Cornea Transplant Chronicle
By Frances Talbott-White email@example.com
Copyright 1997 Frances Talbott-White
Date of Surgery: December 19, 1996 Place: Kaiser-Permanente/Sunset, Los Angeles, CA NOTE: Entries are dated according to when they were posted on KC-link (keratoconus-link), but they have undergone minor re-editing before exposure to a more general audience on this web site. To help the reader locate information, each entry has been given a title with some indication of its content. [Square brackets] are used to mark substantive information or explanation added since the original postings.
(History; diagnosis; joining KC-link)
December 18, 1996: I am a 55-year-old woman living in Culver City, California, a rather quiet municipality in western Los Angeles County (three miles inland from the infamous Venice Beach). My KC was diagnosed 23 years ago. I have been a member of KC-link since May 1996, benefitting immensely from everyone's postings and adding a few words from time to time. I expect to contribute more frequently over the next few weeks, as I'm having a cornea transplant tomorrow (left eye) and intend to chronicle the experience on this list.
Meanwhile, a few words about diagnosis, which has been a 'hot' topic on the list recently. [Debate over whether optometrists or ophthalmologists are better equipped to recognize KC had been the subject of numerous postings.]
In 1973, I was diagnosed by an optometrist a few weeks after an ophthalmologist had told me my left cornea was 'warped,' but that it was not a problem. 'Warped!' Ophthalmologists and optometrists (in three states) had been using that same word with me for about five years previous, so it wasn't any surprise. I had great faith in all levels of the eye-care professions, as I had always had excellent vision corrections since starting to wear glasses at age 8. At age 11 or 12, I had suddenly become more myopic, which the family oculist attributed to the rapid growth of the rest of my body outstripping the slower growth of my eyes at that time. Hmmmmm?! In retrospect, I wonder if that was the onset of KC. I was in full-blown puberty, which is when KC shows up in many patients.
By age 20, my glasses (still an excellent prescription) were thick and heavy enough to be pretty uncomfortable, and I was also at an age when glamour was a significant factor. I switched to hard contacts and had little trouble adjusting. The lenses also temporarily slowed the advance of myopia, which is an added benefit for many lense wearers. By the time I was finally diagnosed with KC I had worn hard contacts for 12 years and had a high tolerance for lens adjustments, though I must admit that some of them were very difficult. Gas perms made a big improvement when they came along.
For at least the last 10 years I have been complaining to optometrists and ophthalmologists alike that my vision isn't good enough. They have consistently told me that my lenses fit beautifully and that this was the best they could do without surgery, which was always represented as a last resort. A couple of years ago, I got more adamant with my optometrist, and he said, "Well, you DON'T want surgery!"
Two years ago, I managed to convince my optometrist that I didn't feel safe while driving. He prescribed a bioptic telescope, a small, high-powered magnifier mounted on the right lens of a pair of glasses with no other correction. The telescope is wonderful for viewing concerts and plays, and for reading signs when another person is driving. However, I never have managed to train myself to use it very effectively while actually operating a vehicle.
[In the fall of 1994, I started using the Internet extensively for e-mail and occasional web browsing. I spent a lot of time searching for info on keratoconus and/or cornea transplants but found nothing, so I gave it up several months before the National Keratoconus Foundation (NKCF) became a presence on the web. Meanwhile, I was experiencing menopause and was advised to consider hormone replacement therapy (HRT). My gynecologist admitted that my HMO's literature on the subject was not very good, so I turned to the Internet for more info. I found an excellent Planned Parenthood web site on menopause, and it included the warning that HRT could cause 'changes in the cornea that would prevent the wearing of contact lenses.' This caught my attention! I started searching for info on corneas and very quickly found the NKCF web set. By the way, I never found out about the HRT effect on the cornea (though I certainly gave it a good try), and I never started HRT. I think I made the right decision, but it was not based on as much info as I would like to have had.]
In late May of 1996 I joined KC-link and quickly developed the 'moxie' to advocate for cornea transplant surgery for myself. My optometrist referred me to a cornea specialist within my HMO (Kaiser-Permanente). Before seeing this new ophthalmologist, however, I attended the League of Women Voters National Convention in Chicago and stayed on for a few days to visit old friends. I had lived in Evanston (just north of Chicago) from 1972 to 1975, and this was where I was diagnosed with KC. Being in different but somewhat familiar surroundings gave me a better understanding of how much my vision had deteriorated. I was not surprised that I couldn't read any of the materials projected on huge video screens at the convention, but it was extremely frightening not to be able to read signs or labels on buses well enough to get around town safely. I had to ask bus drivers what numbers were on the front of their buses, and I couldn't spot the Field Museum until I was right outside it. This experience supported my realization that here in L.A. I 'read' signs only if I already know what they say.
