Yesterday, my surgery was scheduled for 1:35 p.m. Diana and I went the requisite 2 hours early, and checked into the day surgery clinic (on the fifth floor at St. Michael’s Hospital). It’s been designed as a welcoming place — some benefactors must have spent some time there! — with a wood panel reception area. We were directed down a very long hall — the place is huge — and were given a cubicle large enough for a reclining chair and two guest chairs. The curtain was drawn in front, and I was given the usual hospital gown (actually designed with a side slit) and a very large white terry bathrobe. I removed my street clothes, and was down to underwear and socks under the bathrobe. The nurses went about to correct the attendant who had brought me down: for cataract surgery, they’re only interested in the head, so I could actually have kept my pants on. I opted to stay in my underwear, because it’s about as comfortable as being in my shorts at home.

A nurse came in to do the usual medical history, and put a catheter in the back of my right hand for the anaesthetic. Diana and I chatted for for about 45 minutes until the intern came. At that point, I handed over my glasses to Diana, so I wasn’t seeing much, either out of the left eye with the cataract, or my normal myopic right eye! I was wearing little booties over my socks, and the staff decided that I might as well walk down to the operating room (rather than take a wheelchair).

As the operating staff introduced themselves — it was impossible for me to make them out without my glasses! — I got up onto the operating table. They put a folded towel under my head, and then — rip, in a sound like a roll of Scotch tape! — they wrapped a strip of tape over my forehead and under the operating table. I remarked that this seemed primitive, but obviously functional. The staff bundled me up in warm towels, including a little tunnel for my left arm. I remember the nurse introducing herself, as she must have connected the catheter in my right hand to the anaesthetic. I remember the intern telling me that he was going to clean my left eye with three swabs of cleanser, counting 1 … seeing yellow … counting 2 …. and then … I don’t remember much.

In the pre-admission visit, the doctor had said that cataract surgery calls for a light anaethetic, because the patient has to be awake to respond to requests to move the eye. I can imagine that I was awake, but I really don’t remember anything. I do remember a few voices as they were working through the surgery … it sounded like they were having a little difficulty getting out my cataract, and I heard when they said that the artificial lens was put in … but everything else is pretty much a blur. I barely remember them taking off all of the blankets, getting down off the operating table, and then getting wheeled down to the recovery area. The surgery probably took about an hour.

The nurses asked me for Diana’s name, and she got paged to join me. (She doesn’t get called as Diana Ing very often). The nurses took my blood pressure, and gave me a turkey sandwich and apple juice. (It was annoying to be fasting since midnight the night before, but I was the last surgery of the day). I wasn’t feeling any real pain, just a slight sensation of a dry eye. I put on my street clothes, got in a wheelchair pushed down to the front door, and Diana and I took a cab home.

At home, I had some soup (I was on a cooking spurt on Saturday, having found tarkeys on sale for half price on Friday!). I watched tv in bed, and put in eye drops every hour. I guess that I fell asleep about 6:30 p.m., for a few hours. When I woke up, I decided to pop out the left lens from my glasses, which seemed to show that I had normal vision in the left eye, but I really couldn’t get my right and left eyes to line up. I had some cereal, watched some more tv, and went to sleep.

This morning, I had a shower, and decided to put in my right contact lens so that I could wear sunglasses to my post-op appointment. (It’s actually a rainy day). I actually haven’t worn contact lenses since last June, because my optometrist then said that glasses would allow more light into my left eye. Now, however, a contact lens works best. There’s no disparity, as with a pair of glasses with only the right lens in. One thing that I do notice is a slight colour difference between my eyes: the right eye has a slight yellow tinge in it, as I guess my natural lens is getting old.

Diana drove me over to the eye clinic. As we were passing over the Richmond Street viaduct, it’s interesting to observe how blind I was in driving with the cataract in one eye. Sure, I could see, but it was pretty much tunnel vision. With two eyes this morning, I could see traffic, the building, the trees. It was an amazing, joyous feeling.

At the eye clinic, the intern saw me first. He looked into the eye, and said that the lens was perfectly centered. I read the eye chart, and he said that I have 20/20 vision. I asked about the lens that they put in yesterday. He said that my eye is about 6, and they put in a lens to correct to 8. Of course, the downside is that I’m now farsighted in the left eye, so I really need reading glasses. The intern said that the human brain will adapt, so I’ll probably start reading more out of my right eye. He also said that my left eye is still dilated, so my vision should improve over the next few days. He was a bit concerned about a bit of pressure in my eye, but Dr. Squires, joining us, mentioned that the pressure was there before the surgery. I asked what I can and can’t do until the final checkup in three weeks, and Dr. Squires said no jumping up and down — so there goes badminton — no heavy lifting or exertion — so there goes bicycling — but otherwise I can live pretty normally (including showering!)

I’ll get fitted for glasses at the appointment in three weeks. In the meantime, my long vision is great, but with drops in my eye from this morning’s exam, it’s hard for me to judge what life will be like over the next three weeks. In a reversal of the condition before the operation, I can see long distances well enough to drive, but have found newspaper type to be illegible. I’ve been playing with the font sizes on Windows XP, so I can be functional on the computer — albeit with less screen real estate!

[Blogging note: I' behind maybe 6 posts on multiple blogs, so I'll be playing catch up over the next few days. WordPress has a feature that enables changing posting dates, so the entries on Fuschl, Finland, Manchester and Hull will still appear in correct date order.]

