Cover Reveal – It’s Complicated

I’m so excited to announce that It’s Complicated will be republished with Roane Publishing on December 4th, 2017. And today I finally get to share its beautiful new cover.

It’s Complicated is a sequel to Show No Weakness, and it’s Maggie Lapage’s story. As evident in Show No Weakness, Maggie can get herself in a little trouble at times. She calls it helping people. Others might call it meddling. Tom O’Shay is one of those other people. Problem is he needs her help, whether he wants it or not. And he definitely does not. That’s why It’s Complicated.

She’s a children’s counselor devoted to helping others; he’s a stubborn client reluctant to accept her assistance. He wants a warm and loving relationship; she prefers to keep things physical. Professional boundaries dictate neither of them can have what they want.

Having grown up with no one but herself to count on, Maggie Lapage carefully guards her feelings. Professionally, she goes above and beyond to give others the support she wishes she’d had as a child. When she develops a forbidden attraction to a client’s father, she does what she thinks is necessary, to save his family, and to protect her own heart.

Tom O’Shay finds his life caught in a nightmare when he risks losing custody of his daughter. It goes against his character to seek help, but he doesn’t have a choice. That doesn’t mean he has to like it. Everything changes when he falls hard for his daughter’s counselor, and he suddenly has two fights on his hands. One for his daughter, and another for the woman he loves.

It’s complicated, but is it impossible?

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Stepping Away…

Thank you for stopping by my blog. Monday Musings is currently on hiatus while I tend to other projects. I’ve left links below to some of my more popular topics in case you’d like to browse. I promise most of them include gorgeous photos.

Or you can pop over to my bookshelf or excerpts if you want more information on my books.

I’ll see you all in a few months. Happy reading!

Link to:  My experience with torn and detached retinas

Link to:  Cruising around historic Cuba

Sunday Funday Adventures – Exploring the Okanagan

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Link to:  Beautiful beaches and hiking trails on Vancouver Island

Link to:  Monkeys and more at Sandos Caracol and Riviera Maya

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Link to:  Fun in Palm Desert and San Diego, California

Steamboats on the Old Man River, trolley cars and beignets…Adventures in New Orleans

Icebergs and rowhouses…Exploring Nova Scotia and Newfoundland

Favourite Furry Pets – And a few not so furry ones, too

 

In A Literal Blink Of An Eye, Everything Can Change—What I’ve Learned About Torn And Detached Retinas

This is the final post in my series on torn and detached retinas. (Start from beginning here) In December 2016, I experienced a retinal tear in my left eye, which has left me with unstable vision. In April 2017, I had a vitreous hemorrhage in my right eye, and still don’t know the full outcome from that episode.

At the end of August I’ll have another eye surgery, a vitrectomy, to remove the silicon oil that was injected into my eye cavity last April, during surgery to repair a complicated retinal detachment. It feels as if my life’s been on hold ever since that surgery, first waiting for my eye to heal and now waiting to have the oil removed, then I’ll wait to see how much my vision improves.

Many activities I once enjoyed and took for granted are now challenging. The simple act of pouring a liquid accurately requires extra concentration. I sometimes hang clothes inside out and use a knife upside down (those are actually kind of funny). Shopping, using my camera, watching TV, using a computer, looking in my bathroom mirror, sitting near a window, being outside in the sun or at night with lights on—these have all become struggles.

My new normal:

I get intense flashes of light in my right eye, and occasionally my vision momentarily goes black.

When I close my eyes at night, a lightshow starts up behind my right eyelid. Like a kaleidoscope or an erupting volcano, except in black and white. Sometimes it’s rather cool, like flickering northern lights, but mostly it’s just annoyingly bright.

I continue having double vision. The blurry image is always canted to the upper left. Tilting my head can make the two images merge, then by focusing intently, the images will stay together when I straighten my head. This trick doesn’t always work.

Because there’s no functional vision in my right eye, I can’t see details. Faces have no discernible features. And, weirdly, people’s heads are really narrow. Actually, everything looks narrower. When looking through both eyes, there’s right-side fogginess.