Needless to say, when I visited the ophthalmologist/surgeon (Dr. S.) on my return from Chicago I was highly motivated to schedule the transplant surgery that I will have tomorrow. Various other commitments required the six-month wait, and clearing my calendar wasn't easy, but the Christmas season seems ideal for the project.
I think I have given the essential 'background' of my case, though I could certainly go into a lot more detail about multiple images, scar tissue, etc. In closing this entry, I want to emphasize the fact that KC-link has been of tremendous help to me, and has given a great boost to the confidence with which I approach tomorrow's surgery.
Just a few minutes before I started writing this December 18 posting, Dr. S. called to tell me that delivery of the 'new' cornea was all arranged. All systems are 'GO'!
(improved vision; euphoria; weather report)
December 20, 1996: Many thanks to everyone who sent good wishes -- via internet or through the more metaphysical channels.
My transplant went very well. Thanks to local anesthetic, I was awake and able to speak to the surgeon, though of course I didn't keep up a running commentary or do anything that would distract him.
When the patch was taken off at Kaiser this morning, my UNcorrected (of course) vision in the 'new' eye was 20/30 (pinhole), which was a great improvement over the 20/50 (pinhole) corrected vision in the 'old' eye. Also the problem of multiple images is much improved.
I am still very sensitive to light. Unfortunately for me (though the Chamber of Commerce loves it), the weather here is very sunny and bright this week. It's called a 'Santa Ana' condition, which involves warm winds from the north and brings very low humidity. Not the best kind of weather for KC or transplant recovery, as there are lots of little gritty things flying around in the air. So I'm staying inside.
As far as discomfort is concerned, I have had a lot more pain from corneal abrasions in the past. I am using Maxitrol antibiotic/anti-inflammatory drops 3 times a day, plus the occasional Tylenol.
When I get less photophobic, I'll write in more detail about the surgery and about the techniques I have used to transcend pain.
REMEMBERING THE OUT-PATIENT SURGERY WARD
(more euphoria on recovery; a look back at preps for surgery)
December 26, 1996: Today marks one week since the cornea transplant in my left eye. I had hoped to have posted more messages about my progress by now, but I've been too busy celebrating Christmas! Also I have had too much light sensitivity to spend much time at the computer, but that has left more time for things like going out to lunch, playing cards with my husband and sons, cooking holiday meals, etc.
My last post mentioned that I had 20/30 vision in the new left eye upon removal of the patch last Friday. Vision has continued to be excellent in that eye, and it is a great thrill to see more space around objects. For several years, I have seen up to three images with each eye while wearing my RGP lenses, and a lot more than that without the lenses. Granted, most of these are 'ghost' images, but they created a high degree of blur. Now, I am thrilled to cover my right eye and see things like the crisp straight line between the bookcase and the wall! Also, I can see facial expressions on other people when I'm talking to them without my lenses on. This is an immense aid to communication, especially with my husband!
But enough rhapsodizing about the new vision. I should talk about the surgery before I forget it and YOU lose interest.
Outpatient surgery at Kaiser (one of the nation's oldest HMOs) is an adventure fraught with comic overtones. I was one of eight diverse patients herded into a large ward room presided over by three nurses. One nurse addressed us all as a group on how to put on hospital gowns, stash our belongings in two plastic bags, hop into bed, and request extra blankets if necessary. Then one nurse moved down each side of the room taking histories and hooking us up to blood pressure and pulse monitors. I was on the south side of the room, which was the province of the crabby nurse, while the north side drew the cheery nurse. It was interesting to hear how these two characters used different approaches in questioning the patients. The cheery one asked her charges, "How is your tolerance for pain?" or "How well do you tolerate pain?" The crabby one asked, "Do you like pain?" From listening to these dialogues I learned that there were two other eye surgery patients, two hernia patients, and one who was there for some kind of foot surgery. The other two were far enough away to escape my scrutiny.
