Dan's Eye, Installment XVII

Just because some of you keep asking. . .

I went to the eye doc today. It was becoming apparent that the latest and greatest (and last and best hope) contact lens wasn't working. Vision-wise not so bad, but fit-wise, it kept migrating inward and downward, and thus was uncomfortable to wear. Eye doc took one look through the magnifying lens and agreed. So out goes this lens.

Which pretty much shattered any hope of working with a hard (RGP) lens, which would give the sharpest vision in this eye. So just for the fun of it, we're going to try a soft lens - a specialty, back-toric soft lens - once, and see if that works. If it does, I'll have decent (but not great) vision. If it doesn't, then we're going to have to look at glasses from here on out.

In the meantime, I'm back to being one-eyed for the next three weeks (just in time for a trip to Chicago and a camping trip - yeah!), and then we'll give the soft lens a shot.

And now, over to the health desk for our regular feature: "An Update on Dan's Eye"

A couple weeks ago I received the latest in a long string of contact lenses we've been trying in a vain attempt to make one work. I wore it for about a week, and, as has become a custom, it didn't work. But I have to wear it anyway, seeing if it will eventually settle down.

By last Friday (the day after Thursday and the day before Saturday, after which come Sunday) it was becoming quite uncomfortable. Actually, very painful. I assumed it was just because of a bad fit.

So I had an appointment set for yesterday, to see just how this latest lens was doing. As has also become our custom, I sat in the big chair, Dr. Ralph looked at my eye through the big machine, and, upon seeing whatever he sees, he swore. I've been through this enough times to know that that's not a good sign.

So, two things. First, the lens didn't fit like he had hoped.

But more. . .it seems sometime last week my body woke up and said "hey! there's some sort of foreign object here! We need to get rid of it!" So all that pain wasn't the contact lens, it was my body trying to reject the graft. All sorts of white blood cells were flooding the eye, trying to kill off this foreign object which was actually my new cornea.

It's never a dull moment in this ongoing saga.

The good news is it's treatable with steroids, and shouldn't cause any longterm issues. The bad news is that we can't move forward with lens fitting until this is over, since it could actually change the topography of the lens. Which. . .in a convoluted way, may end up being a good thing, since the current topography isn't working out anyway.

In the meantime, if I look a little bloodshot, don't think I've been out doing something I shouldn't. It's just that my cornea is feeling a little rejected.

Quick Update

I had my second eye-cutting-up yesterday morning. If you're following the story, the graft from the transplant I had 2 years ago settled a little off-kilter, so a few months ago the Dr. carved it up, hoping it would flatten itself out. But that didn't work, so he wanted to try it a second time before attempting anything more drastic.

Thankfully, this time around was a lot less painful. It took all of 5 minutes, where last time took half-an-hour. There was some pain, but I was able to take some Advil and sleep most of it off. Today it feels a little raw, but much better.

The doctor was hopeful this time around will do the trick. If so, 4 more weeks and I get set up with contacts and can see again. If not, we go back in for surgery, probably after the first of the year. You can guess which way I'm praying.

It was nice to have a day off today, though. Pretty much resting, but watching the rescue in Chile, too. It's like Christmas over and over again. This world needed some good news.

Eye am becoming annoyed

For those of you tired of reading the ongoing saga of my eyeball, feel free to ignore this post and move on to something more interesting. 

I went to the eye doc today for a followup to last month's torturous procedure, wherein said eye doc carved up my cornea with a scalpel in an attempt to relax some pressure leftover from the corneal transplant. That pressure left the cornea with too much astigmatism, making it impossible to fit a contact lens with any success. The procedure was supposed to flatten out the lens; today was the day to finally fit the eye with a lens, and, after almost two years, return me to the club of "people who can see out of two eyes."

Nope.

Doc looks through machine and says "I need to do it again, and see if it works better this time."

Me: "Um, what? Do what again?"

Doc: "Relax the cornea, just like we did last time."

