Wednesday, 4:30 pm, Oct. 4, 2000:
It has now been only 28 hours since I emerged from the same day surgery operating room of Barnes-Jewish hospital in St. Louis. During an hour and 20 minute procedure, Dr. Lubniewski and associates had performed a vitrectomy, iris repair, and corneal transplant on my right eye. Within two hours of the operation I had eaten lunch and was touring the Missouri Museum of History in St. Louis' Forest Park. Following that, Alice and I toured the Grand Station before having dinner there at Hoohihan's.
Earlier this summer Dr. Lubniewski had recommended this procedure be performed on my right eye. The right eye has for many years had little more than shadow vision and has been of no useful value to me. The left eye, while still providing only partial vision, was at least good enough to let me function a relatively normal life.
In the operating room: It was only yesterday. My eyes were shut and I could not see around me but I heard and was fascinated by the monotonous beeb-beeb-beeb coming from a monitor somewhere to my left. I realized it was the vitals monitor of another patient awaiting surgery. I had the strange feeling I was still home with ER on television in the background. What was real life and what was fantasy? A hand touched my right shoulder and a friendly female voice said, "Hello" as she introduced herself as an anesthesiologist, "I'm going to insert a needle into the top of your right hand for injection of the anesthesia. It may sting a little" Before I could answer, another female voice spoke on my left, "And I'm your nurse. I just need to put these little bandages on you." I did feel the sting as the needle went in but it was no worse than that which I felt the many times I've given blood. And my mind was distracted anyway because the nurse was busy with her hands underneath my gown while pasting the various monitor probes at the appropriate spots on my torso. "What would be monitored?", I wondered. Blood pressure, EKG, pulse rate. Soon they were done and left me alone with my thoughts and with the constant "beeb-beeb-beeb" going through my head. "Beep-beep-beep", now there was a twin to the first beep and this time it was louder and just to my right. I realized then that these beeps were coming from my monitor. I listened intently to the hypnotic sounds. They were out of sync. A beep on my left, then one on my right, then left and on and on . Now one had caught up to the other and they were in sync; a single beeb in stereo. Neat, but they did not stay in sync very long. Every once in a while it seemed as though my monitor stopped for an instant. I did not know why but it was curious to me. The beeps went on.
"I/m sorry to bother you now, Mr. Walker", I heard a young male voice say as it approached me. But there's a paper work problem that needs to be taken care of." "OK", I answered, returning to the present from the curious world to which the beeps had sent me. "Admissions forgot to get you to sign the release for surgery". I thought to myself, "Hmm, I seem to remember signing that at the doctor's office during the last visit." But I said nothing in protest other than, "OK, but I don't have my contact lens in. I can't see where to sign." "That's OK, I'll tell you what it says and then help you sign it". He reviewed what the planned surgery was to include. I was surprised when I heard, "..repair iris.."or something to that effect because I did not recall hearing that before. But I still said nothing but agreed to sign the approval. The young doctor held the clipboard in one hand over my chest while guiding my hand to the right spot on the paper as I scribbled my signature. He left and my mind returned again to within itself.
Another touch on the shoulder. A male voice again. But this time with an obvious accent which seemed to me to be of India origin. Unlike most people with such accents, this man spoke distinct English that was easy to understand. "I will be your anesthesiologist", he said. I did not quite understand why I had another anesthesiologist but let the question go unasked. "Do you smoke?" Do you do this and do you do that. I had heard this same voice asking these same questions to the invisible patient to my left. He asked some of the same questions the female doctor had asked earlier. They were checking and double-checking who I was and that it agreed with their information. Which eye was to be operated upon? Again, I said the right eye. It was the right answer. I already had a hospital identification band on my left wrist when I had entered the room but the nurse had put a second band on my wrist. " If your right eye is to be operated upon, we will put this ID band on your left wrist.", she had said. Three weeks earlier in the doctor's office the nurse there had said, "If they start operating on the left eye, get up and leave the table". I felt good that the medical staff was being so careful, but wondered if they had learned from some bad experience of the past. The anesthesiologist explained once again the planned procedure. He would introduce a general anesthesia to me through the wrist injector. This would keep me calm throughout the operation but I would remain awake. I would remain awake, he said, except for a period of three or four minutes during which I would be put to sleep so that the local anesthetic could be administered to the my eye region. He was very thorough in his explanation and asked if I had any questions. I had none and he left me, alone once more. I wondered when the general anesthesia would start but I felt a new, un-natural calmness and knew that it probably was already taking effect. The beeps continued but were now only background.
