Several years ago my good friend Bernie Milstein who is also my eye doctor and surgeon told me I was developing cataracts in both eyes. He said he would let me know when they were ready to be removed and then we would discuss the various options of lenses, glasses, etc.
It turned out the little darlings were ready to be removed this year and I chose July since I would not be teaching classes and would have a light schedule.
The whole affair is so incredible I thought it worth an essay in case anyone reading this has cataracts and is reluctant to take action. Bottom line is---don’t be scared and don’t delay.
It is possible to have cataracts removed and return to wearing glasses as I had been doing. In my case, examination revealed I could use an intraocular lens that would do away with the need for glasses for either distance or near. The lenses are called the ReSTOR lens, and, no, I am not misspelling the word. This would mean that I would not wear glasses any longer. I liked this idea very much since I have been wearing glasses since the fourth grade. Not everyone can be fitted with these lenses but I understand there are other kinds available.
The only negative to the whole business for me is that Medicare will pay for cataract removal but not for specialty lens implants as that is deemed cosmetic. ReSTOR lenses are not cheap and neither is the surgery cost. Both these charges are due up front before surgery and implanting. I feel it was well worth the money and I am glad I had it done.
There is a kind of irony involved in that there is a good deal of time spent getting the “go ahead” for surgery. You must see your primary care physician for an EKG and complete Metabolic Panel (all the usual blood tests). Then there is a trip to League City to the Eye Clinic there for lens evaluation and measurements. Then a trip to Rebecca Sealy Day Surgery on Postoffice Street to meet with the anesthesiologist. Galvestonians will like knowing that this is our old St. Mary’s Infirmary where so many of us were born. I was sort of gasping for breath after all this activity.
The drill would be that Bernie would remove the cataract from the right eye first and implant the lens there. A couple of weeks would pass, there would be follow-up visits with Bernie and then the left eye would be done.
When a date is set for surgery you receive a call the afternoon before telling you what time to report the following day. You have been putting drops in your eye several times a day on the final day before surgery; a second kind of drop is added and at four p. m. you will begin putting one of these drops in every hour until you go to bed. You must also wash your face with soap and water for a full five minutes after inserting the last drop. There is a good reason for this as there must not be any lotions, creams, etc. around your eye that could get into the eye during surgery and cause complications. I recommend you shower (and if a male, shave) just after the last drop. Then the next morning do nothing more than brush your teeth and comb your hair.
You are required to have someone bring you to the hospital and either remain there or return to take you home as you may not drive the day of surgery or the day after it. You are advised to wear a shirt or blouse with button front.
When you get to Day Surgery it becomes really amusing and that’s something to say about any kind of surgery. First of all, I had already learned there would be only a light local anesthetic used, not a general one. The reason for the button front shirt became apparent when we were escorted to my Day Surgery room. You do not disrobe for this procedure. I went to prep and into the operating room fully clothed, including shoes and socks. The button front was there so the little cardboard squares that hold all the monitoring wires can be easily affixed to your chest.
Within minutes a nurse appears in your room and you stroll down to the pre-op room. The procedure here takes more time than the actual surgery and implant, if you can imagine such a thing. Three kinds of drops are put into your eye three times. The second stings and the third soothes. It’s not bad at all. Your vital signs are taken and recorded and your wristlets are attached. Those are for your name and date of birth, any drug allergies, etc. Finally, one nurse will write above the eye to be operated upon in indelible ink so no mistake can be made. Then your IV is inserted and a bit later the analgesia is fed into the line. You don’t even get a needle in the arm through all this.
It’s two patients to a post-op room with a dividing curtain. In my case, my friend, Mary Lee Moore, was in the adjoining bed so we had the curtain rolled back so we could chat. Mary Lee was also having a cataract removed.
Suddenly it’s “Are you ready?” and off we go with me remaining in the bed this time. A couple of quick turns and we are in the operating room.
Since it’s local anesthesia I was fully aware of what was going on around me and could hear the conversations quite well. When things got started there was something above my eye that seemed to have a “light show” going on. It was really very pretty to watch and since I had no pain I actually enjoyed watching it. Bernie is the kind of surgeon who likes to be reassuring to the patient as things progress and periodically would say “You’re doing just great. Everything is going perfectly.” Believe me, words like this are very welcome when you are the patient!
At a certain point, I began to hear noises that resembled the night club scene from Star Wars I. All sorts of weird squeaks and such. I asked what that was all about and Bernie told me it was the vacuum cleaner removing the dissolved pieces of the cataract from my eye.
