How to survive another pterygium surgery (part 2)

The story continues...

I had a follow-up on the 1st post-op day. Yee-haw, the dressing, which was most annoying and itching all the time by then, was going to be removed. I couldn't wait to see what was underneath.

I left at least two hours before from the hotel and went to Starbucks in the Sky Lobby. 

I couldn't wait to get the dressing off.

I had gone for breakfast in the morning. Thank God I had had breakfast there two days before, so I knew where to find the toast, fruit and coffee. I even managed not to break anything or spill the coffee... but I had taken Tramadol just before breakfast. Mistake. I think I could have managed without it. The whole breakfast was an out of body experience. The relief was huge, when I returned to the room and went straight to bed.

Anyway, the follow-up: I was still very much affected by Tramadol. I knew where I was and what was happening (oriented x 3, GCS 15/15). My speech wasn't quite clear.. somehow. The doctor, that very same cute one (yes, I saw that even with one eye), removed the dressing. That tape is the world's stickiest tape, better than any superglue. The best possible quality. At first I couldn't open the eye. Then when I did, I couldn't see much. The right, healthy good eye, was ok, but images near and far were blurry. We tried eye drops. I couldn't see much better. The eye chart still looked blurry. The eye looked bright red. A monster eye. The doctor showed me the image of the eye. Interesting- was that really my eye? It was better than I had expected. Taking the image involved a bright light and it felt as if the flashes of the light went all the way into my brain. The most painful procedure was removal of the dressing. What a relief to be able to wash my face. I left the clinic with several bottles of eye drops and ointment for the night. 

I walked home- well, back to the hotel, wearing sunglasses in the darkness of the evening. I walked slowly and popped into 7-11 on the way home. I had an early night. There was no way I could have gone out partying and shopping. So instead I went to bed, listening to Buddhist chants on YouTube.

Then I just had to decided how to spend the remaining four days in Bangkok. On the 5th post-op day I would have one more eye check-up.

The eye looked and felt better each day. Pterygium excision and graft, which I had in 2010, was probably as easy as this one, but something about the latest operation felt like I was going to recover a lot better and faster. The eye drops and the ointment helped a lot. Sleeping helped too. Getting out of the hotel helped. Listening to the Buddhist chants was one of the highlights of my day. Good food especially at the hotel breakfast was godsend.

I went to the spa, hairdressers and to the Grand Palace.

The final check-up was encouraging. My eyesight was probably very close to where it had been preoperatively. The graft had healed nicely. I was very very pleased about the result and the doctor's skills and commitment. I wanted to give him a hug so badly, but didn't. 😂

He did a great job and I don't think anything could have gone better. The standard of healthcare and professionalism of the healthcare personnel at Bumrungrad are excellent. I would have no hesitation in recommending the hospital- of course do your research and ask for a second opinion. As I said earlier, I don't know exactly how much money I spent, but  it was worth every cent.

There is a nevus at the back of the left eye too. Without that very thorough eye exam I wouldn't know about it. I didn't even know a nevus could be found on the surface of the eye. That's another story then.

Now, almost two weeks later I feel great. I am very very careful with the operated eye. You could almost say I am overly protective of it.

Horseback riding lessons start next week and I'm going to wear an eye patch to protect it. 

I always have sunglasses on now.

I am very very grateful of having had the opportunity to visit Bangkok, have the surgery there and meet this great doctor, whose skills and knowledge are extraordinarily good.. not just the skills, but his kindness, compassion and respect were a real blessing.

How to survive another pterygium surgery (part 1)

After a long break, Blogger is back. I don't know what happened, but I needed a break.

I went to Bangkok for an eye surgery earlier in September. I had never even been in Bangkok, but in this day and age booking hotels, finding places, paying for stuff online becomes so much easier.
Within a day or two I had everything booked: flights, hotel, surgery.

The hospital, Bumrungrad, is a super cool looking structure somewhere in Central Bangkok. I went for an outpatient appointment and had my eyes checked. It must have been one of the most comprehensive eye exams I have ever had in my life: pterygium in the left eye, smaller one in the right, nevus in the back of the left eye. I think I had already decided on having the operation, no matter what, but I thought about shopping and sightseeing in Bangkok. What if...? Maybe I could have the best of both worlds?

Waiting area

I had to have some pre-op work done, all in the same building: chest X-ray, EKG and blood tests. Al of them were more of less normal, even the thyroid function tests, which I thought would not be anywhere close to normal and might cause the operation to be cancelled. EKG showed the same 1st degree heart block, which I have always had and I was not concerned about it. I was asked if I want to see a cardiologist? Noooooooo! At this stage I wasn't really thinking about money and to this day I don't know how much I really spent. But I really didn't feel I needed a cardiology consult- God only know what they'd have discovered.

So the operation was scheduled for the following day.

I went to McDonalds. Really enjoyed my burger and fries. That feeling of having the last meal ever. After that I walked back to the hotel and thought I should get some sleep.  I should. The sleep never really came: I worried about waking up in the morning, but I should know myself better than that. I am practically never late. I wake up well before the alarm clock. I worried about missing my taxi at 5.30am. I was expected to be in hospital by 6am. I counted sheep, cows and horses and the sleep never came. It was probably close to 2am when I finally drifted off. It wasn't a good quality sleep, but all I needed to do was get dressed, brush teeth and apply lipstick. I wasn't looking too good that morning, but lipstick would surely change it all.

The hospital admission procedures are pretty much the same all over the world.

Pay the bills, get taken to Day Surgery, pre-op checks and IV cannula. When did I last eat and drink? Any allergies? Lots of questions, pre-op eye drops, extreme tiredness- but I still couldn't sleep. I was alone in Bangkok and in this strange place, yet I felt I was very well looked after and safe here. 

