Saturday, August 4, 2018

ESSAY: Seeing the light again

"I can see clearly now, the rain is gone. 
I can see all obstacles in my way. 
Gone are the dark clouds that had me blind. 
It's going to be a bright, bright sun shiny day." 
~Johnny Nash (lyrics from "I Can See Clearly Now")

Cindy La Ferle

There's nothing like a health crisis to stop you in your tracks and force you to take a long, hard look at what matters most to you. 

As longtime readers recall, late last year I had surgery to remove a small lesion from my lower right eyelid. The cyst was biopsied -- and turned out to be basal cell skin cancer requiring additional surgeries. Due to another pressing health issue that had to be resolved first, I had to postpone the eyelid cancer project -- and wait for available surgery dates this summer. 

Which explains why I've gone missing for a while. 

No stranger to skin cancer, I've survived several bouts of it, and for years I've been religious about wearing sunscreen, hats, and sunglasses. But I was totally in the dark and uniformed when it came to periocular skin cancer, which is the medical term for skin tumors around the eye. Not surprisingly, periocular skin cancer is more difficult to treat than skin tumors on other parts of the face and body.

In my case, three surgeries were needed to repair the damage -- after the first surgical biopsy.  

Awake and under the knife

My next procedure was all about removing the remaining cancerous cells in my eyelid. For this, I chose the same Mohs surgeon who's treated other skin cancers on my face in the past. 

Flowers from Deb / Cindy La Ferle
Mohs micrographic surgery is an outpatient procedure during which the surgeon removes thin layers of cancerous tissue and examines them in a lab (on site) while the patient waits for the result. This process is repeated until the margins of the tissue are clear. The surgery typically takes several hours, or up to a full day, depending on how many layers of tissue must be removed. In my case, the surgeon only needed to remove two layers, taking four hours to complete.

Fearful as I was, I was lucky to have had an established relationship with a respected Mohs surgeon. Who wouldn't be nervous about any type of surgery near the eye? Even on the eyelid, Mohs surgery is done under local anesthesia -- so you're fully awake and aware of what's going on during the entire procedure. In short, you end up having long conversations with your Mohs surgeon, and you'd better trust his skill.

Once my eyelid tissue was in the clear, the surgical wound needed to be closed and repaired for optimal cosmetic and functional results. 

Reinventing the eyelid

The following day, Doug drove me to a surgical facility, where an ophthalmic plastic surgeon reconstructed my lower right eyelid. Luckily, this procedure was done under general anesthesia.

Since nearly one third of my eyelid had to be removed during the Mohs procedure, the ophthalmic surgeon had to rebuild the lower lid with tissue from my upper eyelid. Afterward, he opted to sew my eyelid shut -- for two weeks -- to allow for optimal healing of the grafted tissue inside the lid. I was also put under several restrictions -- no bending, lifting, or strenuous activity.
Flowers from Matilda / Cindy La Ferle

Those two weeks of navigating my life with my right eye sewn shut were among the weirdest, and most difficult, I've ever spent. 

The pain and bruising weren't as bad as I'd expected. But I found it nearly impossible to read for any length of time. My emails and texts were peppered with errors, since I had trouble seeing what I'd just typed. I couldn't accurately focus my camera or edit photos. My depth perception was off, so I tripped on carpets and sidewalks. I broke a glass in the bathroom. 

On the rare occasions when I left the house, I wore sunglasses or a patch over the right side of my prescription glasses. I wanted to avoid explaining to others why my right eye was sewn shut; I was tired of rehashing the whole ordeal. I preferred to say, "I just had some surgery on my eye," and leave it at that.

I struggled -- throughout these stressful weeks of surgery and healing -- to keep my spirits up and my anxiety down. 

They say you discover your real friends during a crisis -- and I believe this is true. It helped tremendously to have the ongoing care of my sweet husband, plus the support of dear friends and neighbors who sent cards and flowers, brought me soup and meals, and emailed or texted daily to check on me.

With one eye shut

So what do you do for two weeks when your eyesight is suddenly compromised and you're not even allowed to bend down to do some gardening? 

When I wasn't napping out of boredom, I tried new recipes and reorganized my underwear drawer. I channel-surfed to find news stations I don't typically watch, aiming to broaden my perspective on current politics (which only added to my depression). Finally, I found some relief and comfort watching Gilmore Girls reruns.

During those two weeks, I also thought long and hard about how much time women waste worrying about eye bags and wrinkles. When your eyesight is compromised in any way, you'd give just about anything to have a clear view of the world again. You stop caring about superficial things like eyeshadow or mascara. You promise yourself that you'll never, ever take for granted the gift of good vision.

When the day of my third surgery finally rolled around, I was more than ready for the next step. Going under anesthesia again, I wasn't nearly as worried about how my eye would look after reconstruction as I was eager to have it re-opened in time to celebrate my birthday this weekend.  

Appreciating the view

All said and done, the reconstruction was successful -- and aside from the expected swelling and vivid purple bruising, the newly repaired eyelid appears to be fairly normal even after the second day of its re-opening. It will take take a few more weeks to complete the healing process, and later, my ophthalmic surgeon will reevaluate his work and decide if we need to make any adjustments. Meanwhile, I remain under surgical restrictions, resting quietly.

As both of my surgeons agreed, surgery in the eye area can be both physically and emotionally exhausting. 

Prior to my surgeries, I did an online search for more info about eyelid cancer treatment. That search led me to an informative post by a young military mom who was also diagnosed with basal cell cancer on her lower eyelid. Had I not found Susan's* reassuring two-part blog post on the topic, I would have been twice as frightened by everything I was about to face.

Once I got past my initial fear of the procedures, I marveled at the miracle of modern plastic surgery -- and the privilege of having access to the best physicians available. Throughout my life, I've been grateful to have a team of skilled, compassionate doctors.

Years ago, shortly after I completed physical therapy for my second hip replacement surgery, I adopted a "theme song" that spoke to me about getting through a painfully difficult time and finding joy again.  The song was "I Can See Clearly Now," by Johnny Nash, and I've been singing it again all weekend. ~Cindy La Ferle

*"Susan blogs at where she inspires busy people to live a simpler, more creative life that makes a positive impact. 

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