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COLUMN SIX: A whole new way of seeing

Months of waiting, a few minutes on the table

BY LARRY COTÉ
Special to the VOICE

I recently finished up with cataract surgery, and while in recovery it occurred to me there are many parallels between our bodies and the rust buckets sitting in our driveways. My doctor said, “You need knee replacement surgery.” My mechanic told me, “You need new ball joints.” My podiatrist advised me, “You need corrective foot pads.” The guy at the service station told me, “You need new brake pads.” My chiropractor said, “Your cartilage is shot and bone is rubbing on bone.” The garage guy said, “Your shocks are shot and your rear end is bouncing off the frame.”

There are more parallels but these should suffice to convey the diagnostic analogy. (Both having “spare tires” probably is going a bit too far.)

I don’t claim to be a medical expert, nor a mechanic, and so to avoid culpability I suggest it is best you seek their expert advice for whatever ails you or your motor vehicle.

For those who are beginning to lose some visual acuity, expect your optometrist might soon recommend cataract surgery. If that prospect causes you some discomfort then maybe some lighthearted commentary might help allay your fears. Trust me, as a recent patient and as my elders used to say, “It’s as easy as pie”—the cataract surgery that is.

The formation of cataracts is a slow degradation of your eyesight. For most people that gradual declination is hardly noticeable. Over time, one adjusts to that nearly unnoticeable but growing deficiency. Its development is slower than molasses in January. Simply stated, and in line with the earlier analogy, the lens in your eye becomes cloudy just as the windscreen in your car fogs up on occasion. However, the cloudiness on the lens you were born with is a permanent murkiness and can not be defrosted.

Unless there are more serious issues with your eyes, you continue to visit an optometrist, who checks your eyesight and prescribes corrective spectacles of various types and styles. After all, if you must have something perched on your nose it might as well be a stylish decorous frame to catch the eye of those who must look at you, and distract them from seeing your facial features. Or, if vanity prevails, you could opt to poke yourself in the eyes with contact lenses.

In any case, once the cloudiness gets to a certain point on the optometrist’s mysterious scale that determines severity, he or she will send you along to an eye surgeon, who will verify that your cataracts are “ripe.” It means that your eyesight is sufficiently degraded by the cataract formation that OHIP will pay for the surgery.

The specialist, known as an ophthalmologist, arranges for a battery of tests and measurements to determine which of the range of plastic artificial lenses might be the best implant to correct the specific condition of your eyes. OHIP will only pay for the most basic lens. If you choose to upgrade to a better lens, then there will be an extra out-of-pocket charge for that upgrade.

On your visit to an eye surgeon’s office you will probably note that the waiting area is filled with patients and the crowd is mostly made up of seniors. Much older than you, of course. In any case, this eye condition called cataracts is a very common malaise and especially prevalent for those age 50 and up. That commonality should be of some comfort to you.

Firstly, you are not some odd miscreant with a rare malady due to your poor lifestyle choices. Secondly, this condition and its resolution are pretty much routine to the point where the cure is very successful. According to authoritative health statistics the success rate is at about 98%. A probability that is a far more pleasing than what awaits you on, say, the casino floor.

One of the most annoying issues a candidate for cataract surgery faces is the wait time between diagnosis and surgery. This wait time is measured in months and one’s patience can be tried. The solution to that problem is in the hands of your provincial politicians. Likely, these same hands will be more eagerly offering handshakes at political fundraisers than they will be signing off on added OHIP funding.

The Welland Hospital is the central facility for ophthalmology in the Niagara Region. All of the cataract surgeries for this area, 7,000- plus per year, are carried out there. It is my inexpert opinion that the these facilities are excellent and another solid reason to keep this facility from closure.

But of even more significance, the medical staff are worthy of an A+ for their care, courtesy and competence. They carry out excellent patient care in a pressure-packed environment, but come across as comforting as a warm blanket on a cold winter’s night.

As you arrive on the third floor you are met by a friendly and knowledgeable volunteer, who expertly walks you through the routine that you are about to experience. She leads you to a change room where you are to don a hospital gown from the waist up. Once in the waiting room you are among the least fashionably dressed persons in town. Hospital hair nets complete the natty ensemble. The fashion plates in the crowd wear long faces unadorned of jewellery and without makeup of any kind.

Along the way your identity is checked more often than a Florida-bound passenger navigating departure at Buffalo airport. An intravenous shunt is inserted into a vein prior to your being wheeled to the operating room. Don’t worry. The nurse is good and you don’t have to watch if you are squeamish about such procedures. But don’t mistake the patting of your hand as a friendly gesture on her part. She is trying to make your vein more visible and an easier target.

This shunt is to inject a light sedative to be administered in the operating room. It is common for a person to have the defective lenses removed from both eyes. If that be the case, the surgeries are scheduled separately and a few weeks apart.

Immediately prior to surgery a slight amount of sedative is administered and the eye has been “frozen.” There is absolutely no pain of any kind associated with the procedure. Actually you are feeling pretty good on this drug induced mini-trip. The process to remove the defective lens and replace it with the synthetic one is over in only a few minutes. Although the thought of having a microscopic incision in the eye might be a scary one, the fear is groundless.

Since you have been given a slight amount of sedation you are then wheeled to a recovery room, where you are given a fruit drink and a muffin to help speed up the mostly unnoticeable effects of the sedation. The whole process, from check-in to check-out, takes about four hours.

At this point it is normal that the vision in the eye with the new lens is a bit blurry and, possibly, a tiny bit uncomfortable. You are instructed on some dos and don’ts on your way to recovery over the next week or so.

Avoid heavy lifting, no showering, and no activities that could interfere with the proper healing of the eye. Perhaps the most tedious aspect is having to put drops in your eyes three times a day for the following few weeks. These drops are to prevent infection and promote healing.

Almost from the day after surgery the vision in the eye with the new lens begins to clear. Soon and within days the improved vision is nothing less than awesome. Also, colours become noticeably more vibrant than you can remember. Your night vision is much improved as well. Hopefully, the betterment in all dimensions of your eyesight will be well worth the procedure.

To end this piece in keeping with the analogy it began with, be assured of the following. Your newly enhanced eyesight is far better than having a shiny new SUV parked in the driveway.

And, as a final note, take good care of your eyes. These are the only ones you will ever have.

Larry Coté is a retired college professor. He was awarded a Governor General’s Medal for his community involvements.

 

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