Menopause

Macular Hole Surgery: The Recovery

 

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This post is long-winded and jumps around a bit, but I wanted to thoroughly chronicle the experience for others who may need to have eye surgery and then spend time face down. You can read the first two posts about my macular hole here and here. 

The hospital sent me home with this green bracelet. The bracelet was to remain on my wrist until all hints of the gas bubble in my eye were gone. If I needed emergency surgery, I couldn’t have nitrous oxide because that doesn’t mix with the gas, and I couldn’t be airlifted as that creates a change in pressure. I had to cancel a trip to a conference in the mountains later in the month after the doctor told me the restriction against changing altitudes. The results of not following these mandates can be extreme pain and blindness. Yikes!

The 45 minute ride home from the hospital seemed like ten minutes thanks to the lingering effects of the anesthesia. I kept asking Cliff, “Does this ride seem short to you?” I had no problem keeping my head down in the car since the time magically  flew. I was worried about neck pain, but I had zero trouble.

As soon as I got into the house, I began the serious business of keeping my face down for seven days. The doctor said the first few days were the most crucial, so I didn’t take many breaks during that time. After that, I did use the five to ten minutes allowed each hour. Luckily you are permitted to walk about as long as you keep your head down, so I made lots of circles around the downstairs of my house.

I soon realized that I liked the face support that hooks to the end of the bed the best. The chair I rented wasn’t especially comfortable to me for sitting long periods, and the face support system that works in the bed made me feel like I was sleeping on a ramp. You can see all of these products on the Comfort Solutions website.  The equipment rents for $150 a week, which I think is a very good price, especially since that includes shipping both ways. In fact, this was by far the cheapest part of my surgery.

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Although you are permitted to read, I found it difficult, so I listened to audio books and had a blast. I also put my phone on the ledge on the side my bed and watched three seasons of The Durwells in Corfu. Since I don’t watch much TV, this was fabulously fun. (The ledge of my bed is a little dull for photography, so I thought you might like to see our new headboard and one of the pillows that matches the duvet.)

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Sleeping was a challenge. I dozed some during the day, so I wasn’t super tired at bedtime. Once we turned the lights out, I put my head in the end of the bed face support. About halfway through the night, I cheated by sleeping on the bed itself with my head to one side.

The oddest thing is when morning comes. You think, oh good. I can get up. But you really can’t. You can get up just long enough to grab a hot beverage, and then it’s back down again.

My daughter Laura sent me sunflowers with a lovely note from granddaughter Emerson:

Friends visited and brought entertaining stories, food, wine, and flowers. If I ever popped my head up, they instructed me to put it back down again. Bossiness in friends can be good! I must admit it did feel strange entertaining guests with almost zero eye contact. Since my eye was red and somewhat closed, I have a feeling they were just as happy not to look at it.

Cliff took excellent care of me, and I greeted cocktail hour with gusto. A word of caution: wine is so delicious through a straw that it’s easy to over-imbibe.

On the day after the surgery, I saw the most incredible black and white geometric patterns in my surgery eye. I wished I could take a screen shot so I could later paint them. They were fleeting but amazing. This is the closest pattern I could find to the real ones:

Another time, I saw a bright red oval with brillaint silver tinsel all around it. Christmas in July!

I returned to the doctor the day after my surgery. They removed the bandage, checked my eye pressure, and examined my eye. The doc reported that things looked good. The eye was cloudy, so he couldn’t tell for certain, but he thought the hole was closing. (It starts to happen that fast.)

That day, I began a regimen of eye drops: a steroid and an antibiotic, four times a day for a week. Then the drops slowed to just the steroid, tapering off over a month. Cliff was my drop guy. After a while, I got more used to the drops, and learned to do better about not blinking, but there’ s just something about eyes that shout: “No! Nothing goes in here.” I bet people who wear contacts would have an easier time than I did. I’ve definitely gotten used to the eye pressure tests during the exams since they do this every time I go in.

After six days, the gas bubble began to shrink. At first I could see a small sliver at the top of my field of vision. Every day it got a bit lower. It seems like you’re mostly underwater with just part of you above.

My next eye appointment was a week after my surgery. This time they took films. I waited nervously for the results. The bubble was still obscuring enough of my vision that I had no clue if the hole was closed.