Me: "Is it going to be just like last time? The same amount of work, same amount of pain?"

Doc: "Yes. Why? Did it hurt much last time?"

So, to make a long story short, I talked him out of cutting me up today, since I had lunch plans with a friend I haven't seen in 18 years. But I now have an appointment to go in in mid-October, at which time they'll cut up the cornea again. Then wait another 6 weeks to see if that even works.

Ominously, the doctor said these things usually get their best results the first time; there's a much smaller chance the 2nd time is successful. And if the 2nd time isn't successful, he said, "we go back into the operating room." Not another transplant or anything that drastic; they simply 'reopen the wound and suture it back up again.' Oh. That's reassuring.

For now. . .it will be Thanksgiving at the earliest before I finally get a contact that works (over 2 years since the original operation); but if this 2nd procedure doesn't work, it could easily roll over into 2011 before I finally see well out of that eye.

Um, ouch

Took an early morning drive to Seattle yesterday to see the eye doctor. It's been 6 weeks since the stitches came out; the cornea should have settled to the point where we could (finally!) work out a prescription for a new contact lens.

But nope. Too much astigmatism left over. A "tightening" or "bunching" of the graft to one side. And you know how they release some of that tension, removing the astigmatism?

By carving into the cornea with a scalpal.

After the stitches came out, I mentioned that a great test of self-control is sitting still while a man pokes around in your eye with a small pair of scissors and tweezers. Nope. I had no idea. This was much, much worse. They put a little topical anesthetic on the cornea. Then they slice a crescent-shape slit into the cornea. And you're watching the whole thing, because it's being done to the front of your freakin' eye!

And then. . .they throw an eye patch on and say "come back in 5-6 weeks."

And then the drive home, with one eye on fire (and pouring tears) and the other eye much more sensitive to light. I had to stop and buy some sunglasses, and everybody stared at the 'weird guy with the eye patch.' Took the Bremerton ferry and lay under my sweatshirt the whole trip over. I gutted out the drive home, took a handful of aspirin, and slept the rest of the day away, dozing off and on through the Mariners' "We're idiots and we fired our coach" press conference. Tried to watch Clash of the Titans with Karina last evening, but suffered the whole way through. Each blink brought agony.

Today seems better, but that might be the Tylenol doing its thing.

I had this surgery 2 years ago October. And it was all supposed to be worked out within 6-9 months. I wasn't seeing well before, but the idea was to suffer a few months in order to see much better on the other side. Instead, two years later, we're still cutting and poking and prodding and experimenting. Yes, it's all a little frustrating at this point. Not to mention painful.

Eye 2 Eye

All the stitches are now out my eye. They weren't planning on taking them all out so soon, but we were having a hard time fitting a contact lens with the stitches still in, so out they came today. Need I say my eyeball currently feels like somebody dumped a bottle of hot sauce in it?

Here's my new definition of willpower: sitting in a chair for 25 minutes while a doctor pokes around in your eye with a tiny scalpel and pair of tweezers, slicing and pulling and prodding. It's a little surreal if you let yourself think about it. So I tried to think about something else. Anything else, really.

Now we go six weeks to let it settle, and then I head back to Seattle for a contact fitting. Which means I'm once again back at that place where I'm essentially blind in my left eye for six weeks. As I've said before, if you catch me winking at you, it's not (necessarily) because I think you're cute. Just that I can't see you.

All that being said, it was a lovely day for a ferry ride to and from Seattle, a stroll around downtown, a quiet moment of prayer in St. James, and fish-n-chips at Ivar's. Other than the excruciating pain and perpetual feeling that I had a thorn stuck in my eye, it wasn't too bad.

tuppence for the blind man?

And now we return to our story, the continuing saga of a young(ish) man in search of his eyesight. . .

So the Gig Harbor optometrist didn't work out. You know it's a bad sign in a relationship when they say "Let me check on that and I'll call you back" and three months later, you still haven't heard anything. Especially when they could be making a lot of money off of you.

