Retinal Detatchment

At the beginning of August, I went on a trip to Portland and Vancouver. At that time, my eyesight was fine. Sometime after I got back, I started noticing my eyesight was... odd. I couldn't quite put my finger on what it was, because I had a problem with one eye, but you typically use both your eyes, and so the other eye compensated. I'm sorry to say that I went into bachelor mode and simply assumed that whatever the problem was, it would jut go away eventually.

It didn't go away.

After a week of this, I finally got fed up and decided to investigate exactly the extent of my eye troubles. This included such simple tests as closing each eye and measuring my peripheral vision. And I found that I had lost about a third of the top of my vision. That was troubling enough that I made an appointment with my eye doctor.

Also, the number of floaters in my eye had skyrocketed. Keep the blind spot and the floaters in the back of your mind, so if they happen, you'll seek treatment faster than I did. While a blow to the head can cause this, sometimes it just happens. That was the case with me, though I'm high risk for it (family history, previous cataract surgery, previous myopia, and just plain old age).

Aside: When you call up your optometrist looking for a routine appointment/new glasses prescription, you get pushed off a month in the future. But if you tell them you're worried you're going blind in one eye, they get you in the same day!

Appointment made I go to see the doctor. Exam ensues, and his conclusion is that my retina has become partially detached, but they can fix it with lasers.

“You go to a specialist, and they zap the ends of the detachment with a laser to keep it from getting worse.”

A statement that really under-sells the procedure on multiple levels. Both in terms of just how invasive it is, and also how efficacious it is.

They contact a retina specialist and I get an appointment for the morning two days later.

Two days later, I'm expecting to just see a specialist for an assessment. Little did I know that I was getting onto the roller coaster, and you don't get off a roller coaster half way through the ride. It being at North Hill mall, I opt to bike down. I also skipped breakfast, thinking I would simply have a big lunch after my late-morning appointment.

The specialist confirms my detached retina, and tells me I now have to immediately go to Gimbel to see the on-call optometrist. No one tells me this is because I am going to be treated today. I still think I'm getting assessed. I bike up to Gimbel, because it's on my way home. Knowing what I know now, I'd have biked home and then walked to Gimbel.

Now I'm fine with Gimbel because I'd had two earlier eye surgeries with them. They did a great job, and Dr. V (who did both my Lasik surgery 20+ years ago, and my cataract surgery 7ish years ago) was both an excellent surgeon, and also had a quiet and calm demeanour that puts you at ease. His bedside manner was fantastic.

Gimbel makes me cool my heels for many hours, while occasionally doing random tests. At one point, they dilated my eyes and then left me in the waiting room for three hours – I was worried the dilation would simply wear off before they had a look inside my eye. Finally, I see Dr. W. He explains that I need to have major eye surgery, and that they were going to do it tonight. This put my anxiety at high alert. Ok, surgery, I can handle this. ::breaths heavily::

Then he adds that I would need to spend the next 12 days face down. And I lose my mind.

“12 days?!? I can't spend the next 12 days face down! It's impossible. You might as well ask me to write a concert. How am I supposed to eat? Go to the bathroom? Hell, I can't lay face down in my bed for ten minutes without getting back spasms, and you want me to spend 12 days like that? It would be literal torture!!”

Aside: It was pretty bad, but it wasn't that bad. What they meant was that I would need to spend the majority of my time face down, but I could move around and do things. It ended up mostly being really really boring, inter spaced with sleep deprivation, and the occasional muscle pain. But no one bothered to tell me that.

Dr. W. Barely reacted to my very clear mental breakdown. He clearly did not give a shit. Probably the second worst doctor I've ever had to deal with. When I tell people that, they get the impression that he's a giant prick like Gregory House. This is inaccurate. It's more that the only thing he cares about is your eyes, and nothing else is his concern. Certainly not anything like your mental well-being, or the fact that you're in the midst of a giant panic attack. He was blithely unconcerned about any of that.

Anyway, he handed me off to a clerical assistant who got me to sign consent forms for the surgery, and admonished me to go immediately to Rockyview hospital for the surgery.

I was still in the middle of my anxiety attack when her pen-and-tablet stopped working, meaning I had to sign my name on a screen using a computer mouse. Try that sometime – it's super hard to do and have something that looks anything like a signature, much less your signature. I had to do it while my hands were literally shaking from adrenalin. After about ten attempts, I got something merely horrible, as opposed to impossible. I was very close to just using “x”. She gave me some pamphlets for recovery equipment (literally the closest thing anyone had came to implying my 12 days of torture weren't going to be literal torture).

“Go straight to the hospital.”
“I have to take my bike home – I'm not leaving it locked up here for two weeks.”
“No, you have to go immediately.”
“The doctor is still here, there is no universe where he's getting to the hospital before I get there, even if I do take a 3km detour”
“You're not the only person getting this surgery today. The sooner you get down there, the higher in the queue you'll be.”
“Fine. I'll go straight there.”
“And no food.”

