Nose Knows

I’ve needed a medical procedure for my nose for years now. I’ve been putting it off, but the necessity finally came due and I went thru with it. It didn’t help I had a deviated septum and naturally very narrow passageways combined.

I first noticed the problem after developing an unconscious habit of sniffing to breathe. I guess my body was compensating for the reduced airflow. [1]Shawn was convinced it was more habit than reaction  I also snored more. Throw in the additional effect of allergies, it would get so bad at times I’d lay down for a nap and my nasal passages would completely close up. (My allergies were more constriction than congestion.)

After a while I started using Afrin to help open up my airways at night so I could sleep better. It worked great but wasn’t really a permanent solution. And then…the pandemic hit. Between lockdowns and procrastination, I kept putting off the surgery. That didn’t work out so well. Apparently, Afrin enlarges the prostate. (Who knew?) So, the time came to bite the bullet and “get’ter done.”

Part of the reason I kept putting it off is the docs’ always said it’s an “uncomfortable” procedure, which is code for painful…and it was. However, it wasn’t as bad as I expected. It’s outpatient so I wasn’t expecting a huge ordeal. You pass 50 and suddenly everyone thinks you’re made of glass. During my pre-op with my regular doctor, they were concerned about a small defect in my heart. I’ve had a slightly irregular heartbeat for over a decade and it causes me no problems. However, now that I’m over 50 you’d think my heart was about to give out. And this is a week prior to the surgery. Of course, this also requires a negative covid test, which has to also be scheduled separately and I can’t use a home test.

I managed to get the appointments in time. I show up and they can’t get my heart rate over 140 for a while because…*drumroll*…. I workout 4-5 days a week and my heart is more than used to the stress! After 10 full minutes of speed & incline increases every minute, we finally get to a point where I’m in an all out sprint running uphill. And I’m expected to keep it up for a full two minutes. I won’t lie, the incline made a huge difference, but I made it. The techs were cooing over how awesome my blood pressure was the whole time. Needless to say, I passed the effin’ test. D

Due to timing of the first covid test, now I have to go for a second one prior to the actual surgery. Joygasm!

The surgery was roughly 2 hours and I’m out the whole time, of course. The staff and docs were all great. I have zero complaints about my care. Naturally, the anesthesiologist didn’t give two shits about my very minor heart defect and was bewildered as to why I even needed it. Shawn came to get me and after-care was relatively simple. [2]He was tickled by my apparent incoherence as I slowly shrugged off the haze of anesthesia. The pain was manageable with hydrocodone the first night and day after, and by the third day I was just using Advil. Luckily, they don’t do the bandage-stuffing anymore. (It’s often messy and adds to the discomfort.) Instead, they inject foam which dissolves on its own over time. Shawn totally dodged that bullet! Heehee

They tell you to expect random bleeding and they weren’t joking. The bleeding was minor if not incessant for the first couple days. Afterwards, it was just an annoyance. I had two stents put in and taking them out a week later was an experience on its own. One got stuck and he had to “work” that thing like a male escort at a Republican convention. Ironically, the other one hurt more. It came right out but I thought he was pulling my brain out through my nose for a second. As soon as they were out, no more pain, just a mild throbbing discomfort.

Fast forward a week and a couple days, the nose is still swollen inside and a bit gunky but I am noticing a difference. The doctor was very happy with the results. In my case, it may not be a 100% fix due to the aforementioned narrow passageways; however, any improvement is good at this point. I’m eager to see how it affects my breathing at night without the Afrin. Shawn says I’m already not snoring so it’s looking good so far.

Hope springs eternal…

References

References
1 Shawn was convinced it was more habit than reaction
2 He was tickled by my apparent incoherence as I slowly shrugged off the haze of anesthesia.

Ride

While clearing the backlog of emails from the blog, I got asked if I still ride my motorcycle. The answer is yes. I ride it pretty much every week back and forth to work. I haven’t been doing many long rides due to my continuing diplopia and I "still" haven’t fixed the cracked fin on the left side. [1]It isn’t that expensive but I just have other priorities

You’ll remember I had the two eye surgeries to fix some ongoing issues over a year ago. All the structural issues were fixed and doing well. However, the right eye muscles never adjusted back to normal. The eye had adjusted for so long the muscles are now out of alignment. Luckily, it only affects my vision at up-right and direct-up angles. However, these are the very angles used while riding a sport bike. hehehe I see well enough I can drive day to day commutes and short rides just fine. However, I’m not sure how well I’d do on longer rides. I do exercises to try and bring the eyes in line but if I do to many or I strain against the double vision too much the eyes actually get fatigued and the diplopia increases until I let my eyes rest. I’m planning to go back this year for the extra (and hopefully last) surgery.

