Category Archives: Hospital visits

Edible eyes and appointment anxiety

A few weeks ago, my sister announced that she would be holding her ‘Twinkles at Twilight’ event this year on the eve of my next check-up appointment at Moorfields Eye Hospital.  “It’ll take your mind off your appointment”, she told me, optimistically.  For those readers who don’t know what Twinkles at Twilight is all about, you may like to read, ‘Twinkles at Twilight, dread at dawn‘, but basically it’s an afternoon of tea, cake and games to raise money for Moorfields Eye Charity and Marie Curie.  ‘Twinkles’ relates to a twinkle in the eye, and ‘twilight’ refers to the time at which Marie Curie nurses begin their shifts to provide night-time palliative care for patients in their own homes.  Give us a few years and I’m pretty sure that Twinkles at Twilight will become as much a part of the charity calendar as Children in Need or Comic Relief.  Maybe.

So, following my sister’s announcement that Twinkles would be held on 19 November, I donned my apron* and cracked on with the serious business of baking appropriately themed goodies and cramming them into my freezer.  Much to my delight, I’d discovered packets of edible eyes in my local Sainsbury’s, so I made an array of chocolate muffins and macaroons, decorated with cherry noses and edible eyes.  I made so many macaroons that I actually ran out of edible eyes (there are only 50 in a packet), and had to resort to raisins instead.  That was okay though – the raisin versions just looked as if they’d been sitting in an eye clinic for a while after having dilation drops put in.  I also baked carrot cake (good eye food…?) and chocolate brownies decorated with twinkly stars.  My sister’s creations included fairy cakes with little faces made of chocolate buttons and edible eyes, and giant marshmallows on sticks with cherry noses and rice paper sunglasses.  Other offerings included a beautiful selection of shortbread star biscuits, and miniature star-shaped scones baked by the Duke of Edinburgh students who volunteer at my sister’s workplace.  The process of jamming and creaming the latter naturally led to the inevitable hotly debated question regarding the correct pronunciation of ‘scone’.

A plate of macaroons with edible eyes or raisins as eyes and cherry noses.

Macaroons

Fairy lights were borrowed from various willing lenders and strewn across furniture and curtain poles; sparkly stars were stuck artistically on door frames and mirrors; and the games table was set up.  As last year, we had a tombola (50p a ticket), ‘guess the number of stars in the jar’ (biscuit-shaped stars, that is), and ‘guess where the shooting star is in the night sky’ (each £1 a go).  The games went down a storm and raised a substantial amount of dosh, as well as keeping children entertained and parents probably wishing they’d just popped to the local supermarket and bought that box of chocolates instead of allowing their offspring to have “just one more go!”

A picture of rooftops and a night sky with a crescent moon.

Find the shooting star in the sky!

We realised afterwards that we STILL didn’t have any eye related games this year, so if you have  any suggestions, please let me know in the comments below and we might use them for next year’s fundraising efforts!  Despite this small oversight (pun intended), the evening was a resounding success and thanks to people’s incredible generosity we raised over £400 for Moorfields Eye Charity and Marie Curie.  Thank you very much to everyone who came, baked, helped out, donated, and of course scoffed cake (the best bit, obviously!).

The cake-baking and event organising did help to take my mind off my impending hospital appointment, but as the dreaded day dawned, I awoke to the familiar ‘bang bang bang’ of what I suspect was a tension headache hammering away.  Usually I get these the day after my appointment.  This time, I got one the day before, on the day itself, and on the day afterwards.  “Great”, I muttered to myself, whilst knocking back the drugs** and wondering how I was going to remain alert enough to be able to process any potential bad news if the appointment didn’t go well.  Fortunately, the headache had faded by the time we got into London, which was just as well as we were then faced with signal failures on the tube and had to dash up to the street and flag down a taxi in order to make it to the hospital on time.

The clinic was busier than usual.  There was a huge queue just to sign in, and the receptionist had that stressed look of one who can’t actually see the end of the queue (and not because of dodgy eyesight).  We’d already been waiting for a couple of hours when another patient sat down next to me and sighed, “It’s a long wait, isn’t it?”  I asked her how long she’d been waiting, to which she replied with another sigh, “Almost an hour!”“Ah, that’s not too bad”, I replied, adding, “At least we still have the NHS… at the moment, anyway!”  She agreed, and settled back in her chair as my sister and I exchanged glances and agreed via sibling telepathy that she was clearly a newbie as you never, EVER have an eye appointment which takes less than two hours.