As the history/BP/pulse process continued, the third nurse came along and hooked up an IV for each person. Also, my nurse came back every few minutes with more eyedrops. Dr. S. had told me that these would be Maxitrol (the combo antibiotic/anti-inflammatory that I'm continuing to use) in both eyes, plus a nerve deadener for the left eye and something else to reduce the size of the left pupil so that less light would get in. This whole prepping process took about an hour. Also during this time I talked to two anesthetists -- one who was in charge of the whole ward, I think, and one who was assigned to my surgery. I had already opted for local anesthetic, but Jeff (my anesthetist) explained that I could have one or two sedative/tranquilizers which would make it easier to tolerate the injections of local anesthetic. I wasn't especially worried about these injections but decided to be sedated anyway.
I was the first on my side of the room to be wheeled into an operating room. There my IV was reconnected and I was hooked up to a BP cuff, heart monitor, and fingertip pulse monitor. However, the first thing I noticed in the O.R. was the music -- syrup-y dentist-office soft rock. I asked if there was a choice of music, and I stated my preference for NO music. This request was very graciously honored. (As a serious amateur musician, I always feel compelled to 'play along' with any music that is in the air, and I didn't want my psychic energy to be drained in this way.)
The anesthetist had foam padding of various sizes and shapes to wrap around my arms, making the tubes and cables less noticeable. There was also a special donut-shaped pillow to hold my head at the proper angle. After all of these physical accoutrements were in place, Jeff administered the sedatives through the IV, and I began to feel chemically altered. The BP cuff would turn on every five minutes, so I decided to try to count these occurrences in order to gauge passage of time and also assess my own level of control over my thought processes.
My Internet server just beeped to tell me that this session is about over (I'm limited to an hour at a time and had already spent a good part of it on other e-mail), so I'll close this entry for now. Shucks! I was just getting to the good part.
UNDER THE KNIFE ... SURGERY AT LAST!
(O.R. and Recovery Room procedures; self hypnosis and related techniques)
December 29, 1996: My December 26 account covered pre-op experiences through sedation. Today I'd like to resume that account and cover the surgery itself. First, though, I'd like to say that my recovery continues to go extremely well. I discovered that wearing a baseball cap helps the photophobia quite a bit, so I wear one most of the time -- even indoors.
While in the O.R. (operating room) before the surgery, I was asked several times to look up, down, left, and right. I realized later that they must have been checking to see when my left eye would be unable to move, which it evidently soon was. I think Dr. S. came in about the time my right eye was being draped. I recognized his voice but he didn't step into my field of vision and I wasn't supposed to move my head. I would have preferred to SEE his face and greet him more civilly before the surgery, but maybe he believes that seeing him could be stressful to some patients. I'm going to ask about this at my appointment on January 8.
I had expected not to have any vision in my left eye during the surgery, and this was okay with me. I know a woman who is an O.R. nurse at a local hospital, and most of her work is in eye surgery. She had told me that the nerves can be blocked in various ways, but they usually block the optic nerve so that the patient can't see anything. I had been fascinated last summer by Paul Colley's account of his surgery (the first in-person account I had read) and by other accounts on KC-link about the beautiful things people had seen while having transplant surgery. Nevertheless, I was a little bit apprehensive about this part. On the Monday prior to surgery, Dr. S. had told me that I wouldn't see anything because the optic nerve would be blocked. He said this was a good idea because it would help keep me from moving, and I agreed.
Well, as thing turned out, I saw plenty! And I was very happy that I saw it. I still don't know quite WHY I saw it, and perhaps I never will. It may be that the optic nerve wasn't as fully blocked as it might have been, and of course it could also be the power of suggestion, based on my knowledge of what would be happening and the terminology being used. Maybe it was a combination of these factors.
[For purposes of KC-link, I didn't describe the surgery itself because it's been handled before. However, for non-list members who may be reading this account, I'll try to hit the high spots at least.]
[After a microscope was moved into place above my head, a thin sheet of plastic was spread over the undraped left eye area for protection, and a hole was cut out to expose the surgical site. At this point I was still quite astounded to be seeing anything, and frankly I'd forgotten about the plastic sheet part of the operation (it's not the most exciting part), so I asked Dr. S. if that was the old cornea already. He said it was a sheet of plastic, and of course I could see that it was a very thin oval, close to an inch long.]
[With the plastic wrap in place, Dr. S. called for calipers, and I could see two pointed metal objects hovering over my eye. I said, 'Oh, you're measuring it!' (pretty obvious, but I was still excited about seeing what was going on, and thrilled that I could identify processes). After the measurement was finished, he called for a number 8.5 trephine. I assume the 8.5 referred to millimeters. A trephine is a device like a cookie-cutter which is used to remove the damaged area of the patient's cornea and then to cut the same size piece out of the donor cornea. 8.5mm is about the size of contact lens I have been wearing in recent years, so this was not to be a very large incision.]