I’ve been under the care of Dr. Lam since 1996. He’s dean of the Institute for Traditional Chinese Medicine, the oldest teaching school of its domain in Canada. Dr. Lam was a pediatrician in a hospital in Shanghai, and has the advantage of being able to explain symptoms and problems in the contexts both of western and eastern philosophies. Since I’ve had eczema and allergies since childhood, I know that western medicine doesn’t have any answers. For most maladies, I generally prefer to see Dr. Lam and get some herbs. They seem to clear things up in a few days.

It was a nice day, so I decided to bike over to Dr. Lam’s office. It’s in the Dupont / Bathurst area, all the way cross town, so it’s ride over to the university and then beyond, about an hour in traffic. Dr. Lam is used to seeing me show up on a bike, and I could use the exercise, since I didn’t feel up to playing badminton on Sunday.

Dr. Lam asked about my symptoms. He first said that I must have a cold, and that a lot of his patients are coming in with colds because the winds have shifted. As we discussed more, he started the usual exam. The first step was taking my pulse. I don’t know how to read a pulse Chinese style — it’s a three-finger assessment on the right wrist and then the left wrist. Dr. Lam seemed to be taking a longer time on my right wrist. He then checked my left wrist, and said he wanted to check my right wrist, again. He opened up my file (which he usually doesn’t do).

On the last two visits, my resting pulse has been 84 beats per minute. That sounds about right, as the pulse I’ve had my entire life. Today, Dr. Lam said, my pulse was 60. This measurement was taken 5 minutes after bicycling for an hour. My energy is so low that it’s had systemic effect on my pulse!

The one thing that’s really unusual right now is, of course, the cataract in my left eye. Diana has pretty well taken away the keys to the car, and even drives Noah and me to badminton when we go. I’m not much in the mood to go out, and have been spending lots of time on the computer. I’ve taken the opportunity of staying at home to catch up on e-mail, and update my personal web sites, so I’m probably on the computer even more than usual. It’s productive, but since my left eye is a total blur, all of the information is coming through my right eye. I guess my body doesn’t like that. I assume that western medicine would say that there’s no connection between the cataract in my eye and my pulse. Diagnoses like that are why this is the third visit I’ve had with Dr. Lam since the beginning of the year.

If you’ve seen me at breakfast, you know that I usually have little canisters with lot of little pills — the modern way of taking Chinese herbs. I usually take an hour every two weeks to portion out the pills, because it’s annoying to count 8 of this, 5 of these, etc., every time. With this condition, however, I’m sticking close to Dr. Lam’s prescriptions, where I take some pills three times per day, and some pills four times per day.

Here’s what Dr. Lam has prescribed, this time.

wuchaseng eleutherococcus senticosus:

Dr. Lam says that this is a pseudo-ginseng. It’s not Korean Ginseng (that increases energy, but also increases heat massively), nor Chinese Ginseng (that increases energy and increases heat a lot), nor even Canadian ginseng (which would probably work, increasing heat while cooling). Wuchaseng is also known as Siberian ginseng, with an “anti-fatigue effect … stronger than that of ginseng” and published results in Soviet research showing positive results countering “heat, noise, motion, work load increase, exercise, [with] increased mental alertness, work output and the quality of work both under stress-inducing conditions and in athletic performance“.

dangshen and astraglal tablets

Since I had a “moss” on my tongue, Dr. Lam prescribed these for energy and digestion, reducing phlegm. Dangshen “promotes production of body fluid and blood circulation“. Astragali “warms the muscles and strengthens the striae as well as invigorates qi“.

semen ziziphi spinosae

I’ve been sleeping about 3 to 4 hours less each night, so Dr. Lam has prescribed this to dissolve the cycle of insomnia and fatigue. The herb “[nourishes] the heart to tranquilize the mind, promoting generation of body fluid and arresting sweating“.

qin qi huatanwan

Dr. Lam has prescribed this to take away my phlegm. It’s supposed to “clear heat, eliminate phlegm, redirect rebel qi“.

zhang yian ming

Dr. Lam suggested that these would nourish the eye. I think it’s less for the eye with the cataract, and more for the one that’s taking all of the load. (When I’m tired, that one gets blurry, too!)

cataract vision-improving pills

It seems a bit late for this, since I’m ready for surgery, but it “contain[s] mother of pearl, a calcium source, [and] blood building herbs … improve energy and circulation“.

I asked about the other herbs that I usually take, and Dr. Lam said that I should lay off them, until I get over this.

The primary symptom of being cold seems to have abated. I’m waiting for my energy to pick up.

I tried 5 different contact lenses in the first half of 2005, until my optometrist said that the prescription was correct, but I had opacity in my eye. I returned to wearing glasses — something I haven’t done constantly since teenage years. By November, the vision was getting worse. It’s now definitely been diagnosed as a trauma-induced cataract, but I have to first get an official opinion from an opthamologist.

From early December, the first available referral was in April. A second try was in March. I decided to phone the St. Michael’s Hospital Foundation — I have actually donated (small amounts) of money to the eye clinic, because Diana had a nearly-detached retina some years back. They got me onto the cancellation list for the eye clinic, so I have an appointment on February 12 — next Tuesday. This is just the consult, not the surgery.
In a movement in the right direction, the Province of Ontario is now monitoring wait times, and cataract surgeries are one procedure they monitor. Here’s what I think I’ll have to look forward to, after Tuesday.

I usually work at about 150% — that means that I can do my day job, and other volunteer stuff and graduate studies — but now I seem to be operating at about 80%. I may have to look to short-term disability. This is when it’s good to be working for a big company.