This last surgery should be interesting. Basically, they numb you up but you are still awake. They go in, snip the muscle loose from the base, and put a suture on it. They adjust the suture as you describe improvements to your vision. When it reaches normal (or almost normal) vision, they tie it off and let it heal. Bam! The caveat is if the adjustment is too severe I may not go back to a full 100%. That is ok with me. I just need a modular improvement. The latter being why I put it off this long. I was hoping over time my eyes would adjust on their own. Sadly, they haven’t.

So to answer your question (Tony), yes I still ride just not as often. I do kinda miss it. Especially on sunny warm days.

References

References
1 It isn’t that expensive but I just have other priorities

Bionic

[iframely] http://www.iflscience.com/health-and-medicine/can-procedure-give-you-superhuman-vision [/iframely]
I must say I was pretty excited when I read this. It is scifi come to life even if it does sound almost too good to be true. But seeing it move into human trials means it is past the theory phase and moving into implementation. The implications are staggering. [1]It helps if you go read the not-very-long article first. It wouldn’t help every problem but it would cover a large percentage of people who experience declining vision or have certain genetic issues. Image you could get a surgical procedure on your eye and never worry about most vision problems ever again. Your eyes could focus w/almost perfect clarity. It raises a whole host of questions but I still love the idea. It could help a lot of people see better or even see again.

There are a plethora of questions that come up, of course. What is projected life span of the insert(s)? What happens if one fails? Can it be replaced? Cost? Insurance? The list goes on and on. But a bigger question might be, would said person now be considered bionic? This would certainly fit the bill of artificial enhancement.

*

For myself, I doubt I’d qualify any time soon as my actual vision has only deterriated every so slightly as I age. I don’t even qualify for Lasik right now. And the diplopia issue, being muslcle related, would not be repaired by said replacement either. So clearly it wouldn’t fix every problem. But this last year has taught me how fragile our vision can be. Reading up on advancements like this are amazing.

References

References
1 It helps if you go read the not-very-long article first.

Which

I’m settled into a final prescription for my contacts. Ironically, my prescription is now identical in both eyes. Leave it to me to continue being the odd ball. I’ve had to go with disposable dailies vs single monthly lenses. Blame it on the astigmatism correction. Everyone has said that the disposable dailies will be more comfortable for me. Maybe I’m out of touch but it seems so wasteful to me. At lease I never have to worry about putting the lenses in the wrong eye. hehehe 

Now that I have figured out how to put my contacts in properly and to know when they are in backwards, I do struggle less. I’m down to about 5-6 mins total. As mentioned, I prefer the contacts for a variety of reasons but there are moments where just being able to put glasses on and off are quite appealing. I thought I’d ditch the glasses one I got contacts but I think I’ll hold onto them. They’ll come in handy for those times where I just can’t be bothered to hassle w/putting contacts in.

I’m curious to know how often most people where there contacts? Daily, every other day, etc?  I’ve been trying to wear mine every day. I do notice toward the end of the day a lot, my eyes seem to get tired of focusing. Or maybe a better description is I have to focus more on keeping them in line. Does that sound right?

I won’t see the specialist again till June. She’ll decide then on whether I should proceed with the muscle surgery.

Contact

Well, I’m starting to try out contacts for my eyes. While I’m waiting to see the new eye muscle specialist [1]he is apparently very busy I’m back to the original Optometrist for my actual vision issues. I hate wearing my glasses and riding a motorcycle certainly isn’t conducive to said activity. I’m hoping I’ll be a good candidate for contacts. The Optometrist gave me some trial pair after retesting my eyes. There was only a slight change in my prescription since the first exam, prior to the surgeries. Unfortunately though, having a astigmatism is apparently a hard fix using contacts. Apparently, they didn’t even offer you contacts in the past for said issue. Because mine is not severe, I might be ok.

The first trail trial pair was a disaster. I had a headache within hours of wearing them. [2]Work’s "spring cleaning" my have exacerbated it a bit I promptly threw them out. The second pair has turned out to be much better. I’m working on wearing them all day, then every other day, and finally every day. I have enough ‘daily’s’ for two weeks. Overall, the fit well and don’t really bother me much. Getting them in/out of my eyes was the biggest challenge, even though the lab tech said I was a natural. I tend to blink a lot more and seem to "feel" them more as the day wears on. Is that normal?

Leave it to me to have issues that can just be fixed. The contacts work very well for the right eye, which affects most of my vision. The slight blurriness is all gone and the world takes on its normal crispness when I wear them. This will mostly likely help in the efforts to cure my diplopia left over from the eye misalignment. However, the left eye with the astigmatism may be the deal breaker. Reading up close (like on a phone or tablet) is worse than not having the lenses in. And I read a lot. On the flip side, using them at work is fine. I guess the distance between my face and the monitor is enough to even it out. And while the eyes do adjust a bit given a little time, I’m not sure yet how effective this approach is. I’m going to see how things go. The Optometrist mentioned one other trial pair I could test out.