[I think a scalpel was used along with the trephine. Dr. S. said 'Cut, cut, cut!' a few times, and I wasn't sure whether he was telling the nurse to cut or talking about what he was doing himself. I couldn't see very well at this point; there must have been several fingers between my eye and the lights during this part of the operation. I remember being glad I couldn't feel anything.]
[Next Dr. S. called for forceps, and this is where I saw the old cornea dangling from the instrument and reflecting light as it was being lifted off. I assume that the donor cornea was cut immediately. I heard Dr. S. say that it was a really nice cornea, and this made me pretty happy. I saw the new cornea being dropped into place with forceps, and then I knew the stitching would start soon. Dr. S. called for 'helon', which I had never heard of (not sure of the spelling, but it's pronounced 'HEEL-on'), but I could tell from context that it was suture material when I saw the little tweezers being used to tie knots (and the ends of threads being cut off) just above the surface of my eye. I was able to confirm my suspicion that these were the guy-wire-like separate stitches that hold the cornea in place while a single 'running stitch' was made around the whole thing. I could feel the stitches and told Dr. S. so. He said I could have more medication if I needed it, but I said it wasn't painful. It was more like a pulling sensation.]
[As soon as the running stitch was finished (it was done in three or four passes), the drapes were removed, and my eye was heavily patched. I saw later that there was a plastic shield over the patch. Dr. S. said he'd see me the next day, and I was wheeled out of the O.R. saying that I was glad to have been his first surgery patient of the day].
Besides describing the surgery, I think I should mention that I was able to employ techniques learned in yoga, self-hypnosis, self acupressure, pain management, and natural childbirth classes over a long period of years. Strangely enough, I had not consciously planned to use these techniques, but they came into play as soon as I got into the hospital bed. I would recommend classes of this nature (self-hypnosis is probably fastest to learn) to anyone who is contemplating transplant surgery.
I was able to detach myself mentally from the part of my body which was under stress, so that I could essentially watch the action as an outsider. In fact, I was so relaxed that I think I started to fall asleep two or three times. I would catch myself starting to snore, so I would purposely force myself to pay more attention. The BP cuff, which came on every 5 minutes, was a help in this regard. I counted 11 or 12 BP reps in all and think I was pretty accurate. I also circled my ankles unobtrusively a few times when I felt an urge to move.
After the surgery, I was wheeled into the same large room where I had been before surgery. Some of the other patients were back, and some came in while I was there. I tried to rest as much as possible in spite of all the bustle going on around me (for instance, one of the hernia patients was a demanding loudmouth!), and I asked a nurse if it was possible to turn off the light fixture immediately above my bed. It was, and she did it. I'm surprised someone doesn't automatically do this for eye surgery patients. When I felt my forehead above the eye patch, I could tell that the whole upper left front quadrant of my head was quite numb and woody feeling, but I was not in any real discomfort.
I suppose it was after they were sure that my pulse and BP were okay that I was unhooked from monitors and moved into another adjacent room. Here my IV was removed at last, and I was able to put on my right contact lens. I was given a light meal of cream of chicken soup (obviously made from a powder), jello, and cranberry juice. My husband picked me up just before noon, and we stopped for a more substantial lunch on the way home: a combo plate of three lovely salads at one of my favorite local cafes.
At home I began my concerted healing activity by napping for a couple of hours.
(fun & games; imagery; pain management techniques)
December 30, 1996: Upon returning home from the surgery, I had a nice nap, then got up and watched some news on TV. My next door neighbor dropped by and was surprised to see me up and around. Then my younger son, Ken (age 26; lives in San Diego), arrived and we played Rummy 500 while my husband, Steve, fixed a nice dinner. More cards after dinner. I mention the card games because I think they're important to the healing process. We always laugh a lot when we play games, and 'Laughter is the Best Medicine,' is not just a department in the Reader's Digest.
My head was still a bit numb from the local anesthetic -- like a fat-feeling jaw after a trip to the dentist. Anticipating that the numb head would 'thaw out' and leave me with a headache, I took one extra-strength Tylenol (which had been listed on my post-op instructions as the preferred pain remedy) when I went to bed. I slept well until around 2:30, and then got up for a trip to the bathroom and a drink of water. I probably took another Tylenol at this time too. The headache was not bad, but my whole left eye area was very uncomfortable. I felt like I had a serious corneal abrasion, and in a sense this was quite true.
