Optic Nerve Damage – The Silent Vision Killer

Last week I described my cataract surgery and the disappointing outcome. I had set my hopes of better vision on that surgery, and although the procedure itself was successful, it did nothing to improve my sight. My eye problems started back in April 2017 after experiencing a vitreous hemorrhage. For those of you just joining this topic, you can follow my journey and find detailed information about retinal detachments here or you can catch up with my recent updates here.

When I saw my regular ophthalmologist a few weeks after cataract surgery, I asked what could be causing the worsening vision, if it wasn’t the cataract or the silicon oil residue. He said it was likely damage to the optic nerve from sustained elevated intraocular pressure. The cataract ophthalmologist had told me the silicon oil still in the eye cavity could raise ocular pressure. This ophthalmologist disagreed, saying the residue was too minimal to cause problems, although the oil could’ve originally plugged the drainage tubes.

My pressure was 18 that day, which is upper normal. In the past year it’d often reached the high 20s or 30s, and this can harm the optic nerve. He suggested I have regular pressure checks, and see him periodically. I didn’t know much about optic nerves, so did some online research. I learned:

-The retina and the optic nerve are two of the most important components of vision. The retina creates the image, and the optic nerve sends it to the brain for interpretation.

-Optic nerve damage can cause vision distortion, vision loss, and blindness. Seek immediate medical care if you experience sudden vision loss, halos around lights, any vision distortion or severe eye pain. These symptoms could result in optic nerve damage and permanent vision impairment.

-There are several causes of optic nerve damage, one being glaucoma or high pressure within the eye. Because glaucoma has no symptoms, optic nerve damage might not be detected until vision becomes impaired.

-There’s no cure for optic nerve damage, and various treatments may only prevent further vision loss.

When I had my pressure checked ten days later, it was up to 37. The ophthalmologist wasn’t in the office that day, but the tech contacted him, and he had her take an image of my eyes. He also prescribed an oral medication, Methazolamide, which eases pressure by slowing production of fluid in the eye.

I was already taking three sets of eye drops:

Latanoprost, which increases fluid drainage from the eye.

Timolol, which lowers the amount of fluid the eye makes.

Brimonidine, which helps with drainage. It also lessens the amount of fluid produced.

My blood pressure had been hovering in a lower than normal range, which the pharmacist said could be caused by the eye drops. At 108/59, it wasn’t a concern as long as I felt okay, which I did. Immediately after taking the Methazolamide pills, I began feeling dizzy and spacey, especially in the morning or after the slightest exertion. My blood pressure dropped to an average of 101/54.

Three days after starting Methazolamide, my intraocular pressure was up to 39. Three days after that it was down to 18. Ten days later, it was back up to 28. Despite all that medication, my eye pressure wouldn’t stabilize.

The ophthalmologist showed me the image of my eyes he’d had taken earlier that month. The orb on the left side (which is actually my right eye) reveals an increased whitening in the center, which indicates optic nerve damage. This damage is permanent, and would worsen if the intraocular pressure isn’t controlled. The white mass on the upper right side is damage to the retina from the initial trauma.

There was an invasive surgery in Vancouver to consider, but first he wanted to try a simple laser procedure that’s often successful in lowering ocular pressure. The procedure could be done by the ophthalmologist who did my cataract surgery.

So I waited for that call. Meanwhile I crossed my fingers and hoped this procedure would work so I could stop taking that nasty Methazolamide.

And the saga continues.

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The Results of Pinning My Hopes of Better Vision on Cataract Surgery

Last week I explained how my eye’s progress after a complex retinal detachment had mostly gone backwards in 2017. I faced the new year with worsening vision, a developing cataract and continued high ocular pressure. For those of you just joining this topic, you can find detailed information on the signs and dangers of retinal detachments, as well as the start of my journey, in my initial articles here, or catch up with my recent update here.

At my ophthalmologist appointment in mid-January 2018, I asked about having my eye cavity flushed again to remove more silicon oil residue, hoping this might improve my vision. He said cataract surgery was the priority, and he wouldn’t consider another flushing before then. He thought my eye looked good and he wouldn’t need to see me until after the cataract surgery.

When I got home, I realized my ocular pressure hadn’t been checked, nor had it come up in our conversation. Because I had an appointment at the end of that month with the ophthalmologist who’d be doing the cataract surgery, I decided to have him take a pressure reading. But not knowing was a worry, and I was disappointed it hadn’t been addressed that day.

At my appointment with the cataract ophthalmologist, I got the frustrating news of a probable nine-month wait for surgery. The ophthalmologist said my ocular pressure was elevated more than he liked, but he didn’t give a number. I told him I used Azarga eye drops twice a day to treat that. He didn’t have any further suggestions.

In April, I had measurement tests done, a routine procedure before cataract surgery. I didn’t see the ophthalmologist at that appointment. The blurriness and double vision were continuing to worsen, and I wondered if the cataract was causing this, and how bad it might become by the October surgery date.

In an unexpected turn of events, my cataract surgery was performed in July at the local hospital. It took approximately two hours, start to finish. Unlike my first two surgeries, applying the anesthetic didn’t involve inserting needles into my eye (yay!), and the surgery wasn’t painful. The surgeon kindly took the time to remove more silicon oil from my eye cavity during surgery. While my eye was only mildly uncomfortable afterward, I had a terrible headache and felt really off, so slept most of that afternoon. I blame this on the IV sedative given before surgery.