As I lay there, my thoughts raced back, through the events of the last 52 years that had
led to this point.
Personal Background Account The day of the operation was at hand. "We are going to take you into the operating
room now". My mind returned from the past to the present and I waited for the promised
three or four minutes of sleep. I thought it never came but know now it must have
because, although I was awake and aware of happenings during the operation, I do not
remember the obviously painful experience that would have accompanied the local had I
been conscious. I recognized Dr. Lubniewski's voice as the surgeon on my right. He was
assisted by two of his associates whom I later learned were Dr. Conners and Dr. Parial.
One was on my right and the other at the top of my head. Someday I may learn more
about what actually occurs during such an operation, but at that time and still now I can
only imagine what was happening. I could hear them talking all the time but most of the
medical jargon meant nothing to me. They talked about getting in, getting adjusted,
"..can you get that.." and various other comments that one might expect from a skilled
team at work. As I lay there, I assumed they were making the cut into the eye and
inserting their microsurgical tools. From their conversations, I thought that each of the
three could see into the eye but each had a slightly different view because of their angle.
I could feel absolutely nothing but knew they were cutting, pushing, pulling, snipping.
Several times Dr. Lubniewski would warn me, "We're going to be pushing down on your
nose". I would reply weakly, "OK", and I would feel pressure but ever so softly on the
bridge of my nose. Each time I felt somewhat foolish by replying "OK", because I knew
it was a needless response. At one point during the procedure there was an unusual
amount of discussion among the team. I heard talk about a shadow under the flap, or
something like that. I heard, he uses a contact lens in the other eye already. Could do the
same here or we can go back in later. I heard something about binocular vision. Then,
they seemed to reach a decision. Dr. Lubniewski, as though stepping out from a play,
addressed me directly and told me what they had been talking about. He said that they
had decided not to insert the intra-ocular lens because of a shadow they saw that could be
evidence of small blood vessels that could potentially rupture if the lens was inserted. He
did not want to take that chance since the lens could be inserted later or a contact lens
could be fitted. Again, I murmured my OK in agreement. The doctors went back to
work. There was a lot of side discussion from Dr. Lubniewski to the surgery room staff
regarding tiny fibers he was apparently seeing on or near the instruments. He said he had
been seeing such fibers more and more lately and wanted the staff to investigate the
source of the fibers to eliminate their presence in the future. The contaminants were a
concern but Dr. Lubniewski obviously had things well under control. "Bring over the tissue", I heard him say. "This looks like a very good cornea". I
knew that my own corneal "button" had been removed and they were preparing to
replace it with the new corneal button. It seemed a long time and I did not really know
what they were doing, but I assumed the cornea was being stitched into place. It seemed
like an eternity. Throughout the operation Dr. Lubniewski assured me that everything
was going wonderfully. Finally, he said to me, "That's it. We're done and the operation
went extremely well. I'm pleased with the results. I'll go out now and talk to your wife
and tell her how everything went." Then he gave some instructions to his associate and
left the operating table. But before he went to see Alice, I could hear him either giving
dictation or talking into a recorder as he gave a detailed report of the technical aspects of
the operation. I can't remember or his medical jargon went over my head, but I was
impressed by what seemed to me to be a very thorough and highly professional report. I
thought I heard something about stitches, "sixteen in number", but am not now sure of
what I heard. The only pain I can recall about the operation was at the end. This happened when the
associate was "finishing up", whatever that means. It felt as though something was being
removed, extracted from the area of my eye. That hurt a bit. At the same time, a nurse
was removing the monitor probe tapes from my body. Some of that tape was on the hair
at my navel and the hair on my chest. That hurt too. I said "Ouch" to both, but softly.
The doctor apologized. Then I told him the nurse hurt me more by pulling my hair. She
then said, "he pays me to do that to make him look good". Alice was soon by my side in the recovery room with a few words of assurance, Alice
then left so that Phyllis and Lyle could come in and say hello before starting their return
to the Lake. Then, Pastor Clyde came in to say hello and to pray with us and give thanks
for the successful operation. Pastor Clyde personifies the meaning of the word pastor.