“It’s closing,” the doctor announced. He pointed to the picture.

“Yes! Please thank Dr. Manning for her fine surgery,” I said. “I’m so grateful.”

“I will,” he promised. “She ties fabulous stitches.”

Then I asked, “I’m blogging about this. May I take a photo?”

“Sure.”

I got out of the examining chair and snapped some photos of the screen. Below, you can my macular hole in  a photo taken before the surgery.

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In the photo below, you can see that the hole is closing at the top. The doc says it starts at the top and gradually closes in to the base. Macular holes tend to not reopen because the vitrious fluid that caused the problem in the first place is removed during the surgery.

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As the gas bubble got smaller, it felt like I was looking at the world through the giant bubble that transports Glinda in the Wizard of Oz:

After twelve days ,when the bubble grew so small I figured it would soon be gone, I spoke to it: “Thank you bubble, for healing me eye.” A few hours later, I realized the bubble officially was gone. It had become a buddy of sorts, so I felt a twinge of sadness.

I still had the stitches for company though: delicate black strings dancing across my vision. They were tons of fun to watch. They’d go away and reappear again like a ballerina coming back in from the wings. Now, eight weeks later, I see a tiny speck of black every now and then.

And eight weeks later, after two more trips to the doctor, I am celebrating my completely closed hole:

I never experienced any pain deep in my eye, but it did hurt some when I opened and closed my eye. I took Ibuprofen until that pain went away in about six days. My first foray into the world didn’t go well. Despite the super dark sunglasses they gave me at the eye doctor, the sun caused me to feel off balance and almost blinded. I stayed out of the sun for the next few days, and then  I was able to venture out with regular sunglasses.

Once the doctor gave us the good news that surgery had done its trick, we packed up my face down equipment, and Cliff took it to our local shipping store. Comfort Solutions really is a wonderful company to work with.

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My vision should continue to improve over the next three months. I can read print again, and work on Friend for the Ride without any visual distress.The weird jumping around that my eye did is gone. I began driving again after twelve days, which pleased me as I feared it might be a month or so.

The procedure causes a cataract, which is now forming according to my last check up.  I will need cataract surgery in the next year. I’m at increased risk for a detached retina, and I will forever fail the Amsler Grid. Parallel lines are still crooked. Some part of my central vision is now gone.

By the end of my face down time, I was going a bit bonky. I posted the old song I Am Slowly Going Crazy on Facebook. But all in all, this was not a bad experience. In some ways, it was like a personal retreat. I enjoyed the time to chill and listen to books and watch TV and chat with Cliff and friends. When you know you aren’t supposed to be productive, the time away from life’s pressures can be quite fulfilling.

And I don’t think wine has ever tasted so good as did through that straw!

Menopause

My Macular Hole: The Surgery


If you missed the first post about my macular hole, you can read it here.

The story continues!

This was the plan: During the surgery, the retinologist would scrape off the remaining vitreous fluid from my retina and inject a gas bubble into my eye. For one week, I would keep my head in a face down position that would force the bubble to press against my retina. This process would close and heal the macular hole. (You can see mine in the photo below.) The gas bubble would gradually dissolve over a few weeks, and over several months, my vision would improve. The surgery has a 95% success rate.

On July 8, two days before the surgery, the positioning equipment arrived: a chair, a device for your head that fits on the end of the bed, and a device that fits into the bed.

Cliff set everything up for me. He found that the written directions weren’t great, and he ended up watching the DVD included in the package, which was easier to follow. Cliff’s an engineer and highly mechanical. Just a heads up that the positioning equipment takes a bit of time to set up. The company, Comfort Solutions, is wonderful to work with though. Many thumbs up to them.

The night before surgery, Cliff took me out for an Italian dinner followed by frozen yogurt. I’d have my head down for the next week, so he wanted my last night to be festive, and it was!

We awoke at five the next morning. I needed to be at the surgery center by six-thirty. I’ve gotten braver since my surgery for endometrial cancer, and so I was fairly calm. Many people I told about the surgery cringed (politely). Some said, “There’s just something about an operation on your eye.” But I knew my poor eye needed expert help.

North Carolina Surgery at Wakefield is a great place. It’s new and  stylish. Best yet, you park right out front, and you’re in the door in two minutes. Amazing!

