especially when driving.  The shield was used for sleeping when covers or uncontrolled fingers could damage the eyes.

After the left eye was done and before the right eye, I was in the middle ground of vision.  Left eye was slowly returning to usability.  Right eye was as it was - still obscured by the cataracts.  Glasses didn’t really fit either eye.  Brain was totally confused by the WASH of bright white light input by the left and the yellowish input by the right and the lack of correction by the glasses.  In fact, one day halfway through my morning walk in the pre-dawn I removed my glasses and did better without them after that!

I went to the local eye clinic and had the left lens popped out of my regular glasses.  That better served my need to drive by allowing me to keep both eyes open, but didn’t help with reading.  I got along by squinting, selectively closing an eye, and laughing at myself.

 Original view

 New eye view

 

 

Camera & right eye with original equipment

Left eye with replacement lens

I had a chance to experiment with the differences.  Color differences were incredible.  The bush shown above just amazed me.  The camera agreed with my right eye with the cataracts.  The new lens in my left eye presented my brain with purple flowers.  I talked to a young lady at that bush and she saw purple like my new eye.  I talked to an older man there and he saw the maroon like my old eye.  I took a clipping of the bush and the above pics to the clinic and not only got differences from each person, but I saw differences depending on the lighting.

Not a very scientific investigation, but I found it fascinating.  If anyone had seen me standing in front of that bush blinking at it, I’m afraid they might have summoned the men in white coats.

The right eye pre-op, readying on op day, and op itself were pretty much the same, except that I warned the surgeon not to think about zebras.  The surgery went fine.  They put the vitals monitors on me, but never plugged them in.

Post-op the next day went fine.  I drove there with the wraparounds but without glasses.  I could see the eye chart easily up to the 20/25.  There was no indication of scratches.  The surgeon agreed that thinking of zebras must have been the problem.

Dr. explained the surgery.  A 2.7mm slit is made at the bottom of colored part of the eye. A device is inserted through the slit into the pita pocket that contains the lens.  Device whips the lens to break it up and sucks it out.  Tiny tube containing new folded lens is threaded into pita and lens is inserted.  Lens magically unfolds.  Eye is left to heal - no stiches, glue, staples, duct tape or the like.  Lots of drops - before, during, after, and for next few weeks.  This link and many others illustrate the procedure.

http://www.allaboutvision.com/conditions/cataract-surgery.htm#csv

 

SUMMARY

The entire experience is amazing.  That these relatively short procedures can immediately provide such dramatic improvements is almost miraculous.  The scratch on the left cornea scared me but that apparently happens occasionally.  The right eye was totally improved directly out of the operating room.

I’m writing this several weeks after the second op.  I no longer wear my old prescription bi-focal glasses and have purchased granny glasses for reading.  The grooves in my temples made over the years by the earpieces of glasses are starting to flatten out, which will undoubtedly please my barber.  I need to get more appropriate sunglasses and that should close this experience.  I should probably start practicing for the driver eye test coming up on my next birthday, but I don’t expect to have any problem – I test 20/20 in both eyes.

 

AFTERWORD

I am very happy with the results of cataract surgery.  I can actually hear much better now and I think my hair is starting to grow back!

I was instructed not to lift anything heavier than 15# and not to do anything strenuous like housework for at least 2 weeks after each surgery.  In an abundance of caution I have decided to extend that period to 6 months.

I told my kids they gave me medication to increase my heart rate, but this is what actually happened.  My Medicare and personal insurance coverage is pretty good, but you should see the co-pay on that procedure!

Increase heart rate