Cataract update

At least with private medicine you don't have to wait.
Oh yes? Think again.  Thelma did the phone calls,  first contacting the private hospital outside Carmarthen in mid December. Then the surgeon went on holiday and they couldn't find my notes. Eventually in the first week of January we got some sense out of them. "Ah yes Mr. Turner, Mr. Jones has a spot free in mid February. He's very popular you know."

Clearly not only was the NHS in a bad state in Wales but there had been a knock on effect on the private providers. Feeling a bit like a traitor to my adopted country I started looking for clinics in England and a google search threw up Optical Express in Bristol. As I was looking at their details a pop-up screen appeared: "How can I help you?" Within twenty minutes of typed exchanges I had a rough price and understood their way of working which necessitated a free consultation as the first step.
"OK, I'll go for that, when can you see me?"
I waited about half a minute for the reply
"We have a space tomorrow"
"Thel - can we go to Bristol tomorrow?" "Yes"
"Yes, we'll be there."
They even had a surgery spot available four days later. The consultation was very thorough, and they offered to do both eyes, one a week after the other, for £3000. This was a saving of £1000 on the individual eye cost and cheaper than most I had looked at so I agreed. However, when they found I was taking flomax tablets to mitigate the effects of an enlarged prostate they said I would have stop taking them now and wait for 2 weeks before they could do the first operation.

To help the time pass I worked away at the panelling, fitted desk and fitted bookcase I was making for our small study room. It was hard going trying to read measurements with the tiny strip of relatively clear vision I could get at the very top of my spectacles. I kept away from other people as much as possible to reduce the risk of getting a cold. Two days before the op I had to start with a regime of eye drops to keep the eye as healthy as possible. I had a sore throat which worried me.

At last the day before the op arrived. The sore throat was still there but no signs of a cold so we set off in the afternoon to stay at Hannah's place for two nights. The first operation was at 9.30 in the morning and we got there far too early. It was a cold day and the clinic was barely warm enough as I waited between a series of tests and brief chats with the optometrist, the surgeon, the nurse and the anaesthetist. At least the sore throat seemed to have gone.

Just get me that pre-op tranquilizer please! At last I was on the trolley with a drip in my arm and all became peaceful and still. Anaesthetic drops were put in my eye and a cover was put over me and stuck to the face. I felt hands moving around my face, various dim lights, a buzzing noise and something wet tricking down my face. After about ten minutes the cover was stripped off and a dressing applied. I was taken back to the chair I had been sitting in a few minutes before and offered a cup of tea and a biscuit, both of which were very welcome.

Somewhat unsteadily I walked with Thelma back to the car and when we got to Hannah's took a painkiller and went to bed.

I had my first glimpse of the new world when the dressing was taken off briefly to apply eye drops later that afternoon.  There in front of me was Hannah's little painted dresser looking indescribably beautiful - clear rich colours, pale blue and red, and fine detail; brass handles which shone - an image which I knew would stay with me. Then the dressing went back and I had to struggle through the evening with just the one bad eye.

I went to bed early and managed to sleep until a reasonable hour when I finally got to the pay-off moment - the dressing came off and stayed off.

We are warned that it usually takes a few days for the eye to adjust so I was not expecting the astonishing vista which was laid out before me. It was as if what I was looking at was an old painting which had just been cleaned. All the dirty varnish had been removed and there was the original in all its sparkling colours - colours so rich and vibrant that I could not believe I had seen them like this before. Houses, ordinary streets, small back gardens, rain, dark clouds, black wet streets - they all looked wonderful.

As we were driving home I experimented with closing one eye and then the other. By some extraordinary bit of brain magic the left eye, which was almost completely clouded, could provide a semblance of stereoscopic vision when both eyes were open, and the clouding was just a faint shadow. I kept gazing round in wonder - a seagull flying overhead, distant hills, people's faces inside cars.

The only downside was that everyone, including me, looked older; with every wrinkle and blemish clearly visible.

The Year of the Cataracts

A year of cataracts! I sounds like a sort of apocalyptic weather forecast.

