Some real angst

Wednesday (June 1) I went to my eye doctor because of a shadow in my field of vision in my left eye. It turns out that I have a retinal detachment, a condition that can result in blindness if I don't have an operation immediately. In the course of being examined by 4 doctors (!) it was determined that I need a vitrectomy (removal of the vitreous fluid inside the eye and surgically re-attaching the retina.) I was referred to one of the best retina surgeons in the country, who spoke to me for an hour about the operation and the followup (aftercare) The op isn't a big deal--I had cataract surgery and this is similar. But post-op, I have to stay lying in bed on my stomach with my right cheek on the mattress for 23 out of 24 hours a day for two weeks! Actually, she said that I should only get up to go to the bathroom, but I'm hoping I'm allowed to brush my teeth too! Then, for the next two weeks, I still have to do this but I am allowed three 2 hour periods a day on my feet. Then, for the 5th week, I only have to do it at night. This is done so that the retina heals in exactly the right way with no scar tissue (which I am susceptible to since I have recurring eye inflammation which contributed to this problem.) So, the surgery is this Friday, and tomorrow (Thurs.) I have to go to a pre-op appointment at Mass Eye and Ear.

I will not be able to work for 5 weeks. I have had to cancel literally everything on my calendar for 5 weeks. My father and brother have offered to send me money, so my main worry has been alleviated somewhat. I broke down in the doctor's office and apologized profusely--I usually can't cry in front of people and rarely cry in general, but the stress of not being able to work with Curtiss on disability gave rise to fears that I would not be able to pay my mortgage and bills. The prestigious and very impressive Dr. Sang thought that perhaps my students could come to me once I was able to get up for a few hours a day. I didn't have the heart to tell her that things just don't work that way at Berklee. She was very kind, but she was also very insistent that I have the surgery and that I follow her instructions to the letter afterwards. It seems that I am at risk for the formation of excessive scar tissue (because of my uveitis) which threatens to detach the retina again once it is healed.
The idea is to have it heal just enough (not enough means it won't stick to the back of the eye, and too much means scar tissue formation) so it is a tricky, delicate process. Whereas most people have a 90% chance of success with no future detachments, my chances are only 80-85%. Still pretty good odds, though.

Dr. Sang amazed me by rattling off a rapid-fire list of descriptions to her nurse, who typed them into a computer. This was while she was shining the slit lamp into my eyes (checking both eyes to make sure that nothing was wrong with the right eye) and gazing through a complicated lens to get an even better view. These descriptions occasionally had the word "normal" in them, which made me feel a little better, and lots of opthamological shorthand such as OS (left eye, or os sinister) and OD ( right eye, or os dexter) I felt better until she told me that there were about 20 million pigment cells floating around in my vitreous which had no business being there--they were supposed to be in fluid safely confined behind the retina, but they had now broken loose to cause trouble, namely by increasing inflammation in the eye which will slow the healing process. So Dr. Sang brought out the big prednisone pill guns--I took one tonight and I'm supposed to take another tomorrow--plus the eyedrops that fight inflammation (4X a day tomorrow)

Dr. Sang succeeded where three docs before her (including Dr. Foster) had failed: she found the holes in my retina, which were very small and elusive. By the time I reached her at about 4:30 pm, my eye had been poked, prodded, and abused by bright light from about 8 a.m. until 11 a.m. My eye muscles were sore from moving up, down, right, and left as I was instructed. I wasn't looking forward to another bout with the slit lamp. And the final round with Dr. Sang was more painful and uncomfortable than the previous bouts: she had to hold my lid open with an instrument that pinched. While this was nothing compared to labor pains, it was still no day at the beach. It seemed like forever but in fact it probably only took about 5 minutes. She was speedier than the other doctors and she knew exactly what she was looking for. She proceeded to explain the operation to me using several excellent analogies--the structure of the eye is hard for the lay person to understand, but she was well-practiced at explaining. I was referred to her by Dr. Foster, who for about 6 years now has been assiduously trying to cure my persistent uveitis. Dr. Foster is a world-famous expert in inflammatory eye disease, so I would expect him to refer me to someone similar for this surgery. Dr. Foster's mottoes (which are inscribed on two pieces of crystal in a glass case in the lobby of his office) are "Whatever it takes" and "Never, never give up." Now, this may sound corny, but I have tried to adopt these as my own mottoes. I am normally persistent in most things and not prone to giving up, but this eye condition has been extremely discouraging and demoralizing, especially since it has contributed to an even more serious condition. I of course will do whatever it takes to save the sight in my left eye, and certainly the post-op instructions are heroic if not fanatical, but at this moment I don't know how the hell I can stay in that prone position day and night without getting bedsores, strained muscles and tendons, and temporary insanity from forced inactivity.

I won't be able to read (eye patch on left eye and right eye sunk into the mattress, as the surgeon described it) or type on a computer. Thank God that a) Curtiss will be here to take care of me and b)this didn't happen in Ecuador. It would have been bad enough in Quito, but at least there are doctors there--what if it had occurred in the rain forest? Flying in a plane is absolutely forbidden and I would have risked further damage flying home. Although Dr. S. believes that these tears have been forming slowly over time and doesn't think that the elevations in Ecuador or the flights had anything to do with the problem as it is now.

My best hope is that I will find something funny in the experience of immobility that I am about to have. Funny or instructive, perhaps in a spiritual way. It will force me to abandon my habitual patterns, as the Buddhists call them: being online, watching TV, listening to progressive political polemics on talk radio, practicing, exercising, tracking my food intake a la Weight Watchers, tidying up the house, yard work, driving, shopping, even reading. Actually, everything you do on a daily basis is a habitual pattern, even meditation. But the ones that are particularly insidious tend to be the addictive ones and ones that usually involve multitasking. I think I could use a vacation from multitasking. Who knows, my mind and mood might emerge stronger from this. But I could also take to drinking. I had a large brandy tonight which was the only thing that took my mind off this for a while. And I am willing myself not to cry because my left eye hurts and it's red, and I don't want to make matters worse.
OK, bright side: I don't have to worry about money (as my father said emphatically at least 3 times on the phone) I have Curtiss to help me and a brilliant surgeon will be operating on me. Something can and will be done to fix my eye and even maybe prevent future detachments. They probably couldn't do this 50 years ago. Lots of people have to do something similar to the regimen I'm getting. Also, lots of people have to lie on their backs for weeks after back surgery. People have their legs in casts and suspension for weeks and can't work. I'm not the only one. So I'm not going to ask, Why me? Why shouldn't it be me?