I just got back home ..... feeling tired but restless, with one eye bandaged ie the left eye.
Finally the day came yesterday Monday 5th June 06 for my long awaited lower eyelid reconstruction, ptosis repair and coleman fat transfer to my upper and lower eyes plus also some form of lower eyelid pull up ie like canthopexy.
I'd been busy with my reiki charity day on the Friday before and worked the whole weekend which meant my mind was far from thinking about the surgery which was good.
On arrival at the hospital I wasn't too happy with the finance administrator who called me into his office to fill out some registration forms as I'd forgotten to send them through. He told me that BUPA's approval for payment hadn't gone through and was pending and that I should call them when I got to my room as they may not pay for my treatment. I asked him which surgery he was talking about and he said all of them and wouldn't be specific as to whether it was December's surgery or yesterday's surgery. I looked on his screen and where it said insurance, it had an approved mark so heavens' only knows what he's talking about though it did really upset me as I felt offended by his approach. If I hadn't known any better from my discussions with BUPA, I could have been severely depressed and upset about the whole thing just before my surgery. He should have known better. What did he expect me to do - walk away? DOH! If BUPA had any probs with paying for the surgery they would have contacted me long before.
Anyway, I had a couple of hours wait before my surgery. Jane came in to see me with a surgeon from Australia who was working with her for a year and we went through the procedures I was having done and I signed the customary agreement forms. It was interesting I hadn't seen the "death and blindness" part before or perhaps it just stood out this time. I found it intriguigng that people sign away their consent that if they enter into surgery that they could die. Would this stand up in court if I died from consultant's neglect during surgery ie that I'd signed away my consent? Baffles the mind as to what it means then when I sign away my consent that I could die during surgery. What am I signing? :)
Around 11am I walk into surgery and lie on the table which per usual is cold (I wonder why this is) - perhaps it's cos I'm half dressed! It's a new anaesthesist - than the one I had before whom I liked a lot and who was very kind and concerned about me after my surgery and who came to see me a few times after to make sure I was ok.
I had local anaesthethic this time and I wasn't sure what to expect. The customary needle was put into my left hand and anaesthethic cocktail (gin and tonic as they call it) was injected into me which left a cold feeling entering into my body. I was then left alone for a while by both the anaesthesist and the nurse accompanying him while they went to prepare other stuff. I found this interesting as I was all alone for quite some time with a needle and cocktails floating into me. Hmmmm.... Then he returned and I was wheeled into the operating theatre. A whole bunch of other things happened which are vague to me now ... though I do remember laughing gas being put onto my nose which made it itch but it didn't feel like it had much effect. When the original local anaesthesia went into me, I started feeling drowsy but I soon got used to it.
A few people in the operating room and in my room came up to me and said they recognised me from 6 months ago ... good memory of them :) Right now i can't remember what Jane did to get started .. oh yes I think she put stuff into my eyes and then she started injecting my eyelids with anaesthesia and darn that hurt sooooo much. Jane said that there was a lot of trauma (if that was the right word she used) in my eyelids from my original eye surgery ie it felt like injecting into barbed wire. It stung a lot and I had tears in my eyes. The anaesthesist kept asking me to take deep breaths of the laughing gas but it didn't seem to do anything for me. Then I felt Jane pull on my lower eyelid ie where it had retracted and it felt like she was cutting into my skin .... I think I said something alnog the lines of that really hurts and I may have asked her to stop (I can't remember) as the next thing I think they did was give me more sedation and knocked me out (thankfully as I don't think I could have taken any more pain).
Oh yeah, before they started on my eyes they took fat from my left leg which I did feel but I don't think it hurt but I didn't like it.
I woke up after surgery or just before they woke me up and I felt claustrophobic and couldn't understand what was happening. They told me that they'd bandaged both my eyes and it would stay that way till Tuesday. Oh dear. There was nothing I could do. I remember asking if I'd missed anything as I couldn't remember much about the ending. A man's voice said that they'd increased my sedation and I went to sleep. I heard the same man say everything went really went during the surgery and that he'd see me on Friday. I assume I must have still been in the operating theatre and that it was the Australian man who was working with Jane. I could have been in recovery - I'm not sure as I couldn't see a thing. It was the weirdest feeling to not be able to open my eyes. It's like they were glued shut. (It turnes out later they were under traction ie they'd sewn them shut - eek). I have pictures of the threads hanging down which i'll post some stage later.
I was then wheeled back to my room and I immediately wanted to use the bathroom. The nurse said she'd give me a bedpan to which I said NO - ergh don't like them as they're so undignified and insisted I walked. She said I'd just gotten out of surgery and I said I'd be fine and wanted to try. Thankfully I was and managed to walk the few feet to the bathroom (whew!). I came out of theatre around 2pmish and it all started about 11.30pm - so I must have been in there around 2 hours. I'm so glad I was asleep as I couldn't have taken any more pain.
