Cataract Surgery and Anxiety

I have had two bad experiences with cataract surgery. My right eye
became infected after the first operation, requiring additional surgery
and visits to the surgeon for 2 years.

When preparing for surgery on my left eye, anxiety caused my blood
pressure to skyrocket and the operation was cancelled.
..
I am ready to try the operation on my left eye again. I suffer from a
mix of depression and anxiety. What can a surgeon do to alleviate my
problems? Could he put something in the IV to calm me down or elevate
my mood?
Or speed up the sedation?

I am 71 years of age, in good health otherwise.

Your help will be greatly appreciated.

Allan
..

I believe they give you sedative in the IV to relax you and decrease
anxiety during the operation.

Otherwise, try meditation and visualization exercises starting now.
These, if properly done, will decrease the anxiety before and during
the operation. However, not all people have the discipline to meditate
and do visualization exercises regularly. There are also pills to
decrease anxiety.

Good luck,
Carlos

On Sun, 31 Oct 2004 09:17:33 -0500, (E-Mail Removed) wrote:

>I have had two bad experiences with cataract surgery. My right eye
>became infected after the first operation, requiring additional surgery
>and visits to the surgeon for 2 years.
>
>When preparing for surgery on my left eye, anxiety caused my blood
>pressure to skyrocket and the operation was cancelled.
>.
>I am ready to try the operation on my left eye again. I suffer from a
>mix of depression and anxiety. What can a surgeon do to alleviate my
>problems? Could he put something in the IV to calm me down or elevate
>my mood?
>Or speed up the sedation?
>
>I am 71 years of age, in good health otherwise.
>
>Your help will be greatly appreciated.
>
>Allan
>.
>
>
>
>
>
>
>

CarlosWA wrote:
>
> I believe they give you sedative in the IV to relax you and decrease
> anxiety during the operation.
>
> Otherwise, try meditation and visualization exercises starting now.
> These, if properly done, will decrease the anxiety before and during
> the operation. However, not all people have the discipline to meditate
> and do visualization exercises regularly. There are also pills to
> decrease anxiety.

There is also the possibility of general anaesthesia. They don't like
to do it, for obvious reasons, but sometimes it's necessary. My mom
(86, emphysema, otherwise good health) is claustrophobic and just having
the drape placed over her face (vitrectomy etc. for macular almost-hole)
freaked her out. She was willing to give local anaesthesia a try, but in
the end they decided it would be better to knock her out.

> On Sun, 31 Oct 2004 09:17:33 -0500, (E-Mail Removed) wrote:
>
> >I have had two bad experiences with cataract surgery. My right eye
> >became infected after the first operation, requiring additional surgery
> >and visits to the surgeon for 2 years.
> >
> >When preparing for surgery on my left eye, anxiety caused my blood
> >pressure to skyrocket and the operation was cancelled.
> >.
> >I am ready to try the operation on my left eye again. I suffer from a
> >mix of depression and anxiety. What can a surgeon do to alleviate my
> >problems? Could he put something in the IV to calm me down or elevate
> >my mood?
> >Or speed up the sedation?
> >
> >I am 71 years of age, in good health otherwise.
> >
> >Your help will be greatly appreciated.

--
Cheers, Bev
================================================== ===================
Some people have told me they don't think a fat penguin really
embodies the grace of Linux, which just tells me they have never seen
an angry penguin charging at them in excess of 100mph. They'd be a
lot more careful about what they say if they had. -- Linus Torvalds

In article <(E-Mail Removed)>, The Real Bev
<(E-Mail Removed)> wrote:


> There is also the possibility of general anaesthesia. They don't like
> to do it, for obvious reasons, but sometimes it's necessary. My mom


I had a pre-op appointment the day before my first cataract surgery. I
was in the waiting room, and I could hear my doctor yelling at a patient
at the top of his voice. When it was my turn, the doctor was standing
there shaking his head. He called the nurse and order a general for the
previous patient. He explained to my wife and I that the patient was
deaf, and he was unable to communicate with the patient about what the
surgery was going to be like. The patient's wife was also unable to
communicate. The doctor didn't feel comfortable operating on the guy
awake when he didn't understand what was going to happen.