Getting out a few times a month to enjoy physical activities have been kiboshed. For about six weeks I had to take it very easy while my eye healed. Even after that, my eye socket pain skyrocketed whenever I exerted myself, so it scared me into slowing down. And I question the safety of biking and hiking with my level of vision impairment. A tarnished silver lining is that with spring flooding, extreme fire ratings and smoke haze causing poor air quality, many trails have been closed and we’d have had to curtail most outdoor activities anyway. A terribly tarnished silver lining, indeed, and not one I take solace in.

I haven’t driven since early April. It’s legal to drive with vision in only one eye, but both of my eyes are compromised. If my left eye blurred while I was driving, I’d be in trouble. As well, lights (including car lights, traffic lights, street lights) make me see double. So, basically, I’m unsafe on the roads, at least right now. Not driving is a frustrating inconvenience, but it’s not a hardship. My seven-year-old car had 41,000 kilometres on it, so I obviously didn’t drive much. My hubby is home midafternoon and we usually do our going-out chores together. And, luckily, I live in a community where I can walk to most places.

Unless there’s dramatic changes with my vision, I’ll probably never work again. I might not need to work, but I’d like to. I miss being around people; I miss feeling useful. Being home all day is very isolating, and once this next surgery is behind me, I’ll have to find a solution.

My current vision might never improve, and I have to accept this. Occasionally when I get overwhelmed, the if only engine starts up, but negative thinking won’t change my reality. It just makes me frustrated and sad. I tell myself, it is what it is, so deal with it, and it could be a hell of a lot worse. I’m determined to adapt, to reclaim my life—maybe not the one I had before, but one that’s fulfilling nonetheless.

I didn’t share all this so people will feel sorry for me. Quite the opposite. Please learn from what I’m going through, and take steps to protect your own eye health. Don’t put off that optometrist appointment. Don’t ignore changes in your vision. Read and remember the following information, especially if you have risk factors such as diabetes, if a family member has experienced torn or detached retinas, if you’re middle-aged, or if you’re very nearsighted.

As our eyes age, the clear vitreous gel that fills the central eye cavity liquefies and separates from the retina. This is a natural occurring event that happens in most people between the age of forty and seventy. When the gel separates, a person will often see floaters—dots, spots or curly lines, which move with the eye. Usually this quickly settles down and everything returns to normal.

Sometimes, the retina will tear or detach when the gel separates. A vitreous hemorrhage can occur when blood vessels are damaged during the separation, filling the eye cavity with blood and risking damage to the retina. An acute retinal detachment is an ophthalmologic emergency. The longer the wait for surgery, the lower the chances of a positive outcome. This not only can lead to irreversible vision loss, the health of the entire eye is endangered.

It’s really important to pay attention if this happens to you. I can’t stress that enough—if you experience these symptoms, get it checked out immediately. Go to or call your optometrist, there’s usually one on-call after hours. They’ll be able to check for a break (tear) or detachment and get you the help you need without delay. Some hospital ERs will call in an ophthalmologist, so check that option, as well. 

My road to recovery continues to be long and uncertain. Although it’s too soon to know where it all ends, I remain hopeful the destination will be a good one.

My New Reality After Retinal Surgery

In April 2017, I had surgery to repair a complicated retinal detachment, the consequence of a vitreous hemorrhage in my right eye. To bring awareness of the symptoms and dangers of retinal tears and detachments, I’ve been blogging about my experience. (Catch up here) The following notes are from my post-op diary. All observations refer to my right eye.

Two days post-op:

I can see undistinguishable shapes. My eye is swollen and bruised, the eyeball is bright red and there’s ugly blobs in both corners. I have lots of pain, both in the eye socket and the eyeball.

One week post-op appointment:

I told the ophthalmologist I still have double vision. With both eyes open, I see a blurry image angling off the left side of the clear image. He couldn’t say if this will improve.

When I asked about removing the silicon oil, which was injected in the eye cavity during surgery, he said it might never come out. I didn’t ask why.

My pupil always stays large, and he said the Combigan eye drops can cause this. It should improve about three weeks after I stop using the drops.

I’m still not allowed do anything for another week, then can slowly become more active until I’m back to regular routines in a month. I hate doing nothing all day, but the more I do, the more my eye hurts, and that can’t be good.

