The prodecure.
Dec. 16th, 2010 08:46 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
solipsistnationOkay, Visudyne(tm). The procedure was actually pretty simple. The psychological impact was pretty significant. The side-effects are, at this point, seriously annoying.
The process:
I went in to the retina specialist at about 2:30. They did the usual basic examination-- numb the eyeball, check the pressure, dilate the pupils for easy access to the retina.
There's some background here. For anyone who hasn't been around me enough to know this, eyeball stuff SERIOUSLY fucks me up. I would say it squicks me, but it's far beyond that. I can't watch movies with eye injuries. I can't give myself eyedrops. I have a hard time with other people giving me eyedrops. You might as well waterboard me-- hyperventilation, general freaking out. It takes all my willpower to let people give me eyedrops at all. If my eyes are dry, Visine is not an option. I just tough it out and have dry eyes, because that's less unpleasant than anything having to do with stuff in my eyes.
So, yeah. For two days in a row, I've had multiple series of eyedrops and multiple checks of eyeball pressure, and apparently in California, unlike my old eye doctor, they do it with things that touch your eye. Aaaaaaaaaaaaaaaaaaah. They numb your eyeball so you can't feel it, so I can trick myself into saying "It's really close. You can't feel it, so it's not touching. Just 2 seconds, you can do it." Two days in a row. Ack. The OD last week, she did what she called "The kid way," where I close my eyes, she drops it in, and I open my eyelids and it kind of seeps in. This works. The fancy-pants retina specialists just kinda drop it in. I did okay.
This thing about my eyeball thing, though? Keep that in mind for later.
Once I was good and dilated, the next step began. First, they put in an IV line. Shoot, man, I am a PRO at that by now. Not so long ago (well, 15 years) I couldn't STAND injections. Needles freaked me out. At age 8, I escaped from the doctor and made it all the way across the building to radiology before they caught me, hiding behind some piece of equipment trying to get out of a shot that would, I dunno, keep me from getting polio or something. Polio? Pshaw! I may not be able to walk, but at least I didn't have to have a shot!
Anyway, IV line in, flushed with sugar water (really, not saline. I dunno.), and then loaded up with dye. They used one of those automatic timed injection devices to slowly feed the dye in over about 10 minutes. I chatted with the lab tech, who was a friendly guy and who I'd be happy to hang out with anytime. Then the doctor himself came in.
An aside about the doctor:
He's British. He has a bit of an accent-- a bit posh, but not "HAIR LAIR"-for-hello posh. Upper middle class, I'd say. He noted that I was reading Blackout by Connie Willis and asked about it, and actually wrote down the info so he could check it out later. The tech said he swaps books with patients too, so I have no doubt that he actually will. I'll ask when I see him in a month.
The interesting part came when, while examining my left eye, he muttered, "Good, good, very good, хорошее." That is, "korosho," or as readers of Anthony Burgess know it, "horrorshow." I asked his lab tech, who told me that the doctor is multilingual, and is one of two doctors in the world who perform a particular specialized type of surgery. The other is in Russia, and he spends quite a lot of time there, presenting and working with her.
I have actually really enjoyed seeing this doctor. If you're in California and need your eyeball examined in intense detail, I recommend him. He's a Culture List kind of doctor, if that means anything to you.
Back to the process:
Ten minutes of being packed full of dye led into ten minutes of waiting for the dye to move around and attach to the places it's supposed to attach and get, I guess, washed away from places it's not supposed to be.
Then, the bad part.
To perform the actual treatment, they focus a laser tuned to a particular wavelength of red (693nm) on the spot where the little leak is. The dye does its magic and releases crazy free oxygen atoms which attach to stuff and oxidize, I guess, more-or-less cauterizing the area. This seals up the blood vessels that would otherwise leak blood and stuff into your eyeball and cause all kinds of problems.
This requires exactly 83 seconds of exposure, focused on the piece of the retina with the leak. This means holding one's eye open for 83 seconds while clamped into an eyeball microscope (you've been in those every time you've been to the optometrist-- this one just has a laser attachment on the side).
Here's how they do that. Remember, my eyeball has been numbed with a local anesthetic eyedrop. Note, however, that this doesn't really help.
Imagine a contact lens with a telephoto lens attached.
It's just a normal sort of contact lens (which, I'll note, I don't have because I can't get my fingers anywhere near my eyeballs without FREAKING OUT) with an inch-long giant optical attachment clamped to it. It's sort of conical, about a quarter-inch across on the eye end and about an inch across on the outer part.
