Surgery, and Christmas lights

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I had my right eye’s vitreous removed on Thursday. The surgery center is in Chattanooga, which is not Rome. It is, in fact, about an hour and a half away from our house. A long-time friend of my cousin was volunteered by my aunt to drive me. We left our house at around 5:30 AM, a time with which I am only theoretically familiar.

I was told beforehand not to eat after midnight before the surgery, so I expected to receive anesthesia. Imagine my delight when they told me I would only be sedated with Versed, and would be awake while the surgeon stuck sharp instruments into my eye. It was already to late to run, so I just accepted it, probably the way a condemned prisoner accepts that he is being led to the firing squad.

They draped my good eye, and possibly my bad eye, so I couldn’t see the team as they prepared their foot-long syringes and scalpels, or whatever they used. In fact, I couldn’t really see or feel anything they did. They did tell me that Versed induces amnesia, so it’s possible I just don’t remember. But it certainly seemed that I didn’t feel anything. I felt no pain, and my eye has not hurt since, except for a little twinge that feels muscular when I move my eyes around.

I got home before lunch, and proceeded to keep my head facing down as instructed for the rest of the day. This is because they injected a gas (sulfur hexafluoride, if you’re curious) into my eye to help press the retina up against the back of my eye, as I think I mentioned in my previous post. They put a patch on my eye, unfortunately not a black patch, so I was blind in that eye for the evening. As the evening progressed, I began to see a light display in my right eye. There were blue lights that looked like stars, and bright blue lines that looked like refugees from a neon sign. There were also what looked like wrestling black cats around the periphery of my field of view. That worried me a little. Not just the cats, but the whole thing.

Today, Friday, I went back to Chattanooga for a post-op checkup. We left at 6:15, a more civilized hour. More civilized, but not really civilized. They dilated my eye and looked inside, and then the doctor said it was good. They left the patch off and I found that all the literature I had read that said my vision would be very blurry after the surgery was true. I could actually see better with my right eye completely covered than after they removed the patch. The blurry eye’s vision was competing, and pretty successfully, with my better eye’s vision. I now know what people mean when they say they can see only vague shapes.

I also keep seeing someone sneaking up on my right side, but they disappear when I turn to look with my good eye.

The surgeon told me that the lights and lines are normal after retina surgery, so I am just relaxing and enjoying them. They had disappeared by Friday morning, but they have come back this evening as I write this. Now if I close my eyes I see a very pretty Christmas display, with strings of blue and white lights across my chest and a starry heaven above. I saw a big orange pumpkin that went all the way around the periphery of my vision just a while ago, and the black cats were back. At this moment, the residents of the surrounding hills have put up Christmas lights all along the ridge lines, and there is a large spherical ornament above, kind of like the moon, but with white lights inside.

Now that’s gone and I see orange bat wings.

It’s all quite amusing, but I hope not too long lasting. The surgeon said I can expect my vision to improve as the gas in my eye is absorbed. Right now it’s like looking through an aquarium. only worse. If I look straight down, my vision is slightly less blurry, but not enough that you would want me to drive you to the grocery store. They put a green, plastic bracelet around my wrist warning everyone that I have a gas in my eye which could cause permanent eye damage if I’m forced to go on an airline flight or drive to high altitudes. I discovered that if I brought the bracelet right up to my eye, close enough that it probably looks scary to anyone watching, I could read the text. It’s like using a magnifying glass. That was interesting, but the most interesting part is that I had to use the sharpest region of my eye to do that, the part that was damaged by my vitreomacular traction.The part that was completely blind before my surgery.

So, I can now see with that part of my eye, at least a little. It’s enough to give me some hope for a reasonable recovery.

In the meantime, I will keep everyone posted if I see anything more interesting in my bad eye.

Things fall apart

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As it turns out, Leah and I are the things that are falling apart.

Leah has continuing issues with pain; balance; and, I’m sorry to report, cognition. She has what is apparently a stress fracture in her right heel. I say “apparently” because when the medical people ask how it happened, we can’t point to a particular time, place, and event. They say, “Aha! Its a stress fracture,” because those can happen over time from overuse, or unconditioned use. In any case, her right heel, or driving heel, is fractured and it hurts, strangely enough, in places other than her heel. The orthopedist thinks she has some nerve disfunction that is preventing her heel from hurting as much as it should. As a result, she is using it more than she should.

