I can't, in good conscience, tell you to read this post.  This post, still unwritten, is the ghost pepper of modern literature.  For those of you who don't know what a ghost-pepper is, I will enlighten you.  A ghost-pepper is the hottest mother-f'n hot pepper there is (though I am sure that by now there is a new, even hotter pepper that someone will inform me of in the comments).  When I even look in the general direction of a ghost pepper, I begin sweating.  Furthermore, on my recent trip to Seattle, I voluntarily sampled what I would describe as "one-pixel" worth of a ghost pepper.  I almost, despite my lactose intolerance, chugged straight from a gallon of milk.  Ghost Peppers: One Pixel Packs a Punch.

Why am I telling you all this?  Well, there are two types of people in the world: The sane ones, who can't for the life of them imagine why we would waste the energy to both grow and harvest these death peppers, and the damaged ones, who essentially play taste-bud limbo, eating increasingly hotter foods in an attempt to sear their inner child.  And these people really do seeeeeeeeeem to enjoy it (I don't trust them.  I think anyone who acts like they are enjoying ghost peppers are actually part of an elaborate plan to make me try more of that wildfire).  "Flavorful," they say.  That's like enjoying the taste of "campfire," but whatever.

If you are a sane one, this post may be too much for you.  Everything will be 100% true, and I will obviously attempt to make you laugh at my pain, but nonetheless, some fairly horrid shit went down in the region of my eye these past few Monday's, and I don't want anyone biting down on this ghost pepper without fair warning.

If you are damaged, say like a surgeon or EMT or someone in another potentially life-saving occupation, prepare to enjoy a thoroughly unclinical look into the mind of a thoroughly abused human headlight.
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Monday, April 29, 2013

I have an appointment with my optometrist, who specializes in corneas.  My vision in my right eye has been blurry for some time now, but about a week ago a huge sty began growing on my lower inner right lid, so I was fairly certain that a great big eye zit couldn't be helping my vision situation.

I never wait very long in the waiting room.  I'm not sure if this is because I seem to be the only non-octogenerian that goes to this particular office, or because my father is a local oncologist, and no one but no one wants to get on an oncologist's bad side.  You'll have to trust me on this.  There is a good healthy fear in the medical community toward oncologists.  Nobody wants to have to cash in that particular favor, but they all seem acutely aware that they or someone they love might have to some day.  I often wonder if it is only because of my particular vantage point of "oncologist's son," that I see this behavior.  Regardless, it's still not worth the lifelong fear of tumors growing everywhere on your body.

When the doctor's assistant brings me into what I've come to know as the "first room," I am not completely emotionally prepared for the upcoming moment which will change the course of my coming  weeks.   I cover my right eye.  I read the bottom line.  Then I read the line two below the original string of letters.  I'm impressive.  The assistant is a little impressed.  "20-15," she says.  "Nice," I reply.

Now cover your left eye.  I grimace internally.  She moves the lines of letters back to their original position.  In my head, I know what the string of letters I am expected to read are: A J K E M.  But any impulse to recite these letters by memory is thwarted by the fact that I can't even see that there are letters on the board.  There are just a few blurry lines.  She clicks the letters in the opposite direction.  I know, intellectually, that they are now getting bigger.  I squint.  "Still nothing."  She keeps clicking.

You know, back in the old days, they used to have those charts with capital E's facing different directions.  You would tell the doc which direction the E opened.  Was it backwards, on its front like a table, or laying it's back?  On the top of said E chart there sat a big ol' jumbo E.  Almost always, it was huge and bold and sitting in the classical frontward E position.  The medical assistant turned that projectors crank until alone sat one big giant bold jumbo E.

I squinted.  And through my squint I could reasonable enough make out that that was an "E."  I told her so, but she saw me squint.  She saw that this was not a no-brainer of an E, but rather the beginning of my visual field.  She was the opposite of impressed.  "That one's 20-2400."  I wish she hadn't said that. Considering that legally blind is having 20/200 vision in your best seeing eye, telling a person their vision is 20-2400 is stating the obvious that your eye is busted.  While the lights may be on (so, not what I'm come to understand as "blind blind"--which until recently seemed incredibly redundant to me), you'll never be able to tell whose at the door.

She then took me to the second room.  This was the room where you saw the doctor.  That said, the mood had unmistakably changed. The witty tête-à-tête that we had been exchanging right around the words "20-15," had disappeared in the wake of much larger numbers.  The vibe was unmistakably more "bad-newsy."  Like that moment in a TV show when the surgeon comes out to the waiting room and hasn't said anything yet, but the family kinda knows it isn't going to be good news.  It was a stinky fart vibe.  She knew it stunk, and therefore stopped making as much direct eye-contact with me.

The doctor came in and asked how I was doing.  I told him that I had this stye and I had been putting warm compress on it, but that the process of compressing seemed to be further irritating the rest of the eye.  A Catch-22 of eye health.  He nodded and said, "Well, we'll be able to help relieve that stye here today . . . but more importantly it really looks like your vision isn't coming back in that right eye.  I think I'm going to recommend a tarsorrhaphy be performed."

He said tarsorrhaphy the way I say, "I'm going to get FroYo."  I felt the same way I did when my friends in Public Health reference far off cities and then are stunned to find out I don't know that Sikasso is the second largest city in Mali. The difference in my current situation, of course, was that the tarsorrhaphy was going to be happening to my face.  Thus my follow up question to the doc, "Um . . . what is a tarsorrhaphy?"  I would love to tell you that I said something cooler like "what the hell is a tarsorrhaphy?" or "Tarsorrhaphy, I hardly know Ye!"  But that was not the mood in the room.  Fear, actual fear, an emotion I spend very little time with (fear is different from anxiety), was beginning to seep out of my gut, headed northward.