We registered at the front desk. About fifteen minutes later, I was escorted to the pre-op area. I put on a robe and took off, per instructions, my wedding rings.

One advantage to being the patient is that you get to rest comfortably while you await the surgery. I like to answer questions (easy ones), and so the long list of pre-op questions never bothers me.

The IV insertion went smoothly (or at least I thought it did). My nurse was wonderful, but she wouldn’t let me take her picture for the blog. I always like to ask the nurse a few questions. This time I asked,”Does anyone ever get up and walk out before their operation?”

She replied, “I’ve had people come close, but so far, no one has actually left.”

I didn’t meet my surgeon, Dr. Rebecca Manning, until a half hour before the operation. Imagine looking this pretty at eight in the morning and a few minutes later, tying minuscule stitches inside someone’s eye?

Just before they wheeled me into the operation room, I met my surgery nurses, who were also friendly and upbeat in their scrubs. One said, “You should start to feel a little woozy now, Barbara. We’ve added a relaxing medication to your IV.”

I didn’t. Not a bit. Hmmm.

“Are you almost asleep, Barbara?” a nurse asked once we were in the operating room.

“No,” I answered, firmly.

Like many of us, I’m terrified that surgery might begin while I’m still awake. This actually happened to my daughter Kath during wisdom teeth surgery.

“Let’s try the other arm,” I heard someone say.

I recall them moving very quickly. I hardly had time to anticipate the prick of that needle.

The next thing I knew, I was back in the prep room, propped up so the gas bubble could start to work its magic. A can of coke and a row of crackers sat in front of me. I suspect I requested them when given some snack options. I love Coke and crackers!

Phew. The surgery was over. I felt no pain or nausea, and soon Cliff came to see me.

The bubble had successfully been placed in my eye. I left with a huge plastic guard and gauze patch over my eye and instructions to keep my head face down for fifty minutes out of every hour for the next week, beginning with the car ride home.

Let the healing begin!

(The story will continue in a few days.)

Menopause

Menopause: Choose the Right Perspective (and a Book Giveaway!)

A guest post by health writer and menopause advocate Lori Ann King. Take it away, Lori, and thank you!

I believe perspective plays a huge role in how we enter menopause, regardless of whether it is natural or surgically induced, as well as in how quickly we heal.

Think back to when you first got your period. What was your perspective? Did you view it as an honor as you stepped into womanhood, like my friend Susan? Or were you more like my friend Stephanie, who viewed it as terribly embarrassing—always having accidents and not being able to go in the water at the beach for fear of bleeding through? For me, I understood that getting my period made me a woman and enabled me to have children. With my young naïve mind, I thought that the day I got my period I would become pregnant. Silly? Or the power of a child’s brain who takes things literally?

What is your perspective on menopause? Is it a time of distress and discomfort? A signal of aging? Do you fear the best years are behind you? Are you focused completely on your symptoms? Or do you see this transition as a rite of passage and a time to discover or rediscover your power, purpose, passion, and authenticity?

I love that the Chinese refer to menopause as the second spring. They consider it a time to reflect on life and turn our focus inward to nurture ourselves. That rings true for me, as this season of my life already has had an ongoing theme of self-love, self-care, and self-reflection.

Just like surgery may have benefits of alleviating pain or risk of disease, menopause can be a wonderful transition with positive side effects such as:

  • No more periods, cramping, tampons, or pads.
  • We can finally wear white pants again, any time of the month.
  • We can enjoy sex without risk of pregnancy.
  • We may have greater confidence and self-assuredness.
  • We don’t have to schedule our sex lives, athletics, or vacations around our periods.

After my surgery, it took time for my body to heal physically. It took even longer for my mind and emotional health to stabilize.

There were times when I felt broken. I had to constantly remind myself that I was in a state of healing and change. Even though I felt broken, I told myself that I was whole, strong, and valuable.

Surgery and surgical menopause can be both frustrating and exhausting. The last thing we need to do is to beat ourselves up. And isn’t that one of our greatest strengths as women? We think we should heal faster, we shouldn’t cry for no reason, and we should be able to do it all… even right after a surgery. The only thing we need to do is cut ourselves some slack and remind ourselves that this too shall pass.

That’s a perspective I can embrace.