Eventually, I was called through to see the consultant, whereupon I gritted my teeth and crossed my fingers as I put my chin on the contraption and tried to remember to breathe as I followed the usual instructions for each eye in turn: “Look straight ahead… look up… look up and right… look right… look down and right… look down… look down and left… look left… look up and left…”  Then it was all repeated when ‘the Prof’ came to have a look.  To my delight, he said that everything looked much the same as previously and agreed with my view that it was better not to rock the boat by having further surgery as things were still stable and I was coping.  Of course, they’ve warned me that if I start to get side effects as a result of the oil (e.g. high pressure), surgery may become inevitable, but I really do hope that things will remain stable for a long, looooong time.  Or at least until they’ve figured out a magic solution of how to cure PVR and make the ruddy retina stick…

* I don’t actually have an apron, but I probably should invest in one, as I’d make less mess when baking.  Or at least the mess could then be wiped on the apron instead.

** Ibuprofen of course.  What did you think I meant?!

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Strong and stable?

I was feeling about as strong and stable as a certain indecisive woman’s preposterous policies when my sister and I set off in the grey drizzle for my appointment at Moorfields Eye Hospital on Monday morning.  My last appointment hadn’t gone as I’d hoped, and I was convinced that they’d be booking me in for my much-feared sixth lot of surgery this time.  With an eye full of oil and rising intraocular pressure, it seemed that the only way was up (baby!) in terms of the latter.*  I’d spent the previous week or so in a state of mounting anxiety, and things weren’t helped by a run of stonking headaches, increasing queasiness and belly ache as the dreaded day loomed closer.  Just in case I was in any doubt about my state of inner turmoil, my subconscious saw fit to remind me of it in the form of nightmares on the rare occasions that I managed a bit of decent shut-eye.  I dreamed of being trapped in my house as the sea roared and raged ever closer, flooding my garden in giant waves and seeping into my place of sanctuary.  I should add at this point that the sea is about a mile away from my house, so this was a most unlikely scenario.  However, it felt so real that once I’d woken and calmed my thudding heart, I peered through the bedroom curtains to check the windows for salty spray.  Drumming home the point, the following night I had a terrifying dream in which I couldn’t see properly out of my good eye.  Each time I tried to blink the floaters away and focus on something, it appeared as a blurry mess of confusion – just the same as the vision in my bad eye.

Things weren’t improved on appointment morning, when we missed the train we were aiming for and, upon arrival at Moorfields, discovered that the grumpy receptionist was on duty in the clinic.  (Well, it was a Monday morning to be fair, so she had every right to be grumpy.)  Lucy somewhat gleefully pointed out that it was All My Fault that we’d missed the first train, as I hadn’t been as punctual as her in getting myself ready.  I protested that the reason for this was that I’d been trying to force my breakfast of peanut butter on toast into my churning stomach (much to the dog’s benefit and subsequent surprised delight).  My taught nerves required me to pay an urgent visit to the facilities before we descended to the clinic, so Lucy went ahead to book me in.  The grumpy receptionist lived up to her name when she stared at Lucy in disdain and demanded, “But where is she?”.  Fortunately, I appeared shortly after this and she waved me through without further interrogation.

We settled down for the usual long wait but were taken by surprise when the nurse called me through within the space of a few minutes.  Visual acuity was as expected, and then came the pressure check, which I’d pretty much been worrying about ever since my last appointment back in January.  I held my breath.  Then I reminded myself to breathe, in case holding it affected the pressure.  I opened my eyes wide and stared straight ahead as the nurse advanced with the pressure monitor and I waited for it to flick against the surface of my eye.  As always, she took a few readings in each eye and then stood back and declared, “21 in the right and 20 in the left.”.  “Ooooh, it’s gone down again!  That’s good, isn’t it?!”, I exclaimed.  She agreed, and proceeded with the dilation drops.  I smiled through the stinging and watering as I felt myself relax ever so slightly.

We headed out to waiting area number 2 and settled in again – it’s always best to expect a long wait and this time we weren’t disappointed.  I dampened my sandpaper mouth and we ate bananas, discussed politics, and played ‘I Spy’ as my pupils dilated and my vision blurred.  Each time a doctor appeared carrying a particularly bulky file, I braced myself in expectation, as we waited… and waited… and then waited some more.  After a while I gave up on watching out for thick files and eventually I was called through by a doctor I’d never seen before.  I already knew that my consultant – ‘the Prof’ – was away that day, as we’d spotted it noted on the whiteboard as we’d entered the clinic.  This did nothing to calm my screaming nerves.  We later discovered that he was away at a conference, so I like to think that he was sharing ground-breaking research about a cure for PVR.

