ERM procesure in 3 days and my anxiety is building
I have a epiretinal membrane condition and am scheduled to have a vitrectomy in 3 days, and my anxiety is off the chart.
It's 4am and I can't sleep.
Originally I had a very mild ERM, my retina specialist said I have it but it's not enough to bother my eye sight but if I start to see wavy and blurry lines that may be time to discuss treatment.
I then had a cataract lens replacement. Left eye went fine, saw 20/20 the next day, but when when my right eye got operated, the vision was blurry the next day, the next week, the next month (and more blurry than pre-cataract surgery) so the cataract surgeon said there is something going on with my retina and to return to the retina specialist. The retina specialist said there is significant inflammation on my retina post cataract surgery...did eye drops, tried different eye drops over the course of several months. prednisolone, ketorolac, bromfenac, difluprednate, no improvement whatsoever, progressed to injection of Triamcinolone (3X over a six week period), no improvement, progressed to injection of Avastin (3X over 3 months), also no improvement, so advised to do a vitretomy for a "membrane peel".
Initially I wasn't very nervous because doctor said it's a common procedure and I should see improvement afterwards but could take some time, and was told no need to do the post-op face down. I was also told if I do not operate, and operate soon, I will lose my central vision.
Nonetheless, I went to see another retina specialist for a second opinion, and the second retina specialist said if every thing has been tried surgery is my only option but comes with risks. He said the inflammation that caused the irregular retina surface is what is causing my blurry vision, but this inflammation can't settle back most likely because the EPM scar tissues are keeping the inflammation from settling back, however, sometimes the inflammation may be caused by blood vessel hemorrhage so he did an angiogram of my eye to confirm I don't have any issue, but he did ask if I did an angiogram before and I said no, he commented "very interesting..." That makes me wonder my my first retina specialist didn't do one, but when I asked if he would consider operating, he said my first retina specialist is fine and he would not hesitate to have him do the operation.
So now I am having this procedure in 3 days and I can't sleep.
I asked the retina specialist to confirm there is no need to do the face down since I may have to get a special table for it right? He said no need unless there are complications.
I asked if there are medications like pain killers or drops I need post-op and he said he will tell me on the post op appointment the day after. If there is pain just take Tylenol.
Sorry for the long rant, but I do have some specific questions for those who have been through this procedure. I guess I am especially nervous because this condition came as a by product of the cataract surgery, so it has been one problem after another for me.
(1) Since the procedure involves multiple holes being open into the eye to extract the vitreous fluid and to do the membrane peel, these holes would not automatically seal up afterwards right? So once the procedure is done, a replacement fluid is added into the cavity, wouldn't the fluid leak out of the open holes? Or are the holes stitched up afterwards?
(2) This fluid that is filling the eye, is this fluid a permanent replacement? I read that it replaces the natural fluid permanently, but I also read that the eye will gradually replace it with natural fluid over time? Which is it?
(3) I was told I will have local anesthesia and will stay awake during the procedure, so if I am awake during this procedure, am I going to be conscious enough to speak to the doctor during the procedure? What if I feel an itch behind the ear that is extremely uncomfortable? What if I suddenly have an urge to sneeze or cough? I can't imagine that would be a good thing with such a precision procedure?
(4) Yesterday I had to remove a poster from the wall attached with double sided tape. I had trouble getting it off as I pulled it off the paint came with it. I immediately thought about this procedure of peeling the membrane scar tissue. What if there is no "edge" to grab the membrane to peel? What if when peeling it, the retina detaches at the same time? What if when peeling it, the optic nerves get pulled with it?
(5) My procedure is at 1PM, I was told no food or drink for 8 hours prior. That means no food after 5AM. No breakfast or lunch. Can I at least drink water after 5AM.
I will try to go back to sleep now and see what happens.
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Yesterday was my vitrectomy membrane peel procedure, it went well.
Since my procedure was scheduled at 1pm, and my pre-op instructions said no food or drink after midnight, that was a tough one as my mouth was dry when I woke up at 7am and couldn't drink anything.
Arrived at the surgical center at noon, filled out forms and checked in, the nurse came out and I went inside to get prepped. Laid down on a bed, gave me some eye drops, marked which eye to operate, they put an IV in me, oxygen in my nose, blood pressure machine, sensors for heart rate etc...so now I can't move my arms as one arm had the IV the other arm had the blood pressure restrain. This is probably the most uncomfortable time because I was in that position for about 30 minutes, during which I started to feel an itch behind my neck. I can't scratch it and I can't move it feels like pins and needles, and at times the machine beeped red saying "RR level high" but no one walking around seem to care...I think it relates to my respiratory rate?
Finally the anesthesiologist came and asked me about allergies, and explained that I will be awake throughout the procedure, but they will need to knock me out for 2 minutes first, during which time the surgeon will do an injection to the back of my eye. When the surgeon appeared, he asked if I was nervous, I said yes, he said he was not nervous, they knocked me out, and when I came too again, I couldn't see with my right eye, it is like a piece of frosted glass over the entire visual field.
