Monday, January 27, 2020

Cataracts


Those who know me pretty well, know that I love rafting. I love the thrill, the terror, and the slow, winding parts. I have several rafting stories, including one where a wave almost carried me away from my raft and down a series of rough rapids by myself. I was sixteen.
Since then, and because I love river rafting, I have thought a lot about the nature of fast running water. The best rivers have many cataracts. According to  my fat dictionary, (Webster's New Twentieth Century Dictionary of the English Language Unabridged, 1956) a cataract is "a great rail of water over a precipice; a cascade upon a great scale."
Rafters face cataracts regularly. These days, most rivers are well mapped, so a rafter knows what's coming, though they may not know how to negotiate it safely. Frequently, I would blissfully enjoy being tossed around in a river, then suddenly a hear a roar in the distance. The river was about to become much more dangerous than I had expected.
Then what do you do?
Call for a helicopter? Go back?
Many rivers – at least those worth rafting – flow through deep canyons where there are no roads, no cell phone reception, and no helicopter landing sites.
The only way through cataracts on a river is through them.
Another definition of cataracts is "in medicine and surgery, an opacity of the lens, or its capsule; a disorder of the eye, by which its pupil, which is usually black and transparent, becomes colored and opaque."
Cataracts – that opacity in our eyes – are a fact of life for the silvering crowd.
This month I had two cataract surgeries: one for the right eye, and a separate one for the left eye.
When I met with the surgeon, I asked what really causes cataracts. He said, "Aging."
"No, but really," I persisted. "Is it caused by high altitude? By less oxygen in the air? By genes?"
"Really," he persisted back, "it's caused by aging."
A quick look at Google shows me the truth. "The median age of a patient undergoing cataract surgery is now 65, … In 2004, the average age was around 73 to 75."
I presume that we are not getting this surgery at a younger age because of our bad behavior as youths, but rather because cataracts are being detected sooner, and people are agreeing to surgery more readily. Right now, the improvements in cataract surgery, like many things in medicine, are increasing phenomenally.
Good vision is vital to independent and healthy lives in our current 2020 times. We drive around complicated and heavy machines at very fast speeds every day. Many of us work at a computer station part of our day, which requires decent vision. Most of us use cell phones now, which use teeny, tiny writing to cram a lot of information onto a teeny, tiny screen.
About half of us in the retirement population will get cataracts, and most will get surgery to correct it. As I mentioned my surgery to friends,  acquaintances, and strangers on the street, I discovered that many had already had the surgery. They told me that colors would suddenly be vibrant again.
What they did not tell me – and I'm sharing today with the rest of you, you lucky saps – is the baby shampoo cleansing of your inner eyelids, the eye drops four times each day, the plastic shield over your eye at bedtime.
This surgery happens to a fragile and vitally necessary part of your body: your eyes!
The preparation and healing processes are intimidating.
Let's start with the baby shampoo.
My directions were to use a clean washcloth, dabbed with baby shampoo, to clean out the upper and lower inside lids of the eye facing surgery. Ouch! Doesn't that make you wince just to think about it? One of my friends, a very wise woman, said, "We spend all our lives trying to keep shampoo out of our eyes, now they want you to do that – on purpose?"
My partner graciously agreed to get the baby shampoo for me during a shopping trip. (He is the shopper in our family, not me. Gender confusion. Another blog post.) He couldn't find it in the shampoo aisle of the grocery store, and finally took the closest shampoo he could find – something for children -- up to the pharmacy. He explained that his wife was having cataract surgery and baby shampoo was, for some reason, required.
The pharmacist tried to explain where to find it, then finally took this silver-haired man across the store to – can you guess? – the baby aisle.
I'm not gonna lie to you. Poking my eye with baby shampoo stung! Sure it's "no tears", but it's not meant for direct application into the eyeball. At least on babies. On us, who are well past being babies, apparently it is.
This is when I started to regret my hasty decision to have this very ordinary surgery. I felt as though I was on a lovely, quiet raft trip – my life – and suddenly I could hear, in the distance, a deep roar. It wasn't the roar of a hundred helicopters coming to remove me from this ordeal, it was the roar of fast water falling over a precipice.
Yikes!
What was I doing?
Then come the eye drops. Suffice to say that the application of 3 eye drops takes me about 20 minutes, four times a day, and each eye has its own 30-day eye-drop chart. It's the type of project that people retire from: close attention to time, close attention to a chart (talk about paperwork!), and close attention to teeny, tiny instructions.
Nothing lasts forever; not cataracts on rivers, and not eye drops after cataract surgery.
Then there were the surgeries.
I'm not gonna lie –again! It was scary for me.
Being in the surgery center was like that first tip into the rough water. You can see what's coming, you may know what to expect, but no matter what, you're committed. Will ye, nill ye, you're going down that river, over that precipice.
As the days clicked by and the date of the second surgery loomed, I tried to think of ways to get off that river. Could I throw a terrible tantrum? Well, sure, but who would be the recipient? My husband? He had faced ignorance and shame in front of the pharmacist to get me that baby shampoo, so he was invested in this project moving forward. Maybe I could claim that I caught the flu. However, a quick glance at my medical chart would show that I had received the flu shot for this year. Maybe I could just stay in bed that day with the covers pulled up over my head. But that darn husband of mine was still present and still invested in my successfully completing this project.
The first surgery was nerve-wracking, the second just plain frightening. I knew what to expect, I knew the boulders lying deep under my raft, and I felt adrift.
Everyone at the surgery center was professional and kind. They even gave me extra anesthesia the second time. Thank goodness!
I'm two weeks past the first surgery, one week past the second. Colors are brighter, but then the whole world is much better looking. I can drive quite easily at night, not fearing that I will miss seeing a pedestrian. I need reading glasses to view teeny, tiny print, but not for watching TV.
I'll probably use reading glasses the rest of my life. Darn it! That's why I got lasik surgery all those years ago, to end my relationship with glasses.
I believe that good vision is a gift, and I'm glad I'm past the worst of the rapids and cataracts of cataract surgery.
Here is the third definition of cataract: "in mechanics, a hydraulic brake which regulates or modifies the action of pumping engines and other machines."
I know all those words, but the meaning … I am cross eyed.
When it's your turn for cataract surgery, I wish you confidence, great vision at the end, and excellent anesthesia.

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