October 18, 2019
Dear Everyone:
I had cataract surgery again last Monday, this time in the right eye.
As with the previous procedure, everything went flawlessly.
This is no accident. The eye
clinic has a very strict regimen that all patients are required to
follow. A week before the
actual procedure, I began to follow very explicit pre-op instructions.
Each morning I would carefully wash my hands.
I then saturated a cloth with hot water and applied the warm,
moist compress to both eyes for five minutes.
The instructions said that, should the compress cool off too
quickly, to run it under hot water again.
I avoided this requirement with a plastic compress that I could
pop into the microwave oven for 30 seconds.
By placing this on top of the wet cloth, it kept the whole thing
warm for the full five minutes.
Next I would spray pure hypochlorous acid on a circular make-up removal
pad and use it to scrub the lashes of one eye.
Then scrub the lashes of the other eye with fresh hypochlorous
acid and a second pad.
I followed this with a tiny (3.5 gram) tube of antimicrobial ointment
called Erythromycin, or possibly Bacitracin.
I would delicately squeeze a small strip of the ointment onto one
finger (never let the tip of the tube touch your finger!) and carefully
massage it into the eyelashes for at least one full minute.
Finally, I used a very expensive prescription eye drop called Ilevro, or
Ketorolac, depending on one’s pharmacy and insurance company
requirements, and placed a drop in the appropriate eye.
Then I followed the same procedure every evening.
In between, there were additional drops of Ketorolac every four
hours or so.
Needless to say, at first a lot of the Ketorolac drops landed in places
other than my eye. It’s not
that easy to aim, particularly without my glasses to see what I’m doing.
However, I got a lot of practice.
Three days prior to surgery, we added another eye drop called Vigamox,
or Moxifloxacin, or Polytrim or Ciprofloxacin (my personal favorite), to
be administered at least three minutes after the Ketorolac.
Finally, on the morning of the cataract surgery, I applied one drop (not
counting the missed ones) of Ciprofloxacin and nothing else.
“Jeannie” drove me to and from the eye clinic on the day of
surgery. After the
procedure, which itself took less than 20 minutes, I was handed a whole
new set of instructions for post-op.
No more warm compresses or ointments.
But lots and lots of eye drops.
First came the Ciprofloxacin.
Wait three minutes.
Then the Ketorolac. Wait
three minutes. And finally a
new one called Prednisolone, or Durezol.
The next day, I reported back to the eye clinic for the first post-op
follow up examination. The
doctor pronounced that everything was exactly as expected.
And he gave me yet another tiny bottle of eye drops, this time
called Systane. To be used
prior to all the others and wait five minutes before using the next set
of drops.
That’s a lot of eye drops to keep track of, not mention the amount of
time between applications.
Add to that, the Ciprofloxacin was only to be used for the first week.
And the Prednisolone was to be used four times per day for the
first week. Then three times
per day for the second week, decreasing the number of times per day down
through the fourth week.
By the fourth post-op week on the left eye, I was beginning the pre-op
process for the right eye.
It was becoming the eye drop version of “Who’s on First, What’s on
Second, I Don’t Know is on Third…”
Naturally, being the organized type of person that I am, I looked for a
way to keep everything straight.
I rummaged around among some of the supplies I used to use at work and
came up with a page of colored peel-off, press-on dots.
I found dots with colors that approximated the colored
highlighters used by the eye clinic staff to differentiate between the
many different names for all the drops.
In no time, I had colored dots on the bottoms of each tiny bottle of
drops in the following order:
Purple in the left eye only (wait 5 minutes), then yellow in both
eyes (wait 3 minutes), then green in both eyes (wait 3 minutes), then
blue in the left eye only (no waiting.)
Of course, I carried it further, creating an Excel spreadsheet with
worksheets for each eye and each pre-op and four post-op weeks.
Using the computer made it easy to color-code each prescription
to correspond with the colored dots.
Later, it occurred to me that I could just as easily have used four
colored highlighters and marked the labels of the tiny bottles of drops;
but I already had the dots on hand.
In any case, the pre-op requirements are completed.
I only have to keep track of four, then three, then two kinds of
drops to be used four times each day until November 10th.
As for the eye patch, did I mention there’s an eye patch?
Unlike the kind associated with piracy characters in literature, this
one is made of clear stiff plastic, with small holes for ventilation.
The eye clinic provided me with tape to apply the patch to my
face every night for two weeks.
Ever try to wear an eye patch while sleeping with a CPAP mask?
There’s a kind of inherent conflict involving two plastic things
wanting to be in the same place at the same time.
I believe Sir Isaac Newton had something to say about that.
However, it turns out that the patch came with half-inch slots at either
end, presumably for accommodating some kind of ties to go around the
head. I took some half-inch
elastic (every respectable sewing case contains multiple sizes of
elastic) and a few safety pins, and cobbled together a way to
incorporate the patch with the CPAP headgear.
It’s a little awkward getting the whole shebang into place each night;
but it works. And as an
added plus, the patch automatically gets sterilized in the ozone cleaner
along with all the other CPAP stuff.
It’s a win-win.
And that part only lasts for two weeks.
I won’t even be wearing it for Halloween.
Love, as always,
Pete
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