The doctor I saw was extremely patient, giving both eyes a thorough examination before checking my right eye over a second time.  Much to my delight, he was very receptive to questions, which we naturally took full advantage of and obtained answers to even more than the nine on my pre-prepared list.  My shoulders slackened slightly as he told me that everything looked the same: the area of detachment beyond the laser line hadn’t progressed any further, the abnormal blood vessels were the same, and the oil wasn’t causing any problems at that point.  He emphasised that I must return to A&E if anything changed, adding that I would know in my gut if I experienced anything which needed to be checked out.  He then went on to pronounce that word which is far more meaningful when coming from the lips of a retinal surgeon: ‘STABLE’.  As my eye was stable (aaaah… bliss!), he didn’t see the need to rush into further surgery and therefore asked me to return for another check in six months.  Resisting the urge to kiss him, as I suspected this would be frowned upon, I thanked him warmly instead and headed out to make my next appointment with the grumpy receptionist.

The grumpy receptionist took the full force of my delight and relief, as I gleefully told her that I didn’t have to return for six whole months and added that I felt as if I’d been given a wonderful present.  She smiled, and I observed in a most uncharacteristically chatty manner that we usually saw her in my previous clinic rather than ‘the Prof’s’ clinic.  We were treated to another smile as she explained that someone was off sick, and then she ominously remarked that she’d seen my name on the list that morning.  Considering the huge numbers of patients she must see, and knowing that in my own job I only tend to remember the names of people who are either very nice or incredibly annoying, I briefly wondered which category I fell into.  However, after further chatting as she made my next appointment, she smiled again before bidding us goodbye.  We skipped out into the London streets, where we discovered that the grey drizzle had given way to weak sunshine.

Word that I was in celebratory mood had clearly spread, for as we piled onto the tube and sat down, two men clutching saxophones (soprano and alto) climbed aboard along with another guy who turned out to be the singer as they broke into a jazzy version of ‘Hit the road, Jack’.  Ignoring the stony-faced feigned oblivion of most of our fellow passengers, Lucy and I grinned at each other and bopped along in delight, receiving a nod and thumbs-up from the singer in return.  We continued to celebrate my good news by treating ourselves to posh sarnies from M&S (good eye food ones, obviously).  I demolished my share with gusto as we journeyed back on the train; my appetite having made a welcome return.

*You may like to check this out if you’re wondering what on earth I’m talking about: https://www.youtube.com/watch?v=hOMvs_1UFCk

Oh silicone oil, I thought you were my friend… :-(

After my previous appointment at Moorfields back in July, when I was granted a six month reprieve from further surgery as my consultant believed it would be best to simply monitor my pesky peepers for a while, I practically skipped out of the hospital in delight and relief.  The six months whooshed by all too quickly and before I knew it, my next appointment was looming ominously on the horizon.  As the days passed, my nervousness grew and niggling headaches became a regular feature of my days; not helped by my job, which involves sitting at a computer screen for much of the day.  However, I told myself that hopefully all would be well and that with any luck they would simply grant me another six month reprieve.  So off I set for Moorfields on Monday morning along with my sister, both of us feeling fairly hopeful.

We descended to the clinic in the basement of the hospital, clutching cardboard cups of comforting tea, by now well accustomed to the forthcoming hours of waiting and people-watching through blurred, dilated eyes.  Strangely, most of the chairs were vacant, so we selected a prime spot which afforded us a look-out point to observe which consultants were on duty as well as being able to keep an eye on the whiteboard behind the reception desk, which at that time was predicting a two-hour wait.  I’d just got settled and started to blow on my tea when my name was called, causing me to almost drop the cup in surprise.  My sister and I looked at each other with startled faces and off I went for the first check with the nurse.  I was encouraged by the fact that I was able to slowly read the second two letters on the eye chart with my right eye, but my proud grin fell when the pressure check revealed a pressure of 24 in my right eye and 20 in the left.  Normal eye pressure is between 11 and 21.  During the stable period of the past year or so, the pressure in my right eye has varied between 17 and 19, so 24 was somewhat unusual.  Surprisingly, there wasn’t too much time to fret about it, as we only had to wait a few more minutes once the dilating drops had taken effect before I was called through to the consultant in record time.

Once again, I was asked the dreaded question, “How do you feel about having more surgery?”  Once again, I suppressed the urge to scream and hide under the nearest desk and instead admitted that I’m utterly terrified at the prospect of further surgery, but will do whatever they advise is clinically best.  Of course, unfortunately things are rarely that clear-cut.  As things stand at the moment, if they were to remove the oil, the retina would certainly re-detach.  So the plan is to remove the oil and carry out further work in the form of another retinectomy (i.e. cutting away part of the retina which won’t lie flat), more laser, sorting out abnormal blood vessels, and then either more oil or long-acting gas back in.  With the oil in, there’s less chance of a full re-detachment as the oil holds the retina in place and doesn’t disperse as the gas does.  For this reason, I love the oil.  It’s like my little security blanket.  But silicone oil in the eye also brings the risk of certain side-effects, such as high pressure which could then lead to glaucoma, emulsification of the oil, and scarring of the cornea.  These potential side-effects frighten me as much as the possibility of re-detachments, as it’s my understanding that ultimately they would also lead to further sight loss.

