Thursday, May 03, 2007

Okay, So Here's The Deal

First, sorry for the insanely late update, but a couple of other things -- extremely upsetting things -- kept me away from the blog.

And seriously upped my already through-the-roof stress level.

(More on those "other things" in a later post.)

So let's get down to it.

The eyes.

Well, there's no mistake-- I got me some narrow angles.

And yes, I will likely need to have laser surgery...

Late Tuesday afternoon, I'm sitting in yet another exam chair-- chin and forehead pressed into supports.

Trying hard to breathe.

While Eye Doc #2 looks at each eye through her microscope-like device.

"Sandra, did Doctor C use a goniolens during your exam last week?"

"Um, no- I don't think so," I tell her.

The doc turns to her technician-- "Is she still anesthetized?"

"She should be-- I checked her pressures just a few minutes ago."

Then the doc turns back to me.

"Sandra, I need you to bring your forehead right there, right up against the support."

"Oh," I say-- swallowing hard, and then leaning forward once again.

"Now I'm going to hold your right eye open," she says, as she puts her thumb and forefinger on my upper and lower lids.

" . . . and I'm going to place this lens on your eye."

She then pushes the wide end of a large circular lens against the front of my eye-- a bright light shines through it.

"Sandra, I need you to look straight ahead... just try to keep that eye looking straight ahead."

But I can't.

My eye is movin' all over the place, while my lids try mightily to expel this thing.

She attempts the other eye, but this one is worse-- because I feel a sharp pain as the "goniolens" is pressed firmly against it.

The doc moves her chair back, and for a moment, says nothing.

And then:

"Sandra you're awfully sensitive about your eyes, aren't you?"

"Oh yes."

"Now is this hurting at all?"

"Actually-- yes, it is."

She turns to the tech and asks her to put in more anesthetic drops-- which help a lot.

Because minutes (and much deep breathing) later, the test is done.

"Sandra, you do have narrow angles-- and you've been experiencing pain. The kind of pain that could be indicative of a narrow-angle closure attack."

"But my pressures are good," I remind her.

"Typically, the pressures would rise during an attack, and then return to normal after."

"Oh."

"Have you had any nausea or vomiting? Severe pain in the eyes?"

"No, just headaches and dull pain over the front of my eyes."

"Hmmm... what we could do today is dilate your pupils."

"Wait- what?"

One of the things I'd read -- both online and in the handout the technician gave me shortly before the doc joined us -- was that pupil dilation could trigger a narrow-angle closure attack.

Which in turn, could cause blindness in a matter of days-- even hours.

" . . . we would use a mild dilating solution-- one that would cause your eyes to dilate as if you were, say, in a movie theater.

"We could then see if your pressures increase in response to the dilation-- giving us a better idea of how soon you might need to have laser surgery."

"Wait, wait-- what if something happens? What if my pressures go up right now? What if I have an attack right now?"

"Then we'd give you medication to bring down the pressures-- and once back down, we'd do the surgery."

"I don't know," I say, shaking my head.

"I understand your trepidation, but dilating your pupils would also give me the chance to look at your optic nerve-- to see if there's evidence of an attack."

"But I thought that what was going on with my optic nerve wasn't related to these narrow angles."

"That's not necessarily true," the doc says.

We talk some more-- about the surgery, the risks...

And finally, I say:

"Let's just do it. If something's gonna happen I'd rather it be now than in a movie theater with my kids."

So the drops go in.

And I go out-- to a seat in the waiting area -- with a description of Laser Iridectomy and a consent form sitting on my lap.

Frozen.

For 30 minutes.

Until--

Nothing happens.

Yes, my pressures go up, but not dangerously so.

"Sandra," the doc says, as she looks at the back of my eye, "you do have some prominant cupping of your optic nerve."

"Is that what Doctor C was talking about when she said 'swelling'?" I ask.

"Yes."

She then pulls back her chair and says, "Let's get visual field and corneal thickness tests scheduled-- I'm pretty confident that you're not in any immediate danger of having an acute narrow-angle attack-- yes your angles are narrow, but there's still a good deal of space there.

"However," she goes on, "you could be experiencing something called chronic narrow-angle glaucoma."

"Chronic?"

"Yes, you could be having low-level attacks that may be causing damage-- " she says as she looks through my file, "now, it looks like optic nerve cupping was noted two years ago, and it looks a bit more pronounced than- "

"So do we just schedule the surgery then?" I ask, trying to stay calm.

"Sandra, you're really in the grey zone here. We could schedule the procedure, but because nothing looks imminent, I think we need to do more tests."

And I want to scream.

"I was just hoping to hear something definitive-- you know? One way or the other."

"I know-- sooner or later you may very well need the surgery-- because as you age, those angles will become even more narrow. We just need to determine how necessary it is for you to do it now."

And then she adds:

"You may even decide to do it sooner simply to avoid the stress of wondering if and when you might have an attack."

So, instead of waiting until late June, I'll be going back a week from next Thursday for more tests.

And if those tests aren't conclusive?

Well, I might still do this thing-- because walking around with the equivalent of some kind of time bomb sitting in my eyes going tick, tick, tick with each passing year is almost certainly more than I can handle.


14 comments:

Minnesota Nice said...

Oh man, Sandra - this waiting is really the pits. It sounds, however, that this dr knows what she's talking about. And you, my dear, are an intelligent, well-informed medical consumer who will continue to make wise choices. Whenever possible, I say, "get it done NOW". Good luck and best wishes.

Major Bedhead said...

I totally agree with the "Do it NOW" philosophy. I wouldn't be able to stand waiting either. Keep us posted and hang in there.

cesnh said...

You are so lucky to have a great and patient (no pun intended) doctor. Sounds like she really knows you. I wish you the very, very best.

Rachel said...

Yes, yes, yes, get it done now. Why deal with that ticking time bomb?

Lyrehca said...

Oy vey! Good luck with whatever you decide, and breathe as deeply as you can during those eye exams. They sound just like my own experience with laser eye surgery for retinopathy. (The breathing deeply helped me a bit during it all.)

Scott K. Johnson said...

Thinking of you Sandra!

art-sweet said...

I'm sorry to hear that all you got was more uncertainty. That SUCKS. And I'm sorry to hear that there is Big Stress going on UGH UGH

{{Sandra}}

Can you get valium for the next exam?

Shannon said...

I would just say "screw the testing" give me surgery...get it over with already.

I hope you get through this swiftly. The waiting part is the absolute worst.

Jamie said...

Oh man - all this waiting stinks! I, too, would probably opt for the surgery ... I don't think I could handle waiting for something to happen ...

Hang in there - I'm thinking of you!

Bernard said...

Sandra

This all sounds unbelievably stressful. You take care of yourself - and I mean besides your eyes.

I'll be saying some prayers.

Kerri. said...

Sandra,

Chris and I send our very, very best. Please let us know how you're doing, and stay strong.

-- Kerri.

Carey said...

Sandra,

This stinks. I'm so sorry you have to deal with this.

I think you need some of this right about now.

http://www.youtube.com/watch?v=0WxCEkhGbfM

Sandra Miller said...

Thanks for all of the support, everyone.

While I'm really leaning toward just getting this thing done ASAP, the idea of making that call without all of the relevant information makes me uneasy.

I'll keep you posted.

And Carey-

That was just the ticket.

Thanks, man. :-)

Johnboy said...

Sandra, I'm late as usual but just wanted you to know that I am thinking of you and your eyes.

I hate to think that you would have to worry about this all the time in addition to everything else. If you are confident in this doctor's abilities and experience, do it.