The ophthalmologist and anesthetist both came to see me. I think at this stage I was fine and after that everything just happened so quickly that I had no time to consider escaping from the OR. I didn't start crying hysterically. I didn't feel like anything was going to go wrong. I remember the lyrics "It's gonna be ok" by Robin Schulz feat. James Blunt and I felt I was going to be ok. Both of the doctors had this professionalism in them...  and kindness, something that I don't "feel" so much in some other individuals. They both did an excellent job looking after me.So did the nurses, who were all some of the most polite and kind people. There was nothing at all that the team could have done better for me. They were excellent.

I could have had the surgery under local anesthesia, but I think I would have freaked out and started crying. I guess it can be done under local, but I'm probably not the right candidate. To be honest, I can't even imagine what it would be like: would I be able to see the scalpel and see all the other instruments and feel something... weird. Would I feel the sutures? Would be able to breathe?

I didn't think this was the right time and place for such experiments... at the same time I think I could have done it. There is still another pterygium in my right eye, so who knows...

So we decided to do the surgery under IV Propofol and gas, laryngeal tube and  painkillers. All I remember then was being wheeled into the OR. On to the OR table. I saw the scrub nurse and some of the instruments. After that I was given something by IV and I started feeling great. Happy. Not worried about the lack of sleep. Desperate to talk, but nothing to say really. I wanted to know what that clear liquid was. Whatever it was, it was awesome. Even better after the Propofol went in. The last thing I remember was an O2 mask. 

Then I woke up in the Recovery. Once, twice. I feel as if many people came to ask me how I am doing. I didn't know how I was doing, to be honest. Something on the left side of my face was bothering me (that dressing) and I could kinda tell that the surgery was done, but I was feeling dizzy and tired and dozed off several times. At some stage the eye surgeon popped in to see me. Someone was holding my hand. Then I felt sick. Like sick, you know. Head of the bed up, someone handed me Kleenex, but I didn't feel sick anymore then. Well, I did, but didn't want to throw up on the good old doctor. Poor guy, he wouldn't have deserved it. Someone gave me Zofran and I can't remember what happened then. I slept wondering where I was and who was the kind person, who held my hand? The surgery had started at 8am and when I finally had a chance to check what time was, it was 1.30pm. Had I really spent almost four hours in the Recovery? 

I remember having some juice and Tylenol. I remember feeling very very sleepy, but I was ok. Then I was being wheeled back to the Day Surgery and went to the toilet and got dressed. 

"So tell me now
When every star falls from the sky
And every last heart in the world breaks
Oh hold me now
When every ship is going down
I don't fear nothing when I hear you say

It's gonna be ok."

- Robin Schulz feat. James Blunt: Ok 

The dressing... OMG I don't look too happy there. This is on the following day and I was drugged up with Tramadol, Panadol and found myself very unhappy with just one eye.

This the the hotel room service table and the broken pepper container. I also kept bumping into walls, doors, tables and chairs. I don't know I managed to to get to breakfast in the morning. I recall going to Starbucks too. How did I do that? Hotel concierge looked suitably impressed by my dressing, which I couldn't cover by sunglasses, hair or pretty much anything. The main thing was that the surgery was done, but was it successful?

Survival Guide- Pterygium

Pterygium is:
a) gravitational force field
b) eye disease
c) floral pattern

Wikipedia tells is as it is:
"Pterygium most often refers to a benign growth of the conjunctiva. A pterygium commonly grows from the nasal side of the sclera. It is associated with, and thought to be caused by ultraviolet-light exposure (e.g. sunlight), low humidity, and dust."

Pterygium is sort of eye disease- I wonder how common it really is, because I had never heard of it until I found one in my eye. It was a filmlike worthless growth, not painful at all, but caused irritation and became bright red telling the truth about my sleepless nights. Tiredness, wind and sun seemed to make it worse. At first I thought it's like cling film, something that could be used in kitchen to cover the leftovers and pop the container in the fridge. So I tried to scratch it off, but of course nothing happened- sloppy performance. It was there to remain and nothing except from a sharp knife or another kind of instrument would remove it.

I had my procedure done as day surgery, hospital in the morning, home in the evening, which suited me very well and I recovered from general anesthesia (bless those mind-altering substances!) by the time day surgery ward closed. I was asleep throughout the whole thing, just did not feel comfortable hearing and "feeling" things happening around me, so sleep sleep sleep was the way to go for me. Local anesthesia works well, that I can say from experience, having had eye pressure checked numerous times prior (and as an afterthought, after surgery too) to surgery. But just the thought of someone poking my eye with sharpest tool in the box.. It was a NO.
After surgery I was little nauseated, no pain at all.

The first week wasn't the most comfortable week in my life, but not the worst either. During the worst moments, Brufen/Panadol took care of the discomfort, I would not even go as far as saying it was pain. Just discomfort. Eye drops and ointment caused more headache so to speak, it was kind of a challenge to get the ointment to go where it was supposed to go: not on the top of the eyelid or on upper part of cheek. Into the eye, somehow.
Eye is still red, but white part of the eye is getting back into its normal "white" condition- no pain at all, eye drops daily x4. Eye opens well, eyesight may have improved, but I am not sure about that just yet. I don't even know if pterygium affected eyesight, how far it had really grown. Well of course the doctor explained all this, but I could only absorb so much information- the part that I considered important at the time.

The thought of having something "alien" in my eye was strange and almost as soon as pterygium appeared and I found out what it was, I knew it had no place in MY eye, and out it comes, sooner or later. Latest vision check-up shows perfect vision in the right, and 25/20 vision on the left, this is pretty good I think.
Good result, as good as it can get. Doc said that he removed it all, it was pterygium, nothing malignant, and that message meant the world to me. It was not a painful separation.
Definitely an eye opener- pun intended.