To cope with the discomfort, I decided to try a basic self-hypnosis technique: eyes closed, then envision slowly descending a staircase while counting down from 10 to 1. This didn't work as well as usual, but I did it a couple of times and then proceeded to visit the quiet, secret 'place' I normally go to when under self-hypnosis. That didn't work very well either, so I decided I needed a major change of imagery and, since my eye surface felt so rough, that the new imagery had to deal with smoothness.
I was in a fairly deep hypnotic state (my right eye would've had to WILL itself to open) when I placed myself in a sort of IMAX theatre of the mind and started letting smooth surfaces roll past: lake waters, ponds, fields of snow, sheets of cool metal, aluminum foil, saran wrap. This began to relax me, so I decided to work with it further. I detached a square of something very smooth (at this point it didn't seem to matter what it was) and pictured it billowing around in my mind -- rather like an image on a CAD/CAM screen. The buoyancy of it was extremely attractive to me, and somehow I felt that the soul of my cornea donor was hovering on one side of it with 'me' on the other side. This brought me an immense feeling of well-being. I was able to say hello and goodbye to my donor.
Then I began to focus on the curvature of the smooth object, and as it became more rounded I was reminded of Andrew Marvell's poem 'On a Drop of Dew.' This is one of my favorite 17th-century poems, and I took great satisfaction in meditating on some of its lines: without going too far out onto literary or spiritual tangents I should probably tell you that the dewdrop is a microcosm of the world and also an image of the soul.
>From Marvell, I somehow found myself immersed in Shakespeare: 'Full fathom five my father lies / ... those are pearls that were his eyes.' This was an even more rewarding line of thought! My overall themes of smoothness and roundness had resolved themselves into an image of a single precious 'stone' with an organic source which in real life is actually an irritation in an oyster shell -- like the irritation under my eyelids where the 'pearl' of a new-to-me cornea was developing. Also the transformation of a used-up human body being transmuted into 'something rich and strange' through 'a sea change' (yes, this song from THE TEMPEST is the source of that overworked phrase) seemed extremely relevant. At this point, I wanted to FEEL the pearls. I began massaging my fingertips and actually gave myself a pretty good reflexology hand-massage treatment in the process. Someone in a less metaphysical frame of mind might want to start with the hand massage as a pain management technique, but I was happy to have come upon it via the imagery.
Needless to say, I got back to sleep and felt very relaxed in the morning. Whenever my left eye has felt uncomfortable or scratchy since the surgery, I call up the visual and verbal imagery I developed in the wee hours of Friday morning. It's now a matter of post-hypnotic suggestion to get these elements working for me again.
(post-surgery appointment; real-life schedule kicks in)
January 1, 1997: On Friday December 20, the day after surgery, I had an appointment with my surgeon, Dr. S. I've already mentioned that my vision was 20/30 in the 'new' left eye when the patch came off. Dr. S. was very pleased with the condition of what he called the 'wound.' He said there was a small abrasion on the donor cornea, but that this kind of thing was almost impossible to avoid.
One thing I forgot to mention in my account of the surgery: Dr. S. had said in the O.R. that I'd have a black eye (I think he called it 'a bit of a mouse'). He told me more about this at the 12/20 appointment, saying that a lot of little blood vessels in and around the eye will inevitably be broken during surgery, and adding that I could 'cover it with make-up.'
When I finally SAW my eye in the ladies' room mirror, I could tell that if I Wanted to cover the 'shiner' with make-up I'd have to use heavy theatrical stuff. Industrial strength foundation with opaque powder. As I don't normally wear much make-up at all, I quickly decided that sunglasses would be the best cover.
Another color effect: my iris (normally dark brown) appeared quite green, but this was due to the yellow-dye drops Dr. S. had used to stain my cornea for viewing. My husband was stunned, thinking I'd gotten a whole new eye. In fact, I wouldn't have minded a green left eye. I've heard that in certain Asian cultures unmatched eyes are supposed to be a sign of good luck.
The following may seem like a lot of trivia, but I just want to convey the fact that I was able to resume many normal activities quite soon after the surgery.