The doctor also says the bone in her heel has apparently lost some density. He suspects she may have osteoporosis in other bones as well.

This was on top of her chronic pain from arthritis and some residual pain from her pinched nerve and the subsequent surgery to correct it.

The balance problem has been increasing for months. She is falling fairly often now, usually on her left side. She scrapes the skin off of her arm, and just about the time it has healed, she falls and scrapes more skin off. She is supposed to use a walker, but she usually leaves it some other place.

That is partly the result of her cognitive decline. Her memory is fading fast. She remembers things that did not happen, and doesn’t remember things that did happen. She asks the same question several times, minutes apart. I will tell her something (I hesitate to use the word “explain”) and she responds with, “You used to be able to explain things so that I could understand.” When we watch a television show, she has trouble following the plot and remembering the characters. It’s getting harder for her to find something that she is interested in. One of the worst parts of this is that she is aware of the decline.

The center cannot hold.

Only in this case, the problem is that the center is holding all too well. A couple of months ago I started noticing an annoying after-image in my right eye when I blinked. It got worse, and my vision started to blur. I made an appointment with my eye doctor, and he did some imaging that showed a distortion in the macula. He referred me to a retina specialist, who told me I have vitreomacular traction (let’s call that VMT). That means that the vitreous (people in the eye business use the word as a noun. I can’t help seeing it as an adjective, as in “vitreous gel,” the clear fluid in the eye. But, as I was saying, ) shrinks and doesn’t let go of the macula like it should. They (mainly google) tell me that the vitreous shrinks as we age, normally without symptoms or harm, but in some cases, it refuses to let go of the macula, with which it has been in intimate contact for many years. When that happens, it pulls the macula away from its proper position, causing visual distortion, blind spots, and eventually tears in the macula. The tears may actually be responsible for the blind spots; Google is silent on that issue. I now have a blind spot in the exact place that normally has the highest resolution. You know, the part you read with.

I have eye surgery scheduled for October 5 in Chattanooga, TN, about an hour and a half away from our home, depending on traffic. It would be hard enough if it were in our town, since Leah is not driving now. I am expecting to be gone a minimum of five hours, possibly more. Leah can’t drive now, possibly ever again, and I cannot leave her alone that long. Even if I could, she can’t handle Zoe, our big dog, and I will need someone to drive me home, and then back to Chattanooga again the next day for a post-op checkup.

My aunt has found a friend of her son who says he can drive me. He will soon learn that he will be driving Leah and two dogs as well. That’s the only solution I can think of to take care of her and the dogs. Fortunately, the weather should be cool enough in October that they can stay in the car for a while. I checked the surgery center on Google Earth, and it looks like there are shaded parking spots.

In addition to my VMT, I have a cataract in my left eye, which is now my good eye, but which used to be my not-good eye. It’s having to do double duty, seeing for itself and filling in the details that my right eye is missing. Unfortunately, the cataract is causing a slight bit of double vision, just enough to be annoying when i’m driving at night. So, soon after I get over the VMT surgery, called a vitrectomy, because they take out the vitreous, I will need cataract surgery. It seems that everyone my age has had cataract surgery, and it’s a breeze.

A vitrectomy is not quite a breeze, but it is a relatively short procedure. The recovery involves maintaining a face-down position for up to a week. That’s because the surgeon will inject a gas bubble into my eye intended to press against the macula and try to convince my body that the macula is supposed to be attached to the back of my eyeball. The gas bubble does no good if it’s pressing against the front of my eye, so I will need to be face down to keep it pressing against the back of my eye. The gas will eventually be absorbed by the body, and the eyeball will be filled with some sort of fluid that the body will generate. We all hope.

Various eye specialists, speaking through Google, tell me that the surgery has a reasonably good success rate. The first time I saw my specialist, he said if the VMT is caught early, surgery is 99 percent successful. The second time I saw him, he said it had an 85 percent success rate. I will not ask him again.

And, of course, success depends on your definition. The result of a successful vitrectomy is a gradual recovery in visual acuity. Although Google refuses to commit to a particular level of recovery, the strong implication is that my vision will never be as good as it was before VMT.

Google also tells me that if a person has VMT in one eye, the probability that they will have it in the other eye is greater than 50 percent.