My surgery went well. I was nervous, and I told the anesthesia guy that I
wanted lots of tranquilizer. I felt no pain, physical or mental. I was
told not to go to work the next day due to residual tranquilizer that
might affect my driving. When I had my second cataract surgery, I had a
new doctor because the first had retired. She told me that I could go to
work the next day. When I told the anesthesia guy that I wanted lots of
tranquilizer, he said that this doctor didn't believe in it. I did not do
well at this surgery. I was unable to lie still, and I think I caused
problems for the doctor. As with Bev's mom, I got extremely
claustrophobic having my whole face covered except the one eye. I had a
lot of pain that day and the next day, and ended up missing three days of
work!

--
Dan Abel
Sonoma State University
AIS
(E-Mail Removed)

On Tue, 02 Nov 2004 12:03:17 -0800, (E-Mail Removed) (Dan Abel) wrote:

>In article <(E-Mail Removed)>, The Real Bev
><(E-Mail Removed)> wrote:
>
>
>> There is also the possibility of general anaesthesia. They don't like
>> to do it, for obvious reasons, but sometimes it's necessary. My mom
>
>
>I had a pre-op appointment the day before my first cataract surgery. I
>was in the waiting room, and I could hear my doctor yelling at a patient
>at the top of his voice. When it was my turn, the doctor was standing
>there shaking his head. He called the nurse and order a general for the
>previous patient. He explained to my wife and I that the patient was
>deaf, and he was unable to communicate with the patient about what the
>surgery was going to be like. The patient's wife was also unable to
>communicate. The doctor didn't feel comfortable operating on the guy
>awake when he didn't understand what was going to happen.
>
>
>My surgery went well. I was nervous, and I told the anesthesia guy that I
>wanted lots of tranquilizer. I felt no pain, physical or mental. I was
>told not to go to work the next day due to residual tranquilizer that
>might affect my driving. When I had my second cataract surgery, I had a
>new doctor because the first had retired. She told me that I could go to
>work the next day. When I told the anesthesia guy that I wanted lots of
>tranquilizer, he said that this doctor didn't believe in it. I did not do
>well at this surgery. I was unable to lie still, and I think I caused
>problems for the doctor. As with Bev's mom, I got extremely
>claustrophobic having my whole face covered except the one eye. I had a
>lot of pain that day and the next day, and ended up missing three days of
>work!

I can't imagine anyone going to work the day after a cataract op. I'm
sure it doesn't happen here. Maybe we are wimps.

Ann

In article <(E-Mail Removed)>, Ann
<(E-Mail Removed)> wrote:

> On Tue, 02 Nov 2004 12:03:17 -0800, (E-Mail Removed) (Dan Abel) wrote:


> >claustrophobic having my whole face covered except the one eye. I had a
> >lot of pain that day and the next day, and ended up missing three days of
> >work!
>
> I can't imagine anyone going to work the day after a cataract op. I'm
> sure it doesn't happen here. Maybe we are wimps.


I felt pretty good after the first one. My wife and I went out to lunch
after the surgery. I would have been fine at work the next day, and I did
some work from home.

--
Dan Abel
Sonoma State University
AIS
(E-Mail Removed)

Ann wrote:
>
> On Tue, 02 Nov 2004 12:03:17 -0800, (E-Mail Removed) (Dan Abel) wrote:
>
> ><(E-Mail Removed)> wrote:
> >
> >> There is also the possibility of general anaesthesia. They don't like
> >> to do it, for obvious reasons, but sometimes it's necessary. My mom
> >
> >I had a pre-op appointment the day before my first cataract surgery. I
> >was in the waiting room, and I could hear my doctor yelling at a patient
> >at the top of his voice. When it was my turn, the doctor was standing
> >there shaking his head. He called the nurse and order a general for the
> >previous patient. He explained to my wife and I that the patient was
> >deaf, and he was unable to communicate with the patient about what the
> >surgery was going to be like. The patient's wife was also unable to
> >communicate. The doctor didn't feel comfortable operating on the guy
> >awake when he didn't understand what was going to happen.

You'd think he might have anticipated that, wouldn't you?

> >My surgery went well. I was nervous, and I told the anesthesia guy that I
> >wanted lots of tranquilizer. I felt no pain, physical or mental. I was
> >told not to go to work the next day due to residual tranquilizer that
> >might affect my driving. When I had my second cataract surgery, I had a
> >new doctor because the first had retired. She told me that I could go to
> >work the next day. When I told the anesthesia guy that I wanted lots of
> >tranquilizer, he said that this doctor didn't believe in it.