Upon leaving Kaiser, we walked a couple of blocks down the street to do some recreational shopping at a large thrift shop benefitting Children's Hospital. Then we drove east on Sunset, stopping to purchase a good quality oak dresser at a used furniture store along the way. This was to be a Christmas gift for our younger son. We'd been looking for just the right dresser for weeks, so this was a great 'find.' Then we went to lunch at Barragan's, a fine Mexican restaurant on Sunset in the Echo Park area. In the dark booth, I felt comfortable removing my sunglasses at last.
The drive home -- westward into a bright sun -- was not too pleasant. If I had not experienced such light sensitivity on previous occasions I might have thought I was dying. It helped to hold a piece of cardboard in front of my face, and of course I had my left eye closed.
At home, it was nap time. As instructed, I taped the plastic shield over my left eye so as not to bang into anything.
Later Ken (younger son) arrived after his afternoon visit to the KC lab at Cedars-Sinai. He was full of info about KC and the people on the staff, who are customers for his microbiology lab supply business. We played cards (what else?) and had dinner. Then all three of us were playing cards when the phone rang.
I had cleared my schedule for about 2-1/2 weeks of rest, but that phone call changed my plans. It was news that Ora, an 83-year old family friend, had died the previous day. Her funeral would be on Sunday. Ora had worked for me for several years before a stroke had incapacitated her, and she was a very special person in my life. Also her daughter Sharon is a good friend, and our children had been through school together. Two of Ora's grandsons had also worked for me.
Saturday morning, after a good night's sleep and some careful thought, I walked around the block to Sharon's house and offered to play flute music for Ora's funeral. Walking around the block was a wonderful experience and a chance to test my new vision on flowers and Christmas decorations. The weather had turned cloudy at last, so light wasn't a big problem. I had a nice visit with the family and walked home to organize my music (I have sort of a standard funeral/memorial service repertoire, but I wanted to add some pieces. I did NOT practice, deciding to save my strength wherever possible.
Other Saturday activities included giving the dresser to our son Ken (he and Steve simply transferred it from our station wagon to his van) and seeing him off on his return drive to San Diego after a round of driveway car repairs. Steve had a short dance gig in the evening (he plays in several jazz combos), so I was alone for the first time since the surgery. I wrapped Christmas gifts, did some sewing, and went to bed early.
On Sunday morning, during a major rainstorm, our older son John (age 30; a graduate student at Stanford) flew into LAX from a two-week stay in Japan. Steve went to meet him while I fielded telephone calls. Jet-lagged, John went right to bed upon arrival, so it was a quiet morning.
The Sunday afternoon funeral went very well. It was held at a local mortuary, and I was able to sit and play my flute in the little alcove reserved for family. The family had chosen to sit in the main sanctuary with the guests. In the alcove, I was out of the glare from the windows, and my black eye didn't detract from the proceedings at all. I played about 25 minutes of music before the ceremony, very briefly at one point in the ceremony, and for another 10 or 15 minutes afterward. I could see well enough (I was wearing my right contact lens, of course) most of the time, but the occasional film of mucus was a bit of a problem. Fortunately, I knew most of the music well enough to 'fake it' when I had to. Afterwards, we attended a reception at Sharon's house.
This was a tiring day, but I felt I had done the right thing. Came home, took a nap, played cards with John, had dinner, played Trivial Pursuit with John and Steve, went to bed early (a good routine!).
Sometime on Friday or Saturday (12/20-21) I looked in my 'Prescription for Nutritional Healing' book and found out that grated raw potato (wrapped in gauze) made a soothing compress for conjunctivitis and black eyes, so I added this routine to my healing regimen. I placed about a tablespoon of grated potato in the middle of a 2x7" strip of clean paper toweling, then folded the long ends over. I made one for each eye, then removed my right contact lens and lay down with the potato compresses over each closed eye for about ten minutes. It was wonderfully soothing. Then I would use a 'Refresh Plus' eyedrop, let it clear away, and then use the 'Maxitrol' prescription drop. I felt that this sequence would ward off any infection or irritation the potato might cause. However, it was always nice clean potato, and I kept my eyes closed while using it. This procedure brought a lot of razzing from my techie-oriented sons, but my eyes began to feel much better and the swelling/discoloration was virtually gone within a week after the surgery.
On Monday, 12/23, four days after surgery, Steve went back to work (at the UCLA Music Library) and my son John took me shopping at PriceCostco, a huge warehouse-style store, and Home Depot, another gigantic retailer. Afterwards, I fixed dinner for a vegetarian friend whose birthday party I'd missed on Sunday. We also had a drop-in guest who stayed for dinner. This was the first meal I'd prepared during my convalescence. (I certainly could have done it earlier, but my husband loves to cook too.) We had a mixed vegetable curry, red lentils (masoor dahl), and biryani rice. Both guests left early, leaving us to the usual games.