His wife is a victim al ALS disease. Yet, he and she had awakened at four AM in order
to make the long drive from Lake Ozark to St. Louis. They had arrived in time to meet
with us and pray with us before I was taken into surgery. He is an example to be held up
as a model to every pastor in the country. Before discharge, we were given instructions on care of the eye. I was to keep the shield
and bandage currently in place on until the following day when it would be removed in
the doctor's office. I should avoid strenuous exercise, not bend my head below the waist,
not sleep on the right side, and not lift anything more than 20 pounds. There were no
other restrictions. We left the hospital at about one in the afternoon and I intended to
return to the motel room and just lay around all day. But, having not eaten since the
previous evening, I was hungry. I flopped on the bed in the motel room while Alice went
to Hardy's next door. She returned with a roast beef sandwich and french fries. After
gobbling down the food, I flipped the TV from channel to channel. After about five
minutes of that I suggested to Alice that I was too hyper to stay put in the motel room and
why not go to Forest Park and relax there. We did quickly head for Forest Park and did
not return to the motel room until more than six hours later. The next morning we returned to the vision center at Barnes at 9:30.. Dr. Conners took
us into an examining room immediately upon our arrival . He removed the shield and
bandage and, with warm water, washed away the accumulation on the outside of the eye.
He gently opened the eye and held up his hand, asking if I could see his hand moving. I
could. Then he held up his fingers and learned that I could see well enough to count
them. He was pleased. Dr. Conners then asked if I could read anything on the eye chart.
"Don't worry if you can't", he said. I could not. He then had me try to read anything on
the eye chart using a peep hole; I could not. He examined the eye thoroughly and was
pleased with what he saw. Dr. Parial then was called in to also examine the eye. Finally,
they reported their findings to Dr. Lubniewski and he came in for his own examination.
He also said he was very happy with what he saw. Thus, we returned home and this
journal was started that same day. Thursday,
Oct. 5: Friday night, Oct. 6:
BACK TO TOP
Oct. 4
I have had no pain in the eye but it has been watering
considerably.
Yesterday, during his examination, Dr. Lubniewski had Alice look intently into my eye
so that she would see the intensity of redness in the eye. I guess it looks pretty bad, but
Dr. Lubniewski said that this was normal for several days following the operation.
However, it was very important to watch for signs of infection or rejection and to contact
his office or the hospital immediately should these occur. These symptoms included pain
in the eye and/or a reddening of the eye to a beet-red. My only problem so far has been
more watering of the eye than I think is normal. I have been instructed to wear glasses
during the day to protect the eye and to sleep with a patch over it at night. The eye was
partially matted when I awoke this morning and continues to water. Because of this, I
called Dr. Lubniewski's office. I spoke with one of his associates. He was very
concerned about the watering. At first, he advised returning right away to St. Louis. But
I told him that I had just gotten over a cold and my nose has also been watering a lot and
the left eye was also watering. Alice examined the eye closely, trying to compare it now
to what she had seen the day befor. She could discern no difference in the discoloration.
Given those facts and my assurance that I had no pain in the eye, the doctor agreed that
our immediate return was not necessary. We are due to return for the next check-up on
Monday.
The eye was less matted on awakening this morning. Although it
continues to water, it seems to have moderated somewhat. Except for the watering, the
eye feels confortable Special drops had been provided to me at the hospital and I have
been instilling them four times a day as instructed, But I sometimes forgot the
instructions to shake the bottle before each use. I can't measure any improvement in the
vision since yesterday but it certainly is not worse.
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M
onday, Oct. 9, 2000
It's time for my first check-up. We awoke early and were more than ready to head for St. Louis as we pulled out of our driveway at around 8 AM. We only made it about 15 miles before stopping for a leisurely breakfast at the Country Kitchen in Eldon. We had not discussed it much, but Alice knew from my silence that I was worried and disappointed that the vision in the right eye remains so slight. But on the bright side, the eye is now much more comfortable and does not water nearly as much as earlier. Our next stop was a bit more than an hour later when we stopped for gas in Kingdom City. Then, onto Highway 70, onto Highway 40, and on into St. Louis.
We crossed Lindberg Blvd at 11:30. "Where do you want to eat lunch?", Alice asked. Our appointment was not until 1:20, so we had time for lunch but not a lot of time if we got lost looking for a restaurant. "We could eat in the hospital cafeteria". "No thanks", I replied. "If I remember right, you should be coming up onto Brentwood exit real quick. One of my favorite lunch spots back in the sixties was near there." Sure enough, the Brentwood exit sign soon appeared. "Make a left turn onto Brentwood. The Steak-n-Shake used to be about a quarter of a mile down there on the right. Let's see if it's still there."
