Distractions, reflections

David Ing, at large … Sometimes, my mind wanders

Currently Viewing Posts Tagged St.-Michaels-Hospital

20/20 vision in my left eye

A successful cataract surgery returns my long vision, but it will be three weeks until I get my reading glasses!
What a difference a day makes! As scheduled (for some months now), I had my cataract surgery yesterday. This morning, I went for the post-op checkup, and I now can report 20/20 vision in my left eye.

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.]

Pre-op, and connections to nowhere

I appreciate medical treatment in public services today, but am perplexed by the routing in the transit system.
In the small window of time before leaving for Europe, I had the pre-op for my cataract surgery scheduled. Since this was the day before an international conference that I’ve been working on for months, it was a busy day.

I find the hospitals, like most public institutions in Canada, to be interesting reminders of citizenship. Generally, the health care professionals are more than capable. Public services are an equalizer. Priorities (e.g. emergencies) are mostly driven by need, rather than social status (i.e. money doesn’t usually help jump the queue). In the best demonstration of Max Weber’s machine bureaucracy , pretty well everyone gets the same level of care and treatment. It’s likely that in the perverse Canadian way, the more a person raises his or her voice, the more he or she will be flagged as someone annoying. (In either the American or French culture, it’s probably a way of “getting noticed”).

The pre-admission facility at St. Michael’s Hospital, from a business perspective, seems pretty well thought out. On the one hand, it provides efficient pre-op services. The patient stays in a little room. Then, a nurse comes to take a medical history, various technicians come through (e.g. the blood technician takes a sample), and a doctor does a physical exam. From a function of bedside manner, however, the facility also seems to be on the path towards reducing anxiety in the patient. There’s a standard video that is played. (I was entertained by the shots of not doing anything requiring motor control on the day of anaesthesia, which not only included driving cars, but also cutting vegetables in the kitchen!) The doctor answers any final questions that the patient may have. I suppose that this is a last opportunity to back out, if the patient has any second thoughts about elective surgery!

One personal downside of the medical system is, though, that western medicine doesn’t seem to recognize Chinese medicine. When I commented about my resting pulse changing from 84 to 60 in the past month, the doctor seemed to think that was normal. He said that a person’s pulse can change walking across the room. This feels a bit too much like denial of symptoms, and a potential blindness in a western philosophy of medicine.

The pre-op took 90 minutes, meaning that I was finished just in time to dial into a teleconference call. I’ve been taking the subway and bus to get to work, and getting on the subway would mean that I would miss much of the conference call. As a tactical decision, I confirmed with the subway fare collector that the College/Carlton/Gerrard streetcar runs to Main Street station on the Danforth line. From the Main Street station, it would be a few subway stops over to Warden, where I connect to the northbound bus. Thus, I could take the streetcar as a wending alternative to the subway, and continue to receive a mobile phone signal.

Thus, I got onto the Yonge Street subway at Queen, and went two stops north to College Street. I dialed into the conference call, and in 10 minutes, the streetcar pulled up. The right route … but a sign in the front said that the streetcar wasn’t following the prescribed route, and would turn south at Parliament and go across to Kingston Road and Victoria Park. Without more information, I decided that moving east was better than not moving at all, so I got on the streetcar.

It was a good idea to be on the conference call — there’s all sorts of minutiae that turns up the day before a conference starts. About 30 minutes later, I was at Kingston Road and Victoria Park. I got off. The streetcar went around a loop and returned westbound. I was still on the teleconference, but there’s no TTC service that connects at that point!

After walking around in circles for 10 minutes, I decided to take a taxi to a subway station. (The conference call went on for another 15 minutes after I got there!)

As a downtowner, we make jokes about being in Scarberia (i.e. the depths of Scarborough), but I usually don’t take the TTC there. This is probably more than I wanted to know about the transit system in Toronto.

Wait times in Ontario

The median wait time for cataract surgery in Ontario is inconsistent with my work style.
In December 2004, my left eye was struck by a badminton bird. (I was turned to my left to take a backhand shot, and missed. The partner for the game was overly aggressive, and took an underhand clear, so the bird flew straight into my eye). Continue readingWait times in Ontario
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