Tuesday, the day before Christmas, I did a lot of pre-Christmas cooking: roasted vegetables, steamed pudding, etc. I had planned a simpler feast than usual but managed to come up with quite a nice spread, and of course I had expert help. We always cook our turkey for about 18 hours (Adele Davis style), and it went into the oven around 10 p.m. after a strenuous round of Trivial Pursuit.
Ken arrived early on Christmas morning and made omelettes to order. We opened gifts and had a festive mid-afternoon dinner with three guests in addition to the immediate family.
On Thursday 12/26 I went out to lunch with a group of women friends that usually lunch together once a month. We take turns choosing a place, and it happened to be my turn. My pre-surgery plan was that if I didn't feel like going out they would pick up 'to go' food and bring it over. Needless to say, I was more than ready to go out.
A bit of an aside here. One of my lunch-group friends is totally blind. She has worked for years as a medical transcriptionist at Kaiser West L.A., and is the most productive member of her department. She also happens to be the only person I'd ever met in person who'd had a cornea transplant. Barbara's surgery was not intended to improve her vision -- she was blind before and after -- but several years ago she'd had some kind of roughening of the cornea that caused her a lot of pain, so they'd replaced the rough cornea with a smooth one. She had told me last summer, when I'd first talked about having the surgery myself, that she had to lie flat on her back for days after surgery and not even talk on the phone, so she was astounded by my fast recovery and lack of restrictions. I imagine Barbara had a much larger area of her cornea (and possibly some scleral tissue) replaced.
After lunch, one of my friends dropped me off for a haircut. My hair was almost waist length, and I knew I couldn't wash it without excessive bending, so I'd decided to have about 8 or 10 inches cut off. No trauma. It grows fast. Steve was supposed to pick me up afterwards, but we missed connections so I ended up walking about a mile. Of course I wouldn't have to have set out on foot after leaving him a message about my route, but I wanted a walk.
On Friday, I went back to work for the first time. I've described my home business in another entry. I hadn't planned to go back this soon, but an old friend had called from Pennsylvania and asked me to write a resume for her daughter, who normally lives in Colorado and would be paying a holiday visit to her in-laws in Canoga Park, CA. Of course I agreed to do it. Wearing a baseball cap made working quite bearable, so I also spent some time getting my holiday mailing ready to go. My assistant came in to help, and we also did some routine paperwork and bill-paying (he seemed to want his paycheck, for instance).
John had left early Friday morning in another rainstorm, so by the end of the day we were back to the usual 'empty nest syndrome.' The weekend was uneventful. Steve had a bad cold and had gone to work in spite of it on Friday. He stayed in bed most of Saturday while I sort of 'cocooned,' doing some sewing and writing. Sunday was another quiet day, and by the end of it I was starting to notice cold symptoms myself. This was something I'd really hoped to avoid. Somehow after surgery I'd managed not to sneeze for about four days. That first sneeze was extremely painful -- like my whole eye socket was being propelled into space. I RAN for the antihistamine though I didn't think its drying effect was the best thing for my eye. Then I didn't sneeze again for about three more days, and it was somewhat less painful. By Sunday afternoon, sneezing was barely bearable.
Monday and Tuesday (12/30-31) were partial work days. My assistant came for a few hours each day and we accomplished quite a bit. Got back to two writing projects that had been set aside pre-surgery. The cold turned out to be very minor. I don't think I've sneezed at all today, though I do have some sinus congestion for which I use a tussin-type cough syrup.
Last night was New Year's Eve. Steve had an early gig at a retirement village, so I took a nap. Then we attended a small local party. Today has been filled with watching the parade on TV, catching up on this journal, and, of course, eating. I'll walk to the drug store soon for some more cough syrup.
There! I'm finally up to date on this account of surgery and its easy aftermath! I don't see Dr. S. again until January 8. Normally it would have been a two-week interval instead of three, but he went away for the holidays. I can go to the ophthalmology department at Kaiser if I feel the need, but so far that doesn't look likely.
I probably won't make another entry in this journal for a few days, so this is the point where I'm going to patch in a couple of KC-link postings which went up while the journal was 'in progress.'
