After our pots-op appointment I have been reflecting on the last month or so since the accident and this is what I came up with. Thanks for all the prayers, keep them coming! ~S. I sit in the eye surgeon’s exam room with Richard’s cane in hand. He’s sitting across from me in the exam chair. I watch him as I run my fingers absentmindedly up and down the creases and folds in the Superman duct tape that covers his cane. He’s tired and thinner than I’ve ever seen him and I’m struck by the realization that I can’t remember the last time I saw him smile. My chest tightens around this thought. I take a deep breath and blow it out slowly and try to focus on him and his task right now. His eyelashes are gooped together from the surgery yesterday. He’s been gently working for ten minutes on wiping away the dried blood and discharge so that he can open his left eye for the first time in twenty-four hours; so that the surgeon can have a look. As I watch, His eyebrows pull together forming a deep crease between his eyes as he clutches a small piece of moistened gauze and presses it gingerly to his left eye. His entire body tenses and he holds his breath. I close my own eyes now so I won’t have to watch his fingers tremble from the pain, so I won’t have to see the tear streak down his right cheek. I miss seeing his eyes. With mine shut tightly I’m back in the ICU on the evening of the accident. I’m sitting bedside Richard’s bed staring at the glass still embedded under his skin from his waist all the way up to his head. I’m listening to Doctor Smith the surgeon who will soon be operating on Richard’s eyes. I’m listening, and hearing him even while I stare at the welts of bloody skin that protrude from Richard’s body so unnaturally. Dr. Smith is telling me that he thinks Richard’s right eye is salvageable, but he’s not so sure about the left one. He’s telling me there is a very real chance that he will have to remove the left eye before the night is over. The knot that is clenching my insides tightens some. Take his eye out. They may have to remove his eye. The Doctor is explaining that his left eye was severely damaged and is completely collapsed and removing it may be the only way to stop the bleeding. I think his words are supposed to reassure me as he tells me that he will do everything in his power to save the left eye, but the next thing I know I’m signing a consent form that says they can remove Richard’s eye if they need too. My signature’s on the dotted line and then they are wheeling Richard, on his bed, down to the O.R. I tell him I love him and squeeze his right hand, the only visible part of him that is not covered in blood and glass. The sound of the exam room door pulls me from the not so distant memory. The Technician walks into the room her dark curls bouncing and asks Richard how it’s coming along. I watch as she squeezes sterile saline onto his lashes to help moisten them up. She lightly presses a tissue to his face after the saline rinse and he jumps from the pain in his eye. That eye. The eye that the Doctors thought they would have to take out. It hurts him now, but it’s still there, in his head where it belongs. At this thought, my mind is drawn back to the night of that first surgery. For more than ten hours I had waited in that empty ICU room and when Doctor Smith had come back, the news was not great. They had been able to keep his eye in place and they had tried to get it put back together, but there was still glass in there that they couldn’t get out and a laceration at the back of the eye that was still bleeding and they couldn’t get it sealed off. They hoped it would stop on its own. The eye was still in place, but it wasn’t likely that he would ever see out of it again. And there was still a good chance they would have to remove it later on. They had wheeled Richard back into the room. Metal mesh eye shields covering both of his eyes made him look like The Fly. His left hand was wrapped in clean white gauze and the swollen glassy lumps all over his body had been replaced by staples and sutures making him look like a hastily pieced together human patch work quilt. “Is it open?” Richard’s voice brings me back this time and I push myself out of my chair when I realize what he’s asking. He is holding his left eyelid open between his thumb and forefinger. It’s dim in the room, because the light hurts his eyes, but when I place my face close to his I can see the lashes have finally separated. “Yes,” I say, giving his knee a gentle squeeze, “You got it.” A barely audible groan escapes him as he releases his lid and relaxes his hand down satisfied and dreading that he’s ready for the Doctor’s exam now. “How are you feeling?” I ask studying his expressionless face. He shrugs. I watch him for a minute more before returning to my seat. I relax back in my chair as I think about how far we’ve come. From the hospital room a month before were another one of the surgeons, Doctor Crews, who had operated that first night had come to examine Richard’s eyes. Dr. Crews was a retinal specialist. They had called him in to help with the surgery, despite him not being on call that night, specifically because Richard’s injury was so bad. He had walked into our hospital room a few days after the accident, with his brightly embroidered surgical cap and big black suitcase of equipment and had examined Richard’s eyes. Back then every time they had to touch his eyes, it sent Richard into a fit of shaking and chills from the pain. It had always taken a good five to ten minutes and piling him with warms blankets to get the shaking to stop. So after the exam Dr. Crews had waited. Then when the