It’s just barely possible that I have already had VMT in at least one eye, possibly my “good” eye. About two years ago I started noticing the after-image when I blinked. It was annoying but I didn’t worry too much about it. It gradually went away, and I didn’t even notice when it did. Was that VMT? I do not know. All that I know is that it was almost identical to what I experienced with a diagnosed VMT, and that in some cases VMT can spontaneously resolve without surgery.

Health issues are generally depressing. And, as anyone who has dealt with the cognitive decline of a loved one knows, that can also be depressing, and quite stressful. That’s one reason I have not been able to generate enough momentum to actually do anything lately, including write new blog posts. Maybe a few things will come back together in the not-too-distant future. Things not falling apart would be a nice change.

Divisible by five

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My brother Henry died five years ago on the day this posts, April 6. He would be 75 years old now. My mother would be 100, and my father would be 105.

It’s been long enough for me to get used to my family not being here, but I haven’t. I feel like they are somewhere over there, in some reality next door to this one. There has certainly been enough going on in this reality over the last few years to make me think there must be a better one somewhere.

I no longer think to myself that I need to tell one of them about something that has happened, or something I did around the house, or, more important, a question that I would like to get an answer to. That phase ended a while ago, but the need did not.

As Snoopy* once said, “You never miss the water till the well runs dry.”

So here I am, still with a lot of questions that need to be answered. I don’t know whether they would be able to answer them, but at least the questions would be there, out in the open.

By the way, if you are wondering whether you look old, you know the answer when someone sees you walking your dogs and asks you how old you are, and then congratulates you on being able to walk a dog. “Thank you. Still working at your age, eh?”

But here I am, still breathing. There is a bit of cosmetic damage, and some internal parts are not working as well as they once did. My mind seems to work almost as well as it did, let’s say five years ago. But then, maybe I wouldn’t know.

But I was talking about asking questions.

No one warned me that I would get old, and still not be wise. In fact, no one said a god-damned thing about that, and I want to know why. I thought we were supposed to be able to figure things out about life, the universe, and everything when we got this close to the end of it. Was I standing behind the door when wisdom was handed out? Maybe I was looking out the window, daydreaming, and I missed hearing my name called. Maybe they ran out of wisdom; it does seem to be in short supply today.

However it happened, here I am, needing questions answered. There is no one to answer them, and I’ll be damned if I can answer them myself. Is it like that for everyone?

This is the way I think of my family.

I don’t know when this photo was taken. It looks like the early 1990’s, possibly a little earlier than that. I don’t know where I was, or who took the photo.

Maybe that’s the way they look now, in that other reality.

* I’m pretty sure Snoopy said it once, but the only citation I can actually find was Franklin’s grandfather.

A doctor visit

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First things first; so what have the dogs been up to?

Dogs like Cheetos. In fact, I’m pretty sure this dog likes Cheetos more than we do.

Sam likes thumbs from leather gloves. I caught him before he ate the whole thing. I’m not joking about eating it; either he ate the thumb, or he’s really good at hiding stuff.

We had some light snow back in December. Some canid not a domestic dog left its tracks on the road. I suspect a fox. Look at the shadow to Zoe’s left. It’s not Zoe’s shadow. That’s Sam, best known for blue eyes and big, erect ears.

We had some nice days, too, sunny and warm, but not too warm, well suited for lounging for a few minutes. I hardly ever sit down in the grass of our front yard, so Sam was a little concerned. He also wanted pets.

Zoe invited a few Doberman friends over for a friendly game of poker.

Dobermans do not play poker. This is an image generated by an application called wall-e 2, which uses some kind of AI to generate images based on a simple instruction. The instruction for this image was “doberman pinchers playing poker in the style of Normal Rockwell.”

Actually, Zoe does play poker, but for her, poker means “poke her”, which she plays with the cat using her nose.

Speaking of weather (or were we?), something woke me up just at dawn a few days ago and I was able to see the sunrise. It was nice.

I hear that the sun rises almost every day, and often it’s quite picturesque. Maybe some day I will go to bed early enough to get up and see more of them.

Afternoons can offer nice skies, too.

Look at the evidence of wind shear, waves going two different directions. The sky over the parking lot was about all that our local Walmart had to offer, given the continuing supply chain problems.

Oh, about that doctor visit.