I see colours and shapes, but no details. My eye is less swollen, but still red. The doctor assured me the fatty stuff in the corners will eventually go away.

Amazing how strangers will ask what happened when I wear the shield in public.

Two weeks post-op:

My eyeball isn’t as tender, although it often feels like there’s grit in my eye. I get bad headaches, and any exertion intensifies the eye socket pain, which reminds me to slow down.

External bruising is fading, and the skin around my eye looks more normal. Eye redness is still visible.

A bump has developed on the outside edge of the iris. Blobby stuff is shrinking.

Four weeks post-op:

Despite not taking Combigan drops for two weeks, my pupil’s still nonreactive, and lights really bother me. I can recognize most shapes, but can’t see details. When I stand quickly, my right eye vision goes black, then slowly clears up. Hopefully it’s just the oil sloshing around. Eye pain isn’t as continuous.

Five week post-op appointment:

The ophthalmologist thinks my pupil should be more reactive by now, so it might never function normally again.

My right eye pressure (IOP) is too high at 32mmHG, while the left eye is 15mmHG, so he prescribed Azarga drops twice a day to lower the pressure. He’s concerned I might be developing secondary issues, but didn’t elaborate. I should’ve asked him to explain.

The earliest he’ll consider removing the oil is three and a half months post-op. I told him I’m pleased I haven’t lost my middle vision despite having had a complete detachment, and I feel I might have reasonable sight once the oil is removed. He told me not to have that expectation.

I asked if it’s the oil causing me to have momentary blackness when I stand up. He’s never heard of this before.

Seven weeks post-op:

I can now read the alarm clock using just my right eye—barely—so the vision has improved somewhat. Eye socket pain continues to diminish, except when I’m active.

Nine weeks post-op:

With reading glasses on, images on TV are sharper. This is the first time my right eye has responded to magnification.

Bubbles, which float above an oily looking horizontal line, are becoming more frequent and numerous. They move with my eye, bouncing around the upper half of my field of vision.

I get bad headaches when in bright sunshine, even if I’m wearing sunglasses. I rarely get eye socket pain anymore. My eye is still red and the small bump by the iris hasn’t gone away, but the blobby stuff has finally disappeared.

Eleven week post-op appointment:

I could see letters on the top line of the ophthalmologist’s eye chart, although I couldn’t distinguish what they were. My IOP is now balanced at 15mmHG in each eye. The ophthalmologist wants me to continue with the Azarga drops to control ocular hypertension.

Structurally, my eye looks really good, so at the end of August he’ll do a vitrectomy to remove the oil. He’ll replace the oil with air, which dissipates on its own in a matter of weeks. He explained the surgical dangers—possible redetachment, risk of infection, increased chance of forming cataracts. He said I’m already well down the road to needing cataract surgery, which surprised me because I’ve never been told that before.

I asked if the scleral buckle surrounding my eyeball might be pressing on nerves, causing my pupil to be nonreactive. He didn’t think so, but said nerves might’ve been damaged during surgery. He prescribed Pilocarpine eye drops to mechanically constrict the pupil, which will hopefully ease my light sensitivity.

A single drop of Pilocarpine shrunk my pupil to a pinprick, and it took thirty-six hours to return to its dilated size. The constricted pupil didn’t reduce the glare or haloing from lights, and because a possible side effect of Pilocarpine is retinal detachment, I won’t risk using it again. The light sensitivities are likely an issue with the retina, not the pupil.

Fifteen weeks post-op:

Eye redness isn’t as noticeable, and I rarely have pain. Besides the dilated pupil and the small bump by my iris, there’s little external evidence of the surgery.

Unfortunately, there are plenty of invisible changes. Despite slight improvements, I have no functional vision in my right eye. I still have issues with double vision, light sensitivities and depth perception. Until the oil in my eye cavity is removed, I won’t know if it contributes to these problems. For now, I can only hope for continued progress, while accepting the possibility of a less positive outcome.

Next week, I’ll wrap up my series on torn and detached retinas. Jump to that post HERE.

