Sunday, September 17, 2017

Going blind for a while

One Sunday mid August I went up to Cardrona for the day to volunteer on the adaptive snow program. Our groups weren't starting until 11 am so we volunteers headed out for a few free ski runs. The weather was cloudy with poor visibility, but it wasn't complete pea soup, so we headed down to the Whitestar Express lift. Only I didn't quite make it.

I had followed one of my buddies on the cat track just above the lift, thinking he might have wanted to jump into the line from the other side. He stopped just above a small stretch of ungroomed snow that forms a triangle between the cat tracks as they turn a right angle down to the lift line.

The positive of what happened next is what I wish to dwell on: First, I happily threw myself off the cat track into this little bit of ungroomed snow, made a few nice turns then straightened out to arrive on the cat track. This shows a complete lack of trepidation and a lot of confidence in my skiing given the conditions weren't perfect. I've come a long way...

The next bit I still have no recollection of: I dropped about 2 feet onto the cat track, dug my skis in to the snow and ejected out of my skis hitting the snow face/head first. I also landed awkwardly on my right arm. I was knocked out, and as the others came up to me, they found me groaning, incoherent and trying to get up. After the ski patrol came, which took a few minutes, I began to talk again and stopped scaring the shit out of my fellow volunteers. The positive I take out of this is that I was still keeping my weight forward despite the poor visibility. Win! Not seeing the drop and not reacting to it was my downfall. Oh well. As I have no recollection of the accident I don't really know how I reacted anyway.

I was transferred up to the medical centre by ski patrol and checked over. By then I was fully oriented, and aside from some bruising and facial abrasions, and a sore arm, I was OK. I noticed a little bit of blurring of my peripheral vision in the left eye, but that resolved. However I also noticed a weird jagged shadow in my left eye, known as a floater. After a few hours David and Kathy came up the mountain and took me home, where I spent the rest of the day resting.

The next day I walked down to the local cafe to have coffee with a friend, and after walking home again I noticed that that floater was still there. With a medical degree and the knowledge that I was a high risk candidate, I rang a local optician to get an urgent appointment to exclude a traumatic retinal detachment.

A retinal detachment is where the retina at the back of your eye separates from the eyeball. If nothing is done about it you go blind. Risks for retinal detachment include eye trauma, but if you are significantly myopic (which is caused by having a long eyeball) then you could have one even without trauma. It's probably the main reason I would never bungy jump, though there are a few other reasons! But I didn't expect my little faceplant to have the same devastating effect!!

The optician confirmed I had a retinal detachment in the non bruised, left eye, and that my macula was thankfully still attached so I was referred straight to Dunedin Hospital for emergency surgery. I got home just as Kathy arrived back from skiing the mountain, I packed some clothes and she drove me the four hours south by road to Dunedin. I am eternally grateful to her for doing that, ending up missing out on a day of her training as a result. Also to my friend Sue who let her stay at her place whilst I was admitted to hospital.

We arrived at the hospital emergency department around 8:30pm, where they were expecting us, and I was taken straight up to the eye clinic, seen by the on call eye registrar, and prepped for theatre. There is only one retinal surgeon in the entire Southern region, and he had agreed to stay back from his holidays to operate on me. Otherwise I would have needed to go to Christchurch!

I had a short admission to the ward before going straight up to theatre and being operated some time before midnight. The eye surgeon didn't like the look of my retinal tears and decided to insert what is known as a scleral buckle. This is a piece of silicon that encircles the outside of the eyeball to pinch it in a bit, taking the tension off the retina so that it can reattach more easily. It appears my retina was just waiting for a wee head blow to detach itself!

For some seriously gruesome youtube videos of the type of surgery I had,  the first one explains the causes of retinal detachment and how scleral buckle surgery is done, the second explaining the vitrectomy surgery as well. You have been warned!!

By the way, my surgery was done under local anaesthetic without any sedation! My surgeon apologised for the lack of jungle juice as the original surgery was only planned to be vitrectomy. Putting in the buckle is somewhat more uncomfortable. Lucky for me my pain threshold is rather high!!

I returned to the ward at 2 am and had a fairly uneventful night. The following morning my eye patch was removed, I was reviewed by the eye registrar and discharged home in the afternoon once the paperwork was done. Kathy, who had driven me down and spent the night at Sue's, picked me up, we got my discharge medications and eye drops, had some noodle soup, then began the long drive back to Wanaka.

As mentioned in the videos above, I have a gas bubble in my eye, which means the affected eye is completely without vision until the gas reabsorbs. It expands at altitude, which means I can't fly anywhere, and I certainly couldn't go up a mountain, not even to watch the Winter Games in action. I also can't drive, so I am left at home to twiddle my thumbs whilst Kathy goes off skiing every day. She does ply me with cans of Sapporo beer though!!