I was given some water and ice cream which was welcome as it was a hot day and though I was restless I eventually tried to get some sleep. The whole experience was just weird not being able to see anything and totally relying on the nurses for everything. I felt disabled. They were very kind and patient even when I went to the bathroom like a dozen times ie every hour or half an hour (I drink a lot of water).
The evening was spent listening to my Ipod, falling asleep every now and then and having dinner while I couldn't see anything - one of the nurses had to tell me where my food was and we specially ordered food I didn't need to see ie sandwiches ... it was interesting eating a cheesecake and not being able to see it! :)
The night wasa restless though I dozed in and out of sleep and went to the bathroom a lot plus I got cold around 3.30am and the nurse had to bring my duvet and jacket etc and a whoel bunch of other things ie my mobile alarm went off at 3.48am and she needed to retrieve that for me as it wouldn't stop until we'd switched it off (even though it was off the alarm still comes on). All in all an interesting nite :).
In the morning after breakfast (which I again ate without being able to see), one of the nurses came into take off my bandages. When they were off, which was scary as it felt so bright, she said my eyes were in traction ie they'd been sewn together and she needed Jane to take them off as she didn't have enough experience. Jane did come shortly after and after taking a look she said that the left eye needed to go back up at least until Friday when I saw Jane next). The right eye could be released. She told the nurse to do it tightly as it'd be useless otherwise.
The nurse then pulled out the threads on my right eye and oh boy that stung real bad (ouch). The left eye feels like it's stil open and I rang Jane when I got home but she said it couldn't be as it'd hurt if it was .. so ok, I'll take her word for it.
I took the opportunity to ask Jane a few questions while she was there. Apparently she doesn't see patients after surgery as she's such a busy woman. It does feel quite unsettling when that happens as each time at blackheath hospital where I've had surgeries, I always get a visit by the surgeon after to tell me how it's gone. I guess Jane is just too busy.
She said that she'd put fat in my uppers (left eye about 65% and right eye about25-30% I think) to even them out and she said she didn't put any fat on my lower eyelids as she didn't think it necessary. She'd tried to move any fat she found there around to disperse it and said that was enough. It's too early for me to judge for myself as I'm all bruised though I hope it's all fine as I'd hate to have to have another surgery to do fat transfer to my lowers.
We didn't talk about the ptosis repair or eyelash repair and didn't mention the lower left eyelid retraction ... she said that everything went well which was good enough for me - I trust her judgement. I did ask about the pain of the injections and she said my eyes had a lot of trauma or internal scarring from my original surgery as the area wasn't soft tissue as she expected. Darn original butcher surgeon.
While the nurse went to get some bandages I took the opp to take some photos of my eyes without the bandage and well there's nothing really to see as they just look bruised like after all blephs and it's too early to tell. I'll post pixs later if I get round to it.
One good thing is that I didn't suffer from any nausea from the local anaesthesia thankfully. Just that horrendous pain of the original injections into my upper and lower eyelids and what felt like the cutting of my lower left eyelid. I was traumatised about that for hours after and the pain was all I could think about.
I was upset that I had to take steroids again ie predisterone (spelling?) and antibiotics as that's what caused my thrush for 5 months and I just managed to get rid of it and now it will probably return again. Jane said it was only for 3 days this time and was to reduce any potential swelling. The nurse said it was most likely the antibiotics that caused the thrush. I gave reiki to both the steroids and antibiotics before I took them to take away any bad side effects (it's supposed to work).
The nurse suggested I stay till after lunch before I went home, which I did, and it was good as mom wasn't home when I got back and I'd nothing in the house to cook.
I asked Jane and the nurse if I could exercise and or at least use my exercise bike and they both said no ... (sniffles). I don't wanna get flabby and out shape again ..... (sniffles). A few days won't do any harm but look what happened last time ie Dec 04- I got so depressed I didn't work out for a year and a half and lost the routine. I'll make sure it doesn't happen again.
When I had to fill in the questionnaire at the beginning of the day yesterday as to how many surgeries I'd had, they all said how come so many? Even the nurse yesterday and today who was with me during my Y-V browlift couldn't understand why I was having so many surgeries and I had to explain that I originally wanted to get rid of eye bags and it's turned into a huge reconstruction cos it went badly wrong. She asked quite a few times as she didn't understand it when I explained it to her the first time. I guess if you look at my before picture, I look fine (kinda unless you know what you're looking at). (sighs). I felt bad but hey I don't want all these surgeries and when we said our final goodbyes earlier today we both said we hoped we wouldn't see each other again (in the best sense cos I don't want any more surgeries).
So I think that's it for now ... got a taxi home and the weather was beautifully sunny, I slept in the cab and got charged £10 more than I did in Dec - probably cos we hit a traffic jam.
I just have to figure what I'm going to do for the next 3 days until Friday when I have to go see Jane again and how I'm going to get there with one eye bandaged! During peak hour too!
