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[IP] vitrectomy 101 LONG

Janice wrote:
> I am scheduled to have vitrectomy surgery in a couple of weeks 
> I'm anxious to hear from someone who has gone through this.  
> How quickly did you bounce back?

Mine was done in 94, but from what I hear, things haven't changed much - so, 
some background, some personal experience, and some snide remarks about 
certain so-called medical professionals:

When the eye bleeds, whether due to neo-vascularization (New blood vessels), 
or from the vitreous tearing away from the retina wall, the eye's vitreous 
becomes filled with blood - it looks like black spider webs, or drops of ink, 
or black fuzz, or even slightly red film - everyone is different. As long as 
the body can absorb the blood on its own, no problem - when the doctor can 
see thru the blood, he can laser and hopefully keep new blood vessels from 
bleeding.  Or if he sees suspicious places, he can laser them.  LASER does 
NOT mean you won't maybe have to have a vitrectomy AS WELL.  The laser does 
NOT clear out the blood.  That is left to the body, and it's on cleaning 
mechanisms causes the blood to settle to the bottom of your eye (it will look 
like it is on the TOP of your eye, but remember everything is reversed), then 
it will get reabsorbed by the body.  HOWEVER  Once the body loses its ability 
to clean the blood out on its own, for whatever reason... the black clumps 
just don't go away and the vitrectomy is necessary

For the MOST part, though not always, it is an outpatient procedure but they 
MAY keep you over night - it is usually done at a hospital.  Mine was called 
a 23 hour procedure and I was "technically" an outpatient, but I had to eat 
hospital food.  

You go in fasting.  I kept my pump - and had saline IV drip - you do NOT need 
or want a dextrose drip - you will be able to eat after the surgery so there 
is no danger of going into starvation ketosis.  They put me OUT completely 
with anesthesia, YOU FEEL NOTHING!!!  Then they poke holes in your eyeball - 
one for a camera so he can see what the hell he is doing, one for a laser and 
I think there is one for a hose to pump "stuff" in and out.  They remove all 
the vitreous humor (the normally clear jelly stuff - not something 
"humorous"), they laser the S*** out of your eye, and remove any scar tissue 
that may cause pulling, then they fill 'er up with saline or distilled water, 
I am not sure which - basically, your body cannot remake the vitreous.  

They sew up the holes and send you to recovery, where if you have a bad 
reaction to the anesthesia like myself, you vomit for 2 hours, and worry that 
the stupid nurses are gonna try and give you insulin, or that your dry heaves 
are gonna make the new stitches in your eye ball pop open - which they 
didn't, FYI

Eventually you are sent up to a hospital room for the rest of the day.  Your 
eyes are both bandaged so you don't move them at first, but if you are as 
"lucky" as I was, OJ will be driving his white jeep down the highway at the 
very same time, so you will have people in and out of your room turning on 
the TV THAT YOU CAN"T SEE.  Anyway, by the end of the day, just the one is 
bandaged.  The first time you peek at it, you cry and put the bandage back on 
in a big hurry, cuz it is UGLY.  You are not in Much pain at all, as far as I 
remember cuz you are taking some good drugs..I do remember feeling woozy the 
first time I walked to the bathroom, but that is it...

As for pumping and bg control, will you have someone you trust with you?  My 
advice is don't bog them down with details.  For the vitrectomy,  you will 
only be unconscious for a few hours, and only visionless for less than a day 
(KNOCK ON WOOD).  Have who ever is gonna be with you do a few test runs 
poking your finger and doing the tests so you can tell them if they are 
pressing too hard with the pokie.  

Teach whoever how to give a bolus and how to suspend only - don't confuse 
with temp basals and all that.  Then write it out:  "If my bg is under X, 
suspend.  If my bg is between  A and B, bolus C insulin, If my bg is between 
D and E, administer F insulin  " and so forth.  

I was awake and kicking in less than 4 hours.  I had gotten permission for my 
sister to be in recovery.  Though I could not see due to the bandages, I 
could do the poke and squeeze, Erin aimed the strip at my hanging drop and 
told me what the meter said and then I slurred out, between retches, what to 
bolus.  No one touched the pump during the surgery.  I also kept my meter 
with me - they tried to separate me from it, but you know who THAT battle, so 
they put it and my pump in a plastic bag (cuz GOD knows, neither of those 
things are very sterile).
Let whoever is gonna help you practice bolusing a couple times for meals and 
covering for highs between now and the surgery and have them do a blood test 
or two on himself so they know they are not hurting you - that sometimes 
makes people
uneasy, thinking they may be hurting you.

Lastly, make sure the afternoon before the surgery, that you change the site 
and set, so you are confident that you have plenty of insulin and the site is 
a good one.  It would suck to run out of insulin while you are all bandaged 
up and have to let
the "professionals" draw up and give you an injection!!!

The next morning, the doc comes in and takes the bandage off and looks at 
you, says ok - see ya next week - hands you a box of prescription drops and 
sends you to deal with the billing people who could care less that you just 
had major surgery - all they want is your credit card number because your 
health insurance has not preauthorized this surgery even though you 
personally called them over 3 weeks ago to make sure everything was ok....

Your eye needs to have a variety of drops applied for the next couple of 
weeks - they worry about the pressure, swelling etc. But I don't remember 
much pain in the actual eyeball beyond the first couple days.  Your head, 
however, hurts like a SOB for at LEAST a week (and you thought laser was 
bad), and your eyeball looks like something the cat dragged in - public 
appearances are best limited to those who really love you and don't mind that 
you look like a Cyclops.  It looks like I had a bb lodged in the place where 
the sutures were. and the entire white was blood (ha ha) red for about 2 

Eventually it starts to look a little more presentable so you can show your 
face in public without sunglasses.  My vision remained very hazy for a few 
months - kinda like looking through a dirty shower curtain and then they told 
me I had developed a cataract as a result of the surgery.  This is very 
common.  So then they took care of that.

I had this done on a Friday morning, was home by lunch on Saturday and pretty 
much stayed in bed for the next 2 days.  Finally I couldn't stand the smell 
anymore, so I got up and showered...They don't want you to get it wet for a 
few days.  Mom drove me to the doctor on I think Tuesday and after a few more 
days I only had to wear the bandage at night - to make sure I didn't scratch 
of poke myself while I was sleeping.  I didn't try to drive myself for at 
least 2 1/2 weeks, but I think they "say" you can probably go back to work in 
less than a week.  I took 7 weeks off work to make sure I didn't do anything 
I wasn't supposed to do - i.e., bend over and lift things, which in my 
business is standard daily operations.

My vision in that eye is now  - well how to describe it - I can see 
distances, thanks to the new lens implanted after the cataract, but I have NO 
peripheral vision, I have been bonked in the face many times and people sneak 
up on me all the time - it is even worse now that my OTHER eye is full of 
blood.  However, I have had NO new growth in that eye, and no bleeds - KNOCK 

My other eye, which has been the subject of many posts is now doing the 
bleeding thing - I have had at least 12 lasers on that eye - I have lost 
count.  There are no more NEW blood vessels, thanks to my improved control 
for the last 7 years.  Now what is bleeding is the vitreous itself, as it 
pulls away from the retina, kinda like when you scratch a scab.  A vitrectomy 
in this eye is impending...If it hasn't cleared anymore by December or if it 
bleeds again, he says he will rethink his wait and see attitude. - He, being 
the worlds BEST eye doctor, in MY opinion (he also did MTM's and according to 
him - she can now see MUCH BETTER!!)

And that is my $2,500 worth - at least in FL 1994 dollars...here in NYC I am 
sure it will be closer to $5K  (always accepting donations)

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