If all goes well it will soon be over, but both metaphorically and actually I will see things with different eyes. I hope I will look back on this period as one of learning. The steady decline in my hearing which had been slowly narrowing my world has, in the last year, been joined by a rapid decline in vision and a much more dramatic reduction in the activities available to me. The first to go was bird-watching.  I would catch a glimpse of an interesting looking shape in the sky but it would disappear as soon as I moved to focus on it. By the time my camera reached its first birthday I could no longer see the screen well enough to use it.

The next to go was driving. I had a last trip in the camper in September but I could not read the road signs so kept to roads I knew well.

The loss I felt most keenly was the printed page. Newspapers were the first casualties, but I managed to plough through a book in October before abandoning print. I could still read screens, so kept my brain active with the internet,  ebooks and online news.

Then in November I began to record my "cataract blog". I will update it and sign off after the operations.

24 November 2013

It is now just over a year since I had my eyes tested and got new distance glasses. The optician did not diagnose cataract. It was not until February and my first trial trip in the camper that I became aware of a mistiness while driving. I began to suspect something else was wrong and did some internet research. Cataract seemed to fit and Mark the doctor confirmed it on the 12th of April this year. "No need to do anything now" he said."For most people it takes a long time to become a problem, but in some it develops quite quickly."

I soldiered on, but I was becoming more and more aware of a problem and came to the concusion that I was one of the unlucky ones. In late May I saw the optician and began the long process of getting treatment on the NHS. The first stage is an appointment to see a specialist, and there is a 4 month waiting list for this.

While I was waiting, I saw the ENT specialist who confirmed that there was nothing more they could do for my deafness, but he did agree to write to the Opthalmology department to confirm that I had severe hearing loss.

By September it was obvious that I could not continue driving, and I was having increasing difficulty reading normal size type. I could no longer watch birds, or take photographs. Life was closing in.

I saw the specialist on the 7th of October. The nurse who tested my sight was surprised how good it was, but the specialist realised that because the cataract on my right eye covered the centre of the eye, in bright light my vision was seriously impaired. She fully understood about how much sight affects the ability of deaf people to communicate and made a case for priority treatment.

I was now at day one on a 6 month waiting list - unless I could get a cancellation or was given priority.

A few weeks later I went to have the eyes measured for their new plastic lenses. I had decided that if I didn't get a better date than April, I would have to go private.  I stressed to the technician that I was really worried that if I could not lipread I would not be able to communicate, and if I could not read then all forms of entertainment and information would be closed to me. She made sure I was on tahe list of people who could be called at short notice if they get any cancellations, and said she would ring admissions and see what was happening.

Good news - I'm scheduled for December!

Bad news - they are running two months late.

That meant worst case was late Feb, I decided I could cope with that and felt a great relief. Why, I asked myself, was I so averse to going private? I had the money - about £2000. Some of it was ideological - the typical leftie dislike of private medicine, but I didn't feel too strongly about that. Then I realised that mjy bad experience with private hearing aid providers was the main reason.

Last week I did my last woodworking job for money - the end of a long run of difficult repair jobs for the Slaters. From now until the op I would only do work for myself so that if I made a mistake the customer wouldn't suffer.

Some days I see really badly and start thinking again about booking a private appointment, but I'm actually coping quite well at present because I am spending a lot of time writing my book and really enjoying it.  I decided that this was partly as a result of other aspects of my life becoming so restricted. When I had better hearing and much better sight there were so many things I could do that I never felt like sitting down for long enough to write seriously.

I'm fairly sure that one of the reasons for my good frame of mind at present is that Mark has prescribed a low-dose anti-depressant as a treatment for my stomach ache - which he calls Irritable Bowel Syndrome, a term which covers all sorts of different intractible problems. I'm not entirely sure it has seen off the IBS, but I do seem to be more optimistic and calm than I used to be. This may be because I am getting more sleep. I now find I can go back to sleep at the time when I would normally have been leaping out of bed - well not leaping exactly, more like levering myself out of bed.

So, I have made this resolution: I am going to wait whatever happens. If I can no longer see my screens to read and write I will spend more time just being - thinking, walking, cycling, doing exercises. I can continue writing by dictation. It will be very good for me to learn how to exist without constant information input.