After examination, extensive discussion, and a further consultation with ‘The Prof’, it was decided that I should return in three months.  Although not immediately worried about the rise in pressure, both surgeons noted that it will need to be monitored and that they will need to take the oil out if it starts to creep up.  Of course, I’ve known about the potential complications of the oil for some time, so it wasn’t as if this was a surprise.  However, it was certainly a pretty major blow.  No longer is it myself and my silicone oil against the world.  Instead, it appears that my friend may be turning traitor.  So it seems that I’m once again occupying that most uncomfortable of areas, between a rock and a hard place, which I wrote about some time ago.  The only difference is that this time it seems likely that the issue will be decided by my pressure readings.  😦

Twinkles at twilight; dread at dawn

After contemplating taking part in a sponsored abseil of the ArcelorMittal Orbit, the UK’s tallest sculpture in the Queen Elizabeth Olympic Park in order to raise money for Moorfields Eye Charity, my sister decided to organise a charity tea party instead.  Her decision to abandon the idea of throwing herself off a 114.5 metre eyesore in central London in favour of sitting down to drink tea and eat cake in a leafy Surrey village was one which was wholeheartedly endorsed by myself.  She arranged the event for the evening before my check-up appointment with my original consultant at the Royal Surrey County Hospital so that I’d be around to help with the baking and eat plenty of cake… err, I mean take part in the event itself.  She christened the evening ‘Twinkles at Twilight’ as the fundraising was for both Moorfields Eye Charity and Marie Curie.  For anyone who doesn’t quite follow Lucy’s logic, the ‘twinkles’ relate to a twinkle in the eye and ‘twilight’ refers to the time at which Marie Curie nurses begin their shifts to provide night-time palliative care for patients in their own homes.  The reason she wanted to support these two charities is probably best explained in her own words:

“Palliative care nurses enable terminally ill patients to spend their last days at home with their family.  Caring for a very ill relative is emotionally and physically draining, involving being up numerous times in the night. Marie Curie nurses give relatives a night of cover so that relatives can get an undisturbed night. This enables the carer to recharge their mind and body as much as possible in the circumstances.  Current funding levels only allow a limited number of nights’ cover.  They were my twilight angels when my Grandad was ill.
I grew up aware of how my Gran’s sight trouble increasingly limited her activities as it got worse.  Then in 2014, my sister had a retinal detachment.  This is when the reality of potentially facing sight-loss really sank in.  She has now had five surgeries to reattach it as she is in the minority (10%) of people who suffer recurrent re-detachments.  Each time her retina detaches, she loses more sight.  The fear of losing her sight is very real.  Moorfields are affiliated with University College London Institute of Ophthalmology and carry out sight-saving research.  They also raise awareness of eye health to help prevent problems.  Close your eyes for 60 seconds and imagine you can never open them again.  That’s why I support Moorfields.”
Once the theme was set, we cracked on with the serious business of baking various eye and star themed goodies and getting other bakers on board to help.  The final creations included cupcakes with the Moorfields Eye Charity logo in fondant icing, fairy cakes with little faces made out of chocolate buttons and edible eyes, star-shaped shortbread, and a dazzling array of fairy cakes adorned with various types of edible glitter and tiny stars.  Fairy lights were borrowed from people far and wide, and the Duke of Edinburgh student volunteering at my sister’s workplace was promoted to Artistic Director of Operations and did a fantastic job of tastefully decorating the place.  Lucy had also come up with a few games to keep people amused throughout the evening, including ‘guess the number of stars in the jar’, and ‘guess where the shooting star is in the sky’.  My Eye to Eye walking buddy and myself were in charge of these, and it’s just occurred to me that there were no eye-themed games.  We could have got people to guess how many retinal detachments the pair of us have had between us.  Then again, that may have been tempting fate.  Anyway, the evening went swimmingly and people were extremely generous both in making donations and stumping up money to participate in the games (£1 a go – a bargain!).  We had a couple of rather over-excited boys to thank for interest in the games, as they were so determined to win prizes that we became slightly worried that their father might be reduced to bankruptcy during the course of the evening.
Cupcakes with the logo of Moorfields Eye Charity on them

