Saturday, 7 September 2013

son of stickler - from post-retina op discharge to eve of cataract op day

(I should say at the outset, as per similar post-op emails in early 2010, that I'm typing this mostly without looking at the computer, which is my pre-emptive excuse for the typos.) So, I had retinal detachment surgery in January 2010, due in large part to me having something genetic called Stickler's syndrome, previously undiagnosed. I knew that in due course a post-operative catarct would form in that, right eye, which I would need to get removed.

At the end of spring I went to get my eyes tested, primarily because the left eye was obviously feeling the efects of three years working on its own, more or less, and I was having more difficulty reading, espeically noticeable when precenting or reading choir music. I had decided to change opticians and went to the Institute of Ophthalmology, which is walking distance from our house and which the others had been to recently ( I found out later, soring through paperwork, that I had actually had an eye test there years ago, I guess before even I worked at Scripture Union, which had the opticians very near which i went to then and had still been going to). I understood that you had to wait until the cataract was well in before you should think about getting it removed, and I knew it was coming on well. I hadn't realised until I did the eye test that it had quite gone so far, as I ouldn't even see the letter at the top of the chart, and I remembered how much of the chart I could read when I had my eyes tested for new glasses after the operation and aftermath were all over. The opticians, fair enough, wouldn't give me a new prescription for my left eye as there was no point in doing so, since they couldn't give my right eye a proper test, and I'd need new glasses again after the cataract op which they thought I was going to need. They also had a good look at my left eye, and got someone in to have a second look, as there was patch at the veryedge of theri sight of my retina which they weren't sure about. that I have an ophthalmogical referral to look at my left retina and to determine whether there should be cataract surgery on the right eye.

The process is that they write a letter to my GP with the outcome of the eye test and their recommendation. The GP then refers me to the hospital for an assessment. In fact Southwark have asytem set up, to speed things up, whereby some opticians have someone who is accredited to do those appointments, which means you can get an appointment faster than going through the hospital. As it turned out, because of my prior surgery the chosen optician wasn't prepared to do the test, so I had to get a hospital appointment anyway. They offered me one whil I was on holiday, so I had it put back a week to the day after we got back from holiday - this Tuesday.

I didn't mind the wait. It did make me a bit frustrated with myself that I hadn't gone for an eye tst sooner, since it left me with the left eye reading problem for longer than was necessary when I getthe impression I could have gone back with the cataract sooner.

What I wasn't clear on, though, was where I now was in the process - that is whether this Tuesday's appointment was a pre-pre-op appointment, when they would look at my eye and say yes, you do need a cataract op, we'll get you into the system and call you back for a pre-op appointment, or whether this was a pre-op appontment when they would confirm I needed an op and get the bakk rolling there and then. It did turn out to be a pre-op appointmet of the latter kind.

So on Tuesday I trod the familiar corridors of the St Thomas's eye department, did various measurements, details and drops with the nurse, then saw Prof Zuberbuhler, who took a look at the right eye and offered me a cataract op. He also looked at the left eye and said it was fine, which was reassuring. He gave me all the info about the risks and possibilities of it being unsuccessful, as they have to do before they get you to sign the consent form, and then I signed the consent form (the worst outcome he said was one in five hundred chance I'd lose the sight in the eye, but the alternative is not having surgery and not seeing out of the eye to any effect anyway). As with the retinal surgery, I had drops in my eyes when I was given th form, so i couldn't actually read the document which I was signing, which I still think is funny.

I did some more preparatory tests and measurements after that with a nurse. They had difficulty doing one of the biometric tests, I think because the cataract was so bad. So while they waited for someone to be free to redo the test for me on another machine, they sent me to the reception desk to get a date for the op; they reckoned the waiting time was usualy four or five weeks. When I saw the guy, he offered me the 5th of September. I said 'what?'; I assumed he meant October and had made a mistake. He loooked at me puzzled. You mean three days from now, I said. Two days, he said; Thursday. Oh, I said; I took a moment to think about it, and couldn't think why not, so I said okay. Then I had my tests redone on the other machine by a nurse practitioner (I needed anaesthetic drops in my eye for this,a s it obviously involved direct contact with my eyeball), though she still seemed to be having some trouble.

The doctor had talked about my new lens. He had said they could give me a lens that would mean I only needed glasses for reading, but they didn't like to make the eyes more of a difference than 3 otherwise they would find it very hard to work together. (In my 2010 test the left was minus 6 and the right minus 3.75; this May's test said right was minus 4, though I don't undestand how that was worked out.) So he told me which minus number he'd aim to make the new lens, and said that when it came to the left one they would then leapfrog that lens accordingly to being that much better than the right eye. The nurse practitioner mentioned a new lens as well and I asked her about it. I had thought that they removed the cataract f rom the lens and so restored the lens to more or less what it had been before (hence my thinking of it as 'cataract removal surgery); she said lots of people make that mistake, but infact what they do is take the whole lens out and put in a new artificial lens. So it is less cataract removal surgery than lens replacement surgery. I guess it did used to be more as I had imagined it in 'olden days'. This I guess whas why the doctor on Tueay - and the surgeon on Thursday, when it came to it - was at pains to emphasise that I would still need glasses adn that I would not be getting perfect distance vision. I hadn't expected any change in my distance vision, but I guess some people (who are better informed than me about the actual process) do expect that.

Bethan asked if the Sticklers had come up with the doctor, and I said it hadn't, but I assumed he was a ware of it, since that and all the retinal detachment stuff was isn the folder of notes, I presumed, since that's where I'd had it done. She said not to assume they had picked that up, and to be sure to mention it on Thursday.

I went from the hospital to work after lunch, then to Morris Folk Choir in the evening; I went into work onWednesday morning and home as usual at lunchtime; then handed cherub over to Bethan at her work and went to my other choir, the London Gallery Quire in the evening. Just before I went out to meet Bethan I got a call from the hospital asking me to come in a bit earlier on Thursday in order to repeat some of the biometry (I guessed, correctly, that it was that final test).

It seemed a bit surreal that it was all happening so fast, especialy since I hadn't even been certain that Tuesday's appointment was a 'pre-op' one. But I didn't mind at all; less time to think about it. With my retinal surgery, of course, I toddled along on the Monday after New Year to eye a&e and was under the knife on the Thursday, I think. So, two quick ones.

The day of the op will be covered in a separate post.