An Acute Retinal Detachment Is An Ophthalmologic Emergency – Learn The Dangers

In an effort to bring awareness to the symptoms and dangers of torn or detached retinas, I’ve been chronicling my own experiences with this serious issue. (Catch up here) In December 2016, I experienced a retinal tear in my left eye, which has left me with unstable vision. In April 2017, I had a vitreous hemorrhage in my right eye, and still don’t know the full outcome from that episode.

Important signs to be mindful of:

As our eyes age, the clear vitreous gel that fills the central eye cavity liquefies and separates from the retina. This is a natural occurring event that happens in most people between the age of forty and seventy. When the gel separates, a person will often see floaters—dots, spots or curly lines, which move with the eye. Usually this quickly settles down and everything returns to normal. Sometimes, most often with people who are extremely nearsighted, the retina will tear or detach when the gel separates. A vitreous hemorrhage can occur when blood vessels are damaged during the above process, filling the eye cavity with blood.

If you experience any of these symptoms, seek immediate medical attention.

Last week, I described the surgery to repair my detached retina. Following surgery, I needed to keep my head facing downward for 24 hours. I was so nervous about accidentally rolling onto my back, I didn’t sleep a wink that entire night. Early the next morning, I became incredibly nauseous and from that point on, I threw up nonstop.

Prior to my follow-up appointment, I was allowed to raise my head and remove the eye patch. My eye looked horrendous, but the pain was tolerable. I could see lightness and unrecognizable blurry shapes. Hubby helped me apply three different eye drops: Zymar, an antibiotic, used four times a day for one week. Combigan, to treat high eye pressure, used twice a day for two weeks. And Prednisolone, to treat symptoms of inflammation, used four times a day for four weeks.

In the crowded hotel elevator, I concentrated on protecting my eye from wayward elbows and not upchucking. Thankfully everyone got off before us because the moment I stepped off the elevator, I got sick. With my eye swollen shut and badly bruised, and vomiting into a plastic bag, I must’ve looked like I’d been on a bender that ended in a brawl.

The assistant surgeon at the clinic said vomiting was actually quite common after eye surgery. Something about how the brain interpreted high eye pressure. I wish I’d been forewarned, so I could’ve been prepared.

I asked if the retina had been detached and he said, “Oh yeah, a complete detachment. It was really bad.” He felt confident surgery had stabilized the eye and I should have a good outcome. There’s a difference between repairing the retina and restoring vision, however.

An acute retinal detachment is an ophthalmologic emergency. The longer the wait for surgery, the lower the chances of a positive outcome, because the retina becomes starved of oxygen without proper blood flow. This not only can lead to irreversible vision loss, the health of the entire eye is endangered. Stabilizing the eye and preventing redetachments are higher priorities than restoring functional vision. That doesn’t mean they don’t care whether I ever see again, it’s just not their main objective.

At my prior appointment, the ophthalmologist explained that after surgery either air, gas or silicon oil would be injected into my eye cavity. Air and gas both dissipate on their own over a matter of weeks. Oil, usually chosen as a last resort for complicated detachments, must be surgically removed. Because of the severity of my detachment, the surgeon opted for oil over air or gas. So yay, I’ll need another surgery requiring more needles in my eye.

Four procedures were used during surgery. A vitrectomy, which involves making small incisions in the eyeball so the surgeon, using a microscope and special lens, can insert micro-surgical instruments to clean the vitreous and blood from the middle eye cavity.

A silicone scleral buckle was sutured around the outer wall of the eyeball to create an indentation inside the eye. This pushes on the retina and effectively closes the break. Scleral buckles usually remain in place indefinitely.

A laser beam were directed at the retina to make tiny burns. These burns form scars which seals the retina.

And the last procedure involved injecting silicon oil into the eye cavity. The oil pushing against the retina improves the likelihood of it staying attached. While the oil’s in place, my vision will be poor, but using the oil may increase the overall visual prognosis.

The doctor stressed that I must take it very easy until told otherwise. He looked over at Hubby and told him he felt as though these instructions needed to be emphasized. I obviously have a tattoo across my forehead that says, This lady doesn’t know how to relax.

I’d need to wear an eye shield at bedtime for several weeks, and either the shield or sunglasses when going out, to protect the eye. Then I got some good news. As long as we took the longer, low elevation route, we could go home that day. It’s ironic that I’ve been bugging Hubby for years to take that slower, more scenic highway between the Okanagan and Vancouver, and when we finally did, I couldn’t enjoy it. I threw up all the way home and mostly kept my eyes closed.