I went for a lovely walk along Lake Hawea one day.

Two weeks later, after a slight mix up involving being given the appointment time 12 hours earlier than actual, I turned up for my review. I am extremely fortunate that my eye surgeon happens to run a six weekly clinic in Wanaka, so for this visit I didn't have to go far. I am less fortunate to discover that the surgery has not been successful and some of my retina is still detached.

Kathy had just returned to Australia that afternoon, and I can't drive. And I have to return to Dunedin for more surgery the next day. But of course so does my surgeon, so the next morning he picks me up and we drive back to the hospital. We have a pleasant conversation about medical training, skiing, living in Wanaka, and how much it rains in Dunedin! He takes me up to the eye clinic where I am processed yet again by the same charming young registrar Dr Hong and prepared again for theatre. This time I am having a retinectomy, and having a much longer lasting gas put in my eye.

I couldn't find a video which explained the procedure I had, but the best way to explain it, is a portion of retina was cut to release the traction on it, so that the gas would help it flatten out and reattach. I stay a night on the ward, alongside a poor lady who has been waiting 4 days for hip surgery post fracture, and across from a dear demented soul who can't remember that she has had ankle surgery so keeps calling the nurses to tell them she has a sore foot. I had a lot more pain post operatively this time, and was thankful for a little codeine to dull it. Not much sleep was had....

The gas in my eye this time takes much longer to reabsorb, so I am blind for even longer and my altitude restriction was reduced to 300m. That caused me a little consternation, as Dunedin is at sea level whilst Wanaka is at 300m ASL. Dr Hong came to the rescue, suggesting I stay in Dunedin for at least 3 days, then take a tablet to reduce my eye pressure before attempting the drive back.

Sue and Graeme again extended their hospitality, with a warm bed and the offer to stay as long as I liked. I took the opportunity to visit the nearby Botanic Gardens, catch up with my friend Heather, and do a little retail therapy.

I found this ingenious little gadget for the off grid camper. A plastic bag will suffice, but this keeps your toilet paper clean, dry, off the ground, and most importantly not rolling away out of reach!!

I stayed in Dunedin until Thursday when all three of us returned, via the lowest altitude route, to Wanaka. Then came a nerve racking week, of using my eye drops religiously and continuing to sleep on my left side, before my next eye review. Meanwhile, the skies opened and it puked down snow. I tried to ignore that....

Unfortunately I had to travel back down to Dunedin for my review. Fortunately Sue and Graeme were able to take me again, and the next morning I fronted for the verdict. This time the news was good, although I need to keep sleeping on my left side for another two weeks to allow the gas bubble to work its magic of keeping the retina attached.

Have you any idea how hard that is? I'm using pillows and various sleeping positions to do as the doctor ordered but it doesn't make for uninterrupted sleep. Since I have no routine or obligations I can keep strange hours so I'm not averse to a mid afternoon nap!

Taking my own excellent professional advice, I fronted up to my specialist with a list of questions. Seriously, I used to always tell my patients to do this as it's easy to forget what you wanted to know when in the presence of someone who you feel incredibly indebted to for their medical expertise. My surgeon is a wonderfully personable chap without an ounce of arrogance, not to mention his kindness in bringing me down to Dunedin for my second surgical procedure, so he happily answered all my queries about what physical activities I could partake in and timeline until I could fly again. Given that the average infirmity of most of the waiting room patients was somewhere between hobble and full wheelchair bound, I suspect he doesn't get those sorts of questions all that often....

Since my macula is intact, it is expected that I will recover full vision. I can fly in 8 weeks, but the side effect of my surgery and the gas in my eye is I'll have a very thick cataract and will have limited vision until the lens is replaced. Which means I'll need more surgery sooner rather than later. Until all of this is sorted I'm in a bit of limbo regarding touring more of New Zealand, which I'd planned to do post ski season.

So I've booked myself a flight home late October, because I have a few things I need to get done back in Australia. I'll be returning back to NZ to await surgery and then once the cataract surgery is done I can start exploring the nooks and crannies of this place, do lots of those walks I've been eyeing for a few years, and check out those ancestors of mine up in Nelson. I'm thinking it might be too soon to get back windsurfing this summer, so I'll take a rain check on that and think about a trip to Japan in February instead. I mean I'll have earned myself some powder points by then!!

Meanwhile, I'm beginning to go on bike rides on Dave's old mountain bike, have started a TEFL course, and have started a new venture involving food. Eating food that is!

Intrigued? That's next....