BACKTRACKING TO BACKGROUND
(KC lifetyles; post-op recovery times for working & driving; advice)
December 27, 1996: This entry was written (in two parts) in response to questions from another KC-link member. It made an interruption to the flow of my story, but it gives more background to my case while also dealing with concerns common to anyone who is considering transplant surgery. In revising this diary for the web, I have taken it out of chronological sequence so that the surgery narrative would make more sense as a whole.
Question: Do you work, and if you do.... did your doctor say how long you would be out of work?
In a sense, this is my first day back at work (I'm seeing only one client on a limited basis), so it's a good day to answer your questions. I have my own business, which is located in my garage. In 1979, I started a home-based word processing business in order to pay for the computer equipment I was using to finish a dissertation in English Lit. I got so engrossed with the computers and the business that I decided not to go back into academia in any way. The dissertation fell by the wayside and I remain ABD (All But Diss).
I still do a little bit of rather specialized word processing for 'old' clients who've been with me for years, but I don't advertise this part of my business. What I concentrate on now is writing and editing (my business card talks about 'insightful help with business and technical writing from concept through camera-ready copy') plus a bit of database work and microcomputer consulting. Mostly, though, I write custom resumes. Clients come to me by appointment, and I interview them while composing at the computer. My slogan for this is, 'I write before your eyes!' I do a lot of work for persons whose native language is not English: Latin Americans and Europeans, of course, but (in the L.A. area's multi-cultural environment) also Africans, Asians, and Middle Easterners. It's fun.
You probably didn't want or need to know that much about my business, but I'm just coming to the part that I thought would be relevant, and I think you need the background to understand that part.
If I didn't have my own business and a sort of alternative (work-at-home) lifestyle, I wouldn't have been able to get by so long without transplant surgery. On the other hand, if I'd had transplant surgery 10 or 15 years ago I might have gone for a more conventional career path. Who can say?
The answer is closely related to your next question -- the one about driving. But first, I want to talk about what my doctor(s) told me about going back to work, which was the second part of your first question.
My optometrist told me a long time ago that it takes a period of several months to recover from the surgery, and he seemed to be implying that I wouldn't be able to do much of anything during that time. I think he wanted mainly to discourage me from having the transplant. This may have been 'company policy' for my HMO.
My surgeon told me I could do anything I wanted to do after the surgery except heavy lifting, and that the pre/post and immediate surgery business was essentially a three-day commitment. The booklet from NKCF says you can go back to work (in a sedentary occupation) within two or three weeks, and I think this would be pretty realistic for most people. Two weeks is basically what I have planned on allowing myself.
I hope this doesn't confuse you further. You just have to understand that there are a lot of variables involved. Perhaps the main one, besides the nature of your work, is the condition of your other eye -- the eye not having the surgery -- in relation to its partner. My left eye had not been pulling its weight for many years, and during this time I have done quite a bit of work with the left eye patched, closed, fitted with an inadequate or uncomfortable lens, or whatever. I think this is a major criteria for the surgery -- that you can get along as well with one eye before (and after) the surgery as you can with two.
Question: What about driving? Can you drive right away, or is there a certain amount of time you have to wait before driving?
I can see better than I saw before the surgery, but I would not feel safe driving quite yet. As I mentioned in my pre-surgery posting to KC-link, I haven't felt safe driving for a period of years, so lately I only drove to places where I wouldn't have to read signs to know where I was. And obviously I don't commute. It's about 12 feet from my back door to my office door.
Based on a 'worst-case scenario', though, I was ready to store my car in a friend's garage for six months after the surgery. However, I decided to keep it around for my older son to drive while he was home for Christmas. Now I think I'll be ready to drive in a few days, so I'm glad I kept it.
Question: I work full time and go to school full time and can not afford to take a lot of sick time from my job or school. I guess I just wanted to know how a cornea transplant will affect my life? I know every person's situation is different, but any bit of advice will be greatly appreciated.
So now for the advice. I love to give advice!
You didn't mention your age, but I would guess that you're in your twenties. What seems to be 'a lot of sick time' to a younger person who is in school full time and working full time can be quite different from 'a lot of sick time' for a middle-aged person such as myself. The older one gets, the more relative (e.g., less absolute) time seems to be.
If I had invested/sacrificed a couple of weeks for cornea transplant surgery/recovery in my late twenties or early thirties, I would have saved many times that amount every year in my forties and the first half of my fifties. I can already understand and appreciate how much time I'm going to save every day now that I've finally had the surgery.
In other words, I'd say: 'GO FOR IT!'