Indi
p/s
Side effects of Prednisolone (steroids). Explains why I got depressed and why my menstrual cycles went from 4 weeks to 7 weeks apart for 5 months. BTW I didn't get a steroid card this time. I wonder if it's cos it's only for 3 days.
What side effects can be expected?
It is very important that you always carry a Steroid Card with you in the event that you take ill and are seen by another Doctor. Cards are available from Chemists and should be supplied with your prescription. They tell other Doctors all they need to known about your treatment that might have a bearing on other treatments you require, especially in an emergency. It is often necessary, for example, to supplement the steroid that you take with extra doses by injection if you suffer an acute illness or if you require any form of surgery.
The following is a list of possible side effects some or all of which can occur to a greater or lesser extent. Most are controlled by careful adjustment of dosage and are generally preventable by monitoring from time to time.
Indigestion or abdominal discomfort is a relatively common side effect and the reason why each dose of Prednisolone should be taken with food. Peptic ulcers are more likely to develop in people who require long term treatment with medicines of this kind so that your Doctor should be informed if severe symptoms occur. Further investigation may be necessary in such cases.
Long term treatment with steroids may lead to "thinning" of the bones and development of a condition known as osteoporosis which is associated with an increased risk of bone fractures. This is less likely to occur when normal (physiological) doses or even lower doses are used.
Steroids produce other metabolic side effects (i.e. interfere with the chemical balance of the body). They alter salt and water and potassium and calcium balance and increase blood sugar levels (diabetes may be unmasked in susceptible individuals). There is often an increased appetite, weight gain and susceptibility to infection and poor healing of injuries or wounds.
Menstrual irregularities and complete absence of monthly periods can occur in women receiving treatment with steroid hormones, another reason to maintain the lowest dose feasible..
A condition resembling Cushing’s Syndrome (Cushingoid) results from high or excessive dosage.
The symptoms include the appearance of a typical large, rounded or "moon" face, a reddish/ruddy complexion, obesity which may be noticed as swelling of the trunk, and the deposition of pads of fatty tissue behind the shoulder blades described as a "buffalo hump". The skin texture can become thin and stretched, there may be purple streaks across the abdomen (due to damage to very small surface blood vessels). It is stressed that the Cushingoid appearance can be prevented or controlled by careful dosage adjustment. This is why your specialist aims for the lowest dose of prednisolne which makes you feel well.
Steroids (especially in high dosage) can have unpredictable effects on mood and behaviour. This may be a particular problem for those who suffer from mental illness. Steroids have been associated with euphoria (a feeling of wellbeing) but also depression and occasionally cause sleep disturbances. They may also raise the intracranial pressure (pressure within the brain) associated with the development of headache.
Steroids also raise the pressure of fluid within the eye ball (intra-ocular pressure) predisposing to the related condition glaucoma. Cataracts are more likely to form in people treated with steroids and there may be thinning of the outer cover of the eye with increased risk of eye infections.
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From another site - acne and irregular periods are what I've had for 5 months - I ran this through Jane and she insisted it wasn't the steriods (it frustrates me when that happens ie something happens to me and a doctor insists it is not the medication when I know full well it is as my periods were never like that for ages and my body was depressed and I wasn't myself.
Possible side effects of prednisolone
http://www.cambridge-transplant.org.uk/drugs/prednisolone.htm
As with any medication side effects are possible. This means you may experience some or none of the following side effects:
Stomach irritation which can sometimes lead to bleeding ulcers. You will be given anti-ulcer medication to help prevent this. Always take prednisolone with or after food. Report to your doctor if you vomit blood or if your stools become blackened.
Weight Gain, especially around the face. This will decrease as your dose is decreased. Weigh yourself regularly and if you gain weight suddenly in a short period of time notify your doctor. Follow the dietary guidelines.
High blood glucose (which may lead to Diabetes). Your blood glucose (sugar) levels will be monitored. Again, follow dietary guidelines.
Mood swings may occur -emotions may swing from very happy to very depressed. Ensure family and friends are aware of this so they can be supportive and understanding.
Skin changes - acne, delayed healing, papery skin, bruising and muscle weakness or loss. Use strict hygiene when dealing with open sores. Use moisturising barrier creams. Try to avoid knocks and bumps to the skin and follow exercise guidelines.
Softening of bones (osteoporosis). Eat foods high in calcium or take supplements.
Salt and fluid retention, this may lead to an increase in blood pressure. Avoid excess salt in your diet - follow dietary guidelines.
Eyes may be affected . Have regular eye checks.
Irregular periods may occur in females.
Increased risk of developing infections may occur with all anti-rejection drugs. Report any signs of infection (e.g. sore throat) to your doctor. Report to your doctor immediately if you come into contact with anyone with chickenpox or if you catch chickenpox within a three month period of stopping treatment.
Never stop taking your prednisolone without your doctor's instruction.
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