The next morning, the surgeon said the new lens looked great. Both he and I were surprised my sight hadn’t improved. He said it might still improve over time. He switched me from Azarga to Combigan eye drops to treat the elevated ocular pressure. I told him I’d just noticed my right eye was aligned slightly to the right instead of looking straight ahead. He said the surgery hadn’t caused this, and explained that when an eye doesn’t see well, the brain sometimes stops using it, causing it to wander off-center. This news, and the lack of progress with my vision, wasn’t encouraging. Ever the pragmatist, I decided to keep a positive mind-frame.

A week later, my ocular pressure had dropped slightly, so the cataract ophthalmologist had me continue with the Combigan drops and start another one, Latanoprost. Still no change in my eyesight.

Two weeks later, my ocular pressure was up to 37 (normal is 12-21), so the cataract ophthalmologist put me on a third eye drop, Brinzolamide. He said the gritty feeling in my eye was caused by dryness irritating my cornea, and suggested using lubricant drops. This was my last cataract check-up, and he forwarded his findings to my regular ophthalmologist, who I was scheduled to see in a few days.

So, a third surgery was behind me, and besides no longer having a cataract, my vision remained poor and unstable, and my ocular pressure remained high and untreatable. I had to face the stark reality of never regaining functional vision. My upcoming articles will address other challenges I had going forward. Click here for the next one.

The Aftermath of a Complex Retinal Detachment

Two years ago this month, my life changed forever when I awoke one morning with no vision in my right eye. Back then, I posted a series of articles on my journey going forward, and rather than repeat everything again, you can read them, starting here, if you’re interested.

Basically, I’d experienced what’s called a vitreous hemorrhage. As our eyes age, the clear vitreous gel that fills the central eye cavity liquefies and separates from the retina. When the gel separates, floaters may appear—dots, spots or curly lines, which move with the eye. This usually resolves quickly and vision returns to normal. Sometimes the retina tears or detaches when the gel separates. In my case, the eye hemorrhaged and the cavity filled with blood. The damage was enough to detach and severely damage my retina. This resulted in complicated surgery, including a vitrectomy, attaching a scleral buckle and inserting silicon oil.

My articles have been read upwards of a thousand times, and many people have reached out to compare stories. While I’m pleased to have offered reassurance or at least let them know they aren’t alone, a part of me is heartbroken that so many people have gone through this awful experience.

I stopped documenting my journey shortly before I had the silicon oil surgically removed. I wanted to have something constructive, some improvement, to share. So I kept waiting. I realize now, there won’t be a positive outcome for me. But it’s time to relay the rest of my cautionary tale, and reiterate once again to please take the best care of your eyes possible. It’s vitally important to recognize the symptoms and understand the dangers of torn or detached retinas. Don’t delay in getting medical attention if you have concerns.

At the end of August, 2017, I traveled to a nearby city, where the silicon oil was removed in a day-surgery procedure, which entails flushing the eye cavity numerous times to remove its contents. A local anesthetic was injected into my eye in two places, an intensely but fleetingly painful process. The actual flushing procedure only took about fifteen minutes. An air bubble was instilled into the eye cavity afterward.

Thankfully I didn’t have to do the awful head positioning that was required after my first surgery. There was minimal swelling and bruising around the eye compared to the previous surgery, and the pain was negligible. My eyeball was quite red and my vision was horrible, because of the air bubble. I had to patch my eye to read or watch TV. Walking was a challenge, too.

A week after surgery, the air bubble was only a third its original size. I had extreme and very clear nearsightedness, with anything more than a foot away just a blur. There were also lots of small black, very mobile, floaters. My ocular pressure was in the upper normal range, and I continued using an eye drop called Azarga, to control the high pressure.

Two weeks after surgery, the air bubble had completely dissipated. My distance vision was still nonexistent, beyond vague blurry shapes. My ophthalmologist had no suggestions for why my sight had worsen after the surgery. He said I was developing a small cataract that could be causing problems. Cataracts aren’t uncommon in situations like mine where numerous eye drops have been used over many months.

Four weeks after surgery, I still couldn’t see as well as before the oil was removed, but my vision had improved slightly. No change in the number of small black floaters. My eye pressure was beginning to climb back up above the normal range despite using Azarga.

Six weeks after surgery, my ophthalmologist conceded there may still be oil residue in my eye, causing the floaters and possibly affecting my vision. He said he’d consider flushing the eye cavity again if there was no further improvement. My eye pressure was up to 32, which is considerably high (normal is 12-21). Because I was already using Azarga to treat the condition, he opted to take a wait and see approach for a few months.

And that’s how 2017 ended for me. Oil removed, with possible residue remaining. Less vision than before I had the oil removed. A cataract developing, and the ocular pressure continuing to hover in the high range. None of this was cheery news, and I didn’t want to share my lack of positive progress for fear of discouraging others.

I’ve since had more surgeries and procedures, which I’ll explain in future posts, starting here.

 

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.

An update two years later here.

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)