I owe my hubby and son such a debt of gratitude. I don’t know how I would’ve managed without them. My son navigated us around to my various appointments, which saved us all kinds of time and stress, and he babysat Roxy so we didn’t have to leave her alone at the hotel. And poor Hubby! He taxied both my son and myself back and forth to all our appointments, while coping with big-city traffic, pedestrians and cyclists. He doted on me constantly, taking care of my every need. And he did it all with surprising patience and good humour.

My next post will give an update on my progress so far. I might include some photos. They won’t be as pretty as the ones I usually post, just to warn you. (Next post here)

A Belt, A Buckle and Suspenders – Surgery To Repair A Detached Retina

To repeat my introduction from last week: In December 2016, I experienced a retinal tear in my left eye, which has left me with unstable vision. In April 2017, I had a vitreous hemorrhage in my right eye, and still don’t know the full outcome from that episode. I want to reiterate the importance of recognizing and understanding the symptoms and dangers of torn or detached retinas.

As our eyes age, the clear vitreous gel that fills the central eye cavity liquefies and separates from the retina. This is a natural occurring event that happens in most people between the age of forty and seventy. When the gel separates, a person will often see floaters—dots, spots or curly lines, which move with the eye. Usually this quickly settles down and everything returns to normal. Sometimes, most often with people who are extremely nearsighted, the retina will tear or detach when the gel separates. A vitreous hemorrhage can occur when blood vessels are damaged during the above process, filling the eye cavity with blood.

If you experience any of these symptoms, seek immediate medical attention.

Catch up on my previous posts here.

After another restless night, on the morning of my surgery I woke up with a splitting headache. Lack of sleep and nervous tension, I imagine. Hubby had me at Mount Saint Joseph Hospital half an hour ahead of my appointment. At eight o’clock, I was taken to a curtained cubicle to change into a hospital gown. Eye drops were administered and I answered all the same medical questions I’d answered the previous day.

An anesthesiologist put an IV in my hand and explained he’d be injecting a local anesthetic into my eye in two places. He told me it wouldn’t hurt as much as getting the IV, which had actually stung quite a bit. The first injection into my eye was really unpleasant, but thankfully the pain was brief. My eye was frozen enough when he did the second injection that I didn’t feel anything.

Around 10:00, I was brought into surgery. The anesthesiologist touched my upper cheek and apologized for bruising me while freezing my eye. I assured him I bruise easily. A sheet was placed over my face, leaving only my eye exposed. I heard someone ask the retinal surgeon which procedures he’d be using. The doctor joked he’d be doing the belt, the buckle and suspenders, meaning he needed to do several procedures besides the scleral buckle.

During the procedure, I occasionally felt sensations in my eye, but no real pain. At one point the surgeon said, “Oh my God!” in a rather strained voice, then he asked for PFO. Seconds later, he repeated more urgently his request for PFO. Definitely not what I wanted to hear from the person operating on my eye, and I made a point to remember those words so I could ask what this meant.

After surgery, the surgeon told me I needed to get on my tummy right away, then he left. Because I didn’t get a chance to ask him about PFO, I’ll explain what my local ophthalmologist told me. PFO’s full name is Perfluoro-N-octane, and it’s a heavy liquid used to flatten the retina during complex detachment surgery. Although he couldn’t say for certain because he wasn’t there, he believes the surgeon must’ve been having difficulties getting my retina to stay flat.

I got back to the cubicle at 11:00, so surgery took approximately one hour. I had a shield covering my eye, and the nurse instructed me on the importance of keeping my head postured down for the next 24 hours. Silicon oil had been inserted into my eye cavity during surgery—more on that in my next post—and facing downward, even while sleeping, ensures the oil bubble floats to the back of the eye to keep the retina flattened.