The doctor slathers the contact part with a sort of goo and slaps this onto your eyeball. You, the poor bastard with optical ridiculousness stuck in his (or her) face, now have a huge fucking chunk of gear on your eye like the worst damn cyberpunk protagonist ever.
You can't blink, because it's huge. You can't move your eyeball because it's glued to this giant lens with goop and the lens can't move. You have to just hold your eye in place and not blink and not faint for EIGHTY-THREE SECONDS.
83 seconds is one long-ass time when you have camera accessories glued to your eyeball.
The doctor, to his credit, was very encouraging.
"Very good," he said. "Now relax. Breathe normally." I tried. "You can relax your jaw." I tried. "Sixty seconds to go. You're doing very well. You can breathe."
It was a long, long time. He told me I'd done well, told me it had gone well and there were no complications, and if there were any problems we'd find out within about ten minutes. He pulled out the Huge Fucking Lens and peaced out, telling me to make an appointment for 5 or 6 weeks from now and to call if I noticed my vision improving in the next week or two. "We like good news too!"
I then collapsed back into the chair and tried to breathe. My eye was covered with goo and stung. The tech was sympathetic, although he said I'd done well.
"I need to wash your eye out with saline. This will help."
"Well, shit, might as well." I managed to let him do this-- it was probably the first time I've ever had somebody wash out my eye with anything without freaking out. He got some of it out, but it was still kind of rough. He did it again, and it was a bit better. I was breathing.
"Take your time," he said.
The aftermath:
"Hey, I see you came prepared. Great!"
Since I knew I'd been all photosensitive, I'd brought my Burning Man kit: my Tilley hat (hemp, of course, for total hippy bullshittitude), clip-on sunglasses, Saudia Arabian headscarves. Actually, not QUITE the full kit-- I didn't bring my dust goggles (I didn't anticipate the wind whipping up any dust storms between Campbell and Ben Lomond). That's just as well, since they gave me a pair of wrap-around sunglasses of the appropriate color to block the wavelength of light that would activate residual dye in my eyes and DESTROY MY VISION FOREVER or whatever. They were better than my clip-ons, anyway. I also had a pair of gloves. I chose to bring my work gloves, the relatively thin pair I use for stacking wood and similar jobs. I didn't bring my cold-weather gloves because it's 60 degrees outside here, and I didn't want to cook my fingers.
I made an appointment for February. I sat in the waiting room for a few minutes. I was still recovering from the near-panic-attack during the procedure. My hands shook. I closed my eyes. My right eye still stung, but it could have been minor abrasion from frantically trying to close around a huge damn cylinder of metal glued to my eye.
Then, behatted, begloved and bescarved, I went out to the car. I sat there. I called Nikki, who had taken the baby to a nearby park to play while I was seeing the doctor. I sat for a while longer, and then, when I felt like it was a good idea, I drove over to pick them up. I waited in the car while they played some more and the boy had a snack, convinced that anyone who noticed me there would call the police and Homeland Security to come and pick up the obvious terrorist scoping out the vulnerable children of Campbell. (Head scarf! Hat! Dark sunglasses! WEARING GLOVES IN a CAR! Near a PLAYGROUND! Hell, I'd call the police.)
Then we drove home, slowly. As the sun went down, my vision got worse. If we'd started any earlier I might have made us wait longer somewhere, which would have been unpleasant.
Dinner, Top Chef (Stephen isn't a very good chef these days, that's for sure. No surprises there.), a bottle of nice wine that Nikki picked out, and some pudding, a treat for me that she also picked out because she knew I was feeling off.
My right eye is about 75% useless, and unfortunately, the 25% that's any good is a ring around the outside edge. The inside bits are a wide grey circle where everything kind of shrinks and is stretched inward as if my eye were being used to demonstrate a gravity well with a black hole right in the center of my vision, stretching it all toward a single point. I can really only use my left eye at all right now. I can read with both eyes open, but it doesn't work very well. My depth perception is WAY off, and it's been giving me a headache all night. I'm looking forward to going to sleep.
So yeah, trying to keep spirits high, and at least this is part of the recovery process and not part of it getting worse, but man. I like depth perception. I use it for all kinds of things. I had to use two hands to refill my glass of wine-- one holding the bottle, and the other holding the glass AND the top of the bottle to make sure they were lined up right. I could get used to this, but I don't want to.
