Friday, December 03, 2010

Do You See What I See? Part IV

The assistant put numbing drops in Emma's eyes. Last year when I noticed her right eye wasn't tracking as well with her left as it used to, I took her into the retinal specialist who said everything looked fine. But when they tried to do an eye pressure test by tapping on her eye with a special "pen" she freaked out. Ultimately, they never did the test.

This year Emma took her numbing drops like a woman and didn't freak out even slightly over the test.

"That was easy!" she said when the assistant had finished. She and I were both very proud of this new accomplishment. Little did she know what else she would have to endure before the appointment was out.

The retinal specialist, Dr. Corey, came in asking questions about why we were there and so on and brusquely dismissing the answers as information he already had. He spoke a bunch of doctor mumbo-jumbo into a handheld recorder with a message for Dr. Lloyd. Emma looked at me wonderingly, asking with her body language if I had any idea what he was saying.

I shrugged my shoulders and motioned above my head. The most I was catching was "open parentheses, close parentheses".

Dr. C bustled through the appointment with appropriate awe at the indescribable "situation" in Emma's right eye and talked a bit about macular degeneration.

"This looks like a case of what we call wet macular degeneration. These situations are rare in children and we need a dye test to verify what I think, but that fluid and debris build up that Dr. Lloyd showed you in his scan, that looks like wet macular degeneration. First the dye test. We will inject dye into your blood stream and track it's movement in the eye..."

He went on for a while explaining that only 1 in 100 people start puking when they get the dye and only 1 in 100,000 has immediate cardiac arrest, so, really that means it's very, very safe. That wasn't really what Emma and I got out of those statements, but I acted cool, trying to extract the phrases like "safe" out of the doctor.

We were walked into the photography room where Emma was first photographed as she has been before. Up close pictures of her eyes were taken, then it was time for the dye. Emma hates needles. She burst into tears as the photographer was taking out the dye and syringe.

It had been a long morning and now she was being stuck with a needle. I tried to distract her, cracking lame jokes and plying her tissues for her running nose. Once the needle was in--it wasn't nearly as bad as she'd thought. As the dye was released into her blood stream, the photographer took a 20 second video clip of the dye entering and moving through her left eye then took pictures of the interior of each of her eyes every 30 seconds for 10 minutes. It actually wasn't as long as that sounds.

Emma was keen on the photographer. He was young and handsome and funny without meaning to be. She reported later that he was her favorite, him and the woman with the chocolate.

Once all the photography was complete, Dr. Corey came in and walked us through what we'd just seen.

"This is a standard case of macular degeneration. If I didn't have Emma sitting right here and I was just looking at these pictures of the eye, I would say that she was 55 with macular degeneration. See the brighter spots here and here," he said pointing at screen, "this is where she has leakage."

He explained that the eye has the retina, a layer of protective tissue, then blood vessels. If the protective layer weakens, as it has in Emma's case, then the blood vessels begin to leak like a garden hose that's perforated. As that fluid accumulates beneath the retina, the retina bends distorting the vision.

Then he said the best thing I had heard all day, "Fortunately, we have a couple of medications that work on macular degeneration. They must be injected into the eye, but the eye is easy to numb and the procedure will be completely painless."

Emma was whimpering already, so he continued, "I mean completely painless."

I am not a squeamish person by nature. And having been diagnosed with Juvenile Rheumatoid Arthritis when I was ten only added to my courage when it comes to medical procedures. I have never squirmed, whimpered or cried during a blood draw and I could take injections too. I've been given them in my hip, my backside and I've even given them to myself in the stomach.

But eyeball things have always bothered me. Stories of people going blind by accidentally poking a fork in their eye or even fake eye procedures on TV or in a movie left me queasy and unable to watch. I would clamp my hands over my own eyes and say loudly, "Is it over, is it over, is it over?" until the answer was, finally, yes.

So, as Dr. Corey instructed us that we would move into the next room to do the procedure immediately, Emma and I would both have to face our worst fears.

"Did you hear that he said, 'painless'?" I asked Emma as she grudgingly allowed herself to be led in to the procedure room.

"I don't like needles," was her only answer.

Dr. Corey popped in and out of the room dropping numbing drops and antibiotics over and over in Emma's eye. I pulled a chair up and loudly read Eragon, working to keep her calm.

Eventually, Dr. Corey came in and was ready to begin. First, we learned, she would get an injection of Novocain--exactly like they use at the dentist's office. That would, he revealed, pinch a little, but it wouldn't be bad and everything after that would be painless.

I held Emma's left hand with my right. "You can squeeze my hand a hard as you want if it hurts."

The doctor put an eye clamp on, to keep her eyelids out of the way, exposing her whole eyeball. She picked a spot on the wall and stared at it as the doctor poked a needle in my daughter's eye and injected enough fluid to pucker a spot on the white of her eye into a tiny, puffy pillow. She squeezed my hand hard, but made it through.

"That was the worst," Dr. Corey assured us. "The next one is easier."

I looked my daughter constantly in the eye, even with the puffy puckered part, and told her that she would be fine. As I settled down to read Eragon again, a thin blonde woman poked her head in the door.

"Do you need some chocolate?" she asked.

To Emma, this women was an angel with special vision to present her with the perfect gift. Emma just gaped for a moment.

"You see," the woman explained, "we have this leftover chocolate from Halloween and, I don't know about you, but chocolate helps me feel better."

Emma giggled a little, "Me, too."

"Would you like the chocolate now or after?"

Emma paused, thinking. "Um... after," she answered without conviction.

"Because, if it were me I'd want it both. Now and after."

Emma relented with a giggle again. "Me, too."

The woman returned momentarily with an unopened bag of mini candy bars and insisted that Emma take two handfuls. I unwrapped them for Emma, who could see less and less clearly, as I read. She was, for a moment in heaven, a book to listen to and chocolate in her mouth. She has just polished off the last mini candy bar when Dr. Corey returned for the final time.

1 comment:

Tara Rickards said...

You are such a good mom, Jenna. I'm sure it was so hard to sit and be calm and strong for your daughter while your own heart was pounding. So, did it work?