I had my second cataract surgery last week and wanted to share some details of the experience that I glossed over in describing my first surgery so first-timers will have a sense of what the experience is like and to reduce their natural fears and anxiety. Rather than making everyone wade through my story before making my point, I’m going to cut to the chase. It’s a breeze, a dawdle, a walk in the park. And, best of all, you get to really see the world again. Not only is your vision sharp and clear, but you’ll probably notice that colors are brighter and truer. The success rate of cataract surgery is virtually 100%, so that’s not an issue you need worry about at all. The worst part is, of course, the obvious – the emotional impact of the prospect of willingly allowing someone cut into your eyeball… while you’re awake! The good news is that patients are given a mild sedative to keep them serenely unconcerned while they’re undergoing the procedure. They also douse your eye with a local anesthetic so you don’t feel a thing. Between that and some other drugs they put in your eye, all you see while they work is some blurred spots of light surrounded by darkness. When they’re done, they slap a protective patch or shield over your eye and wheel you off to recover until the effects of the sedative have sufficiently diminished so that you can safely walk out the door with a bit of assistance from a steady arm of a friend or family member. So, take it from a devout coward that it’s one of the easiest procedures you could have, second only to having your blood pressure taken. Now, forgive me for being long-winded here in telling my story.

My first surgery, about a year earlier, did go swimmingly.  I arrived at the ungodly hour of 6:30 AM for check-in.  By 7AM I was in “prep”, where the meds are administered and allowed to kick in for a bit.  The procedure itself only took about 20 minutes – in and out, POOF!  They put some drops in my eye and all I saw was flashes of light as they exchanged my natural lens for the new artificial one.   It was almost totally devoid of any sensation whatsoever, so it was trauma-free for me.   The surgery was followed by a brief stay in recovery to allow the drugs to wear off a bit, and I was home within a few hours, relieved, relaxed and happy. There was just a tiny, dull ache in my eye – barely a background twinge you might get with any eyestrain, and which a couple of Tylenol alleviated nicely. By early that afternoon, the only lingering side-effect was the annoying large plastic shield taped over my eye for protection. At my post-surgical exam the next afternoon, I was seeing better in my left eye than I had since I was in grade school some 50 years ago. It can take a couple of days for your vision to stabilize, but within 24 hours I was 20-20 in my left eye and happy as a clam except for one thing.  The exam had shown that my right eye had developed a cataract of its own, and it was now clear that my life-long astigmatism was growing increasingly worse as well.

Over the course of the next year, the difference between my eyes became increasingly painful. The eyeglasses I got soon after that first surgery had been a complete fiasco. They were unbearable and I stopped wearing them entirely. I was reduced to relying on drugstore reading glasses to work at my computer. Even then, I could only work for an hour or two before I’d get a nasty headache. So, in late September I decided the time had come and I scheduled another cataract surgery. But I had to rush things because, thanks to my pending entry into Medicare (an emotional trauma unto itself) in November, I was being funneled into a different health insurance company in November which didn’t work with my eye surgeon. So, I came up with a “cunning plan”! I pushed every button to quickly schedule the initial consultation with the eye doctor and the pre-surgical physical to get my surgery done by the end of October when my insurance would change.  All of which would have been fine, except that I was counting on my sister Donna (The Perfect Child) to be able to again escort me to and from the hospital as she had before. But fate or karma stepped in and foiled my “plan”.

My sister’s closest friend in the world died in late September from breast cancer and she had named Donna as the executor of her will. Unfortunately, that task required Donna to attend a hearing in a court in Hudson, Wisconsin on the day of my surgery. There was no way around it for Donna. She simply had to be there and I had no opportunity to reschedule.  But, while I really wasn’t concerned about going through the procedure on my own, the medical staff didn’t like the idea at all for two very understandable reasons. First of all, cataract patients are prone to hyper-anxiety, which is no fun for the patient and can complicate the surgery itself. Second, sedated patients need to be watched immediately afterwards for physical safety and medical complications. Now, I’m far from the first cataract patient to be on their own, and so when scheduling the procedure, after getting my surgeon’s required approval, I was offered the option of having the surgery without sedation, which I easily accepted because (a) I was desperate to get the surgery done without delay, and (b) I arrogantly thought I knew more about it than I actually did.

You see, I mistakenly believed my first surgery was also done without sedation. I mean, I knew they’d given me some anti-anxiety meds the first time around through an IV and a couple of pills, but my idea of being “sedated” was what we see on TV. You know, having a gas mask on and being unconscious during the procedure. And I knew that never happened the first time, so I thought I was golden. Even though they’d made me fast overnight so my stomach was empty, as is routine when undergoing anesthesia, back at the time I’d guessed that they’d taken my recent high blood pressure diagnosis into consideration and decided against “general anesthesia”. Au contraire, mon frer! It turned out that the IV I was dismissing as inconsequential actually contained the sedative they were talking about all along!  It’s just that it was simply anti-anxiety meds instead of knock-out gas.  Thus, on that still early morning of my second surgery, I suddenly found myself being wheeled into the surgery without so much as a St. Joseph’s Aspirin for Children, even if for no reason other than to act as a placebo. Naturally, my male ego kicked in and I kept acting as if everything was exactly what I expected.  In my defense, once things got underway, I was actually very calm. In fact, I was comfortable enough to make a joke. All through the surgery, the doctors were talking me through everything, which was reassuring until a point where I thought they were getting a little condescending.  So when one of them said something like, “Now we’re going to do the next step. Okay, Richard?”, I responded with “Who’s Richard?” Yes, I’d recently watched the episode “Evidence of Things Not Seen” from “The West Wing” on Netflix – the one where C.J. claims you can balance an egg on its end during the equinox.  Anyway, it took the doctors a couple of heartbeats to realize I was joking, and they seemed to take it in good humor – or, at least, they didn’t display too much annoyance.

To be clear, I don’t recommend foregoing the sedatives to first-time patients. My previous experience with this surgery was the sole reason I had no significant fears.  I knew exactly what was going to happen, and wasn’t really upset when I realized I wouldn’t be getting any drugs at all. Then there was about a 30-minute post-surgical process that largely consisted of a quick examination of my eye, taping the plastic shield in place, and putting my clothes back on. After that, they gave me a blueberry muffin, patted me on the head, pointed me to the exit, and I was done. Ultimately, the two experiences were nearly identical from my point of view except for the realization in the waiting room afterward that I could have driven myself rather than having had to hire a taxi. But for that first time through the ordeal, I was enormously grateful to have had my sister there to keep me calm going in and for driving me home afterward. And, of course, the drugs were very helpful in keeping me from screaming bloody murder as soon as I was out of Donna’s earshot since it was the first time in my 60-odd years of life having to undergo anything more serious than a vaccination.

So my advice to those about to have cataract surgery boils down to, “Don’t worry! You’ll be fine!” You aren’t going to embarrass yourself. You’re going to be awake and in control for the whole procedure, and I promise it’s nowhere near as scary as it sounds. I’m the world’s biggest coward about doctors and dentists, and I’m telling you it’s nothing to fear. The actual surgery only takes about 20 minutes. It’s absolutely painless, nowhere near as emotionally traumatic to endure as you might think, and altogether you’re in and out of the hospital in about 3-4 hours. And in the end, on top of the fact that within 24-48 hours your vision seems almost too good to be true, you get to brag to everyone about how brave you were, and nobody will ever know how easy it actually was!