Book Giveaway:  Win a copy of Lori’s excellent and very readable book, Come Back Strong: Balanced Wellness after Surgical Menopause. For a chance to win, please enter a comment by September 20. Thanks!

Lori Ann King is a writer, speaker, certified sports nutritionist, and wellness coach with over eight years of experience in health and wellness with Isagenix. Lori currently resides in the Hudson Valley of New York with her husband, Jim, a certified personal trainer & sports nutritionist and wellness/business coach.

Menopause

Grandma Update: Brilliance and the Pink Butterfly

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Moments with a child make life simple again, the good sort of simple, at least for a bit. And they remind us that brilliance really is in the eye of the beholder. I often go back to a moment with Emerson in the spring:

I held up my painting of a pink butterfly.

“Can you say it, Emerson? Can you say ‘butterfly?”

She grinned from her high chair.  A grin that took over her face. Then her expression grew serious. She studied the painting as if she were going into deep recall.

I waited.

Then out came a jumble of consonants and maybe a vowel or two.

“You said it, Emmie! You said ‘butterfly.”’

In that moment, I saw brilliance.

The brilliance of butterflies and line and paint and color.

The brilliance of a baby girl.

And the brilliance of language, even if only a grandmother can understand it.

Emerson

Grandma update on Emerson: Emerson learned to say “butterfly” in April. My favorite new expression is “golf ball.” She had a good time last month bouncing one off the beach house deck into the shrubbery below. She’d come find me and announce, “Golf ball!” clear as a bell. I was then in charge of finding the ball, not an easy task.

Menopause

The Ladies Room Door Art Series: Part Forty-five

Joyce found these neat doors at the stadium in North Carolina where the Hickory Crawdads play. The Crawdads are a farm team for the Texas Rangers.

This is Iguana Joe’s Caribbean Bar and Grill in Aruba, photographed by Cathy.

Susan took this door at the brand new nail salon near our gym in Hillsborough, North Carolina.

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I found this door when I went back for a check up at the Gynecological Oncology Clinic at the Women’s Hospital at UNC in Chapel Hill. The receptionist told me that someone added the hearts on Valentine’s Day, and they’ve been there ever since.

This is a unisex door at The Scrap Exchange in Durham, North Carolina.

Becky sent these doors from The Fiesta Mexican Grill and Cantina in Oneonta, New York. Hers:

And his:

This is the sign that leads to the ladies room at Bandido’s  Mexican Cafe and Restaurant in Hillsborough. I’ve been there dozens of times but never noticed the sign.

Candace found this door at Fat Boys Crab Shack in Croton, Maryland.

This is a rustic door at the recently renovated Village Diner in Hillsborough.

Candace ran into this funky door at the Rendezvous Tavern in New Orleans. Hers:

And his:

And finally,  Haralee discovered the doggy restroom at the Las Vegas Airport.

A happy woof woof to all of you who contributed doors to this edition of our Ladies Room Door Art Series. Thank you!

Menopause

Birthdays: Are You Happy on Your Birthday?

Birthdays. Lots of people loves them. A few are indifferent. Some have an actual aversion to birthdays. Here’s a thread on Psych Cafe where people discuss how much they hate their birthday and why.

I am in the camp of liking birthdays. I think it’s important to be grateful for our existence. I think it’s lovely to celebrate ourselves. I like presents and cards and flowers and I LOVE cake. Sure, I get a bit freaked out as my birthday numbers creep up, but all in all, I enjoy birthdays for myself, and I love helping others celebrate theirs.

I had a great-aunt who would look at me on my birthday and say in the most sincere voice, “Happy birthday.” Just two words, but she said them in a way that made me understand as a little girl that your birthday is a day of happy significance.

I’ve been painting birthday cakes, and here’s a poem I wrote about birthdays that was published a few years ago:

Before I make a wish

And blow out the candles,

I’ll take this moment

To admire my cake and

To look at the faces around me.

Thank you family

And thank you for friends.

Thank you for cakes

With plenty of frosting

And for one more candle every year.

What about you? Do you like your birthday?

Menopause

Menopause: Only 19% of Women Know What to Expect

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I’ve written before about the importance of women understanding menopause BEFORE it happens. Had I known more, I would have worried and suffered less.

