Chapter 9 - Diabetic Retinopathy

Heather, Papa, Joshua

While on vacation one week, I was raking leaves on a neighbor's lawn. Needing to remove leaves from a bush, I leaned into the bush to grasp them and a twig went into my eye. Going home to wash out my eye, I noticed what I thought was a slice on the cornea. Calling my doctor I was referred to an optometristˆ . I immediately called the optometristˆ and was informed that he just had a cancellation for 11:00AM, an hour from now, and if I could get there he would see me. During my examination he diagnosed a small laceration of the cornea and prescribed an ointment to assist in the healing process. He also blew my mind when he asked how long I had been a diabetic.

Continuing, he explained that I had second stage diabetic retinopathyˆ , which is a proliferation of blood vessels in the retinaˆ and that I would require laser treatments to cauterize these proliferations.

After he referred me to Suffolk Ophthalmology he called Dr. Charles Beyrer, his friend and ophthalmologist who worked there. If I could be there in an hour he would see me that day. Dr. Beyer advised I have someone with me to drive me home after the examination. His reaffirming the optometrist'sˆ diagnosis came as no surprise, however, his saying that there had been a cancellation for a treatment the following morning at 9:00AM did.

My vehicle at the time was an old clunker of a pickup truck. Joann ended up driving me home in rush hour traffic and really had a bad time. She was nervous simply with my eye problem; her nervousness now being complicated by the traffic and my truck. Finally arriving home, she was frantic! She just couldn't face getting behind the wheel again in the morning. I agreed. If worse came to worse, I'd simply drive myself then sit in the waiting room after my treatment until my eyes were no longer dilated and drive myself home.

At 5:00AM the next morning our Pastor called.

"Something woke me up early this morning. There's some reason I felt I had to call you this early. What's happening? What can I do for you?"

Not having spoken to the pastor since Sunday he had no way of knowing I needed a ride.

After our pastor drove Joann and I to my appointment, I had drops applied to my eyes to get them dilated. An hour or so later they asked me to go to the treatment room. Dr. Beyrer explained the laser treatment, positioned me in front of the hardware and began to work on my left eye. It's difficult to describe the feeling of a laser beam as it enters your eye. Your pupil is fully dilated and your eyelids are held open with the insertion of the lens of the laser 'gun'. I declined the option of being strapped into the device framing my head and specially designed to rest my chin. I compare the discomfort to someone holding a thumbtack to your eye and every few seconds applying extra pressure. Two hours and several hundred lasers later my eye was patched, another appointment was scheduled and I was allowed to go home. My thinking I would have been able to drive myself home was a real joke.

My headache lasted until well into the evening. Because my head had to be elevated, I slept in my recliner. Saturday and Sunday gave me two days of rest before going back to work on Monday. Because my vision was impaired, they placed me on restricted duty and used me to train new computer operators. This included hands-on loading of paper into printers and loading magnetic tapes into tape drives. It was amazing what I could do from memory.

Later that week, Suffolk Ophthalmology contacted me. Dr. Beyer had been impressed by my demeanor during the first treatment and asked me if I would be willing to talk to other ophthalmologistsˆ who were being taught laser technology while I was undergoing treatments. Because I was willing, I never paid a cent for the following six treatments. Joann and I were even treated to buffet dinners. Having also purchased a new pickup after the first treatment, Joann no longer had a problem driving me to my appointments.

If you look in the glossary under retinopathyˆ you will see the words poorly controlled diabetes. Questioning endocrinologists, three out of four agree with this definition. However, the fourth believes that even with "decent" control, long term diabetes can and sometimes does cause problems such as retinopathyˆ . Agreeing with this approach doesn't make me feel any better that I still required laser treatments.

I had diabetes twenty-four years before beginning laser treatments. I had prided myself on good diabetic control, doing everything possible at the time to stay within proper guidelines. During these twenty-four years I was under the care of a General Practitioner. During my earlier diabetic life, endocrinologists were not readily available. Today, an endocrinologist is a most valuable asset while attempting to achieve the best control of diabetes.

Today it's necessary to wear one pair of glasses to read, another pair for driving, yet another for computer work. It doesn't seem a big compromise after being legally blind for six months. My eyesight didn't get worse because of the retinopathyˆ . The laser treatments actually saved my sight. Only aging has caused me to need glasses.

My laser treatments (pan retinalˆ photocoagulationˆ ) started with the argon laser which emits a blue light. Its predecessor was the ruby laser; its descendants were the carbon dioxide laser and neodymium YAG laser.

My advice to any diabetic:

• have an ophthalmologistˆ examine yours eyes twice a year
• become a member of your own health-care teamˆ
• beyond your primary health care provider, work with an endocrinologist

Becoming friends with my ophthalmologistˆ and his entire staff, I have an entire collection of pictures of my retinaˆ during my fluorescein scansˆ as well as before and after photocoagulationˆ . My scrapbooks, plural, are full of articles about the first laser treatments and the progression of different styles of lasers as well as a collection of personal diabetes paraphernalia.

Deuteronomy 4:9a-NIV Only be careful, and watch yourselves closely so that you do not forget the things your eyes have seen or let them slip from your heart as long as you live.