shaking had subsided he had told us that the right eye was looking good and Richard even had some blurry sight in it, but the left one…Well, the left, out of which Richard could see only black…that one would probably have to be enucleated within the next week or two. This had been the first time Richard had heard in no uncertain terms that he would likely lose his eye. Doctor Crews had explained that inflammation from one bad eye could cause the good eye to also react by becoming inflamed which would cause both eyes to be destroyed. He had told us we couldn’t take that chance. He had apologized in a “cut your losses” sort of tone even as the tears rolled from Richard’s sightless eyes. And then he had packed up his black case and was gone. I had stood beside Richard’s bed and held his hand as we both cried. Then there had come the weekly eye check-ups by one surgeon or another. The other wounds were starting to heal up nicely so the focus was on the eyes. They had told us that they were watching his eyes with the idea that as soon as Richard was strong enough for another surgery they would remove the left one. After each exam the Doctor would wait for Richard’s shaking to subside and then tell us about prosthetic eyes, or living life with vision in only one eye. But with each new day that the inflammation hadn’t develop, Richard still only saw black out of the left side, but he could sense light in it and by this the Doctors were perplexed and encouraged. They decided to leave it alone and “see what happens”. Maybe they had said, maybe he could keep the eye, but he would never see out of it again. Doctor Siringo walks through the exam room door now and brings me back to the present. He is the surgeon who assisted Doctor Mandava with Richard’s procedure yesterday. “Hi Richard,” the Doctor says peering over his shoulder through his round rimmed glasses as he washes his hands at the sink. “How are things today? Better than last time?” I nod at him because while He’s addressing Richard verbally, he’s looking at me. This is something I’ve noticed people do a lot. It’s uncomfortable for them to look at Richard while they talk when they can’t see his eyes. I’ve never before realized how much communication comes from a person’s eyes. Without the use of his eyes Richard’s face is mostly expressionless these days. “Yeah,” Richard says, “It still hurts, but not like last time.” He goes on to describe the pain after this surgery in comparison to the pain after the last surgery on his right eye, which was a few weeks ago. As Richard talks the Doctor prepares his examination instruments and my mind goes back to the first time we sat in this room. The Doctors in Fort Collins had sent us down to Denver because the Surgeon at University Hospital’s eye center, Doctor Mandava, was in their opinion, the best at what he does. If anyone could bring some vision back to Richard’s right eye, they had told us, it would be Doctor Mandava. The left one the Doctors in Fort Collins had decided Richard could keep, but they had no hope of him ever seeing out of it again. So attention had been turned to the right eye. We had made the long, nauseating, drive to Denver and we had sat in this exam room the day after Richard had been discharged from the hospital. His left hand had still been bandaged and immobile, the hundreds of shrapnel wounds all over his body still raw from the recent staple and suture removal. Doctor Mandava had examined Richard’s right eye and then his left eye all the while muttering seemingly illogical information to his resident who dutifully click-clacked at the key board as he entered the medical gibberish into Richard’s chart on the computer. The Doctor had pushed his microscope table away from Richard’s face. Washed his hands and then sat down on one of those round padded wheeley stools that Doctors like to use. He had told us that the right eye looked good and that they wanted to get back in there as soon as possible to do another surgery before the retina started to detach. There had been no surprise there. This was after all, the reason we had come down to Denver: to save the right eye. We were banking everything on that eye. If Richard would ever be able to live a somewhat normal life again, the right eye was all the hope we had left. After discussing surgery dates and times I had thanked the Doctor expecting to be done with the appointment. But Doctor Mandava wasn’t through. He had surprised both Richard and I when he told us that while the left eye was damaged severely, the initial surgery that had been done to close the eye after the accident was done amazingly well. He had told us it was almost unbelievable that the other surgeon was able to get the eyes closed again after the trauma, but since he had closed it and it was retaining pressure, Doctor Mandava thought he might be able to do something with it. “I think there might be some hope for getting some kind of vision out of that eye after all,” he had said to us that first day and when he was answered by our stunned silence he went on, “I know that is probably very different than what the other Doctors are telling you, but I’m not giving up hope on this one yet.” He had gone on to tell us that based on what he was seeing in the left eye the vision would probably not ever be great, but Richard might be able to get some blurry motion back in to it at some point down the line and after more surgery. Blurry motion. We had come from the prospect of total removal of the eye to maybe regaining blurry motion! And while blurry vision wouldn’t get Richard back on his feet and teaching this fall, it had been something and the first