Cupcakes with the Moorfields Eye Charity logo in fondant icing

I crawled out of bed at the crack of dawn the following morning after a restless night which could probably be blamed equally upon excess sugar consumption and pre-appointment dread.  Even though it was just a check-up with my original consultant and I knew he wasn’t going to suggest any treatment due to the fact that I’m currently under Moorfields, I still hadn’t been able to block out the familiar fear of, “but what if he finds a hole or tear in my ‘good’ eye?” or “what if the detachment in my bad eye has got worse?”.  So I sat with my sister in the chilly air-conditioned waiting area, shivering as much with cold as in fear.  An hour passed, and I was called in by the nurse for the initial sight test.  Another half hour passed, then another, and the clinic gradually became a little less crowded.  After another half hour, those of us who were still patiently waiting glowered in disbelief as a patient arrived, handcuffed to someone else with a prison officer in tow and was promptly fast-tracked through the system.  “Ah!”, remarked my sister, “So that’s the way to skip the queue in the eye clinic!”.  I briefly considered whom I could murder in order to achieve this status but was fortunately interrupted in my musings by the familiar soothing Irish tones of the consultant calling my name.  I leapt to my feet and practically ran to his door before he could change his mind and call in another patient instead.
“So how are you doing then, Emma?”, he asked.  “Ploughing on”, I trotted out my stock answer before remembering that actually I could tell him the truth without fear of him either rolling his eyes in boredom or telling me not to be negative, as many people seem to do these days.  “So what are Moorfields planning for you then?”, he enquired, at which point I launched into a brief run-down of the rough plan.  He nodded approvingly, adding admiringly, “Well, you have learnt a lot about your eyes, haven’t you?!”  I thought it probably wasn’t the time to tell him about my plan to go on Mastermind with the specialist subject of ‘retinal detachment’, and left him to get on with the usual business of checking my eye pressures and inserting dilation drops before sending me back out again to wait while they took effect.
Twenty minutes or so later I was back in his consulting room for the dreaded retinal check.  Fortunately, it was all fine.  Or as fine as it can be with my eyes.  We said a cheery goodbye and bolted for freedom.  The fact that we were the very last people to leave the clinic after having spent the entire morning there no longer mattered.  Nor did the fact that we suddenly realised our parking ticked had expired over half an hour earlier and we may have a huge parking fine to deal with.  We called into the hospital cafe for celebratory tea and cake (well… the previous evening’s sugar rush had subsided by this time), and hurried back to the car in the bright afternoon sunshine, as fast as my dilated eyes would allow.
Eye fairycakes

Eye fairycakes

Note: The final amounts raised at the Twinkles at Twilight Tea Party were: £210 for Moorfields Eye Charity and £178 for Marie Curie.  Huge thanks to everyone who supported the event, whether it was baking cakes, eating them, or both! 🙂

I spy with my little eye something beginning with R…

As my check-up appointment at Moorfields loomed closer, the feeling of dread and impending doom increased.  I’d been granted a reprieve from surgery at my last appointment but had been told that they’d book me in for it at my next check-up.  So I set off on the train with my sister at the crack of dawn on Monday morning after a night of particularly spectacular insomnia, feeling as if I was going to attend an interview, sit a final exam, take my driving test, and move house all within the space of the next few hours.

Over a calming cuppa in the cafe at Moorfields before heading down to the clinic, we agreed that there were four potential outcomes of the appointment:

  1. They might discover something disastrous and whip me straight in for emergency surgery.
  2. They might decide to book me in for my next lot of planned surgery.
  3. They might allow me another reprieve in terms of further surgery and just continue to monitor the situation.
  4. They might declare in amazement that a miracle had occurred – that the retina had magically reattached itself, the PVR and abnormal blood vessels had disappeared, the lattice degeneration had healed, and the oil had disappeared of its own accord.

I was pretty sure I’d get option 2, but I’m always nervous about the possibility of option 1, whilst simultaneously continuing to hope and pray for option 4.

We trudged down the stairs to the clinic and settled in for the long wait, passing the time by people-watching and playing ‘spot the surgeon’.  I tend to recognise quite a new of them now.  After the initial eye check by the nurse, we moved onto a game of ‘I Spy’.  This wasn’t the most sensible choice as I’d had dilating drops by this point and my vision rapidly became increasingly blurry.  My sister therefore felt it necessary to give me massive hints, pronouncing, “I spy with my little eye something beginning with F”, as she stared fixedly at a spot on the ground to the left of her shoe.  “What are you looking at down there?”, I asked in alarm at the intensity of her gaze, before I realised exactly what she was staring at and answered my own question with rather more pride in my own observation skills than was strictly fair to claim: “Oh!  Floor!”.  “Yes!”, she confirmed, instructing “Your turn”, as she sat back expectantly.  We spied ‘glasses’, ‘trolley’, ‘drawers’, ‘patients’, and a number of other topical objects before she became stuck on, “I spy with my little eye something beginning with O”.  My need to visit the loo had become something I could no longer ignore by this stage (a calming pre-appointment cuppa is all very well, but it inevitably results in certain action becoming necessary).  So off I went, leaving her to ponder the mystery of something beginning with O.  Later, she told me that she’d been looking up and down when the elderly lady sitting opposite, whom I’d recognised from my last appointment, leaned forward and asked what she was looking for.  Upon explaining that we were playing ‘I Spy’ to pass the time, the lady nodded in approval.  “Ah, I thought you were”, she said.  “What’s the letter?”  “O”, replied my sister in flummoxed tones.  Our new teammate ummed and ahhed for a while before suggesting, “What about Ophthalmologist?”  As usually happens when daring to visit the loo whilst waiting in the clinic, my name was called just at that point.  Fortunately, I rounded the corner just in time to hear what was happening, and so hurriedly sped up in pursuit of the blurry shape of the surgeon.

