30 April 2013

No One Tells You About the Smell: And Other Adventures of Eye Surgery in India

I'm typing this with limited vision. But I'm bored and my painkillers are now in full effect so I'm taking my chances with the bright screen for a few minutes. (Thanks to a high school typing class I can do a pretty good job with my eyes closed.)

On Friday I had my PRK eye surgery. It was about as terrifying as I imagined it would be for about twenty minutes. One relief was that they only force one eye open at a time; for some reason I thought they would both be forced open at the same time. The doctor was soothing and conversational, talking me through each step. I relied on my yoga breathing to help me relax. And then there was a horrible burning smell. I never made the connection between lasers and eyeballs burning together. I panicked a bit but there was nothing I could do except try to keep breathing. My fear of moving my eye and messing up the surgery overcame my revulsion of the smell. (Mike later told me that he intentionally didn't tell me about the smell because he knew I'd never go through with it.) They did my right eye first. My left eye didn't take as long and since I was prepared for the smell it wasn't so bad.

The surgery part when precisely and perfectly and surprisingly on time. But as usual for India, the follow-up bedside manner left something to be desired. They gave me some sunglasses that were hardly dark enough and set me down in a sunny, well-lit waiting room. They gave me a juice box, which was nice. They handed me a sheet of instructions that I couldn't read. They explained that I needed to take three different eye drops four times a day for the next week. One person told me to take them five minutes apart, someone else told me ten minutes apart. They told me to take one tablet for pain after lunch and another one after dinner and they told me to use a skin patch before going to bed. Then someone dropped me off at the door and I fumbled with my phone to call my driver. When he pulled up I gave him my instruction sheet from the doctor and told him to go to the pharmacy and pick up all the drugs listed. He parked me in the shade and went in. He came back a few minutes later and handed me a little bag and asked me to look at the sheet and check the contents of the bag to make sure they matched. I pretended to read and said "Sure, it's fine," because I couldn't see and I had no reason to assume that the pharmacy at the eye hospital wouldn't give me what I needed to recover from eye surgery.

Ah, but you know what they say about assuming things.

I got home that day before Muffin, so while I was still on the anesthetic from the surgery I fixed myself some lunch and made the final preparations to hunker down in my bedroom for the afternoon while Muffin stayed with the baby-sitter. I took a pill, put on my patch, and felt pretty groovy for the afternoon.

I took my dinner-time pill and did my eye drops and had a reasonably good night's sleep. I had a follow-up appointment first thing Saturday morning so I woke up early, took my eye drops and my last pill, and got on the road.

I'm a little hazy on the details from then. I remember sitting for a long time in a sunny waiting room again. I saw one doctor who said that despite some irritation in my right eye, both eyes were healing as they should be. Then they wanted me to wait and see another doctor, but he was in surgery. I watched patients go in and out of the office. I don't know how long I was there but my pill was starting to wear off and I was still in that sunny room. I got up and made a scene. My appointment was at 8:00 and it was nearly 10:00. I just had surgery, I needed to be at home resting, not sitting in a sunny room indefinitely. The first doctor I saw happened to walk through and witness my scene. He grabbed my arm and led me to another room. Within a few minutes I had my appointment slip for my Thursday appointment to have my contact lens band-aids taken off. I went home, took my eye drops, and laid down.

By Saturday night I was in agony. I couldn't understand why the pharmacy hadn't given me more pills, but I was too delirious to think about asking for more. I assumed my last pill that morning was meant to get me through the worst of the pain and I began to fear that my worsening pain now was due to an infection or botched surgery. I was loading up on extra-strength Tylenol, but it wasn't making a dent in the pain. I'm sure I was near passing out at one point on Saturday night. By Sunday afternoon my eyes were even more red and irritated than they'd been the day before and my pain was getting worse. Mike remembered from his own surgery that I was supposed to be feeling better by this point in the recovery.

He called the emergency contact number. And there was no answer. He called the main receptionist and from his side of the conversation it sounded like she kept asking why he'd called her instead of the emergency line. Eventually she told him to bring me in.

Considering how badly a visit to the emergency room could have been on a Sunday afternoon when Mike, Muffin, and I were already pretty cranky (the baby-sitter and driver were already gone for the day so it was a family adventure), it went better than expected. I saw two doctors who both agreed that my eyes were healing just fine and they couldn't understand why I was in so much pain. Finally one of them asked me if I was taking my pills and using the patch. I said I used the ones that were given to me on the first day but I was all out. I told them exactly how many pills and patches. They said that was only a one-day supply and I was supposed to get enough to last for a week.

I had essentially gone through the worst of the pain with no painkillers.

I told the doctors I gave my paper to the pharmacy and accepted the number of pills and patches they gave me. I said if I was supposed to take more, how come no one told me that and how come it wasn't written down for the pharmacist to know that? They apologized and wrote me a new prescription. It still didn't say how many days' worth to get.

And this is a problem I've had with doctors here in India. It's up to the patient to tell the pharmacist how much medicine to give out and that is totally ridiculous. Never mind all the abuse that's happening as people get way more pills than they need to drug themselves or sell them, but what about people like me who are delirious after surgery and have no idea how much medicine I'm supposed to be taking? It needs to be written down somewhere! This seems so obvious to me.

The pharmacy at the eye hospital was closed and another nearby pharmacy was closed so Mike drove to a hospital near our house and we decided on three days' worth of medication. (And if I need more I can send my driver out for it, since there's no concept of dates or number of refills.) By the time he got back to the car and gave me a pill, I was nauseous with pain and saw strobe lights when I closed my eyes.

Even with the meds, Sunday night was pretty hellish. But I was doing much better by Monday morning.

This post was written over the course of several hours, in between eye drops and pain pills. I'm feeling much better and even went out of the house for a little bit today, with sunglasses and a hat. My vision is getting better and my irritation is decreasing (the irritation in my eyes, at is, not with the health care system here).


Victoria Mason said...

I totally forget about the smell. Dom mentioned that. I do remember him being in a dark room for four days, no lights at all and he only came out at night, again no lights on. It was a long week. I am glad youare on the mend. It sounds horrific.

Connie said...

No fun at all, but having the surgery is very much worth it! I did not care so much about the smell, but I do wish someone had shown me and explained the process of propping my eye open with whatever gadget they used. It didn't actually hurt, but dang that was weird!! My favorite part was seeing an instant result... I was looking up while in the chair. Before the zap, the ceiling was a white blur. Immediately after (and before the pain and swelling) I could see details in the ceiling tiles plain as if I had my glasses on! I had mine done in the US and proper meds... so sorry to hear of your crazy experience there. One other thing to keep in mind is after healing, I found my eyes, esp. when tired, had 'glare' at night when driving. Asked my optometrist about it and she gave me OTC rewetting drops and glasses with just the tiniest prescription that she told me was for driving only. That was about 5 years ago and that's all I've needed since. Good luck with the rest of your healing and recovery, and enjoy your 'new' eyes!

David Moon said...

You capture the essence of India so well, Stephanie! I truly hope that I don't have to have any type of surgery, or even just plain medical care, while I'm here.

Hopefully the rest of your recovery goes well. I know you're probably pretty much back to normal now, but let me know if I can do anything to help.