Monday, September 17, 2018

Update on the Eye Issue

This morning I was to have the YAG procedure performed on my right eye. It was an inconvenient date and time as our daughter was visiting us from Los Angeles for a long weekend, and I was looking forward to spending her last day here doing fun things. Thinking the right eye was going to be taken care of on September 12th, I was not anticipating this conflict. See my previous post for more on that.

When I got to the office today for my 10:00 appointment, I explained that my left eye just is not right. So again they sent me upstairs to have an eye exam done, fitting me in around patients who were already scheduled for such activities. Obviously I was screwing up the schedule of not only the surgi-center but the regular office as well. Dr. Pepose said this time there is not any filament or stray cells on my lens. Instead it is my astigmatism in the left eye that is causing the problems.

My vision with both eyes together is 20/20, and I have tried to explain that I am happy with the outcome in terms of what I can read. However, it is the quality of what my left eye sees that is the problem. Everything is slightly blurry. My frustration comes from the fact that I paid (a lot!) for the enhanced intraoccqular lenses to be implanted during the cataract surgery, and also for my astigmatism to be corrected in the left eye. The lenses and correction were not covered by my insurance, so that was all out of pocket. So to be told now that the astigmatism still exists came as a shock to me.

Apparently my astigmatism was corrected to a certain point, which is obvious as I was reading 20/50 with that eye before surgery and it is now 20/30. However it was still not as good as my right eye, which is why I am seeing the difference between the two eyes. My choices are 1) live with it, or 2) have an additional procedure know as Limbal Relaxing Incisions (LRI) done to further correct the astigmatism. The downside is that I may lose a little near vision, but what I do see will be clear. What a choice!

While I have tentatively scheduled the procedure just to secure a spot on the calendar, I'm not really sure what I'm going to do at this point. One decision became clear to me, however. I am definitely not going to have the YAG done on the right eye at this point. I'll be leaving well enough alone on that one for the time being.

Thursday, September 13, 2018

More Eye Issues

eye ball
Yesterday I went back to the eye surgeon to have the same surgery performed on my right eye that had been done on the left last week - the YAG laser procedure. But that is not what ended up happening. After I got checked in and before the nurse put the dilation drops in my right eye, I mentioned that the left eye was still cloudy. In fact, I think my vision was worse in that eye than before I had the laser done. That proclamation resulted in her talking to Dr. Pepose once he came out of the surgical suite he had been in, and he decided he wanted me to have a thorough exam done on my eyes before proceeding.

The bottom line is that they determined I had a filament that was still covering my left eye, and he wanted to go ahead and take care of that first. So the YAG was repeated on the left eye, and the right eye was rescheduled for Monday.

I'm not convinced the left eye is totally cleared up yet. I'm going to see how things look in the morning, and may give the doctor's office a call. At this point I'm not even sure I want to have the right eye done, because I certainly don't want to have it turn out like the left eye.

All of this is pretty disappointing as my vision was better before I had the darn cataracts removed!

Friday, September 7, 2018

More Skin Cancer

skin cancer removal
To add to the list of medical procedures I'm having done this week, yesterday I went to my plastic surgeon to have yet another suspicious spot removed from my forehead. It's one we have been watching for a bit, but as it has not responded to liquid nitrogen (it should blister and then peel, but it does nothing), the dermatologist said to was time to have it removed.

In checking my records I realized that I had not been to the plastic surgeon since September of 2016, so that actually is not too bad for me. Unfortunately this is my 14th skin cancer, if indeed the biopsy comes back positive. I have resigned myself to the fact that this is my life from now on, but I have been taking extra precautions with my skin so hopefully I won't have too many more that will need to be surgically removed.

I did not sleep well last night as the doctor told me to keep my head elevated to lesson the risk of bleeding. It hurts today, but not as much as yesterday. It should feel much better by tomorrow, which is good because I am volunteering at the Michelob Ultra Pickleball Tournament in the morning. It was supposed to be outside at Forest Park, but because rain from the hurricane is headed our way, it has been moved indoors. Unfortunately that means a 45 minute drive for me in the morning, and I have to be there by 7:00 a.m. It is the first sanctioned tournament to be held in St. Louis, so I am eager to see the 4.0 and 5.0 players in action once my volunteer work is finished.

On a more fun note, last weekend was Paint Louis 2018. This was an organized event allowing graffiti artists to legally spray paint the flood wall that runs along the Mississippi River in downtown St. Louis. Hundreds of artists came from mostly around the Midwest, with live hip hop music adding to the party atmosphere. By the time we got down there Monday morning, most of the artists had packed up and left. But there were a few remaining, and it was interesting to talk to them about their work and the process they use in creating art to cover such a large space. Sadly, it won't last for long as other graffiti artists will come along and paint over what is already there. It is a constantly evolving work of art.
Paint Louis 2018

Wednesday, September 5, 2018

Eye Yi Yi

creepy eyes
This morning I had the YAG laser capsulotomy performed on my left eye to remove the cells that were forming on the back of the new lens that was inserted following my cataract surgery in June. Essentially it was as if I was looking through a window that had finger prints on it. That is not exactly the result I was hoping for after bucking up for the expensive replacement lenses. My surgeon noticed the problem when I was in for my one month follow up appointment. In fact he said the right lens had some cells on it as well, but that the left eye was more prominent and the cells should be removed.

My insurance company insisted that I wait 3 months post-surgery before they would approve the YAG procedure, which is why I didn't have it done before now. Fortunately for this I could drive myself to and from the appointment. I arrived at the surgical center about 8:50 for a 9:00 appointment. I signed the appropriate paperwork, and at 9:15 was taken in the back to have my eye dilated before returning to the waiting room. Shortly after 10:00 I was again taken back, this time for numbing drops, and then seated before Dr. Pepose in front of what looked like the normal machine they use to examine your eyes. He placed a clamp on my left eye to keep me from blinking, and as I kept my chin and forehead pressed against the machine, he zapped my eye with the laser. In less than five minutes it was all done.

The assistant rinsed my eye, and then placed Lotemax drops in my eye. Lotemax is an anti-inflamatory steroid drug, and one of the three drops I had to use in both eyes following cataract surgery. For this, I need to place one drop in the affected eye three times a day for a week.

I asked Dr. Pepose if I could go ahead and schedule the right eye since my deductible and maximum out of pocket expenses have been satisfied for the year, which for us ends on September 30th. He said absolutely, so I will get it done next week. I also told him about the fact that my left eye has a bit of discomfort still. I asked him if he ever wore the hard contact lenses. I got my first pair of those before my sophomore year in high school, and they were extremely painful to get used to. You had to build up a callus on the back of your eyelid, and that is sort of how this feels. He suggested I try taking fish oil pills twice a day, as that has proven to help some patients with dry eyes. Otherwise the option is for me to use prescription eye drops like Restasis. I'd like to avoid that if possible, so I'll give the fish oil a go and pray for the best. My left eye has seemed a little better the past few days, so perhaps I am turning the corner on that problem anyway. Of course, having the laser treatment done may change all that.

In all, I was at the office an hour and twenty minutes. They had warned me to be prepared to be there two hours, so getting out early was a bonus. Hopefully next Wednesday will go just as smooth.