Oh, Say Can You See?

As you already know, tomorrow is my second cataract surgery.  The first, three weeks ago, was on my right eye.  That eye now sees wonderful shades of color I missed before.  I’m so eager to see what my photography will look like now.

I also don’t need my glasses to read with that eye, although it’s been made clear to me that this may change.  I am eager to do the left eye. I’ve never had perfect vision and this is as close to that as I can come.

As usual, the surgery (well, anything really) got me to thinking if this was in any way related to my chronic kidney disease.  In a Google search, this is the first site that came up – my old friend DaVita. http://www.davita.com/kidney-disease/overview/symptoms-and-diagnosis/eyes-and-chronic-kidney-disease/e/4732

 Eyes and Chronic Kidney Disease

The leading causes of chronic kidney disease (CKD) are diabetes and high blood pressure. These conditions are also the leading causes of eye disease and loss of vision. If your renal disease is a result of either condition your vision may be at risk. Diabetes and high blood pressure often go undiagnosed because people don’t notice any symptoms. As time goes on without medical treatment, these conditions can worsen and other complications—such as kidney disease and eye problems—arise.

If you have chronic kidney disease not due to high blood pressure you may still want to monitor your blood pressure regularly, as kidney disease can cause high blood pressure and put your vision at risk.

Cataracts

Cataracts occur when the lens of your eye becomes cloudy. The lens of the eye is normally clear. Its purpose is to focus the light coming in from the pupil to the retina at the back of the eye. A cataract scatters the incoming light and can make everything look blurry.

Cataracts develop as we age. But patients with diabetes are at a higher risk for cataracts. Diabetics can develop what is known as “sugar cataracts,” a cataract that appears suddenly and grows to such a point that the entire lens is clouded. High levels of glucose react with proteins found in the eye and form a byproduct that settles on the lens.

Hmmm, I don’t have diabetes but I do have high blood pressure (oh, okay, and I’m old – scratch that and make it older).  That got me to thinking about what it looks like.  Although I’m a writer, visuals make difficult subjects easier for me to understand. That’s when I looked for this:

Let me describe the surgery to you.  There was the usual fasting as of midnight the previous night and the wait broken up by filling out forms and watching videos about post op care.  Almost forgot: I was told to take only my hypertension medication and no others. I must mention that Bear was a wreck during the whole wait  while I was eager to see clear colors again. (He loves me.)

Then I was escorted into the pre op area where the usual vitals were taken and I was  put out for a few minutes while the substance to paralyze the eye was injected directly into the eye. In retrospect, I’m glad I didn’t have to suffer that wide awake.

But the surgery itself was an incredible surprise.  I knew I was going to be awake during the procedure but I was unprepared for the beautiful colors I would see through the eye.  I had to be reminded to be quiet so that the talking wouldn’t make my head move.

I wanted to know why I was seeing the enchanting turquoise auras around the ceiling lights.  Then I became more interested in what I can only describe as turquoise circuit boards that I saw in that eye.  I’m pretty sure that was the original lens being blasted to pieces. I distinctly remember losing interest during the  insertion of the new lens.

This more scientific explanation makes the procedure more clear: “Most modern cataract procedures involve the use of a high-frequency ultrasound probe that breaks up the cloudy lens into small pieces, which are then gently removed from the eye with suction. This procedure, called phacoemulsification or “phaco,” can be performed with smaller incisions than previous surgical techniques for cataract removal, promoting faster healing and reducing the risk of cataract surgery complications, such as a retinal detachment.

After the cataract and all remnants of the cloudy lens have been removed from your eye, the cataract surgeon inserts a clear intraocular lens, positioning it securely behind the iris and pupil, in the same location your natural lens occupied. (In special cases, an IOL might be placed in front of the iris and pupil, but this is less common.)