We both sat down in the consulting cubicle and he introduced himself as one of the Fellows before turning to concentrate on my ever-growing file of notes.  The minutes ticked by and my sister could obviously no longer contain her curiosity as she gently prodded me in the back and whispered, “Was it ophthalmologist?”  “No!”, I whispered back.  “It was ‘one’ – there was a giant number one on the door opposite where we were sitting.”  The Fellow was obviously under the impression that we were discussing something of great importance concerning my eyes and so asked us what we wanted to know, at which point I had to admit that we’d been playing ‘I Spy’ to pass the time while we waited.  Fortunately, he appeared to have a sense of humour.

Then came the usual eye examination, followed by a new experience with a dentist’s chair and a dazzling head torch to enable him to see more of the peripheral areas.  He drew lots of diagrams and wrote careful notes in my file and I followed my usual rule of not interrupting his concentration as I sat there silently whilst screaming in my head, “please-let-it-all-be-okay-please-let-it-all-be-okay-please-let-it-all-be-okay-please-please-PLEASE!”  Eventually he stopped writing and gave me the news: no change.  Pheeeeeeeeeeeew!  Then followed a discussion of proposed treatment and potential options, and he patiently answered lots of my questions about PVR before heading off to get ‘the Prof’ to have a look.  They both asked me the dreaded question, “How do you feel about further surgery?”  I always feel that this question is somewhat superfluous.  Surely it doesn’t take too much imagination to guess how someone feels about the prospect of having their eye cut open and various instruments inserted for the sixth time?  Maybe they’re just testing the limits of my bravery, but to be honest I’m just a quivering wreck when it comes to thinking about any more surgery.  Anyway… I asked ‘the Prof’ what he thought was best, and he said that as things are currently stable he would advise to leave surgery for a while longer.  My chin nearly hit the floor when he said that he’d see me again in six months, and then he had to assure me that he wouldn’t be saying six months if he didn’t think it would be okay to wait that long until the next appointment.

Suppressing the urge to kiss both surgeons and the receptionist on my way out, we headed up to the cafe and celebrated the good news by sharing a roasted pepper and halloumi panini and a slice of summer fruits sponge cake.  Fortunately, my appetite had made a dramatic return and I demolished my share with ease and delight.

Note: For the more observant and/or curious readers, ‘something beginning with R’ is of course a reprieve!  Or relief, for that matter.  😀

Blind spot

After having my last check-up appointment at Moorfields cancelled at pretty much the last minute (https://rdramblings.wordpress.com/2016/04/03/q-whats-more-stressful-than-an-impending-eye-appointment/), I was more of a nervous wreck than usual by the time the hours, days, and finally three weeks had slowly dragged by until I eventually reached the rescheduled date.  After getting a few headaches I’d convinced myself that my pressure must be high, I was already terrified of the inevitable discussion of when surgery to remove the oil should take place, and to top things off I’d noticed a blind spot in my good eye (perhaps I should describe it as ‘better’ eye rather than ‘good’ eye) which had been freaking me out for a good few weeks.