Time for, I dunno. Bed eventually, I guess. Sitting up for a while. I'd like to read my book, but I don't think I'm going to be able to.
The process:
I went in to the retina specialist at about 2:30. They did the usual basic examination-- numb the eyeball, check the pressure, dilate the pupils for easy access to the retina.
There's some background here. For anyone who hasn't been around me enough to know this, eyeball stuff SERIOUSLY fucks me up. I would say it squicks me, but it's far beyond that. I can't watch movies with eye injuries. I can't give myself eyedrops. I have a hard time with other people giving me eyedrops. You might as well waterboard me-- hyperventilation, general freaking out. It takes all my willpower to let people give me eyedrops at all. If my eyes are dry, Visine is not an option. I just tough it out and have dry eyes, because that's less unpleasant than anything having to do with stuff in my eyes.
So, yeah. For two days in a row, I've had multiple series of eyedrops and multiple checks of eyeball pressure, and apparently in California, unlike my old eye doctor, they do it with things that touch your eye. Aaaaaaaaaaaaaaaaaaah. They numb your eyeball so you can't feel it, so I can trick myself into saying "It's really close. You can't feel it, so it's not touching. Just 2 seconds, you can do it." Two days in a row. Ack. The OD last week, she did what she called "The kid way," where I close my eyes, she drops it in, and I open my eyelids and it kind of seeps in. This works. The fancy-pants retina specialists just kinda drop it in. I did okay.
This thing about my eyeball thing, though? Keep that in mind for later.
Once I was good and dilated, the next step began. First, they put in an IV line. Shoot, man, I am a PRO at that by now. Not so long ago (well, 15 years) I couldn't STAND injections. Needles freaked me out. At age 8, I escaped from the doctor and made it all the way across the building to radiology before they caught me, hiding behind some piece of equipment trying to get out of a shot that would, I dunno, keep me from getting polio or something. Polio? Pshaw! I may not be able to walk, but at least I didn't have to have a shot!
Anyway, IV line in, flushed with sugar water (really, not saline. I dunno.), and then loaded up with dye. They used one of those automatic timed injection devices to slowly feed the dye in over about 10 minutes. I chatted with the lab tech, who was a friendly guy and who I'd be happy to hang out with anytime. Then the doctor himself came in.
An aside about the doctor:
He's British. He has a bit of an accent-- a bit posh, but not "HAIR LAIR"-for-hello posh. Upper middle class, I'd say. He noted that I was reading Blackout by Connie Willis and asked about it, and actually wrote down the info so he could check it out later. The tech said he swaps books with patients too, so I have no doubt that he actually will. I'll ask when I see him in a month.
The interesting part came when, while examining my left eye, he muttered, "Good, good, very good, хорошее." That is, "korosho," or as readers of Anthony Burgess know it, "horrorshow." I asked his lab tech, who told me that the doctor is multilingual, and is one of two doctors in the world who perform a particular specialized type of surgery. The other is in Russia, and he spends quite a lot of time there, presenting and working with her.
I have actually really enjoyed seeing this doctor. If you're in California and need your eyeball examined in intense detail, I recommend him. He's a Culture List kind of doctor, if that means anything to you.
Back to the process:
Ten minutes of being packed full of dye led into ten minutes of waiting for the dye to move around and attach to the places it's supposed to attach and get, I guess, washed away from places it's not supposed to be.
Then, the bad part.
To perform the actual treatment, they focus a laser tuned to a particular wavelength of red (693nm) on the spot where the little leak is. The dye does its magic and releases crazy free oxygen atoms which attach to stuff and oxidize, I guess, more-or-less cauterizing the area. This seals up the blood vessels that would otherwise leak blood and stuff into your eyeball and cause all kinds of problems.
This requires exactly 83 seconds of exposure, focused on the piece of the retina with the leak. This means holding one's eye open for 83 seconds while clamped into an eyeball microscope (you've been in those every time you've been to the optometrist-- this one just has a laser attachment on the side).
Here's how they do that. Remember, my eyeball has been numbed with a local anesthetic eyedrop. Note, however, that this doesn't really help.
Imagine a contact lens with a telephoto lens attached.
It's just a normal sort of contact lens (which, I'll note, I don't have because I can't get my fingers anywhere near my eyeballs without FREAKING OUT) with an inch-long giant optical attachment clamped to it. It's sort of conical, about a quarter-inch across on the eye end and about an inch across on the outer part.