Keep your fingers crossed for me. I really want to be able to wear contacts. I might try to do glasses over contacts (even though the Optometrist wasn’t a fan of that idea) or alternating between glasses and contacts.

Of course, if this is the worst I have to go thru as I age, I can live with it.

References

References
1 he is apparently very busy
2 Work’s "spring cleaning" my have exacerbated it a bit

Better

The wonky eye saga continues.

As previously mentioned the last eye surgery was a success. It fixed the structural problem with my right eye. Sadly, the diplopia has not disappeared. I should clarify it is much improved but I’m still having some issues. The doc who did the surgery doesn’t deal with that so I’ve been referred to yet another doctor. This will be doctor #5 in the series.

I put off contacting him as there is still a chance my eyes my just readjust on their own. It seems the eyes are improving ever so slightly every month. It is possible that they my slowly go back to normal given enough time. That said, I’m just not willing to wait that long. And to be fair, it has gone from a chronic problem to a minor annoyance. It only affects the extreme angles of my vision now.

Anyway, the new doctor deals with eye muscle problems and possible rehabilitation of the muscle. I’m hoping it doesn’t require another surgery and its looking like it won’t. He is booking a month out so won’t even get to see him till late March. Maybe I’ll get lucky and the eyes will be even better by then.

Of course, I still have the underlying vision issues that started this whole caper. My right eye happens to be the weaker of the two in vision as well. It’s minor but the combo of weakness and double vision is what makes it so frustrating at times.

I’ve finally reached a point where I can wear my glassed pretty much all day w/o getting severe headaches. I’m down to a dull ache after a day of wear. I’m forcing myself to get used to them so I can switch over to contacts permanently. Luckily, I’m still eligible for contacts. I go back to see the optometrist in a week. They’ll recheck my eyes and if no major prescription changes, I’ll get my contacts within the month.

I’ve noticed that if I wear my glasses for awhile, the next day my vision seems slightly better. I’m wondering how common such an occurrence is? Is it possible to wear glasses to temporarily retrain you vision and then not need them anymore? I’m sure the Opt doc can tell me.

Still Double

​I had my first follow up with the doc since the surgery. Structurally, everything is pretty awesome. Both the docs seemed overly pleased with how well the implant placement and eye adjustment turned out.

Sadly, I’m still seeing double vision. It is much improved in many ways but still happens enough to be bothersome. It doesn’t help that the right eye is also weaker from a vision stand point. He said it is still too soon to know for sure. It is very possible my eyes may just start adjusting and the double vision could go away completely.

Worse case scenario, he says if it doesn’t improve more I could go back for an additional surgery. This time they would adjust the muscle of the eye where it attaches to the eyeball. If the muscle has atrophied too far away, this might be the final fix.

He told me I could start wearing the contacts/glasses again. The extra sharpness would benefit by brain trying to refocus my eyes in sync with each other. I’ve reached out to my original optometrist and will mostly likely see her this Monday or Tuesday.

It is hard to be upset because my vision has improved a lot. As previously mentioned, I hadn’t realized how much I was compensating until after the surgery. Hopefully, my ‘old eyes’ will kick in and readjust themselves. I really do not want to have surgery again.

Time will tell. And as always, hope springs eternal….

Corrected

Well,  I survived my surgery. Lol  As you

image
My eye

can see,  I’m on the mend.  The doc says the procedure went very well and he was able to accomplish everything.

Apparently, the problem has been brewing for some time.  The lower orbital bone was very thin due to constant pressure over a long period of time.  The final conclusion is my condition is genetic and the previous latent sinus infection may have just helped bring it forward sooner. He said had the bone completely disappeared,  the fix would have been much more involved. I guess in an odd way,  the infection turned out to be a good thing. 

The procedure itself was pretty simple.  The goal was to insert a polyurethane ‘sled’ into the orbital sheath that surrounds my eye. It sits above the orbital bone but below the eye.  He didn’t have to cut my face at all; he went thru the eye lid.  Basically,  he made an incision in the orbital sheath, shoved the sled in,  and then placed it properly.  Apparently,  he had to make some last minute modifications as the eye sinkage was down and backwards or inward.  The inwards part is what is believed to have caused the double vision.  Anyway, he was very pleased with the procedure and said it went as well as it could have been expected. 

My vision was immediately better,  even from my initial recovery from anesthesia.  The range I could turn my head without incurring double vision was greater and my eyes take less time to focus. At the follow up visit the next day he said I should continue to expect small gradual improvements as the swelling goes down and it heals.  I can no longer see a difference in my eyeballs,  they look perfectly even again.  [1]On close inspection,  you could actually see that my right eye was lower and slightly sunken in compared to the left one.   My eye still looks a bit sunken but that would be from all the swelling.  Lol  He seemed a bit proud of himself when measuring them.  I guess it isn’t a perfect science and ‘results may vary’. I still have some double visions but even that is reduced and the angle to incur it is back to levels that would be very livable even if I saw no more improvement. 

