Well surgery went well on Weds. We made it out there early bc they were going to squeeze us in only to get started later than originally scheduled!! We arrived at 2:30 and Pat came out of surgery around 8!! I made it home a little after midnight and had to be up there at 7:00 to see the doc!! We finally got discharged at 10:30 and after a long slow pukey ride home for Pat made it home.
He's been pretty sore this time around. They flattened out his retina and lasered the bottom to keep it intact. But the lens in the front of his eye was very unstable and they had to remove it. He won't be able to see much without it, so when his eye is closer to being healed, he can get a contact lens. He has the option of another surgery to place a sutured in lens, but I don't think he'll go for that one ;) He's really light sensitive again- even having trouble looking at his phone! And his eye is pretty swollen. He went home with some pain meds but we'll have to keep an eye on his pressure, it was normal in the hospital but he had been receiving IV meds to keep it low.
Home is dark and quiet yet again!! We mostly caught up on sleep yesterday. I took last night off so I could spend a little more time with him before the weekend is underway. We'll head back to the eye doctor Monday morning.
Fortunately, I am off of work next weekend!! I doubt that we will do much but just catching up on cleaning will do for me!!!
My mom is having a lumbar spinal fusion on the 10th!! Back to St. Luke's on the plaza!! I feel like I live there!! She'll be an inpatient for 5-6 days and then go home for 4-6 weeks recovery. Of course I will be there!! I know that she'll do great. It's amazing how well she recuperates after surgery!! We should know, shes had plenty!!
Thanks for all of your kind wishes and prayers!! We have faith that things will get better, we're attempting to stay patient :)
Friday, January 30, 2009
Monday, January 26, 2009
More surgery :(
Poor pat. There's an area in the back of his eye that has fluid underneath the retina. We were hoping that over the weekend, forcing his air bubble to the back of his eye would smooth it out and then today they could laser that area. Unfortunately, it didn't work. Pat has to go under a general again on Wednesday and have all the air and fluid removed, his retina flattened out again and more air placed in. they are going to tighten the buckle (belt around his eye) and hopefully no air can get around his lens implant creating the pressure issues like now!!
It's very disappointing. Another 6-8 weeks recovery all over again!!! Hopefully, this is the last of it!!
Again thank you everyone for your support!! I can't stress how much it means to us!!!
It's very disappointing. Another 6-8 weeks recovery all over again!!! Hopefully, this is the last of it!!
Again thank you everyone for your support!! I can't stress how much it means to us!!!
Saturday, January 24, 2009
Update on Patrick....
Well today's visit wasn't as easygoing as we had originally hoped for!! Basically, its common for some to have scar tissue formation in the eye that causes further problems (aka. proliferative vitreoretinopathy). Pat has that now and over the weekend has to get his air bubble against the back of his eye as much as possible to smooth out the retina and then have it lasered on monday!!! I found a really good link with pictures and everything that I'm posting to better explain it!!! Pictures always help!!! If the laser isn't as affective or this type of thing reoccurs we have discussed using the oil (the article will explain)!!I'll keep everyone posted on how it goes!!!
Proliferative Vitreoretinopathy
Proliferative vitreoretinopathy (PVR) is the most common complication of a retinal detachment (RD), and occurs in approximately 8-10% of patients who develop an RD. Proliferative vitreoretinopathy, despite the long name, is simply scar tissue formation within the eye. This condition has been called by many names, including massive periretinal proliferation (MPP) and massive vitreous retraction (MVR), and was finally dubbed proliferative vitreoretinopathy (PVR) by the Retina Society Terminology Committee. "Proliferative" because cells proliferate and "Vitreoretinopathy" because the problems involve the vitreous and retina. Proliferative vitreoretinopathy can be divided into multiple categories based on the configuration of the retina and the location of the scar tissue, and this categorization is used by eye care specialists to describe to one another the severity and configuration of the retina in PVR.
At the time of a retinal detachment and the formation of a retinal tear, RPE cells that are normally under the retina come through the retinal tear and enter the vitreous cavity. After the retinal detachment is repaired or not repaired (if the patient does not seek help) these cells proliferate on the surface of the retina (and sometimes under the retina) in sheets, which contract and pull the retina back off.