The doctor slathers the contact part with a sort of goo and slaps this onto your eyeball. You, the poor bastard with optical ridiculousness stuck in his (or her) face, now have a huge fucking chunk of gear on your eye like the worst damn cyberpunk protagonist ever.
You can't blink, because it's huge. You can't move your eyeball because it's glued to this giant lens with goop and the lens can't move. You have to just hold your eye in place and not blink and not faint for EIGHTY-THREE SECONDS.
83 seconds is one long-ass time when you have camera accessories glued to your eyeball.
The doctor, to his credit, was very encouraging.
"Very good," he said. "Now relax. Breathe normally." I tried. "You can relax your jaw." I tried. "Sixty seconds to go. You're doing very well. You can breathe."
It was a long, long time. He told me I'd done well, told me it had gone well and there were no complications, and if there were any problems we'd find out within about ten minutes. He pulled out the Huge Fucking Lens and peaced out, telling me to make an appointment for 5 or 6 weeks from now and to call if I noticed my vision improving in the next week or two. "We like good news too!"
I then collapsed back into the chair and tried to breathe. My eye was covered with goo and stung. The tech was sympathetic, although he said I'd done well.
"I need to wash your eye out with saline. This will help."
"Well, shit, might as well." I managed to let him do this-- it was probably the first time I've ever had somebody wash out my eye with anything without freaking out. He got some of it out, but it was still kind of rough. He did it again, and it was a bit better. I was breathing.
"Take your time," he said.
The aftermath:
"Hey, I see you came prepared. Great!"
Since I knew I'd been all photosensitive, I'd brought my Burning Man kit: my Tilley hat (hemp, of course, for total hippy bullshittitude), clip-on sunglasses, Saudia Arabian headscarves. Actually, not QUITE the full kit-- I didn't bring my dust goggles (I didn't anticipate the wind whipping up any dust storms between Campbell and Ben Lomond). That's just as well, since they gave me a pair of wrap-around sunglasses of the appropriate color to block the wavelength of light that would activate residual dye in my eyes and DESTROY MY VISION FOREVER or whatever. They were better than my clip-ons, anyway. I also had a pair of gloves. I chose to bring my work gloves, the relatively thin pair I use for stacking wood and similar jobs. I didn't bring my cold-weather gloves because it's 60 degrees outside here, and I didn't want to cook my fingers.
I made an appointment for February. I sat in the waiting room for a few minutes. I was still recovering from the near-panic-attack during the procedure. My hands shook. I closed my eyes. My right eye still stung, but it could have been minor abrasion from frantically trying to close around a huge damn cylinder of metal glued to my eye.
Then, behatted, begloved and bescarved, I went out to the car. I sat there. I called Nikki, who had taken the baby to a nearby park to play while I was seeing the doctor. I sat for a while longer, and then, when I felt like it was a good idea, I drove over to pick them up. I waited in the car while they played some more and the boy had a snack, convinced that anyone who noticed me there would call the police and Homeland Security to come and pick up the obvious terrorist scoping out the vulnerable children of Campbell. (Head scarf! Hat! Dark sunglasses! WEARING GLOVES IN a CAR! Near a PLAYGROUND! Hell, I'd call the police.)
Then we drove home, slowly. As the sun went down, my vision got worse. If we'd started any earlier I might have made us wait longer somewhere, which would have been unpleasant.
Dinner, Top Chef (Stephen isn't a very good chef these days, that's for sure. No surprises there.), a bottle of nice wine that Nikki picked out, and some pudding, a treat for me that she also picked out because she knew I was feeling off.
My right eye is about 75% useless, and unfortunately, the 25% that's any good is a ring around the outside edge. The inside bits are a wide grey circle where everything kind of shrinks and is stretched inward as if my eye were being used to demonstrate a gravity well with a black hole right in the center of my vision, stretching it all toward a single point. I can really only use my left eye at all right now. I can read with both eyes open, but it doesn't work very well. My depth perception is WAY off, and it's been giving me a headache all night. I'm looking forward to going to sleep.
So yeah, trying to keep spirits high, and at least this is part of the recovery process and not part of it getting worse, but man. I like depth perception. I use it for all kinds of things. I had to use two hands to refill my glass of wine-- one holding the bottle, and the other holding the glass AND the top of the bottle to make sure they were lined up right. I could get used to this, but I don't want to.
Time for, I dunno. Bed eventually, I guess. Sitting up for a while. I'd like to read my book, but I don't think I'm going to be able to.