Hello, my surgery will be March 12Th for MH. I am thankful to know the surgery will prevent further sight distortion in my eye but am VERY CONCERNED about positioning recovery. I Have RA/ LUPUS/ Sjgorens Syndrome so I have 24/7 pain in normal life....Is their anything that truly is the VERY BEST for comfort while face down recovery?
God Bless Each Who Are Having This Problem, I am so very tankful these past few years they have found a successful surgery and treatment plan for us with MH problems.
Thank you,
Evelyn
Evelyn:
THE BAD NEWS: there is nothing that is going to make vitrectomy recovery easy.
THE GOOD NEWS: there are things that can help.
Most companies offer very similar items; they are all designed to allow your neck, back and shoulder muscles to get some releif from the torture of maintaining the proper positioning. Everybody is different and only you know what you need to get yourself through. Some people do it with no equipment at all! For a look at some of the items available for relief take a look at the vitrectomy positioning devices on my website: www.KellyComfort.com Good Luck!
Toni Kelly
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I will be having MH surgery in about 10 days and am trying to prepare. I have not seen any discussion of taking anti anxiety meds (e.g. ativan) during the face down recovery. Has anyone tried this? If so, does it help?
ReplyDelete-- Len
Dear Len:
ReplyDeleteI look forward to hearing from others on this...
Toni Kelly
Kelly Comfort Solutions
What are the products that are most helpful for the face-down solutions? Thanks in Alabama.
ReplyDeleteI like to think all the items we offer are helpful! But if I had to say the one item to get, if you can get no other, is the bed support. Sleeping face down is miserable if you are not use to it! The bed support offers a large breathing channel so you are not breathing in your own hot air all night.
ReplyDeleteToni
May, 2010
ReplyDeleteMy husband had a full macular hole causing central vision to be completely gone and the peripheral vision was like looking through a special effects lense - all pinched, skewed and distorted.
On May 5 he had his vitrectomy surgery. The surgery was fairly painless and went smoothly. Due to the fact that he has sleep apnia he was not sedated quite as much as someone without this condition and he was quite aware of what was going on during the surgery but not uncomfortable at all.
He returned to the surgeon within 24 hours following surgery, at which time the eye patch was removed. After that, we needed to apply a sterile patch before bed for 10 days or so and had two different drops twice a day.
Once the patch was removed my husband felt extremely discouraged because he felt his vision was worse than before the surgery and that his surgery must surely have been a failure. However, as a matter of normal after surgery protocol, a retnal photograph and dye tests were done and they showed the hole had been successfully repaired. Within a short period of time he began seeing slight improvements to his vision and is now very optomistic on his recovery. Each day things continue to get better and better.
I want to share this with you because I know how scary the prospect of this surgery was for us and how much we wanted to read information from people who had gone through the surgery and recovery.
I'm sure you have heard this many times by now, but the most important key to the success of the recovery truly is the face down positioning. The gas bubble MUST press against the hole. If you cheat on this part of the process you will be disappointed with your result and be seriously cheating yourself.
The two things that made the difference for his positioning success were the Kelly Comfort bed support (economy vitrectomy kit) which gave him the ability to sleep face down. The second thing for him was the vitrecomy mirror. The mirror forced him to keep his head down if he wanted to view the TV. It is amazing how being able to watch your favorite show or a baseball game can distract you just a little and help you to not feel isolated.
His neck and back were uncomfortable as head down really is not a natural position, but he needed to hold that position for 10 days before the doctor told him he could stop. Except for the occassional washroom break and quick bite to eat, he kept his head down continually. Even drank his coffee through a straw. When things got too uncomfortable, we would bring the bed support (vitrectomy wedge and face pillows to the family room and he'd lie face down on it on the floor for a while to relax the back.
Good Luck as you start your process.
what if anything do you know about the silicone use instead of the bubble? has anyone had this done?
ReplyDeleteThe following are the opinions of two retina surgeons. Mitchell S. Fineman, MD, is an ophthalmologist at Mid Atlantic Retina and Wills Eye Institute in Philadelphia. Eugene de Juan, MD, is an OSN Retina/Vitreous Board Member.