He thinks my vision,  in regards to the diploma,  will return to normal once all the swelling goes down.  In the event it doesn’t,  any minor corrections can be accomplished with contacts/glasses.  They would not go back in to ‘adjust’  the sled unless there was ‘slippage’.  Again,  he seemed to indicate the sled was a perfect fit and I shouldn’t expect any problems.  Since,  I already need contacts for my slight near-sightedness in the same eye,  it would just be a matter of adjusting my prescription with a slight prism enhancement.

So far,  my daily vision is better.  I’ve noticed several improvements including  no more feelings that my eyes were routinely fighting with each other for focus.  It sounds odd but I’d begun to notice my right eye was weaker. Anytime,  my head tilt didn’t compensate for proper view,  the right eye would sort of just give up for a bit then finally refocus.  That affect is all but gone now. The double vision at sharp angles and looking up is still present but greatly reduced.  I’m hopeful each day will bring additional improvements.  Either way,  I’m eagerly awaiting being all healed up.

I don’t think I realized how much it bothered me until after I had the surgery.  We pretty much take our vision for granted in our daily comings/goings.  Before the surgery,  it had gone from being a random annoyance to a daily struggle.  It would often take minutes vs seconds for my eyes to gain cohesive focus in the mornings. Anything outside the front facing slightly downward view would become two images.  It was odd noticing how much detail was lost when trying to ascertain between two distinct images. My apprehension level went up every day as my vision decreased. People had started commenting on the angle of my head as I had developed an unconscious habit of tiling my head up to compensate. Ironically,  work life was impacted the least.  I think because I already tend to view my monitors slightly below eye level.  Anyway,  the daily coping would have only lasted so much longer. Now that the surgery is over my eye sight is amazingly better.  Seeing the abrupt difference really brought home how bad it had gotten.  I’m incredibly grateful it went ok. 

Now, I just need to wait it out.  Daily eye drops and lots of ice for the swelling. Time will tell if my vision is 95% or 90% restored.

References

References
1 On close inspection,  you could actually see that my right eye was lower and slightly sunken in compared to the left one.

Eyeball

I’m scheduled to go in for my second (and hopefully) final procedure tomorrow. As mentioned, the first procedure was to clean out the latent infection in my sinus.

I’ve officially been diagnosed with asymptomatic chronic maxillary sinusitis, otherwise known as silent sinus syndrome. It is somewhat uncommon but basically my right sinus is reduced in size. The infection could have been part of that, it could have been genetic, or both. Regardless, the reduced sinus is putting negative pressure on my orbital socket. Basically, it is pulling my eye down.

The procedure tomorrow requires the doc to insert a ‘sled’ into my eye to restore the orbit to its normal position. In most cases, patients with diplopia symptoms, like myself, go back to normal or almost normal vision. I certainly hope I fall into the ‘normal’ category.

It is considered out-patient procedure and I should only need a day or two recovery. Last time I had more recovery from the anesthesia than I did the procedure itself. lol

This will be the 4th official implant. Both collar bones and one leg. If I turn ashen grey and start spouting "we are borg", you know I’ve turned into an evil cyborg bent on world domination. Until then, fingers crossed everything goes well tomorrow!

Loopy

Well, I’m finally feeling almost normal again. It only took four days after the sedation for it to happen. I must say I’m a little bit surprised it took so long. Everyone keeps telling me my body needs more rest but I’ve never taken this long to ‘bounce back‘ before. I have very little physical discomfort but the light-headness and down right crankiness has stayed with me. The Pup says I’ve been a little more silly at home the last few days. [1]I’m never cranky with him. Yes, I realize it could be my age. But I’m also thinking it has a lot to do with my lack of gym attendance. I haven’t really been consistently working out and I definitely feel the difference. The last couple surgeries were much more invasive and I was nowhere near this messed up aftewards.

I ended up calling off work early yesterday as I just couldn’t focus and my crankiness was getting the better of me. [2]Never a good thing. lol I guess I should have taken more time off. Coworkers have noticed and commented on how much more of myself I am today so I guess it has showed.

I had my Post Op appointment with the doc yesterday and he didn’t seem worried. He indicated it wasn’t unusual to feel some after effects. The procedure was a success and there appears to be no need to do any follow up work to clean out the latent infection material. He did spring the news that he wants to refer me to yet another specialist for the final surgery. Just what I need, another round of copays and visits. But to be fair, I guess I’d rather have someone who already does the work I need vs just taking a stab at it. I’m looking at 4-6 weeks, which puts it right smake in the middle of the holidays. Work will be so pleased. (NOT!)

References

References
1 I’m never cranky with him.
2 Never a good thing. lol