And it was. It looked exactly the way I remembered seeing it more than thirty years ago. There were ample parking spots in the driveway so we thought we should be able to get lunch and still have time to get to my appointment a few minutes early.
REMINISCENCES
We arrived at the Vision Center fifteen minutes early and were immediately sent from the front office back to Dr. Lubniewski's waiting room. After a short wait we were ushered into an examining room and were soon joined by Dr. Parial who commenced the familiar procedures of examining my eye. The bright lights of the scope hurt my eye and I hoped that Dr. Parial would hurry with his examination. His left thumb gently but firmly forced my eyelid to remain open. Then he told me I could relax for a bit as he carefully wrote notes, recording what he had observed. He took the tension in the right eye and found it to be 24. Not alarmingly high, but above normal and higher than it had been prior to the operation. Having completed his examination, Dr. Parial left, telling us that Dr. Lubniewski would see me shortly.
We waited a long time. I hated to leave, even for a moment, but finally told the receptionist that I would be right back as I excused myself to head for the men's room. You can wait only so long. There had been only a couple people waiting when we first entered the examination room and I was surprised now to see that Dr. Lubniewski's waiting room was over-flowing. A couple people were actually sitting on the floor just outside the office. I was glad we had gotten there a few minutes early.
Once I returned to the examination room, I did not have to wait much longer for Dr. Lubniewski. He scanned Dr. Parial's notes before commencing his own examination. He was much quicker than Dr. Parial had been. "Can you count my fingers?"", he asked. "Three fingers and a thumb", I replied, as I mimicked with my own right hand. The doctor said the eye looked very good it and the vision were about what he had expected at this stage. Prior to the operation, I had been adding both Cosopt and Alphagan twice a day to the left eye, but only the Cosopt to the right eye. "I'd like for you to start using the Alphagan twice a day in your right eye too", said Dr. Lubniewski, obviously concerned that the tension had increased in the right eye. "But otherwise, everything looks great." "Come up here and look closely at his eye", he said to Alice, "and check it out every once in a while and call my office or the hospital if it starts to look very red. Also, test him to make sure he can still count your fingers." I knew that he wanted to be contacted immediately if there was any sign of rejection. If caught in time, rejection could often be stopped by proper medication. "I also want you to change the drops you are using four times a day in the right eye to a new prescription I will give you." The initial drops, provided at the time of surgery, were a combination of a steroid and antibiotic. "The eye's looking fine and you don't need the antibiotic any longer," he advised, "but keep the original drops in your refrigerator in case you need them in the future."
"Ask the receptionist to make your next appointment for
in about three or four weeks", Dr. Lubniewski
instructed as he left the examination room.
We made the next appointment for Tuesday, Oct. 31 at 1:15.
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T
uesday, Oct.16:
The eye remains relatively comfortable but I can't tell any improvement in the vision. I have been spending many hours at a time on the computer and both eyes feel extremely tired at the end of such a day. Alice and I have started our two mile daily walk again and I am glad to be finally getting some exercise. I closed my left eye as we were walking today and could clearly see the white line along the edge of the road in front of me and the double yellow lines down the middle. Although I can't discern any difference in vision when counting fingers, I seem to be more aware of peripheral vision out of my right eye.
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T
uesday, Oct. 31.2000: EYE APPOINTMENT
This was another afternoon routine appointment just as assuance that the transplanted cornea is remaining healthy. Our wait was short and I was seen only by Dr. Lubniewski. I still could not read any of the chart, even with a magnifier on the left eye. Dr. Lubniewzki peered into my eye using the frightfully bright light much longer than he had in the past. I think he is a very positive person and he continues to talk very optimistically. However, he recommended that at the next apoointment I also see one of the institutes retinal specialist. The clear cornea and vitreous now allow for a much better view of the back of the eye than had been possible in the past. I would not be surpirsed to learn that there is more permanent damage to the retina than Dr. Lubniewski anticipated. We'll see.
I am also about due to see Dr. Wax as routine follow-up for control of the glacoma. Today, the pressure in the left eye was 20, which is better than it had been the last time and not a whole lot above normal. To keep us from making multiple visits, Dr. Lubniewski's receptionist set us up with an early morning appointment with the retina specialist, a late morning appointment with Dr. Lubniewski, and an afternoon appointment with Dr. Wax. If I'm correct about how long it might take with the retina specialist, I think these time-lines may be a bit optimistic. The appointment is set for Dec. 18.