I only noticed this during the course of my usual visual field checks at home.  One day I realised that when I sat at my table and stared ahead with my bad eye shut, I was unable to see one of the pictures on the wall across the other side of the room with my good eye.  Once I’d calmed down slightly from my initial panic of thinking, “****, I need to get to Moorfields first thing tomorrow morning”, I remembered that various people on the RD Facebook support group site had discussed suddenly noticing blind spots and it had turned out to be a result of laser surgery and they just hadn’t noticed them before.  So I told myself it could just be from the cryotherapy I’d had in that eye to mend the two tears back in April 2014.  Or, I told myself, it might be the natural blind spot which everyone has.  Or, I told myself, it might be a hole or a tear in the retina.  After telling myself all this and freaking out all over again as a result of the last possibility, I’d then try to calm my breathing down and stare at the blind spot once more, willing it to be a figment of my imagination.  It wasn’t.  I obsessively measured it each day (I’m not admitting to how many times a day) by using various visual markers so that I would be able to tell immediately if it got any worse.  I also started ‘looking’ for it when I was out and about.  This was not really a sensible thing to do.  Once, during a walk down the road, I managed to make an entire red telephone box disappear into the blind spot, which caused me to feel rather sick.  However, as the blind spot didn’t seem to be growing when measured against my set markers at home, and I wasn’t getting any other new symptoms, I gritted my teeth and attempted to plough on through my daily life as normal whilst desperately trying to quell the evil little voice inside my head that said “It’s going to be a tear, it could detach at any minute… you’ll end up at that appointment and they’ll whisk you straight into surgery”. 

We arrived at Moorfields in plenty of time – so much so that we even managed to nip into the cafe to get a cuppa to take down with us for the long wait in the clinic.  “What are you doing?”, asked my sister in aghast tones when I sat down with my cup of tea.  “I don’t want to go down to the clinic!”, I said, clutching my stomach which had been churning uncomfortably for most of the morning.  However, down we went, reluctantly.  We settled down for the long wait, briefly pausing in our important discussions of setting the world to rights to glare disapprovingly at one patient who obviously wasn’t accustomed to the NHS in general and eye clinics in particular as he proceeded to harangue the receptionist and demand to know when he would be seen.  We observed with disgust as he turned his back on her whilst she was still explaining that she would check where he was in the queue, and plonked himself back down inserting headphones into his ears as he did so.  Unfortunately, I’d already disposed of my banana skin, otherwise I’d have been sorely tempted to toss it under his heel and watch him go flying down the shiny corridor floor.

We didn’t have to wait too much longer before I was called in by one of my consultant’s team.  Upon asking if I’d experienced any problems since my last check-up, I told him about the blind spot and he said that he ‘hoped’ it was my natural blind spot, which everyone has.  Following the usual drill with each eye in turn (see https://rdramblings.wordpress.com/2015/07/30/a-grand-day-out-at-moorfields-eye-hospital/ if you’re interested to know what this is), he sat back and used magical words such as ‘okay’ and ‘stable’, as well as assuring me that the blind spot was indeed simply the natural one.  I quickly suppressed my urge to leap up and do a little dance as he then started talking about the dreaded subject of surgery to remove the oil.  However, even this ended happily as in answer to questions, he said there was no clinical need to remove it immediately and it would be fine to wait for another few months.  Of course, I’d still like a miracle, but while I’m waiting for this to be arranged, I’m more than happy with the outcome of today’s appointment.

In the meantime, if anyone’s wondering, let me just explain the sciencey bit about the blind spot, which all of us have.  Light enters our eye through the pupil and hits the retina at the back.  The optic nerve then carries this information to the brain.  However, the optic nerve is kind of ‘plugged in’ to the retina itself, which means that this part of the retina is in effect redundant, thus creating a blind spot.  Most of the time, the other eye will see what’s in the blind spot, but if the person is only looking through one eye, the brain just fills in the spot by taking information from the surrounding area.  So, for example if a picture on a green wall falls into the blind spot, the brain will fill in the blind spot with the green colour of the wall and it will look as if the picture has just disappeared.  This is what was happening in my case at home, doing my visual field checks.

To demonstrate this, have a look at the picture below.  Close your right eye and look at the cross on the right.  You should still be able to see the dot on the left, but don’t focus on it.  Keep your eye on the cross and move your face slightly closer to the screen, and then further away again.  At some point, the dot should disappear.  At this stage, you have found your blind spot. Do the same with your left eye, but this time focus on the dot and move around until you see the cross disappear.  The same should happen if you use a different coloured background, but your brain will fill in the colour of the background.

blind-spot

 

Flash, bang, wallop, what a picture!

Appointment day dawned, and a quick peek through the curtains confirmed what I’d already suspected after lying awake listening to the hoolie which had been blowing for most of the night: the end of the world was obviously nigh.  The sky looked as if yet another deluge of horizontal rain was imminent, it was bitterly cold, and part of the road was flooded.  In addition to this, my head felt as if the entire family of Borrowers had crawled in through my ear during the brief moments of sleep I had actually managed to achieve and were trying to tunnel out by means of hammering an escape route through my skull with tiny pickaxes.  Just to top everything off, my mum’s dog (who isn’t supposed to go down any stairs due to a slipped disc a few months back) decided to nudge open the living room door and gallop up the stairs gleefully to have a good sniff around.  When I glared at him and asked him what he thought he was doing, he just gazed back and wagged his tail.  It took me the next few minutes to coax him gently down again, one step at a time.  Obviously I couldn’t lift him, for fear of it playing havoc with my retinas (see https://rdramblings.wordpress.com/2016/01/31/dont-get-a-head-trauma/ for further explanation).  He’s pretty heavy too.  So I set off to Moorfields that morning feeling particularly out of sorts, but trying desperately to quash that irritating internal voice which insisted on running through all the worst-case scenarios as to what the outcome of the appointment might be.

