Thursday, January 16, 2014

Avoiding the Evil Eye

I normally don’t go into my personal life beyond whatever public behavior I advocate, enjoy or regret, but this is a private behavior ‘regret’ post. The only thing that makes it suitable for publication here is that I feel I must warn others not to do what I did.

I delayed getting some surgery done, which might adversely affect my final healed-up post-surgery state. The surgery was delayed, because not only did I not get a third opinion, I SHOULD have gotten that opinion…in a different state, or at least in a different part of the state I was in.

I noticed I was having trouble in my right eye about 5-6 years ago when I was on temporary assignment in California. I saw an eye doctor who diagnosed my right eye as having “cellophane maculopathy” AKA “macular pucker”. He told me that it occurs in about 5% of people without diabetes in my age group. (very much higher rate for people over 70) and referred me to a retina specialist, with a warning he could probably not help me. The specialist repeated what the first eye doctor told me. Yes, he could do a surgery, but it had a very low probability of improving my vision.
Why get surgery with little hope of success? I’m not masochist, and my other eye was working ‘fine’.  My left eye has always been dominant anyway. I passed on the surgery and the disparity in my eyesight did cause me some minor problems, but it was tolerable. I forgot about ever getting the eye fixed.

Well, after being back in ‘Merica (Texas) a few years, ‘Old Man Cataracts’ started making his presence known. 7-8 Months ago I had cataract surgery which really made an improvement in my vision. Of course, when the new doc looked in my eye he saw the old problem and asked me if I was having problems seeing detail in the right eye. ‘Duh!’ I said, and told him about my earlier experience.

New Texas Doc said he he was surprised—he thought the surgery had a pretty good success rate, rarely getting 100%, but often in the 90%+ improvement range. He referred me to a retina specialist in Fort Worth for another round of tests. I repeated the story about being told success rates for this kind of surgery as being low, and the Retina Doc looked stunned, shaking his head ‘no’ the whole time. At the end of my recap, Retina Doc tells me ‘No’, they usually get in the 90%+ improvement range if there are no other problems (glaucoma, macular tears, holes, etc—none of which he saw on me). Then he asks “Where were you again when you were told there were low success rates?” I told him People’s Republic of Kalifornia.

This got me an ‘Ohhhhhhh, that explains it’ expression and the comment (quoting as best as I can remember )“I know they don’t get as much practice most places in California as we do because they don’t have as many people with good insurance plans. They may have lower success rates than we do because they don’t get enough practice.”

I’m certain if I had been in a big city in CA, I eventually could have found a doc with the skills, but how would I have known I got the right one ahead of time? Better to go where success is a presumption, rather than an exception if you need work done.

Well I’m now two weeks post-op. Doc says I’m doing ‘excellent’, and by my estimation, I’m already in the 80-90% improvement category with the problem up close with expectations of further improvement as I heal.

When the Retina Doc went in he found a small retinal tear caused by the pulling of the vitreous membrane he was fixing. It was at the top of my retina where I never would have noticed until it got bigger, so it was ‘lased’ while he was inside my eyeball. I’m certain it eventually would have had to have been taken care of for reasons of its own, so this was a good decision: even if I didn’t get an improvement, I prevented serious damage.

But I’m kicking myself for not getting that third opinion right after the second. If you have morbid curiosity and a strong stomach, this is the procedure I had done. Fortunately I don’t have any other problems like macular degeneration that the patient in the video has, so my recovery is (so far) remarkably fast.

Bottom Line:

Don’t assume that because you can’t find a doctor that can help locally, that you won’t find one someplace else.

P.S. I backdated this so as to not run over the CAS post that I want to keep at the top for a bit.

2 comments:

David McSpadden said...

Damn, hordes of the uninsured in Cali adversely affected your treatment. That sucks.

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