8 December

I've stopped writing the book. Most of the anomalies and omissions have been dealt with and it's long enough. At first I felt elated - "I've finished a book!" but the next day depression set in. It was all rubbish and would make me look silly. I had a couple of bad days trying to read the computer screen.

Last week Thelma rang the admissions people and they said it had been postponed and would not now happen before March.

I decided to go private.

All this stuff about "just being" is all very well on a good day, but we've both had colds for a fortnight, and I'm feeling a great sense of anti-climax now that so much of my time is no longer spent writing.

29 December

I get waves of panic when there is a step change. Yesterday was bad - total blur-out in the right eye and left not much better. For the first time I struggled to read the white on black type on my phone. Then I remembered I could increase the font size again and it was better. Today I couldn't read my diagrams for the next bit or work on the panelling - something I could do 2 weeks ago.

What happens if I can't read at all before I can get the operation done? Even if I still can, for a few days afterwards I will be unable to read.

New strategy: even with three quarters of my hearing gone,  I can still hear after a fashion. And perhaps if I persevere with my bluetooth headphones I will be able to watch videos and even perhaps listen to music.

Help came from an unlikely quarter - my much derided laptop is now gaining in my estimation. I tried a few film trailers but the sound was too quiet. Then I realised I hadn't turned up the volume on the headphones themselves. Try this music application. It is an internet radio app and is asking me to suggest an artist, and it will find other similar music. I type in "Sting" and here is Joan Armitrading singing loud and clear. I try Massive Attack and get one of theirs I'd not heard. Really good sound!

19 Jan 2013

I'm now counting down the days. Two weeks ago we finally managed to get some sense out of the private hospital near Carmarthen, but the best they could offer was mid February. I decided to give up on Wales and look to the nearest bit of England. Google soon came up with Optical Express in Bristol, and as I was typing in details to get an appointment a "live chat" option popped up. Within about 20 minutes I had got a price guide and an indication of availability, and a few minutes later had booked an appointment for the next day!

Thelma and I did the familiar trip to Bristol. The clinic was in the new Carbot Centre so for the first time we parked in the multi-storey linked to the shopping centre by an overhead walkway.

The appointment took several hours. At the end of it I was offered one eye for just under 2k but both for 3, and the promise that the second could be done a week after the first. They had put some strong drops in my eyes so that they could see through the cataracts better, and when I came out of the dark room into the main reception hall of the building I was amazed by the strong colours and the light. This altered perception took the edge off my disappointment when it transpired I would have to stop taking my prostate drug "Flomaxtra" for 2 weeks before the first op.

I signed up for 5 appointments beginning on the 23rd, and paid a deposit of £500.

Sitting in the car on the way back I was thrilled by the amount I could see. I could even read my phone screen without reversing the colours. What if the drops had made a lasting improvement? I certainly didn't mind a long wait with this level of sight.

The next day the effect was still there, but on the third day the accustomed mix of gloom and glare returned, seeming to be worse than ever. Since then I've struggled on with the panelling job in the study. It's getting very hard to read a tape now and I've had to give up using Sketchup to model the difficult bits - back to trial and error.

The man who did the eye tests said that the modern cataract operation came about because during the war surgeons had operated on the eyes of air crews injured by shards of perspex from shattered aircraft windows. They noticed that the eyes did not react to bits of perspex embedded in them. From that came the plastic lens and more recently the technique of using ultrasound to remove the clouded natural lens.

I've spent a lot of time thinking about what sort of technology would be available in a sustainable society, and it seems to me that this is a perfect example of a technology which does not depend on fossil fuel - it is simple the result of an increase in knowledge. How much of this knowledge would we have now if we had not exploited fossil fuel? If for example human society had developed with a powerful taboo on using something which cannot be replaced, would we have seen the exponential growth in knowledge which we have seen in the last 100 years or so? It seems one of our distant ancestors lived for thousands of years with the same stone-chipping technology. It seems probable that our brains have changed sufficiently in the last 2 thousand years to prevent this happening in the future.