Stream of (semi)consciousness

Mom had her cataract surgery today and everything went just fine.

Our show-time was 9:30 a.m. so we left at 8:15 a.m. to make the roughly one-hour drive. We actually arrived about 9:05 a.m. No traffic. That's my story and I'm stickin' to it.

It was a nice drive. The cold front is passing and the sky was full of mostly white, mostly puffy springtime clouds.

Then we waited until she was called back at 9:45 a.m.

The surgery is pretty straightforward and today's ophthalmologists have become very adept at the procedure. It's really kind of neat.

Before the procedure starts they give (this is how they did it here) the patient sublingual xanax. The tiny pill goes under the tongue and is almost instantly absorbed into the blood stream. Mom said she felt it right away. Xanax is a pretty potent benzodiazapine, similar to valium. It causes relaxation and drowsiness.

They then start an IV and give versed and fentanyl.  Versed is a more powerful and shorter acting benzo which also has a significant amnesiac effect. Fentanyl is a rather powerful opioid pain medicine which provides pretty much the same sort of sedation as the benzos but through a different mechanism.

They also give eye drops to numb the eye and dilate the pupil, and give an injection of local anesthetic into the muscles inside the eye which control the shape of the lens. This paralyzes those muscles so nothing moves while the surgery is going on.

Once everything is ready, a small incision is made in the eye, ultrasound is used to break up the cataract, the broken-up cataract is suctioned out, then an artificial intra-ocular is placed where the old lens was removed. Then it's slap on an eye patch and you're good to go.



Of course, after receiving all that sedation the patient might be a little bit groggy. Loopy even. Especially if the patient is 110 pounds soaking wet and unaccustomed to the ingestion of spirits or mind altering drugs.

When they called me back to go over the post-op instructions with Mom she was struggling mightily to pretend that she wasn't smashed. But she couldn't pull it off. The nurse would explain something, I'd respond, then she would start in on the next item. At which point Mom would try to repeat the previous bit of instructions. As best she could. It was a little bit like listening to a live and a slightly delayed radio broadcast at the same time.

When we left, Mom wanted to get a cup of coffee. She's had a cup of coffee most mornings for the last 50 years and she was jonesin' bad this morning. I rather hoped she'd forget the coffee idea, but it was planted firmly in her mind before she got the meds and it was a powerful message that fought through the opium and tranquilizers.

So we went to Scooters, a little drive-through coffee shack, and ordered two Americanos. As we drove away she forgot all about the coffee and began holding forth on various topics.

"I don't like Iowa," she declared. "I like Montana and Idaho and Utah. And New Mexico. Colorado is okay. I don't know anything about Kansas. My Grandpa Hill was born in Kentucky. No, he was born in Missouri. I think. But Gramma Hill was born in Kentucky. Or Ohio.

"like that person told Elwyn, all the intelligent people are from the east coast. And the west coast. But I don't like Iowa. Or California. Oregon is okay. I don't know anything about Kansas."

Then she found her coffee and began trying to figure out how to work the cup, which had no moving parts. I was rather concerned that she'd spill hot coffee on herself, but she managed fine. She spent most of 30 minutes blowing on the 1 mm x 3 mm sipping hole in the lid, trying to make the coffee cool enough to drink. She didn't cool the coffee a bit, but eventually natural convection did.

"This is the best coffee I've ever had," she said.

We got home and managed to get into the house without any major falls or spills. "The doctor said I don't have to cook," she told Dad. She tried to play a game of solitaire on the computer, gave up, and laid down on the couch. 

In a little while I'll check in and make sure she gets her eye patch off okay and gets started on the post-op eye drops. Most of the happy juice should be worn off by then. And tomorrow morning we'll go back for her 24-hour follow up.