This info, sent to me by BodyLogicMD, speaks to the perceptions about menopause by both women and men and the actual experiences of women. Here’s the link to the full study. Lots to ponder here. With the permission of BodyLogicMD, I’ve posted it for you:

There comes a time in every girl’s life when she learns about what will happen during puberty. Understanding the dramatic shift to womanhood is an essential part of growing up, and many techniques are used to explain the details of what’s to come as a girl enters her teenage years.

Why then, if educating girls about the first stage of hormonal change is so significant, do we try to keep the inevitable second stage of adulthood so hush-hush? Menopause is a tricky subject for both women and men to understand. Why are so many women and their partners in the dark about the facts on menopause? What are some of the preliminary symptoms? What effect does knowledge have on our overall experience with menopause?

To answer these questions, we conducted a survey consisting of women who’ve experienced menopause, men whose partners have experienced menopause, and women who’ve not experienced menopause. We asked them a range of questions about menopause.

Read on to learn about this extraordinary process of the human body.

What Is Menopause and Why Don’t People Know More About It?

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Menopause occurs around age 51, on average, when a woman’s natural production of the hormones estrogen, progesterone, and testosterone decreases. This is characterized by the end of menstrual cycles, the beginning of hot flashes, and a slew of other symptoms. Knowing what’s to come can better prepare women for the next few years of their lives.

Gaining as much knowledge about menopause as possible will help you later in life. Women who’ve not yet experienced menopause were more likely to believe this stage of life was way worse than it actually became. In this case, knowledge is power. Having at least a general idea of what a woman can expect is extremely helpful when understanding these changes firsthand.

For women who’ve experienced menopause in some way, the overall effect menopause had on their lives was less than those who didn’t have a clue about what to expect. We found a correlation menopausal and postmenopausal women’s awareness of what to expect from menopause and the effect it had on their lives.

Positive and Negative Feelings Toward Menopause

Women had a range of emotional responses to menopause, dealing with both maturity and frustration toward what happened to them.

People who didn’t know what to expect scored higher in every negative parameter we included in this survey. Feelings of anger, disgust, shame, and sadness were felt more by those who went into the experience blind than those who knew how to treat and react to the symptoms. However, one parameter was felt by respondents relatively equally: fear. Many women experience anxiety attacks during menopause, due to changing levels of estrogen and progesterone. Being afraid of or anxious about what’s to come is a natural and normal part of menopause, and overcoming those fears is a part of acceptance.

Women who were prepared to acclimate to their new lives with menopause were more likely to experience positive emotional responses. Feelings of femininity and maturity were common among women who were educated about the symptoms versus women who weren’t. This showed a healthy and happy shift of their mental state going into menopause. Acceptance of menopause also offered feelings of healthiness and even relief.

Nearly 53 percent of women who were not informed about menopause were angry, while less than 18 percent of women who knew what to expect felt anger toward these changes. Feelings of anger can induce high levels of anxiety,putting a negative impact on our physical bodies and mental health. This means that, for our mental health’s sake, we ought to value the open discussion of menopause more.

Women who had yet to reach their 40s didn’t begin to think about menopause until many symptoms had already started. Younger women were less likely to think about menopause, as it hadn’t affected them yet. However, eventually, the time will come when thinking about it is almost too little too late to be prepared for symptoms that can come unseen.

The Most Visible Symptom: Hot Flashes

One of the symptoms that aren’t unseen, however, is the hot flash. In fact, it is the most apparent sign that a woman is reaching menopause. Hot flashes are unpredictable and can heavily impact the day-to-day life of a woman undergoing menopause-related changes.

A hot flash begins with an intense feeling rushing to the upper half of the body with sudden overheating, specifically to the face and chest. Lower levels of estrogen in the hypothalamus – the part of the brain that manages sleep, appetite, sex drive, and body temperature – can cause this reaction.

Hot flashes can seem intimidating. However, this interference might not be as dramatic from the other side.

While it seems overwhelming to think about, women who had dealt with hot flashes said they weren’t as life-altering as they thought they’d be. While most women admitted some effect on their day-to-day lives from hot flashes, they reported a low interference in their lives from these episodes. Women who had experienced a hot flash also admitted they weren’t as debilitating as women who hadn’t experienced them predicted these episodes to be.