hint of hope for the left eye we had received in weeks. Doctor Mandava had sent us on our way with some renewed hope that maybe the left eye wouldn’t be totally useless after all and with a surgery date for the following week for the right eye. “Alright,” Doctor Siringo’s voice calls me back again, “Let’s see what we have here.” He’s seated in front of Richard. “Go ahead and open your eye.” Richard pries his left eyelid open with his fingers again. The Doctor places a black plastic device that shields one eye at a time over Richard’s face to block out the vision in the right eye. The Doctor waves his hand in front of Richard’s open left eye. “Can you see anything?” He asks. I already knew the answer to this question. He can’t see anything out of that eye. He hadn’t been able to for weeks. And while this was their standard exam procedure the two dozen times they had given Richard this test over the past month the answer was always the same. All he could see was black. My mind slips back to just two weeks ago, sitting in this room again when Doctor Mandava had told us he wanted to do surgery on the left eye and soon. Richard had immediately and visibly recoiled at the idea. He was just coming down off of a nightmarishly painful recovery from the surgery in the right eye. The thought of going through all of that again for an eye that, at the very best, would possibly one day down the line get blurry motion back didn’t seem like it would be worth the severe pain he had suffered the past week. Doctor Mandava and Doctor Siringo had both sat across from me and Richard explaining that they couldn’t guarantee that the left eye would ever have useful sight again because of this surgery, but they could guarantee that it would never have any use or vision without it. They didn’t know exactly what they would find when they got in to the eye, but they could see from their exams and the ultrasound that the retina was beginning to detach and if that continued there would be no hope for it. So the answer was to act surgically and act as soon as possible. Ultimately Richard had decided to go through with the surgery, hoping that the complications from the last surgery would not return. But trying to believe that even if they did, a week of torturous pain and pressure in his head would be worth preserving his eye structures so that one day, perhaps down the line and after many other procedures, maybe that eye could give him some sort of blurry motion. “I can see your hand.” Richard’s voice rings in my ears and I’m back in the exam room. I stare in shock not sure if my eyes can be trusted, at the Doctor’s hand waving in front of Richard’s left eye. If Richard is surprised by this development he hides it well. His voice is even and completely normal. The Doctor puts up three fingers and waves them again. “How many fingers?” He asks. “I can’t tell,” Richard says, “I can just see your hand waving.” “You can see him?!” I ask as if Richard telling me again would make it more real than what I had just seen. “Yeah, but it’s blurry,” Richard replies as if this isn’t a thousand percent better outcome than we had hoped for. Then talking to the Doctor again. “I can see your hand and the peachy color, but it’s too blurry to see fingers…I think I can see your white shirt.” I am sitting in stunned silence the tears gathering in my eyes, but all the Doctor says is, “Okay.” and his voice is all business like Richard’s. For a moment I feel as if I’ve been missing some important bit if information all along, as if I’m the only one surprised by this outcome. But then Doctor Siringo glances at me and he is grinning from ear to ear. “I’m so glad you guys decided to do this surgery!” He says. I only nod, because emotion is clogging my throat at the moment. “You should have heard the cheers that went up in the O.R. from our team when we got that big piece of glass out.” I nod again trying to keep my emotions together, but wanting to stand and cheer myself. “Really once we got in there,” Doctor Siringo continues, “and cleared out the blood we could see clearly to the back of the eye and if we can see in, there’s no reason why he shouldn’t be able to see out.” He goes on to tell us that the damage in the eye wasn’t as bad as they had initially thought, or at least once they got in there much of it had repaired its self. He explained that there was some corneal and iris damage, but that those thing could be addressed and replaced via contact lenses or transplants down the road. He said we would know is four to six weeks what kind of vision Richard would have. And in the mean time we would have to come back for check-ups every week for a while. “I’m SO glad you decided to go through with this procedure,” Doctor Siringo said, as we were getting ready to leave. “Me too,” I say, “And thank you!” He nods. “I know we’ve been counting on the right eye all this time, but after seeing the results of this surgery, I wouldn’t be surprised at all if the left eye ended up being your stronger one for vision.” He says goodbye and leaves us sitting in the exam room a little awestruck. I walk over to Richard and take his hand. “You can see.” I whisper. He nods. “That’s great news.” He squeezes my hand a little tighter and we just stay like that for a few minutes, him in the exam chair and me standing beside him. “Ya know what I was thinking?” He finally says to me. “What?” “Maybe I’m the last person to realize this, and I know we have a long way to go, but I think my left eye is a miracle.” “Yeah,” I say nodding my head, “I think you’re right.”
Posted on: Mon, 09 Jun 2014 05:41:51 +0000
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