Friday, January 11, 2013

Tues Jan 8- Eye Update

Today was a quiet day for James. Aside from CT scan ordered by the neurosurgeon, he rested in bed on about 50% O2. His "PEEP" which I don't really understand, has to do with his breathing, is at a 5, which is very good. When he first came in on the 31st his PEEP was a 15. They want the intubation out soon and to do a tracheotomy instead to his mouth and throat from damage by the tubes.

I got parking passes for the garage here- $5 for 5 days instead of $9 for one day. Whew.

I went to Nature's Treasures, one of James' favorite stores, to get an estimate to replace a necklace he had made that I couldn't find in the van. It was a long piece of Moldovite, a translucent dark green stone made from when a meteorite hits the earth.

Most interesting and coveted for me today was the long-awaited talk with eye specialists.

One ophthalmologist explained to me how after a ruined eyeball is removed, they attach a plastic globe to the four eye muscles so that the globe is moved in tandem with the other eye as it tracks things. Six weeks later  they fit him for a large contact-lens like "shield" that goes in front of the globe, behind the eyelids, and an iris and pupil is painted on it to match James' other eye.

I also was glad - the big-wig super DR that they moved James here for called me. She explained her take on the situation- that James should wake up, get told about his eye, and decide for himself that it should or shouldn't be removed. She said her own grandpa had his eye ruined and that he decided to keep it. I was very glad to hear her be compassionate to James and his emotional reaction to (possibly) losing, essentially, a limb.

She has read all the publications and research and done this before, and her opinion is that since James' eye has been closed since the morning of  the 1st, that he isn't at much risk for what I've been told to worry about: a thing called sympathetic opthalmia. This is when the ruined eye sends jacked-up images to the brain which the good eye picks up.Since our eyes work in tandem, the good eye wants to match the signals sent by the bad eye, and it spontaneously sympathetically degenerates itself, so that James would have no vision in either eye.

However, on the first the ophthalmologist stitched up a cut on James' cornea, and she said the report said his upper eye was ruined, the conjunctiva acted like saran wrap and kept his eye from leaking into his bloodstream. If the body finds eye fluid in the bloodstream, when it should only be in the eye, it starts an auto-immune response and attacks the good eye.

Well she is the big-wig super DR  we came here for, so she's the one who would know.

She said that Wednesday they would move on with the facial bone setting surgery, that should be 6-10 hours, but that she would prefer for James to wake up and decide for himself to have the eye removed, or not.

I am glad for this, because I was imagining that if I was unconscious for days and days, and to save me James signed for me to have a mastectomy, I would wake up and feel thankful that I was saved but upset that an important part of my body- emotionally- was just suddenly gone with no time to process. Totally not the same. But I'm signing for them to do procedures to James that I  know are important, and this one, I was told, would save his vision, so I was all for it.

Now the expert is telling me it's ok to wait a week or two and let James process and decide for himself, and I'm thankful that's off  my plate.

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