Proliferative Vitreoretinopathy
In PVR scar tissue forms in sheets on the retina which contract. This marked contraction pulls the retina toward the center of the eye and detaches and distorts the retina severely. PVR can occur both posteriorly (as shown) and anteriorly with folding of the retina both anteriorly and circumferentially.
These sheets can occur in the posterior portion of the retina, or in any other location of the retina, including in the far anterior periphery of the retina, and causing redetachment. The surgery to repair an eye detached from PVR includes pars plana vitrectomy, membrane peeling where we use small instruments to peel the membranes from the surface of the retina, and scleral buckling.
PVR with total RD
The PVR scar tissue (yellow) proliferates on the surface of the retina then contracts and detaches the retina (gray). Vitrectomy is used to remove the scar tissue and re-attach the retina with special gases and fluids.
These techniques are combined with fluids placed in the eye to flatten the retina and reattach it to the outer wall of the retina followed by laser photocoagulation to connect the retina to the outer layers permanently. In recent years Perfluoron (PFO), perfluoro-n-octane, has revolutionized our surgery by allowing us to push the retina into its normal position with this heavier-than-water fluid. Perfluoron, when injected, settles to the back of he eye and pushes the subretinal fluid to the front, simplifying removal. RVT members were fortunate to participate in the Perfluoron studies.
Perfluoron and PVR
Perfluoron used to "push" retina back into position while PVR membranes are peeled from retina allowing the retina to be re-attached and vision to be rehabilitated.
A gas bubble may be placed in the eye to hold the retina in place while it is healing, or as an alternative silicone oil may be used to hold the retina in position. The advantage to the gas bubble is that is goes away on its own, and the patient does not require another operation. The advantage to the silicone oil bubble is that the patient does not have to have any head positioning for two to three weeks following surgery like they do with gas and can go back to normal activities in a few days. The disadvantage is that silicone oil requires removal in several months following the procedure. These were compared in theSilicone Oil Study and were found to be equivalent in outcome (long-acting gas vs. silicone oil).
Retinal Reattachment
The retina is now reattached with Perfluoron holding the retina in position while laser is applied to connect the retina permanently. PFO is then removed and replaced with gas or silicone.
Although PVR is a catastrophic complication of retinal detachment surgery and can cause profound visual loss, it has gone from being unsuccessful to be repaired in the late 1970s to having a very high success rate in repairing PVR detachments today. Repair of retinal detachments due to proliferative vitreoretinopathy is one of the specialties of Retina and Vitreous of Texas. We were fortunate to have participated in both the Perfluoron and Richard-James Silicone Oil studies associated with this condition.
The most recent possibility for treating PVR is VitrenAse (Vit 100), a new medication aimed at halting the growth of PVR membranes by actually stopping the formation of the proteins necessary to make new scar tissue. RVT was the study center for this medication in this region of the country. Vit 100 did not prove to be beneficial in short term use, but we are hoping a longer term version will be helpful.
Proliferative Vitreoretinopathy
Proliferative vitreoretinopathy (PVR) is the most common complication of a retinal detachment (RD), and occurs in approximately 8-10% of patients who develop an RD. Proliferative vitreoretinopathy, despite the long name, is simply scar tissue formation within the eye. This condition has been called by many names, including massive periretinal proliferation (MPP) and massive vitreous retraction (MVR), and was finally dubbed proliferative vitreoretinopathy (PVR) by the Retina Society Terminology Committee. "Proliferative" because cells proliferate and "Vitreoretinopathy" because the problems involve the vitreous and retina. Proliferative vitreoretinopathy can be divided into multiple categories based on the configuration of the retina and the location of the scar tissue, and this categorization is used by eye care specialists to describe to one another the severity and configuration of the retina in PVR.
At the time of a retinal detachment and the formation of a retinal tear, RPE cells that are normally under the retina come through the retinal tear and enter the vitreous cavity. After the retinal detachment is repaired or not repaired (if the patient does not seek help) these cells proliferate on the surface of the retina (and sometimes under the retina) in sheets, which contract and pull the retina back off.