And did I mention that when the surgeon who performed my transplant got a look at the initial work this GH optometrist did, he said "that lens fits like $#@$!"

The good news is, the original lens-fitter I was working with pre-surgery, one of the top specialists in the nation, hasn't completely retired, and still comes into the office every couple weeks. And he's willing to see me.

The bad news is, to get a correct fit, I have to let the cornea settle back into its natural shape. Which means no contact lens for two weeks. Which means that, starting today, I'm back to being relatively blind in one eye. I survived a year of this, I suppose I can survive another couple weeks. And, honestly, that last lens was getting painful to wear.

Mostly, I just want you to know that if I'm winking at you, it doesn't mean I like you. It's just that I can only see you out of one eye. Plus if my sermon comes across as 'funny' this Sunday, it's probably just that I can't read my notes.

For those of you following the story of my eyeball

The doctor who performed my corneal transplant is based over in Seattle, a good 90 minute drive away. He recommended I find a local optometrist to take care of my day-to-day needs, including fitting me with a new pair of contacts. I found one out here who took our insurance, and went in to her office, hopeful and excited that I would be entering into a new day of painless vision.

The day I first visited, the primary doctor was out, and a sub was there in her place.

To put it kindly, he didn't know what he was doing. Without going into detail, he had no idea how to handle the fact that I'd had a transplant (hint: it shouldn't have mattered at all. But he wouldn't accept that).

Still, he ordered me a contact; the regular optometrist, for whom he was covering, suggested I try it out, and we'd go from there.

I tried it out. It worked. Sort of. But not really.

I went back to see my surgeon, a corneal specialist. He looked through his machine at my eye, and groaned. Or was it a laugh?

But I was due back at my new optometrist the next week, so I went in. She agreed it didn't fit, and told me she would order a new one.

That was well before Thanksgiving. I haven't heard a word back from her, since. I did stop by her office right after Christmas and left a message, but still no word.

So I went back for my check-up with the corneal surgeon. He looked (again) through his machine. This time he swore. "It looks like they just grabbed any old contact and threw it on there."

So we're on to plan B, which involves heading over to Seattle and letting the specialist fit me with the *correct* lens.

Oh, and this from the specialist.

"You seem to have a little cataract in your right eye. Your left eye, too. Nothing to worry about, except it's rare in somebody as young as you."

And the journey continues. . .

I can see clearly now. . .

Well, not really.

But yesterday I tried out the new contact lens for my left eye. Which is the first time I've had any contact in that eye (other than quick fittings at the optometrist's office) since last October. Which means this is the first time I've been able to see clearly out of that eye.

Yes, it hurts a bit, as my eye is adjusting to this new lens, as a very sensitive cornea (with some still-healing scar tissue) gets used to this thing sitting on top of it. And, I think, we'll still need to make some adjustments, because it's not quite as clear as it ought to be.

But still. I put it in yesterday morning, and then drove Clara to preschool. I didn't notice much at first, other than excruciating pain, which slowly gave way to plain ordinary pain. But when I turned the car around and picked up some speed heading out the driveway. . .the mystics talk about creation becoming suddenly infused with light, with magic, with a sharper clarity, of seeing the world take on a new posture. It was like that. I was seeing in 3-D for the first time in over 11 months. I'd just gotten used to a flat world. All of a sudden that world was moving toward me. Everything from the way tiny pebbles sat on the road to the way trees waved in the forest was different, was sharper, was moving. The world took on a fluidity I'd never seen before. It was amazing. All the way to Clara's school I marveled at the way trucks drove past, the way clouds scooted overhead, the way birds disappeared into the trees. I don't know how to describe it, except to say it was a magical world, this 3-D world.

Maybe you could try it out, just to see what I mean. Simply cover one of your eyes for 11 months and then open it up - you'll see.