The most affected part of a menopausal woman’s life is sleep disruption. Across the board in all categories, hot flashes had the highest interference in a woman’s sleep cycle. These issues regarding sleeping specifically during menopause can lead to other issues, such as obesity, heart disease, cancer, depression, diabetes, and more.

Someone experiencing a hot flash or night sweat for the first time can be terrified. There are many types of hot flashes, but they all have the same general steps: The body becomes weak and overheated, with feelings of dizziness, sweating, nausea, and headaches soon to follow. As we’ve seen regarding sleep, many women can experience hot flashes in the middle of the night.

Mood can also be heavily affected by hot flashes. Among women who have experienced menopause, about 23 percent have dealt with changes in their mood or dramatic shifts in their emotions.

The Symptoms of Menopause, Ranked by Intensity

The anticipation of symptoms is extremely important. Knowing what’s to come will better equip women and their partners for the future. However, it’s important not to allow that knowledge to consume you destructively. Often, what you expect is not nearly as bad as the results turn out to be.

Perception is not always reality. In most cases, women expected menopause to have a larger negative effect on their lives.

One thing the genders disagreed on was how they perceived the emotional response of menopause to affect women. Men rated mood changes and depression as extremely intense and noticeable, while women rated depression 26 percent less intense than they predicted it would be before menopause.

Loss of sex drive and low libido are common reactions to menopause. A decrease in normal levels of testosterone in women may cause a negative change in a woman’s reaction to sexual activity. Dramatic decreases in sex drive can make a woman feel less feminine. Despite all this, the men polled did not see it that way at all.

Infertility Results in Mixed Reactions

One topic regarding menopause that respondents had mixed feelings was about infertility. While there are still risks related to becoming pregnant over age 35, it’s possible to carry a healthy fetus to term. For most women, however, the possibility of having a baby disappears during menopause. Accepting this becomes a fact of life for many.

Almost half of all women who had familiarity with menopause accepted the reality that the time to be a mother was over. Other responses were varied, with a high number of respondents feeling relief and sadness.

Fear is a completely natural part of this experience. Human beings are designed to fear what they cannot control. A staggering two-thirds of women are afraid when even the thought of menopause crosses their minds, showing how few women are prepared for what’s to come. Lately, many have been speaking out publicly about their experiences to encourage more women to fear it less and embrace the changes.

So, What Do We Actually Know About Menopause?

Our survey asked both genders a variety of questions about menopause, and the results spoke to how uninformed we truly are.

On average, neither men nor women were able to pass a quiz related to basic menopause facts, with men scoring around 52 percent and women scoring around 58 percent.

When asked how long perimenopausal symptoms last on average, only 10.5 percent of women and about 20 percent of men answered correctly. The reason behind this could be due to the broad nature of the question. Symptoms can last for shorter or longer than the average of four years, depending on when women start menopause and their body’s response to the symptoms. Interestingly enough, this was the one question men were able to answer correctly more often than women.

As you may have predicted, women answered more questions correctly than men; however, two questions still evaded female respondents: the length of perimenopause (correct answer: four years on average) and a true-or-false question related to estrogen levels and cardiovascular disease (the majority of women incorrectly said higher estrogen levels meant a higher risk for cardiovascular disease).

Menopause and Me

The time to start thinking about menopause is as early as possible. Beginning to research the changes your body will have during menopause is as important as educating young girls about how their bodies change during puberty. Unfortunately, women only really start thinking about menopause until right before the onset of symptoms.

The symptoms of menopause cover a wide range, with changes affecting both the mind and body. Being prepared for this life-altering shift is crucial to accepting your new reality. Treatment is the first option for many. Relief of these symptoms can be found through natural menopause hormone therapy services at BodyLogicMD.

Methodology

We surveyed 149 women experiencing menopause, 151 men whose partners have experienced menopause, and 702 premenopausal women using Amazon’s Mechanical Turk. Statistical testing was performed on the symptoms of menopause ranked by intensity, and significance was found in each case between predictions from premenopausal women and women experiencing menopause. We found a correlation between menopausal and postmenopausal women’s awareness of what to expect from menopause, and the effect menopause has had on their lives, with a P-value of 0.04. To determine the effect of hot flashes on a woman’s daily life, we used the Hot Flash Related Daily Interference Scale from the Journal of Pain and Symptom Management.

Sources