An eventful week

It has been an eventful week. Part of the fallout from my chemotherapy is that there is damage to the corneas of my eyes. It's not threatening to blind me, but it has caused problems with my vision. I got new glasses, which helped quite a bit, but the ophthalmologist says the cataracts in my lenses have also increased to the point where she is recommending cataract surgery. 

But first, she needs to deal with that corneal damage. So, Monday I had a superficial keratectomy, aka a "Super K," procedure on my right eye. This amounts to having the surface of the cornea "scraped" (makes my knees weak just thinking about that) to remove the irregularities. Then the surgery site was covered with a contact lens, and now I am on a regimen of four different kinds of eye drops each instilled into my eyes four times a day. Hey, at least I have something to do every day!! At my post op appointment yesterday. Dr. Osterholzer (Dr. O for short) said everything is looking good!!

Now, let's back up here for a moment. When Dr. O proposed the Super K, I was kind of concerned about "scraping" of my eyeball. Jill suggested we could, perhaps, call it "polishing" my cornea. Dr. O laughed and said she liked that term. Even though the Super K adds a step to each cataract operation, she said that the risk/benefit ratio is in favor of a better outcome for the cataract surgery. 

As is my wont, when facing a new medical procedure, I asked her two questions. First, "Do you like your parents?" (Say, what?) She answered in the affirmative, so I asked the second question: "If I were your dad, would you recommend this procedure?" She replied, "Definitely." One of the things I like about being a member of an HMO is that the doctor gets the same paycheck, whether or not she does the surgery, so I never worry that there is a conflict of interest if, say, there is a payment due on the Porsche. 

In spite of the description of the Super K being "scraping the cornea," the procedure was quick and painless. She started by instilling some anesthetic drops into my eye. Next she added Betadine, an iodine based disinfectant, followed by a gob of lidocaine ointment to further numb the whole area. 

I was interested to hear that she was using Betadine, since, back in the days when I was practicing dentistry, some 20 plus years ago, Betadine had been abandoned as a pre-surgical scrub, due to a relatively high percentage of patients having an allergy to iodine. Dr. O explained that it is the only pre-surgical scrub that is compatible with the eye tissues. Fortunately, I don't have any drug allergies. 

After the medications had time to work for a few minutes, she inserted a speculum into my orbit, in order to retract the eyelids. Then the "scraping" (aka polishing!) began. For that part of the procedure Dr. O used a microscope. To me it felt like she was swabbing my eye with a Q-tip. It took about five minutes for her to complete that step. Next she placed a contact lens over the surgical site to act as a bandage, until the surface of the cornea heals. 

I had been concerned that this procedure would make my new glasses useless, but to my great relief, it did not. There is some aberration of my vision in the right eye, but that is mainly because the contact lens has a slight correction in it, which was not taken into account when my glasses were made. That contact lens will stay in my eye for about a week, during which time the amazing miracle body that the Lord has given me will heal the surgical site. 

For you biology nerds in the audience, I will share Dr. O's description of the healing process. My cornea is approximately 11 millimeters (mm) in diameter. The removal of the "wonky" (Dr. O's word!) tissue is limited to an area about 7 mm in diameter, leaving a ring 2 mm wide around the perimeter. Those 2 mm are where the stem cells that create new corneal cells reside. The stem cells are alerted that there has been damage (doctors like to call this sort of thing "an insult") to the corneal surface. They begin reproducing and differentiating into cornea cells. The new tissue grows in from that ring of stem cells until the wound is completely covered with brand new tissue. Amazing. I am truly fearfully and wonderfully made. Thank you, Lord!

The time frame for the wound to be completely covered with new tissue is about a week, so the contact lens may be removed that quickly. Another couple of months will be needed for the corneal tissue to mature to the point where cataract surgery to replace the cloudy lens in my eye can be undertaken. Think of a scrape on your skin that heals over but remains a bit tender for a while before it is back to normal. 

In other news, I had a complete blood count on Monday, too. That was my monthly check ordered by Dr. Waugh, my oncologist. The result is that every parameter is within the normal limits. Dr. Waugh commented in my chart, "Blood count looks great!"

God continues to take care of me! I am so grateful for His generosity and for wonderful medical insurance and skilled practitioners and for the amassed medical knowledge entrusted to mankind by the Lord, including medicines and surgical techniques that allow me to continue enjoying good health and bodily function. 

It is humbling to be the recipient of such wonderful care. And let's not forget my beautiful wife, who cares for me in the aftermath, and has been holding my hand (often literally) through this year of medical challenges. I can't imagine how any man could be more blessed than I am!

"Our Father, Who art in heaven, hallowed be Thy name. Thy kingdom come; Thy will be done on earth as it is in heaven. Give us this day our daily bread, and forgive us our trespasses, as we forgive those who trespass against us. And lead us not into temptation, but deliver us from evil, for Thine is the kingdom and the power and the glory forever. Amen!"