The Floppy Iris

When one of my copy writers informed me last week that she was taking a day off because her son was having some surgery done on his eye muscles, I mentioned that my father would soon be having eye surgery himself, to have cataracts removed. She shared a horror story about her husband, who found the procedure to be more uncomfortable than he expected. Afterwards, he notices a shunt in his arm but no IV line attached, and in reviewing the paperwork they soon discovered that the nurse forgot to hook him up, and he wasn't sedated. “You didn't ask,” was the defense they received when they questioned it.

I've seen my dad gouged and burned and continue working on a car like nothing had happened. So it was to my mom that I relayed the cautionary tale of this woman's husband, as she would be at the hospital on Thursday morning to communicate with the doctors, especially important as my dad's hearing declines. I found it difficult to concentrate on work even though it was a relatively routine procedure he was going through, and at some point during the morning I found myself researching Cataract surgery online instead of doing my work.

The success rate was high, and statistics were encouraging. I came across a video that I'll put at the end of the post for the faint of heart; I couldn't watch more than a few seconds of it. My dad had already had an EKG the other day, the doctor knew his medical history and allergies, and everything seemed fine.

Then I read about Flomax' effect on cataracts. I knew my dad, like most men his age, had problems with an enlarged prostate, and had even had a procedure to try and alleviate the problem a few months ago. I wasn't sure if he was taking Flomax to treat the problem as well, but several sources linked it to something called “Intraoperative Floppy Iris Syndrome”, which can complicate the procedure. The iris needs to remain as dilated as possible during surgery but Flomax can affect the muscle that controls it.

Surely the doctors knew already whether or not my dad was on that particular medication. There wasn't much I could do; my mom wouldn't have her cell phone on in the hospital, especially since she only turns it on to make outgoing calls once or twice a year. She had assured me in the morning that she'd call, and by noon the phone rang.

I could hear something was wrong in her voice, and as soon as she said “complications” I mentioned Flomax. “Yes, how did you know?” she said. My dad was fine, sitting there more annoyed than anything else, awaiting a retinal specialist. They managed to get 90% of the cataracts on the first try before the iris caused problems, and wanted to make sure they got it all while he was there. One of my supervisors glanced in my office as he walked past, and I realized it was time for a meeting. My mom was using the doctor's phone and didn't want to stay on long anyway, and promised to call back in an hour.

By the afternoon I'd heard nothing, trying home as well as her cell phone, even though I knew it would go right to voice mail. Finally around 4:00 she answered at home, and said they were back. The specialist was excellent, quickly and efficiently finishing the job, and my dad didn't feel a thing. His right eye is bandaged right now and he'll have to go for a follow-up visit as well as wear sunglasses and use eyedrops for the next month or so. Apparently he had stopped taking Flomax a month ago, since he was still waking up several times a night and it didn't seem to be helping. The doctor said it could still be in his system up to nine months from the time he stops taking it. One study I read mentioned people having floppy iris syndrome as much as two years after ceasing Flomax. Hopefully, when he has the left eye done around the end of the Summer the surgeon will be better prepared, and his iris won't be so floppy.

Treasure your eyesight young ones, and pray medical technology changes by the time any of you have to have surgery. Suddenly, the dentist's office looks pretty good. I'm not going to show my dad the following video until after his second surgery:


Blogger SPM said...

I've seen that video lots of times, except I saw it LIVE.

I worked for a company that provided phacoemusolifcation equipment to hospitals so the docs at these smaller hospitals could do cataract surgeries. I was in the OR running the equipment.

What the unit is doing is using sonic technology to crack the cataract (actually the lens of your eye getting hard and cloudy), break it up and then suck it all up. The doc them inserts a new lens into the eye.

I've seen docs do the entire surgery in 20 minutes and I've seen docs do the surgery in 60-90 minutes. I saw one really talented docs have two ORs set up and go from one surgery to the next back to back changing gloves for each surgery. I think he did like 20 surgeries in one morning.

What is amazing, you must remember, is that the docs are performing this surgery using a giant microscope. I know, I had to put it together. The space they are working in is very, very small.

Several times I watched the doc perform the surgery using the secondary eye piece and it looked exactly like the video.

Hope things are better for your Dad.

6/06/2008 1:02 AM  
Anonymous thewritejerry said...

completely and utterly irresponsible on the doctor's part not to have checked if Flomax was in the medical history of an aged male patient.

thank God your dad's okay.

and I am so not watching that video.

6/06/2008 4:05 AM  

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