Hubby arrived soon after to take me back to the hotel. He picked up some straws, so I could still drink with my head down, and he also bought a selection of tempting foods. Despite missing breakfast and lunch, I felt too queasy to eat much. I had surprisingly little eye pain, but between the pounding headache I’d woken up with and my arthritic neck complaining about the position I had to keep it in, I was extremely uncomfortable. I alternated between lying on my stomach with my forehead resting on a pillow, which gave my neck a break but tensed up my shoulders and back, and sitting with my face supported in my hands and my elbows braced on my knees.

Next week, I’ll go over all the procedures used during surgery, and explain what I was told in my follow-up appointment the next morning. (Next week’s post)

Whirlwind Day of Appointments in Vancouver

A quick recap on my series of eye health posts. (Start from beginning here) In December 2016 I experienced a retinal tear in my left eye, which has left me with unstable vision. In April 2017, I had a vitreous hemorrhage in my right eye, and still don’t know the full outcome from that episode. I want to reiterate the importance of recognizing and understanding the symptoms and dangers of torn or detached retinas.

As our eyes age, the clear vitreous gel that fills the central eye cavity liquefies and separates from the retina. This is a natural occurring event that happens in most people between the age of forty and seventy. When the gel separates, a person will often see floaters—dots, spots or curly lines, which move with the eye. Usually this quickly settles down and everything returns to normal. Sometimes, most often with people who are extremely nearsighted, the retina will tear or detach when the gel separates. A vitreous hemorrhage can occur when blood vessels are damaged during the above process, filling the eye cavity with blood.

If you experience any of these symptoms, seek immediate medical attention.

I ended my last post with our rushed trip to Vancouver to see a retinal surgeon. We had a nice view from our hotel suite, and I wished we were there under better circumstances.

The eye clinic was huge and crowded, but operated like a well-organized production line. I filled out some paperwork, then had drops put in my eyes and various tests done. After a thorough examination, the retinal surgeon explained he could see enough of my retina to confirm it was severely detached, so I told him the ultrasound had shown the retina was okay. He said that might’ve been true at the time, but it had since detached, with potentially dire consequences. He didn’t offer false hope, but promised he’d do everything he could to restore as much of my vision as possible.

I asked if now that both eyes had experienced the vitreous gel separation, there’d be no danger of this happening to me again. He replied that some retinas keep falling off even after being reattached several times. This worried me because my left retina has had to be repaired twice since tearing.

He told me it could take a full year to know the quality of vision I’d end up with. I asked if that meant the sight in my left eye might still improve and he said no, but I’d probably adjust to the blurry vision. Damn, eh? Got my hopes up for a moment.

I filled out reams of paperwork and received pamphlets explaining what a vitreous hemorrhage and a detached retina were, and which procedures would be used during surgery. One procedure is called a Vitrectomy. This involves making small incisions in the eyeball so the surgeon, using a microscope and special lens, can insert micro-surgical instruments to clean the vitreous and blood from the middle eye cavity.

The other procedure entails sewing a silicone scleral buckle around the outer wall of the eyeball to create an indentation inside the eye. This pushes on the retina and effectively closes the break. Scleral buckles usually remain on the eye indefinitely.

After all that cheery news, I had to have my blood pressure checked (Surprise, surprise, it was way higher than normal). After lunch, Hubby dropped me at another clinic to have an electrocardiogram. I’m not sure if this is standard procedure for all the eye clinic’s surgery patients or if it’s because I have an aortic valve insufficiency. Regardless, the test was performed quickly, with no problems detected.

We picked Roxy up from our son’s place and headed to Kit’s Beach for some relaxation.

About 25,000 pot smokers, who’d gathered at Sunset Beach for the 420 cannabis rally, began disbanding about the same time we were returning to our hotel. Extra police presence with road blocks to monitor those partiers, combined with the usual rush hour traffic and few left-hand turn lights, meant it took us two hours to travel what should’ve taken thirty minutes. It was certainly frustrating, but rather than getting all worked up, it became almost a game to us – let’s see if this street will take us where we want to go.

After dinner, we did a dry run to Mount Saint Joseph Hospital, where I’d have my surgery the next morning. Hubby likes to be prepared, and he didn’t want anything unexpected making me late for my appointment. Thankfully, the crazy traffic had dissipated and the trip there and back took no time.

Our hectic day ended with this lovely sunset.

Next week, I’ll share my eye surgery experience. (next post here)