I went to my vascular specialist on Thursday of last week to talk about pulmonary embolisms, or blood clots as I don’t like to call them. Since my clots were not explained by any of the normal causes or risk factors, the various physicians I have dealt with have mentioned that cancer often causes blood clots. My vascular specialist repeated that, and added that in 10-to-20 percent of cases of unexplained pulmonary embolisms, cancer is diagnosed within two years.

I went home after that because it seemed like the best place to go. I considered not telling Leah what the doctor said, because I knew she would worry. I was right about that. I told her not to worry, and that, while I was considering potential courses of action should I be diagnosed with cancer, that was not the same thing as worrying. I spoke to my primary care doctor the next day, and he was more reassuring. He said that a cancer that was advanced to the point of causing blood clots would almost certainly be causing other symptoms, of which I had none.

The main concern at this point was that imaging of my chest right after my blood clots had found a nodule in my lung. Doctors said that it was small and did not show some typical features of a cancer, so it was probably benign. But not definitely.

I told Leah that we should hold off on the worrying until I saw the pulmonary specialist on Thursday of this week. I had a CT scan last Friday in preparation for that appointment to see whether the nodule had grown, which would be bad, or was the same, which would be good. The pulmonary specialist told me it had not changed in the six months since the previous CT scan. So, good news. In fact, he said it was probably not really a “nodule” but rather an enlarged lymph node possibly from a past infection, or something.

He said, “You do not have cancer.”

But the mention of an infection causing the enlarged lymph node made me wonder. About 10 years ago I had some heart function problems that were potentially pretty serious. A few months after that was diagnosed, my heart functions had recovered to the point that one of the two cardiologists I had seen discharged me. I asked what had caused my problem and why had it essentially cleared up. The cardiologist said he didn’t know, but that it might have been some kind of infection. So I asked my pulmonary specialist if the enlarged lymph node could have been caused by the same thing that caused my heart problem. He said it certainly could have been.

The doctor wants me to have another CT scan in a year, just to be sure, although the radiologist who read the CT image said there was no need for more imaging.

When I drove back home I felt as if a weight I didn’t realize I had been carrying had been lifted from my shoulder. I felt pretty good. When’s the last time you felt that good after leaving a doctor’s office?

𝕬 π–›π–Žπ–˜π–Žπ–™ 𝖋𝖗𝖔𝖒 𝕾𝖙. π•―π–”π–Œπ–”π–‘π–†π–˜

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β€˜Twas the night before Christmas, when all through the house, not a creature was stirring, not even a mouse;

The stockings were hung by the chimney with care, in hopes that St. Dogolas soon would be there; the animals were nestled all snug in their beds… 

Well, it looks like some of us may be stirring.

I see you two.

No peeking. Santa won’t come if you peek.

Yes, Zoe, you’re in your bed, but not asleep.

That’s better, Sam and Zoe, but I think you’re still awake.

Zoe, come on back to bed.

That’s better. I almost believe you’re asleep.

Mollie’s asleep.

I hope she’s not planning to try to snag Santa with those claws.

Now, finally, everyone is in bed and asleep. It’s easier these days with so few of them left with us.

Now, we wait for St. Dogolas.

He’s chubby and plump, a right jolly old elf. I’m sure we’ll see him, if I say so myself.

Will he come to our house before we sleep? Let’s be careful and quiet, not making a peep.

Out on the lawn there arose such a clatter,
I sprang from the bed to see what was the matter.
Away to the window I flew like a flash,
Tore open the shutters and threw up the sash.
What to my wondering eyes should appear,

A little old furkid, so lively and quick,
I knew in a moment it must be St. Dog.

He was dressed all in fur, from his head to his foot,
And his leash was all tarnished with ashes and soot;
A bundle of Dog Toys he had flung on his back,
And he looked like a pedler just opening his pack.
His eyesβ€”how they twinkled! his dimples how merry!

He spoke not a word, but went straight to his work,
And filled all the stockings; then turned with a jerk,

… laying his paw aside of his nose,
And giving a nod, up the chimney he rose;
He sprang to his sleigh, to his team gave a whistle,
And away they all flew like the down of a thistle,
But I heard him exclaim, ere he drove out of sight,

β€œ … and to all a good night!”

We here on top of the mountain wish everyone a holiday filled with happiness, rainbows, sun dogs, pink clouds, friends, family, and good cheer.