ReplyDeleteA limited role for silicone oil
by Dr. Fineman:
I do not think there is any question that gas is more effective than silicone oil at achieving macular hole closure. Notably, Lai and colleagues reported in Ophthalmology in 2003 a 65% macular hole closure rate after surgery with silicone oil compared with a 91% rate with gas tamponade. Gas accomplishes its intended purposes and is easily absorbed without the need for a second surgery, which is another drawback of silicone oil.
Recently, it has been suggested that silicone oil may be beneficial for patients who cannot or will not adhere to face-down positioning after surgery. Silicone oil, because it fills the entire vitreous cavity and remains the same size until it is removed, may not be as dependent on postoperative positioning as gas. Finally, silicone oil may have a role in reoperation of a macular hole when the prior surgery failed due to inadequate positioning.
However, I do not believe that silicone oil has a real role in primary repair of macular holes. It has been my experience that face-down positioning may not be necessary if the internal limiting membrane is peeled and long-acting gas is used. In patients who can position, I normally use SF6, a gas with a shorter duration. This improves the patient’s postoperative experience because once the hole is closed, visual improvement can be achieved more quickly. In patients who cannot or will not position, I use C3F8, which takes longer to absorb, but still achieves anatomical closure in more than 90% of cases.
Gas is usually preferred
by Dr. de Juan:
Although tamponade with either non-expansive SF6 (20%) or C3F8 (14%) is the standard for the repair of both traumatic and age-related macular holes, silicone oil tamponade has been suggested as a means to overcome suspected limitations of gas. Namely, use of gas requires prolonged face-down positioning by the patient in the postoperative period, and vision is reduced by the presence of the gas.
In practice, however, silicone oil has not achieved wide use because of reduced long-term results both in primary closure rates and vision. Also, it requires a secondary procedure to remove it. The reason why silicone oil is not as effective is not obvious but may relate to the reduced “drying” effect around the hole because of the buoyancy of the oil vs. gas.
Silicone oil does play a role in selected cases of macular hole. Myopic macular holes with more extensive surrounding subretinal fluid may need chronic or very long-term tamponade due to reduced healing of the posterior retinal pigment epithelium and choroidal “suction.” It can be useful in patients who are unable or unwilling to position as required with gas, such as elderly, children or those with physical limitations. But stage and size of the hole, along with surgical technique, affect the results in macular hole surgery more than the selection of the tamponade agent, making gas preferred in most cases.
I just bought the ergo lounge and put a foam mat on it. The ergo lounge chair is basically a beach chair with a hole in it for your head....put some foam on it and work with it....not too bad. I plugged in my book on tape and went to sleep....the horizonal position is good for those with joint and back issues
ReplyDeleteAs for meds, I used soma--which is non-addicting, but makes you very relaxed and sleepy. I had to be face down for 2 weeks. We had a massage table with a donut hole attachment. My husband was there for me, and so supportive. This was for retinal detachment/gas bubble. Just recently I went through vitrectomy for macular pucker. Still recovering. I have two blinds spots in my central vision. MD says they are bruises and will go away. I have to be patient.
ReplyDeleteI had macular hole repaired 2/7/13. The doctor says all looks fine and the hole is now completely closed. From the moment I woke up, I saw odd shapes in my vision, even through the bubble and even when I closed my eyes. I liken it to a weather radar screen of a circular storm. As the bubble disapated, I still had the "weather radar" It has been almost 1 month and it is still there. It looks like my vision would be great, but it looks like I'm trying to see through a lace curtain. I can see past the lace, but not the lines. The doctor says the retina gets moved around in my eye while making the repair and my have wrinkles in it that will eventually flatten out and this could take 8 weeks or more. Being the worry wort that I am, I want to see improvement. While the lines on the graph are now straight, my overall vision is much worse than it was before. Has anyone had this sort of issue? Thank you for any input!
ReplyDelete