Proliferative Vitreoretinopathy
In PVR scar tissue forms in sheets on the retina which contract. This marked contraction pulls the retina toward the center of the eye and detaches and distorts the retina severely. PVR can occur both posteriorly (as shown) and anteriorly with folding of the retina both anteriorly and circumferentially.
These sheets can occur in the posterior portion of the retina, or in any other location of the retina, including in the far anterior periphery of the retina, and causing redetachment. The surgery to repair an eye detached from PVR includes pars plana vitrectomy, membrane peeling where we use small instruments to peel the membranes from the surface of the retina, and scleral buckling.
PVR with total RD
The PVR scar tissue (yellow) proliferates on the surface of the retina then contracts and detaches the retina (gray). Vitrectomy is used to remove the scar tissue and re-attach the retina with special gases and fluids.
These techniques are combined with fluids placed in the eye to flatten the retina and reattach it to the outer wall of the retina followed by laser photocoagulation to connect the retina to the outer layers permanently. In recent years Perfluoron (PFO), perfluoro-n-octane, has revolutionized our surgery by allowing us to push the retina into its normal position with this heavier-than-water fluid. Perfluoron, when injected, settles to the back of he eye and pushes the subretinal fluid to the front, simplifying removal. RVT members were fortunate to participate in the Perfluoron studies.
Perfluoron and PVR
Perfluoron used to "push" retina back into position while PVR membranes are peeled from retina allowing the retina to be re-attached and vision to be rehabilitated.
A gas bubble may be placed in the eye to hold the retina in place while it is healing, or as an alternative silicone oil may be used to hold the retina in position. The advantage to the gas bubble is that is goes away on its own, and the patient does not require another operation. The advantage to the silicone oil bubble is that the patient does not have to have any head positioning for two to three weeks following surgery like they do with gas and can go back to normal activities in a few days. The disadvantage is that silicone oil requires removal in several months following the procedure. These were compared in theSilicone Oil Study and were found to be equivalent in outcome (long-acting gas vs. silicone oil).
Retinal Reattachment
The retina is now reattached with Perfluoron holding the retina in position while laser is applied to connect the retina permanently. PFO is then removed and replaced with gas or silicone.
Although PVR is a catastrophic complication of retinal detachment surgery and can cause profound visual loss, it has gone from being unsuccessful to be repaired in the late 1970s to having a very high success rate in repairing PVR detachments today. Repair of retinal detachments due to proliferative vitreoretinopathy is one of the specialties of Retina and Vitreous of Texas. We were fortunate to have participated in both the Perfluoron and Richard-James Silicone Oil studies associated with this condition.
The most recent possibility for treating PVR is VitrenAse (Vit 100), a new medication aimed at halting the growth of PVR membranes by actually stopping the formation of the proteins necessary to make new scar tissue. RVT was the study center for this medication in this region of the country. Vit 100 did not prove to be beneficial in short term use, but we are hoping a longer term version will be helpful.
Thursday, January 22, 2009
Back to the eye doctor
Well we couldn't seem to keep the pressure down in Pat's eye. We went back to the doctor Weds out at St. Luke's South b/c he felt like his eye was going to explode!! His pressure was up (36, normal is 21 and below) and we restarted the pills to decrease the pressure once again!!
We have another appointment Friday morning in Liberty, they might start him on more drops, we're just not sure how things are going to work out now!!
Other than that things are good and we are attempting to be patient though we are both really getting sick of going to the eye doctor all over the place and waiting around two and a half hours to see him!! But this too will pass!! Hope everyone is doing well!! I am eagerly starting my countdown to some time off the beginning of February!! 11days!!!
We have another appointment Friday morning in Liberty, they might start him on more drops, we're just not sure how things are going to work out now!!
Other than that things are good and we are attempting to be patient though we are both really getting sick of going to the eye doctor all over the place and waiting around two and a half hours to see him!! But this too will pass!! Hope everyone is doing well!! I am eagerly starting my countdown to some time off the beginning of February!! 11days!!!
Tuesday, January 13, 2009
Dancing with the stars!!!