Sunday, Nov.19,2000:
The eye continues to be comfortable and I can't discern any increase
or decrease in vision. However, while watching television tonight I
put on the thick glasses I had worn before I started using the contact
in the left eye. I wouldn't want to try and watch TV that way, but I
closed the left eye to see what I could see on the screen with the right
eye. The subject of the day was of course the presidential election and
I could see the talking head on the tube at the moment. I could see that
it was a man with a fairly thick mustache, wearing glasses, and with a
high forehead. Definitely encouraging.
Monday, Dec.18, 2000:
We returned to St. Louis Sunday night in order to make a 9:40 appointment on Monday
with Dr. Shaw, a retina specialist, then a 11:40 appointment with the corneal
specialist, and then a 1:30 appointment with the glaucoma specialist.
Retina Problem: Prior to the corneal transplant, doctors had not been
able to get a clear view of the retina. But now, the cornea in the right
eye is perfectly clear. Unfortunately, what Dr. Shaw saw is what I suspected.
The retina shows permanent damage, from the original accident no doubt, and
there is nothing further that can be done. Dr. Shaw said he wished we could
go to Wal-Mart and buy a new retina, but that is not possible. Unlike the
cornea, modern science is not yet capable of doing any replacement on that
part of the eye. But the bio-genetic guys are working on it. However, Dr.
Shaw said he has his doubts that anything will happen along that line soon
because there are over a million connections between the retina and the nerve
to the brain. There still will probably be some improvement in the vision
in the left eye, particularly since the stitches are still in, but obviously
not to the extent we had hoped.
Corneal Specialist: The corneal continues to look very good and clear.
What ever vision that is possible with the damaged retina will now at least
be available. And that certainly is a lot better than it had been before.
But Dr. Lubniewski now says that he would not proceed with a corneal transplant
in the left eye. Since that is for all practical purposes my only
functioning
eye, he does not think the operation would be worth the risk of failure. If
vision in the left eye deteriates to the point of that of the right eye,
then the operation should be considered.
Physically, everything is very good. Stitches will not be removed for
several months yet. Since Alice and I plan to leave for Florida right after Christmas,
the next appointment has been made for early April.
Glaucoma:
At least, this is some good news. The tension in both eyes was normal. It was 14
in the right eye and 11 in the left. This is the lowest it has ever been
in my memory. We'll keep doing what we are doing.
Light Phobia?:
Sometimes I can see much better out of the left eye than at others. Glare is
a real problem and I see very poorly outdoors on a bright day. Many years
ago, about 1959, I stumbled into the fact that my useful vision was greatly
improved by the use of homotropine. Apparently, this dilating drop was
opening my pupil enough to allow more access of the retina to the outside world.
I ceased using the homotropine after my left eye was operated on in 1978
because I then no longer needed it.
But today, because of the retina exam, Dr. Shaw dilated my eyes. Again,
when I left the hospital several hours later I had the distinct impression
that I could see things more clearly. This day was a poor proof of the postulate, however, because this day was snowly
and, at best, cloudy bright. I have mentioned this several times in the past
to various eye doctors and they always said that it was just my imagination.
(I am always amazed at how wise doctors are that they can even see into our
minds.) The doctors reasoning has been that, although the dilation originally
had been effective, it would no longer be because the vitrectomy and cataract
removal had taken care of any obstruction. Indeed, they pointed out that
the cataract removal always made the eye more sensitive to light and that
dilation would have a deleterious rather than helpful effect.
When I mentioned to Alice that general vision in the left eye seemed better,
she insisted that we turn the car around and go back to see Dr. Wax and
demand that he prescribe a dilation drop. We compromised by making a phone
call from the car instead. This time, I would not make the same mistake I
made in the past by asking the doctor, "What do you think?". This time, I
asked, "Would my use of a dilating drop on a routine basis be bad
for my eyes?" Dr. Wax sounded quite dubious on the phone, but agreed that
use of such a drop once a day would not have any harmful effect. On my
urging, he agreed to call a prescription into my pharmacy.
To be sure, this is a shot in the dark. But anything is worth a try. I'll
let you know later what if any effect the dilation drop has on my vision.