They rolled me into the OR, and put a plastic cover over my entire body including the left eye, only the right eye was exposed but since I can't see, I don't know what was going on.
They put a speculum on my eye, and for the next 10 minutes, I could only hear a few whispers, some background music, and occasionally the sound of power tools kind of similar to the tools used when you go get dental cleaning. I know my vitreous fluid would be extracted, the membrane to be peeled, and new fluid injected, stitches, but I could not feel any of this and finally, the surgeon said OK, they started to tape up my eye, I said, are we done this is over, surgeon said "all finished no issue see you tomorrow in my office".
Afterwards, the eye feels a little sore, but no pain. I was told to take Tylenol if needed, but I didn't. If I tried to open or close the one eye under the cup, it feels a little like sand in my eye and I think this must be the stitches.
I am going to take it easy for a few days and hope the vision gets better sooner or later.
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1 Reaction@miamicuse1960 You are welcome my friend and i am so glad it is over with,now let the healing begin,great luck,don't miss any drops and rest lots,it will be blurry for awhile and cataracts will form which is normal,don't be afraid to ask all the questions you need answered,Blessings Brian!
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2 Reactions@miamicuse1960 Thank you for the detailed explanation of your procedure,almost right to a tee compared to mine,this will help other future patients and will relax them,great job,i am so glad everything went well,Happy Healing and enjoy your first meal after fasting Brian!
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2 Reactions@miamicuse1960
That's great news!!! Please keep us posted on how it heals up.
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1 ReactionThank you for sharing your story and your update.
I hope you will let us know your progress. Best to you!
@miamicuse1960
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1 ReactionI am right now on day 4 after surgery. I thought I would provide a brief progressive update.
Day 0 - the day of surgery, right after the surgery, my operated eye (right eye) was completely covered by a plastic cup and taped over my face. Inside the cup they stuff some tissue paper to kind of keep my eye closed, so it was difficult to open my eye a little. I felt on pain, and after surgery I drank two bottles of water because I had nothing to drink since midnight and my surgery was 1pm the next afternoon. I eye felt a little sore, and I did not take any Tylenol. There were no bleeding or leakage that I could tell, I basically stay in bed except for meals and bathroom breaks. Note that I have a membrane peel procedure so no need to do the face down some of you had to.
Day 1 - first thing in the morning 8am was the post-op appointment with the retinal surgeon. First it was the tech who pulled the tapes and opened the eye patch, my first reaction was double vision. There was a rectangular mirror on the wall and I saw two mirrors a clear one from my left good eye and a blurry outline of a second mirror to it's lower right. She irrigated my eye and took my eye pressure, it was 10. Read the eye chart and my right eye couldn't read, I could see the outlines of the letters but it was not only blurry but also distorted, the letter B and number 8 looked the same to me. For some reason they didn't do a retinal OCT scan that day, when the doctor saw me he looked into my eye with a bright light and said looks good, swelling, some bleeding and sore is normal. I have been using Bromfenac 0.09% drops 2X a day to try to control the ERM and Latanoprost 0.05% 1X a day to control IOP, he said to continue with those two and go back in one week. The rest of the day when I opened and closed the eye it felt a little like sand in the eye, and I think that may be the stitches interfering. I looked at my eye in the mirror and my right eye was swollen and blood shot. Wore an eye shield at night.
Day 2 - I woke up and looked in the mirror and the eye has swollen even more, I can't even open my eye lid half way. I took multiple naps and kept the eye shield on all day since I laid down most of the time.
Day 3 - The swelling seems to have reduced a bit, eye still blood shot, but I can open my eye lid a bit wider, the sand in my eye sensation has gone, but feeling some itching sensation around the eye. I used some cotton pads with distilled water to clean the area near the eye very gently. Vision is still unsteady, I would say worse because prior to the surgery, my left eye was basically taking over, now after surgery, the right eye is affecting the overall vision, so I am hoping that it will improve over time where both eyes will help each other instead of fighting.
Day 4 - The swelling has subsided a little bit more, the eye white area still look quite red and raw, but as long as it's improving, I am hopeful.
Right now I was told I can't carry anything heavier than 5 pounds, so I don't know how long before I can go grocery shopping where I can carry the groceries back inside the house instead of one bag at a time. Heavier stuff like a 2L bottle of water or a watermelon I just can't do it without help.
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2 Reactions@miamicuse1960
Good update. Hard restrictions. I’m sure that was scary to see the double vision and all. Praying that every day will be better for you and that it’s a big success. Eye stuff is scary.
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1 Reaction@miamicuse1960 Thanks for the update,your recovery is going exactly as the Dr. planned,the retina will be swollen for awhile so don't expect miracles right away,it is a super slow healing process,Great that there is no complications,for weeks after the operation i would keep my head above horizontal when bending down to put on shoes or pick something up off the floor,keeps the pressure off the eye.Great luck with healing and prayers for an awesome recovery,Brian!
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1 ReactionThank you for this update, and I hope you will post more as you heal and get better.
Sending thoughts and prayers out to you.