Pat is napping so I am attempting to find quiet things to do!! He's never been much of a napper so I always try to be as quiet as possible!! I don't think he's sleeping very well in the recliner!! Poor guy!!
I realized that I hadn't posted some pics from Dancing with the Stars last week!!! It was an absolute blast!!! My mom, sister and I got together and ate at that tengo said cantina in P&L. My mom had never been to P&L!!!! We made her walk around in the frigid cold before we headed to the sprint center!! It was a blast!! I love girls nights with the fam!!! Best birthday present ever!! It was amazing to see those girls running and sprinting up staircases in those heels!!! I would be getting daily pedicures and foot massages!!!!
Monday, January 12, 2009
Update
It's been a long day!! Went back to the doc today. Appointment for 12:30, didn't leave till 3:00!! I'm so glad that I didn't work Sunday night or I would be a total zombie!!!
Things are looking good with Pat's eye, he still has some gas in between the lens implant and his cornea creating a lot of pain but his pressure has decreased to 18. Much improved!!
We see him again on Thursday and hopefully will be able to lessen the drops from 4 times a day then!! Poor Pat has to stay in the recliner for a while, we've tried getting him to lay face down but its still too much throbbing for him to tolerate. We have to keep his eye relaxed and dilated and this also dilates his blood vessels around his eye making it painful to lay in such a way. He's hanging in there!!
I might get him massage package somewhere because he is so tense in his neck and back from 24/7 in the recliner. If anyone has any suggestions let me know!!! thanks!!
Things are looking good with Pat's eye, he still has some gas in between the lens implant and his cornea creating a lot of pain but his pressure has decreased to 18. Much improved!!
We see him again on Thursday and hopefully will be able to lessen the drops from 4 times a day then!! Poor Pat has to stay in the recliner for a while, we've tried getting him to lay face down but its still too much throbbing for him to tolerate. We have to keep his eye relaxed and dilated and this also dilates his blood vessels around his eye making it painful to lay in such a way. He's hanging in there!!
I might get him massage package somewhere because he is so tense in his neck and back from 24/7 in the recliner. If anyone has any suggestions let me know!!! thanks!!
Friday, January 9, 2009
Taking it one day at a time!!
Well, we made it through the night without having to go to the emergency room. I spoke with the doctor around 11:30 last night and basically made Pat sit in the recliner all night, not reclined and with an ice pack on his eye!! It was uncomfortable but he managed.
This morning I spoke with the nurse practitioner about his pain management. At 10am his pain was still just as excruciating and all that I had was Tylenol!! We got him on some Darvocet but have been easing him into it, just one at a time b/c if he vomits his pressure will go up even more!! He finally got some sleep early this morning and after lunch. I force fed him soup and a sandwich this afternoon, I didn't have to with the big chocolate chip cookie :).
He looks like he's doing better and occasionally smiles. He is on the maximum pressure reducing regimen so there is not much else we can do but wait it out. He really has to take it easy tough. I'm laying down the law that he has to sleep in the recliner all night while I'm at work!!!
Thank you everyone for your prayers and support!! I apologize for the endless amounts of emails!! I don't want to leave anyone out, nor do I want to spend hours on the phone!!! It's been a long week and unfortunately my work week begins tonight!!! I feel a mental health day coming on :)!!
This morning I spoke with the nurse practitioner about his pain management. At 10am his pain was still just as excruciating and all that I had was Tylenol!! We got him on some Darvocet but have been easing him into it, just one at a time b/c if he vomits his pressure will go up even more!! He finally got some sleep early this morning and after lunch. I force fed him soup and a sandwich this afternoon, I didn't have to with the big chocolate chip cookie :).
He looks like he's doing better and occasionally smiles. He is on the maximum pressure reducing regimen so there is not much else we can do but wait it out. He really has to take it easy tough. I'm laying down the law that he has to sleep in the recliner all night while I'm at work!!!
Thank you everyone for your prayers and support!! I apologize for the endless amounts of emails!! I don't want to leave anyone out, nor do I want to spend hours on the phone!!! It's been a long week and unfortunately my work week begins tonight!!! I feel a mental health day coming on :)!!
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