Anyway, I'm thinking to myself that it's a wonderful world. But, if I'm talking to you and squinting, or if you think I'm winking at you, don't get any wrong ideas. It's going to take a little time to get this thing right. At least we're on the way.

Want a headache?

Here's an odd tidbit. As most of you know, at the moment I'm wearing a contact in only one eye, due to the corneal transplant I had last October. Which means, generally, I can only see clearly out of my right eye, while my left eye is simply along for the ride, adding some color commentary. And the brain is remarkably adept at sorting things out, basically ignoring those fuzzy signals coming from the left while focusing on the sharp, clear signals from the right. (no, that's not a political statement)

But. . .the other day in the pool I put on a pair of goggles and went under water. Can anybody guess what happens?

Underwater, everything reverses. Suddenly the left eye is the one with clarity of vision, while the right is the out-of-focus one.

At first, I was struck by the fact that, for the first time since October, I could see clearly with my left eye. But quickly that fascination gave way to a grinding headache, as my poor brain desperately tried to click over and process this new information.

And then reverse the process once again upon surfacing.

Yep. A whole night of headache for 5 seconds of underwater coolness.

Thankfully, as I just tweeted, tomorrow I go in and get tested for a contact for the left eye. Another week or so, and I'll be back to seeing with both eyes. It's been nine months. I'm looking foward to it.

Quick Tuesday Updates

Woke to a gentle snow today. Not enough to worry about, but nice. Drove to Tacoma for another post-op visit with my eye surgeon. He said the eye "looks very good." He also took another couple stitches out. 6 down, 18 to go. The best news is he told me I'm at the point where I can finally be fitted for a contact lens in that eye. It's been 4 months that I've essentially been one-eyed; it will be nice to finally have depth perception again.

Following the appointment I went and had lunch with Bill and Ethel Peterson. A lovely lunch and good fellowship. Until Karina called and said "you'd better get home. The snow is getting deep out here." She was right. What was a gentle snowfall in Tacoma was a heavy snowstorm by the time I reached Lakebay. So we're now hunkered in for the night, with a fire in the woodstove and hot water in the kettle. Might be a good night for popcorn and a movie.

Post-op follow-up #4

I had my fourth post-op appointment with Dr. Rotkis today. All continues to heal nicely. I'm down to only one eye-drop (the steroid) and dropping the other (the infection fighter).

In addition, he removed a couple of the stitches today. That was an experience. First, he applied the local anesthetic to the eyeball. Then he poked around with a tiny slicer thing. Then he went in with some little tweezers and began yanking. At least once I actually felt the little string pulling through the cornea. It only stung a bit, but the concept itself was sickening enough.

Ah, well. All is well and good on the road to recovery. Praise the Lord and thanks to good doctors.

Without the patch

Today

I've been without the eye patch most of the day. And I'm taking tylenol, rather than the hard stuff the doctor gave me. Mostly, it hasn't been too bad. A little dizziness, a little pain and pressure, but progress over the last few days. I tested out the "new eye," and could read a little with it, although it seems a little foggy. Still, they told me it would "get a little better each day," and that seems to be the case.

Just don't ask to look at the eye. I took one glance, and it's a pussy mess. Not pretty.

How the day goes

First order of business: Get out of bed.
Second order of business: Get food in stomach.
Third order of business: Take pain medication.
Fourth order of business: Clean off wound.
Fifth order of business: Apply eye drops.
Sixth order of business: Blog about it all.
Seventh order of business: Go back to bed.

I did get in a couple of movies yesterday - Iron Man (note: sfx-laden movies don't work so well when you can only see out of one eye) and Grace is Gone, a Jon Cusack movie about a father attempting to tell his two daughters that their mother was killed in Iraq. It was a tender, understated yet powerful movie. I had tears in my eyes. . .but then again, that may have just been because I have stitches in my eye, too.

As a quick follow-up, I go back to see Dr. Rotkis next Tuesday, and he'll let us know if everything is still healing up nicely.