Tarsorrhaphy (n.): Tarsorrhaphy is a rare procedure in which the eyelid is partially sewn together to narrow the opening.

He said, "they're going to sew the outside of your eyelid together."

The fear inside me drank a Red Bull. It got wings.  It took off up my throat.

"But for today (he changes the subject as quickly as possible), let's try to help that stye."

He asks the nurse for a syringe filled with some liquid which forces the stye to pop and expel its grotesquery, relieving the pressure in the eye.  For a moment my attention is redirected, and I begin wondering why he hasn't done this procedure to my previous eye zits.  The nurse with the needle enters the room.

"No no," says the doctor, "I need a needle half that size.  I don't want to put it into his brain."

Ha mother-fucking ha.

Great, I think, another needle headed towards my eye.  (Previous experiences can be read here and here.) A new chapter of "Worst Fear Realized except now we are about to enter the front of the tunnel marked "Worse than Your Worst Fear's Nightmare."  This tunnel, incidentally, is a week long -- and instead of light at the end of it, my eye gets sewn shut.  Foreshadowing.

I'm sitting on the prototypical eye doctor chair.  It has a separate head piece which connects to the body of the chair via a flat metal bar.   The doctor tells me to lay my head back on the headrest and remain very still.  (NO SHIT! There is a needle coming at my face.  The "remain still" command is the picture of redundancy.)

I feel the needle enter my eyelid and the pain is sharp but not extreme.  It is not a searing pain, but like a large pinprick.  He holds it there.

Then, the headrest comes loose and falls back about 3 inches.

I'll write that again so you can soak in the terror of those words.

Then, with the needle still in my eyelid, the headrest comes loose and falls backward 3 inches.

I can't say what my expression looked like, but inside my body went to full-Defcon 1, red-alert, fight-or-flight, kill-or-be-killed panic-mode.  The doctor and nurse's faces, however, seemed incredibly nonplused.

WHY!?!?

"That wasn't you, that was the headrest," says the doc.  "No shit," I think, adding (to myself) "Might wanna get that thing checked out!"

Unfortunately, he hadn't relieved the stye yet.  The needle has to go back in.  "Here we go again," he says, as I now focus every cell in my body into both remaining absolutely motionless while putting the minimal amount of pressure possible on the head"rest."

While the relief of a stye feels incredible, it is messy.  It is a statement to my mental space at that point, that the resulting money-shot across my eyeball was the least disturbing part of this particular visit to the optometrist.

The stye alleviated, I quickly turned my attention back toward the surgical appointment that seemed to be getting scheduled in the back rooms while all this happening.  The procedure, he tells me is minimally invasive and the necessary next step to trying to get clarity back to my cornea.

"Unfortunately," he continues, "the clarity of the cornea is no longer the only issue we are dealing with. at the moment."

I can't believe he just started another sentence with "unfortunately."  I am currently existing in a state of total misfortune, and the idea that there is more bad news is pushing me towards either comatose or panic attack.

"It seems that your cornea, along with being occluded, is also no longer the correct shape."  He explains to me that the outside walls have thinned (as a mutual result of lasik eye correction years ago and rubbing more recently), and the current shape resembles more of a nipple instead of a crescent.  (The word nipple has never sounded less sexy before).  My next doctor would describe this same corneal issue as the cornea misshaping like in a Dali painting.  I prefer the nipple analogy.

"Well, what do we do about that," I heard myself say.

The reply was not the usual doctoral 'you get this malady, so you do this remedy' reply.  It was more wistful, full of wiggle-room.  He made clear that he won't know exactly what's to be done until he can see what my cornea looks like when its intact, post eyelid closure.  That said, there were a few potential procedures to be done.   One he mentioned, is not yet FDA approved in the United States, but is approved in Europe.  It involves bombarding the damaged cornea with UV rays to cause it to defend itself by regenerating.  Pretty futuristic stuff.  Like all futurist stuff, there is a guy who does the procedure in Connecticut.

The procedure we are trying to avoid, he tells me matter-of-factly, is a corneal transplant.  He does say that on some level, while a worst case scenario, with a new cornea my vision would be immediately better.

This doesn't feel comforting.  In the past 15 minutes I have had a needle in my eyelid twice and was told they will be sewing my eye shut (partially--but still).  The fact that the idea of removing an entire component of my eye and replacing it is on the list of potential solutions makes me more sad than comforted.

As I left the office, all of the questions which I'm sure you must have right now had not yet entered my consciousness.  I was in shock, both from the experience that had just occurred and the news I had been given.  "Could I just wear a patch?" "How long would they sew my eye closed for?" "What are the other potential Step 2's?"

All of those questions did their laps in my mind later that night, while I pretended to sleep.  What was first and foremost in my own mind was that there was no way to get around the fact that I was blind in my right eye.

When you are having vision problems, there is always an optimism that when you wake up the next morning you'll be able to see a bit more, a bit clearer.  And this feeling that it would get better had stretched itself over the course of at least a month at this point, holding myself at arm's length from the disillusionment of my own weakness.  My denial simply could no longer exist in the face (pun) of the upcoming surgery.

Additionally, in admitting my blindness to myself, it also meant that I had to tell my wife and family the extent of visual degeneration.   As asking for help is generally something I need help doing, admitting weakness to those I love was one of the more humbling and rewarding pieces to this whole eyemagedon.

And to think, it had just begun.