The accident occurred just 9 days before my eleventh birthday. During
the next 51 years my vision has ranged from almost none to good enough to drive to
almost none, back to good enough to drive, and most recently to not good enough to
drive but good enough to get around. And now, here I was about to enter the next phase.
I, Alice, and many others had been praying for this to be a successful operation. My
mother was praying that it would help me to see. But she has been saying that same
prayer every day since she first saw me wheeled into the hospital in Kansas City. I had
been brought there by ambulance from the small hospital in Pittsburgh Kansas to which I
had been taken immediately after the accident. Staff at the Pittsburgh hospital had
simply said, we won't touch him, take him to Kansas City where he may be able to get
help. Mom and Dad drove from St. Joe to Kansas City to meet the ambulance as it
arrived at the hospital. Mom saw a small frightened figure with thick bandages covering
both eyes. She was still there many days later when the bandages came off after
extensive surgery on my eyes in an effort to repair the damage caused by the homemade
firecracker bomb. The doctors swabbed clean the matted eyes and gently forced them
open. Silence was in the room. Then, Mom said pleadingly, "Can you see anything?"
"Only your face", I replied and she cried.
That had been 52 years and four months ago. What would happen now? The doctors were prepared. We were prepared. It was in God's hands. "The best is yet to come". That is the name of a church sponsored social club that meets the first Monday of every month in the Lodge of Four Seasons at the Lake of the Ozarks. The operation was planned for Tuesday Oct 3 and our instructions were to be at the same day surgery desk by 8:30. Since the hospital in St. Louis is about a three-hour drive from our Lake Ozark home, we had planned to drive up the night before and stay in the close-by Forest Park Holiday Inn. But we attended the social luncheon gathering that Monday and were heartened by the encouraging words and prayers of the forty people in attendance. Some of them were strangers but many were new friends we had met this summer. The best is yet to come. With that theme in mind, Alice and I headed for St. Louis. My sister Phyllis and her husband Lyle wanted to be with us during the operation. They had their own medical problems and were in Jefferson City following up on those when we started out but we met up with them at Kingdom City, Missouri. They followed us to the St. Louis motel as Alice led the way. That night we had a nice dinner on the riverboat Admiral but made it home in time to see the second half of the Monday night football game. I felt good that one of my favorite teams, Kansas City, made an exciting comeback and won over Seattle. I needed the diversion to keep my mind off the pending operation. During the game, Alice asked me how I felt about what might happen the next day. How did I feel? I had asked myself that question, but avoided dwelling on the answer. Excited. Hopeful. Expecting a miracle, yet knowing that the worse could occur. I remember ophthalmologists over the years examining my eyes and just making a wordless sucking sound with their lips against their teeth. I have never forgotten Dr. Gifford in Omaha almost 50 years ago. He shook his head slowly, "Gosh, these need to hold together for you another 50 years, I hope they make it.". A team at the Missouri University Falk Center vision clinic examined my eyes in 1997. I had gone there hoping that they would be the most update on current technology and would be able to recommend something to improve my vision. Their consensus; hold the course. I specifically asked if they thought a corneal transplant would help and was told "No", the problems were not primarily with the cornea.
Alice and I had been away from our Pittsburgh home for over a year thanks to a sabbatical leave from her job as a first grade teacher in Moon Township PA. When we returned in the fall of 1998, I was saddened to learn that my ophthalmologist for the past 30 years, Dr. Terner had passed away during our absence. I therefore made an appointment with his younger associate, Dr. Baumwell and Dr. Baumwell remained my physician until June of this year when we permanently moved from Pittsburgh to the Lake of the Ozarks in Missouri. During my first appointment with Dr. Baumwell, he and one of his colleagues thoroughly examined my eyes and consulted in my presence as to what could or should be done to improve my vision. Their conclusion was that "…leave well enough alone". However, they did comment that part of the vision problem in my left eye, the functioning eye, was due to imperfections on the cornea. Maybe, they mused, that vision could be improved by the use of a hard contact lens on that eye. The theory was that the moisture barrier between the lens and the corneal would help to smooth out some of those imperfections. Dr. Terner had always been of the opinion that the eye would not tolerate a contact lens and I relayed that information to Dr. Baumwell. "I think it will", he stated. So he proceeded to fit me for the lens. Although there was not a great improvement in the measurable vision, to me there was a world of difference in what I could see. My vision was no longer limited to a narrow sweet spot in the middle of very thick lenses but was uniform throughout my field of vision, as narrow though as that was. I initially had a lot of difficulty in inserting and removing the gas permeable hard lens, but now manage it with little difficulty. It was a great improvement for me.