Fortunately, there were no train disasters on this occasion and we arrived in plenty of time and settled down for the long wait.  Eye dilation and pressure checks were duly done, and then we waited a while longer.  We’d just started to wonder whether they’d forgotten me and we were debating putting ‘Operation Toilet Visit’ into action, which usually works a treat (i.e. just when one of us nips to the loo, I’m called to be seen), when we heard my name being called faintly from somewhere down the corridor and around the corner.  I cautiously followed the summons, and realised that I was being called by someone I’d never seen before, which always makes me feel slightly more nervous.  He asked a few questions about exactly what treatment I’d had, and then clocked my sister sitting in the chair just behind me, notebook open and pen poised.  “Do you have a question?”, he asked.  “Oh, we’ve got lots of questions written down here”, she admitted.  “Don’t tell him we’ve got 14 questions!”, I desperately tried to communicate to her via sisterly telepathy.  However, unlike my very first consultant, he didn’t seem at all phased by this and just said that it would be helpful to know some of the questions so that when he examined my eyes, he could look at the things I wanted answers to.  My chin was already firmly on the chin rest of the contraption at this point, otherwise it would have dropped a fair distance.  We made the most of the invitation to ask questions and then he proceeded with the usual business of “Look up, look up and right, look right, look down and right, look down, look left”, etc.  He then stopped, and drew a few diagrams and scribbled notes in my file.  This part always seems worse than the most effective cliffhanger in a particularly intense psychological thriller.  I’m always desperate to ask whether everything is okay, but at the same time I don’t want to interrupt the accurate recording of information so I clench my teeth and force myself to wait until all scribbling and drawing has been completed.  After what seemed like at least an hour but was in reality probably only five or ten minutes, he said that everything looked good (wehey!), the detachment hadn’t progressed beyond the laser line and didn’t seem to be any worse, and he was just going to fetch ‘the Prof’ to have a look.

Along came ‘the Prof’ and repeated the drill: “Look up, look up and right, look right…” etc.  Much to my delight, he said that the adhesion of the retina was better than it had been when he first saw me back in October, and he also said that the PVR appeared to be less active.  (Wehey, wehey!)  Then he asked how I felt about the prospect of further surgery.  I resisted the urge to stick my fingers in my ears, crawl underneath the nearest table and wail loudly in agonised terror, and instead settled for quietly admitting that I’m frightened of more surgery because of everything that’s happened but that regardless of how I feel, I will do whatever they advise is clinically best for my sight.  To my relief, he said that there still isn’t any rush for surgery, and advised me to return for a further check in a couple of months.  There was then a bit of medical talk between the two of them, which I did my best to follow but mostly failed miserably, and a discussion on whether to use oil or gas in the next surgery (“Eeeek – gas?!”, I thought), and some further questions from me on how to limit the possibility of PVR developing again after further surgery.  I was then sent off to Medical Imaging for a spot of retinal photography.  (Cue today’s musical accompaniment, available at: https://www.youtube.com/watch?v=YPQyd_kELVw)

I’d never had retinal photography done before, and it was actually really interesting.  I wasn’t too keen on having my head physically pushed against the machine and having to keep my dilated eyes wide open while I waited for a horribly bright flash, but it was fascinating to see the images on the screen afterwards.  The guy who did it seemed quite happy to show us the images and explain various things, pointing out the optic disc, the fovea, the macula, and then going on to indicate the marks which showed where I’d had various treatments.  The areas of cryotherapy and laser were clearly visible as bright yellow blobs, lines, and dots.  Being the sort of person who likes order and tidiness, I stared at the mess that was the image of my right retina in fascinated dismay.  He pointed out a giant floater on the image of my left retina, and then zoomed in on some strange marks on the right one and explained that they indicated the oil in my eye.  He even gave us a little history lesson of the machine itself, telling us that it was invented by a Scottish man whose son had gone blind because something had been missed in his diagnosis and so he went on to invent a machine which would take a picture of the entire retina.  I was tempted to ask if I could have a copy of the images, but suspected that it wouldn’t be allowed.  Plus, I’d probably just get depressed every time I looked at them.  So off we went, into the windswept streets, following the green line to the tube station as we discovered that the world didn’t appear to have ended after all and that relief acts in much the same way as a warm blanket.