Sunday, May 11, 2014

Personal Detachment

My right retina detached roughly ten years ago today.  I say roughly because the detachment was not the dramatic affair of a "curtain" being pulled over the vision like many people say.  My eye bugged me for a few days until my vision began to noticeably deteriorate.  May 11, 2004 is the day I was actually diagnosed. Ugh.  The second time in the same eye within four years. 

I had a detached retina seventeen years before which left my left eye legally blind, so this was a desperate problem as far as functionality was concerned. The retina in my right eye had already detached once years earlier, but had been repaired with virtually no damage. I was even able to renew my driver’s license with no problem. But the more times a retina detaches, the less likely it can be fixed. Even twice can spell disaster.

I left law school in Virginia Beach to have surgery in Columbia, South Carolina. I kept my fingers crossed. There is a six week period after surgery which is the danger zone for another detachment. If you make it out of that period, conventional wisdom is you are golden. My left eye has stayed repaired even though damaged. My right lasted for four years at least. Pretty much everyone was trying to hide their pessimism the repair job would stay. They were right. It lasted only three weeks.

It was a tough three weeks. The surgeon decided to insert a gas bubble it my eye after laying the retina flat in its proper place. I had to lay face down for the duration so the gas would put pressure on the retina. Hopefully, the pressure would make it seal up permanently. As the gas dissipated, the exposed parts off the retina came undone. There was too much scar tissue from the last surgery and the second detachment for it to stick. The surgeon had hinted numerous times that might happen, so there were no surprises.

He referred me to the Duke University Eye Center. In spite of what anyone says about the superiority of ivy league research, when it comes to medical innovation, there is no place like Duke. Some of the methods described to me to help detached retina and macular degeneration victims sounded almost medieval. I realized it was because this was the place you were sent when all else failed. Desperate people willing to try anything could meet up with researchers willing to do most anything in order to get a feature article published in the New England Journal of Medicine.

My expectations were low, but I kept my doubts internal. I did not want to think about going blind at the ripe old age of twenty-seven. For what it is worth, the doctor performing the pre op examination was the last person to ever show an ounce of optimism regarding any health issue I have had in the last five years. He told me the surgical staff was going to insert oil rather than gas this time. The oil would fill the eye completely, putting more pressure on the retina regardless of whether I was laying facedown or not. He said I could see through this oil with only a gassy tint as the only detriment. I was skeptical it could be that easy, but with Duke, you never knew.

The most hopeful bit turned out to be the worst. Scar tissue was going to be the biggest barrier to the surgery’s success. They had much success over the years giving patients the steroid prednisone in order to prevent scarring. The one-two combination of oil pressure and predisone was supposed a sure thing. Ah, if only we had known I had diverticulitis, too. But that is a story for Wednesday.

So I showed up for surgery five years ago today. It was a fascinating experience, all things considered. In the pre op room were a series of recliners in which patients waiting for surgery were put in. I was in the first chair closest to the operating room. A medical student came by to start up an IV to pump some fluids in me. The anesthesiologist came out and explained that I would be awake during the whole procedure, but so doped up I would not care about that huge scalpel that was going to be digging into my eye for the next three hours.

I had been referred to Dr. Brooks McCuen. Dr. McCuen is the head researcher in complicated retinal detachments and macular degenerations. Most of the time, he does lab work and teaches classes on the two subjects. He only performs surgery one day a week. Getting to see him is special. The anesthesiologist, sensing my desperation, I assume, told me that if George W. Bush’s retina detached, Dr. McCuen would be the one to fix it.

He was not exaggerating. The medical staff started scurrying about the moment they knew he was about to arrive. He flung the heavy swinging door open and I swear there was a bright light shining down--an aura, if you will and a hallelujah chorus. Barack Obama could take messianic lessons from this guy. Perhaps if his retina detaches, he will. He walked slowly down the middle of the room between the two rooms of recliners parallel to each other making eye contact with each of the patients he was going to be operating on. he stopped in front of me.

"You’re up first? Are you ready to see again?” he said.

The guy was like Alec Baldwin in Malice. He oozed a God complex out every pore. All I was interested in was having my eye fixed. He could be as arrogant as he wished as long as he got the job done. I assured him I was ready.

It was an experience. The previous two surgeries on my right retina had involved me laying on a regular hospital bed, doped up, but awake while the surgeon worked. This time around, I was strapped down, my head was held fast in what felt like a loose vice grip. Suddenly, Dr. McCuen seemed like a James Bond villain. They usually have a case of egomania, too.

I do not actually remember much of the surgery. Contrary to what I had been told, I started sawing logs almost immediately due to the medication. When it was all said and done, Dr. McCuen himself woke me up--loudly. He does not like being ignored, even by patients who cannot currently identify what planet they are on.

At this point, strong hints started to appear things were not well. He told me he used the gas again rather than the oil. He never explained why, but the usual rationale is gas dissipates on its own while oil requires another procedure to eventually remove it I asked if I was going to have to lay face down another six weeks. He was dismissive of the idea where the first surgeon spoke of it as a matter of life and death. I figured I was too hopeless a case for the oil, there was no reason to risk me having another surgery to remove it on a lost cause, but he used the gas just to say he tried something.

Subsequent events made it impossible to know exactly what happened. The only definite thing is the end result--I have gone blind in my right eye. It has been the most detrimental health issue I have ever faced, hard as that maybe for those who know me to believe. But in some ways, having Dr. McCuen, arguably the best there is, not be able to fix it has given me an odd since resignation. There was obviously nothing else that could be done. Fate was not quite through kicking me in the ribs yet, but the retina detachment made more sense than what was about to come.

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