Suddenly, it was all over, the lights came on and I had a clear plastic patch over my right eye. The purpose of this is to prevent you from accidentally rubbing your eye and dislodging the lens implant. In the old days, it was a black patch. This way, I could see immediately with both eyes. And the almost unbelievable part is that before I was discharged from the hospital my distance vision was absolutely perfect and the right eye with the lens implant was compensating for the left. It was an incredible experience.
Total time in the operating room for removal and implant was about twenty-five minutes. Astounding.
When I got back to my room, the nurse immediately asked if I would like something to drink and a warm roll with butter. I almost salivated at the thought as I had nothing to eat or drink since eleven the night before and it was well after eleven the next day.
The nurse began to prepare my discharge papers. No diet restrictions, but wear the patch to bed. No driving the day of surgery or day after. Bernie came in to see me at the same time and said again that things had gone beautifully. My great friend, Brian Teichman, had been waiting in the room and was ready to roll. It was a short walk from Day Surgery in an elevated tunnel across Postoffice Street to the garage where we had parked and home we went. As my anesthesia was a local, it was not necessary for me to be taken to the car in a wheel chair.
Upon arriving home I felt perfect in every way and encouraged Brian to be on his way back to Houston where he is in business. I would be fine and could handle everything. In addition to the few restrictions mentioned above, I was not supposed to lift anything over five pounds, nor do any bending over. No one had to police me on that one. I was glad to just sit and read as well watch television without wearing glasses for the first time in my life.
I was due for a checkup visit in the afternoon at Bernie’s office at the Eye Clinic of Texas on 23rd Street and Avenue P. Another good friend, Lise Darst, had volunteered to drive me back and forth for this visit.
The waiting room was like a Galveston cocktail party without the booze. I saw an incredible number of people I knew who had surgery the day before. We were all wearing the clear plastic patches so even someone you did not know was identifiable as “one of us.” There was enough chatter and comparing of notes going on to make you think you were at a rally of some kind. Mary Lee Moore was there, former Sheriff Joe Max Taylor had brought his wife, Anita, in for her checkup and the waiting room didn’t have an empty seat. Apparently Bernie does all Galveston surgery on Wednesdays and all follow up visits on Thursdays.
Bernie was absolutely satisfied with my vision and the results of the surgery and implant. He told me to continue wearing the patch to sleep for three nights but leave it off in the day time. I was to come back in two weeks for another check up and we would schedule the date for removing the cataract from the left eye and doing a lens implant there. The visit ended with the customary lollipop being handed out---long a feature of seeing Bernie in his office. (I asked him about this one time and he said that he had wanted to think of something he could “give” to patients when they were leaving and this idea had occurred to him. I don’t know about other patients but this one consumed his on the ride home since he didn’t have to drive).
Two weeks later I returned to Bernie’s office, this time under my own power, and we set the date for the next surgery and implant. To my delight, the multiple visits to Primary Care, Day Surgery and League City office of the Eye Clinic of Texas were not to be necessary.
Brian Teichman returned to get me through the second procedure but it was more like some kind of excursion or lark than anything else as I was completely without apprehension. Check in time this go-around was ten in the morning, but from a standpoint of total time spent in Day Surgery, it was still minimal.
Things went beautifully once more. Brian suggested I might like to stop and get something to take home for lunch. I said, “Head for Sonny’s on 19th Street”. When we got there we decided there was no reason I could not go inside and have lunch at the bar. That we did and I was the star of the show with my clear plastic patch over the left eye.
Patience has never been my long suit. While my distance vision is perfect, close up can blur a bit. When I bitched about this to Bernie he gently reminded me that my last surgery had only been a week before and that it did take a little time for adjustment to take place. However, he also assured me that if things did not work out on their own, he could do some fast LASIK surgery up in League City and fine tune the lenses. In the meantime, I got some cheapo reading glasses at the grocery store and am once more cursing and reviling my way through the Sunday New York Times Crossword Puzzle. I am a very happy camper.
want to repeat how gentle the whole experience was and once more encourage any of you who have cataracts not to delay when your doctor says they are “ripe” or “ready to harvest.” Get with the program as quickly as you can. You’ll be glad you did.
A nice way to close this piece is to commend everyone in Day Surgery at Rebecca Sealy/UTMB. These people are kind, dedicated, interested and wonderfully cheerful. I cannot say enough nice things about them, as they are credits to their professions.
While I am on the subject of being kind and professional, I also commend the entire staff at the Eye Clinic. I have long been impressed with their efficiency and thoughtfulness. This time I came in contact with a staff member I had not met, Sheila Erwin. Ms. Erwin is the Surgery Counselor. She makes sure everything is in order with paperwork, dates, etc. She also answers all questions promptly and simply. Ms. Erwin also gets as much paperwork done in her office as she possibly can so that when you are making your pre-op visits you are saved a good deal of time filling out forms.
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