Murray (who is a saint) had a day off, so I was able to get him to come fetch me and my bike, then take me to the hospital. He took my bike back home, and awaited my phone call to come get me post-surgery.

I checked into the hospital and then waiting around for about five hours, because – and this will shock you – the doctor did not get there before me). On the bright side, I got excellent care. Every nurse and porter I encountered, as well as the surgery team, were nothing but empathic and professional. Kudos all around. Except for Dr. W., who still had the warm and cuddly nature of a clay golum. At least he was good at eye surgery.

Waiting for the surgery, I got to hear a conversation between the patient in front of me (different suite and surgeons) and the nurse. He was a diabetic who did everything wrong, and now they were going to amputate his foot. He had a good humour about the whole thing (he admitted it was gallows humour), and made me a little ashamed about how much I had been panicking earlier.

My surgery was a vitrectomy (removal of the fluid in the eye), followed by laser surgery that reattached the retina to the back of the eye. Finally, there was a pneumatic retinoplexy (refilling the eye with a gas to keep the retina pressed against the back of the eye). The gas bubble in my eye is why I needed to stay face down for 12 days.

I haven't worked up the nerve to watch an example video of the procedure (I'm sure it's on YouTube somewhere, if you're curious). Of note it took about 45 minutes and I was awake for all of it. I had the option of general anesthetic, but the anesthesiologist assured me I was in good hands (again, if everyone else can have a decent bedside manner, why couldn't Dr. W.). I also had the option of a silicon gel in the eye instead of the gas. I very nearly went for this because it would have eliminated the need to be face down for 12 days. It would have required a second surgery (to pull out the silicon and replace it with “water” after I'd recovered. Spending so much time waiting around, I had plenty of time to read up on the pros and cons of each surgery. Begrudgingly, I had to accept that gas vitrectomy was the better option.

Another aside: while prepping for surgery, they weighed me and I was way lighter than I thought I was – 275 instead of 290. Still way higher than I like, but it was nice to get some good news that day. Especially given 275 is one of my internal mental thresholds on a day I was doing poorly mentally.

Anyway, after the surgery they sent me home. Murray (still a saint) fetched me and on the way home I finally got a burger to eat. It was around 10pm, my first meal of the day.

I attempted and largely failed to sleep face down. The face down part I stuck to, it was the sleeping part that didn't come. Too much anxiety, too little relaxing.

The next day I followed up with Dr. W. Again, he didn't care about my questions, and just gave me my marching orders. Stay facedown, take four different drops at varying times over the next two weeks. I went home and called Calgary Vitrectomy Recovery and they brought me all the linked equipment, demonstrated all of it, and made my recovery 100% better. Seriously, if someone had just told me about this stuff, it would have saved me a lot of anxiety.

And there was a lot of anxiety. My depression is always near the surface, but this was the first time in years I was seriously thinking about suicide. It was bad. Thanks to the assorted distant support I got during it all, it kept me going until I got used to the recovery. I hate thinking about my mortality, and I had 12 days with nothing to do but sit with my head down and nothing to do but be alone with my black thoughts. If you ever wondered why I bike so much, it's to distract me.

Over the next two weeks, I got a T3 prescription to deal with neck pain (it was bad enough one day that I sought a doctor's treatment). I renewed my library membership (lapsed in my 20s) and downloaded an app called Libby for audio and ebooks. Listened to several novels.

I also came up with a nightly routine to get a small amount of sleep: Strategic placement of pillows and the equipment I was renting allowed about 90 minutes of sleep before soreness woke me up. Then I'd switch to the massage chair, which was actually a comfortable sleep for 60 minutes. Repeat both of those twice per night, and I got enough sleep I wasn't losing my mind.

And how am I doing now?

My eyesight is slowly returning. I think the retina is healed, but the fact that my eyeball has slowly been replacing the gas with fluid means my eyeball is like a carpentry level – the top of my field of view is liquid that I can see through, and the bottom is gas that makes things fuzzy. Right in the centre there's a surface tension line I can't see through at all. Every day, the line moves a fraction lower and I have more vision. I can read and write (obviously) and watch TV, but I'm not safe to drive my car or ride my bike, since I can't effectively shoulder-check to my left. I figure it should all be back to normal by the end of October. The blind spot at the top that triggered all this is gone, so they actually fixed the problem, and didn't just stop it from getting worse. Today is the last day I have to take drops. I have to wear a medic-alert bracelet for another two months, which is also the amount of time I'm not allowed to fly. In both cases, because of the gas bubble in my eye.

Mentally I'm better. Not 100% (or more accurately not even up to my normal 75%) yet, still thinking dark thoughts, but they're responding to my training more now. Being hyper-vigilant about the fragility of my eye isn't helping, but that's not going away until my vision is back.

When I got my diagnosis, one of my thoughts was “I wish it was four weeks from now, and all this crap would be in the past”. Well here I am four weeks from then, and it was all in the past.

So there you go folks. If your eyes go weird, see your optometrist right away, and if it's a detached retina the recover will suck, but not so much that you can't do it. We live in a time and a place where this stuff can be fixed.