Yeah, easy for THEM to say. I believe it's some kind of morality thing
-- if it doesn't hurt it can't possibly be good for you and asking for
pain relief is akin to demanding recreational drugs. It's unfortunate
that we don't find out about these nasty little annoyances until it's
too late. How many people are willing to get up off the table and say
'Screw you, I'll go somewhere else'?

> >I did not do
> >well at this surgery. I was unable to lie still, and I think I caused
> >problems for the doctor.

I twitch a lot and have something which might be like restless leg
syndrome, but only occasionally. Being unable to move when the urge
hits would be maddening.

> >As with Bev's mom, I got extremely
> >claustrophobic having my whole face covered except the one eye. I had a
> >lot of pain that day and the next day, and ended up missing three days of
> >work!
>
> I can't imagine anyone going to work the day after a cataract op. I'm
> sure it doesn't happen here. Maybe we are wimps.

A friend just had two done. He wasn't supposed to drive afterward, so
he walked around for a few hours until he was sure that nothing awful
was going to happen. The next day was a normal day and he felt fine --
especially since the vision that made us call him 'Hawkeye' had been
restored. The second one was similar, except his vision wasn't as good
-- the doc told him he had a wrinkle in the back part of the capsule and
that it would flatten out eventually. He had great faith in the doc,
which probably helped a lot.

--
Cheers,
Bev
================================================
The beatings will continue until morale improves

On 11/2/04 8:25 PM, in article (E-Mail Removed), "The Real
Bev" <(E-Mail Removed)> wrote:


>>> My surgery went well. I was nervous, and I told the anesthesia guy that I
>>> wanted lots of tranquilizer. I felt no pain, physical or mental. I was
>>> told not to go to work the next day due to residual tranquilizer that
>>> might affect my driving. When I had my second cataract surgery, I had a
>>> new doctor because the first had retired. She told me that I could go to
>>> work the next day. When I told the anesthesia guy that I wanted lots of
>>> tranquilizer, he said that this doctor didn't believe in it.
>
> Yeah, easy for THEM to say. I believe it's some kind of morality thing
> -- if it doesn't hurt it can't possibly be good for you and asking for
> pain relief is akin to demanding recreational drugs. It's unfortunate
> that we don't find out about these nasty little annoyances until it's
> too late. How many people are willing to get up off the table and say
> 'Screw you, I'll go somewhere else'?
>
>>> I did not do
>>> well at this surgery. I was unable to lie still, and I think I caused
>>> problems for the doctor.


Sedation is NOT the same as anesthesia. Pain is NOT relieved by sedation, so
your comment about pain relief and morality in this instance is not
relevant.

Sedation is strictly to relieve anxiety during the surgery. Anesthesia is
provided by the topical anesthetic drops and sometimes by intraocular
lidocaine. Some are still using retrobulbar anesthetic injections, but
fortunately this is waning now - no chance of retrobulbar hemorrhage, or
double vision due to anesthetic complications with the extraocualr muscles,
and no chance of perforating the globe.

Excessive sedation is dangerous. Can cause respiratory arrest. The ocular
probles stem from the overly sedated patient being unable to keep the eye
straight suring the surgery, or just moving around too much, which you can
imagine can cause all sorts of problems while trying to operate on a moving
target. Some patients also become disinhibited, or lose track of where they
are, and try to get up off the table during the surgery, causing subsequent
loss of the eye. Just enough sedation should be used to make someone calm,
but not unconscious. If retrobulbar injection is used, more sedative can be
administered, because the eye is not under conscious control in any case -
it can't move. An eyepatch must be used to keep the eye closed afterwards,
however. If an eyepatch is used, patient can't put in eyedrops that day
(antibiotic and steroid), so injections are often given under the
conjunctiva, which are uncomfortable, and cause a red eye. Leaving the eye
open, as with topical anesthesia, lets you use no patch, and can then use
eyedrops at home.

Regardless of how much or how little sedative is used, most instructions
recommend no driving for 24 hours, no alcohol, no signing important papers
or cooking over a stove, etc., just in case.