Vision in my left eye had gradually become poorer from 1960 to 1978. Although vision during the decade of the 60's had been good enough that I could drive, I ceased driving soon after we moved to Pittsburgh in 1969. By 1977, vision in the left eye had declined to such an extent that I became more aware of vision in my right eye. The lens in that eye had been removed many years before but no cataract lens had been fitted because the two eyes did not work together. I discovered that I could read with the right eye by using a magnifying glass. Based on that, Dr. Terner fitted me with new glasses and by 1978 I was functioning, maybe not well but functioning, with the right eye instead of the left. That's when Dr. Terner recommended cataract removal and a vitrectomy for the left eye. The procedure was performed by Dr. Sorr. Along with the vitrectomy and cataract removal, retinal repair of a nasal retinal tear was also performed. That operation was a great success and vision in that eye returned to better than 20/40. I was able to drive again and did so until vision slowly declined again and forced me to quit. I had not driven for two or three years when I turned my driver's license in to the state for a "Non-driving" state photo identification card. People with normal vision who drive don't have a good appreciation for the importance of a driver's license for identification purposes. This alternative identification now offered by most states is a great help in that regard. I have been frustrated at times by clerks who refused to accept any identification other than a driver's license. Not even a US passport was acceptable to them. I'm sure their bosses had given them specific instructions, "Accept only driver's licenses as identification". Nowadays, even in airports you suddenly become a non-person if you don't have a photo-ID driver's license to show the passenger agent before boarding a flight. Being thusly rebuffed makes you feel not only like you are not a citizen, but that you don't even exist. The solution? A state "driver's license" that says that it is not a license to drive. Everyone seems to accept that. I can live with it. But deep down I greatly resent the fact that all of our freedoms have been slowly stolen to the point that it is no longer possible to live in the United States society of today without a state issued identification card. I know that the next step will be a tattoo on the hand, or rather, modern technology's equivalent to the tattoo on the hand.
But I digress. Alice and I so enjoyed the year of her sabbatical that we could not wait until the day she could retire for good and we could start our new life. Our plans were to move permanently to the Lake of the Ozarks to which we had been drawn every chance we could get since the day we were married. We had purchased a fifth wheel camping trailer during the sabbatical and planned to use it to spend time in Florida during the winter months. Prior to leaving Pittsburgh, I had asked Dr. Baumwell to recommend an ophthalmologist in Missouri who could provide me the routine follow-up my eyes required. He could not, but suggested I check with Washington University in St. Louis. Subsequently I read an article in a news magazine which listed top rated vision centers in the United States. The vision center at Washington University was rated among the top ten so I felt confident in contacting that institution. As suggested by Dr. Baumwell, my initial contact to Washington University was for consultation relative to my glaucoma problem. The glaucoma has always been a concern but has been kept will under control by medication. But you cannot go to a vision center to see an ophthalmologist. You must go to see a specialist and everyone is a specialist. I guess you would be in a lot of trouble if you had a problem with your eyes and you did not know within whose specialty area the trouble resided.
Washington University vision center, I learned, is located at the Barnes-Jewish hospital in St. Louis. Indeed, more specifically it is located in the maternity building of that hospital. A strange place to be. I went with Alice to St. Louis in July of year 2000 for my first appointment and was introduced to Dr. Wax. Dr. Wax is the University of Washington glaucoma specialist and we were very impressed with his obvious knowledge, professionalism, and helpful and friendly manner. The ocular pressure within both eyes was normal. Dr. Wax said that I was obviously using the right medication and should continue without change. However, he said, "there is some bulging of the cornea and I think your vision could be improved with a corneal transplant in the left eye. I'm not sure anything can be done for the right eye. I'd like for you to make an appointment with Dr. Lubniewski, our cornea specialist, for as soon as possible."
"I think we should go ahead with a corneal transplant in the right eye", Dr. Lubniewski said. "The right eye?" I questioned. "That's right", replied the doctor, "before we take a risk with your only functional eye, let's see if we can restore useful vision to the right eye. If that works, then we can do the left eye." That made sense to me and the thought of restoring vision to both eyes excited both Alice and me. All my life I've felt that some day medical science would become good enough to give me back the sight I had lost due to youthful carelessness. Maybe that time had come. I was anxious to give it a try.