The surgeon then completes the cataract removal and IOL implantation procedure by closing the incision in your eye (a stitch may or may not be needed), and a protective shield is placed over the eye to keep it safe in the early stages of your cataract surgery recovery.”  This is from http://www.allaboutvision.com/conditions/cataract-surgery.htm

The only complaint I had about the entire procedure was that the surgery table I was laying on had no shoulders making it uncomfortable after a while. This same table was rolled into the surgery room, so it made sense that the  shoulder areas were cut out.  That’s so that the surgeon could pull his stool as close to my eye as possible.

Here’s the part you have to watch out for (oh, poor choice of words for describing cataract surgery).  Although I had carefully explained that I have chronic kidney disease, I was still given a sulpher based medication to prevent pressure from accumulating in the recovering eye.  If you’ve read the book, you know that this is not good for the kidneys and my nephrologist was very upset that they were given to me when I had a bladder infection a couple of years ago.

I talked this over with my ophthalmologist, Dr. Gary Mackman of Phoenix Ophthalmologists, who seemed surprised that it was given to me and assured me I needn’t take it after the second surgery. I hope I hadn’t made a mistake by taking it after the first surgery, but when the nurse said BOTH my doctors prescribed it, I thought she meant Dr. Mackman and my nephrologist.  As I sat there for the required hour for recovery before being released, I realized she’d meant the ophthalmologist and the anesthesiologist. Uh-oh, I’ll have to keep a close eye (sorry!  I couldn’t resist) on my numbers on my next labs.

I am now laughing out loud – lol – because I’m re-reading the book with the new eye and can more readily appreciate the high cloth content in the paper; in other words, it’s really easy on the eyes.

Until next week  (when you’ll be reading a pre-canned blog),

Keep living your life!

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8 CommentsLeave a comment

  1. Thanks for your book and blog and the info about cataracts. I’m coming up to a colonoscopy and can’t find good help about that procedure for CKD patients. Going crazy worrying about the prep and the anesthesia. HELP.

    • I know what you’re going through! Look at June 4th’s blog for info on that. The title of the blog is “The Thing You Don’t Want To Talk About.” Sorry I can’t do it for you but I was literally walking out the door for the second cataract surgery when I read your message. Let me know if the info in the blog was helpful and good luck.

      • Thanks so much. I’m to do miralax and golightly. The anesthesia still in question. Propofol is suggested. Supposedly quick and doesn’t last in the body. Will do more research. Thanks for your good work. Wish there was an index since I came in late to the “party.” Sandy

      • There is. An index, I mean. There is a list of archived blogs on the right side of the blog. You may need to scroll down a bit. I gather the date didn’t help.

        I have a call into my nephrologist now about propofel, which the anesthesiologist felt was the safest for the five minutes I was under today. My usual method is to place a call to the nephrologist to check the meds to be used beforehand. Unfortunately that didn’t work this time since the office was moving and records were misplaced.

        I do remember miralax being safe, but am not familiar with golightly. Please do let me know what you find out.

        Thanks for joining the party. Gail

        Sent from my iPad

      • I did find your blog about it. Thanks. Did some research at Cleveland Clinic Journal of Medicine. They say Nulitely or Trilyte are ok, NOT Colyte that I was prescribed. Not all preps that appear alike are exactly alike. No solution but doing our own research! My nephrologist is too busy to help much. Doesn’t seem to believe in diet. But, was good at getting the right BP med. Thanks Gail.

      • Nice job, Sandy. I started writing the book partially for the same reason: my nephrologist was just too busy. I was annoyed at first, but then I took a look around me at the people in the waiting room that obviously needed more of his time. Thank goodness I was all ready a non-fiction writer and used to doing my own research.

        Gail “It’s not that I’m old; it’s just that I’m older than I’ve ever been before.”

        ________________________________

  2. Good information. Lucky me I discovered your blog by accident (stumbleupon).
    I’ve saved as a favorite for later!

    • You discovered my blog and I discovered how to embed videos into it. Sounds like a fair trade to me. Thank you.


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