This article is a detailed account of the past 90 days of my life. A big part of me wants to forget everything that happened to me over the past three months, but something inside of me wants to tell the story. I warn you, that every time I go into detail about what I actually went through, people squirm and shy away, so this is my forum to get it all out. It was the darkest, lowest part of my life to date and I am still only just collecting myself to re-establish some normalcy for my family and business. I returned to work just a few weeks ago, under three weeks after my fourth eye surgery in two months after I was struck in the right eye with a hard orange floor hockey ball on August 19th, 2014.
My wife and three children were away at our family cabin. I had returned to work for the week after an amazing almost 3 week holiday, but I only made it to Tuesday before my world changed. Earlier in the summer a client had told me about a regular pick up floor hockey game at a nearby community centre. I went a few times before my vacation, but I was the new guy amongst a group that had been playing together for a while. The only guy I somewhat knew was my client who had told me about the game.
The game was social, but competitive. Every guy had a different level of protective gear, but most did not have any form of eye protection. I happened to have my squash goggles with me, but forget them in the car because I was running late. I had never worn eye protection playing floor hockey before, but was definitely considering it with this group; unfortunately I never got the chance. I decided to jump right into the game and was having a great time. I scored five goals in the first two games before it happened. I ended up in the corner just off to the side of net. I turned back to follow the ball when I saw a split second of an orange ball flying right at my face.
I have managed to hurt most parts of my body over the years, and there is usually a question in my mind right away "are you hurt" or "are you injured," this time it took about 10 seconds to realize that I was in trouble. I dropped to my knees in pain and had a slow trickle of blood dripping from my nose. My eyeball hurt and my vision was 100% gone in that eye. One of the guys I was playing with was a doctor. He covered my eye with a patch and helped me call my father to take me to the hospital. It turns out the guy who shot the ball was my client whom encouraged me to come play. He felt awful, but all he was guilty of was a bad shot.
Sitting at the Vancouver General Hospital (VGH)emergency room that night, I had no idea how intense of a physical and emotional journey I was about to go on. Trips to the ER were not a foreign thing to me, but this injury took me well beyond the ER. I was triaged into 'the eye room' that seemed to be full of equipment that the ER doctors only somewhat knew how to use and only had to very occasionally. I had a few doctors fumble around with tools to measure the pressure in my eye unsuccessfully before they said that I was in luck and the ophthalmology resident was close by and would see me at the eye care centre down the street. The doctor highlighted the building on a map and said good bye and good luck. By this time it was 10:30pm at night and I was walking by myself in the dark with one eye looking for a specific building. As I got to the right block, I heard a man call out "floor hockey?" It was the resident standing outside the building. It was closed, but he opened it up to bring me and one other man into the clinic.
The other man seemed to have spilled a chemical in his eye, but it sounded like he was going to be fine and the resident sent him home relatively quickly. Then he came to me and spent almost an hour looking at my eye with every different tool he had and kept making little comments about this being quite a bad injury. I slowly started to realize that my lack of vision might not be temporary. He finally told me to meet him back there the next morning at 9am and he would get me in to see the retinal specialist. I was sent home with a patch on my eye and a prescription for some eye drops.
My dad drove me home that night with a pit stop at Shoppers Drug Mart on Broadway to pick up my prescription. He left me in the car on a hot August night while he ran in to fill my prescription. After about five minutes I started getting extremely nauseous and ended up throwing up all over the sidewalk of one of the busiest streets in Vancouver. It was beginning.
I slept OK that night, all things considered, my eye hurt, but the vomiting seemed under control. Before I knew it I was back at the Eye Care Centre, but this time it was full of hundreds and hundreds of people between the ages of 60 to 85. There was barely anywhere to sit and the air conditioning was on full blast. My dad dropped me off in shorts, T-shirt and flip flops to a meat locker full of old people that all looked they had been sitting there for two hours already and it was only 9am. I checked in and was taken in right away to see the doctor I saw the night before. He referred me over for a retinal scan and an angiogram right away and then promptly walked me over to Dr. Ma's office, a very busy retinal specialist that treated Manny Malhotra's eye injury. I was happy to be seen so quickly, but understood the fact that I was triaged to the top of the list was likely not a good thing!
Dr. Ma looked at my eye and the test results and informed me that I was going to need surgery to try and remove the blood from behind my retina. He sent me back out to the waiting room where a nurse helped me fill out the paper work for my surgery. I understood the back of my eye was damaged and that Dr. Ma was going to try and fix it. I was told to rest for two days until my surgery. At this point, I had zero vision in my right eye, it was just darkness. I developed a nice black eye and had a headache, but looking back, I didn't feel all that bad all things considered.
Then I had surgery. Most eye surgeries are done under local anesthetic where you are sedated but conscious for the procedure. It didn't sound like a great idea to me, but I trusted them that it wouldn't hurt. Guess what? It hurt! They did what is called a vitrectomy with the insertion of a gas bubble into my eye, which means they suck out the vitreous fluid from my eye and replace it with a gas bubble. They then have me lay face down for the next three to five days in attempt to have the gas bubble press into the hemorrhage on the back of my eye and hopefully push the blood out from behind my retina. Apparently, I also had an orbital floor fracture (bottom of the eye socket) which is why the tugging and pulling of the procedure hurt. The freezing they gave me didn't affect this bone. Lucky me.
Warning: this video is quite graphic and when it mentions her macula was not involved...mine was so ignore that part
In the recovery room the nurses had me flip onto my stomach and told me I would have to stay in this position 90% of the time for the next 3-5 days. I was free to go home once my pain level was below a 4 out of 10. It took two Tylenol 3s, gravol and two oxycodone for me to get under a 4 out of 10 pain, but I did and they sent me home. My wife and three young children were still at our cabin, so my mother and father in law were my nurses and taxi drivers. I don't know what I would have done without them. My mother rented me a set of cushions designed for lying face down after eye surgeries and my business partner Harry borrowed a colleague's portable massage table for my face down sentence.
I had a pretty good attitude at first. I had an injury. I had a surgery to fix it. I thought 3 days face down wasn't the end of the world if it would save my vision. The first 48 hours were uncomfortable, but I managed, but beyond that point I started to sense that something was wrong. I just couldn't stay face down because my eye was hurting and the parts of my face that I needed to rest on just couldn't tolerate the pressure. I started taking the Tylenol 3s, but they just made me feel like shit and didn't help the pain. I shifted to my side and tried to stay looking down. In the back of my head I kept thinking you need to stay face down or you might not get your vision back. I held out longer than I probably should have but by 2 O'clock in the morning I woke my mom up and told her I wasn't doing well.
My mom tried paging the resident ophthalmologist on call, but technology in a sleepy state was not her strong suit. We couldn't get a hold of him, so at 3am she took me back to the VGH emergency room. I felt like the right side of my head was going to explode. I could feel every bone in my face and head and then the nausea started. I threw up through the check in process and pretty quickly found myself back in the 'eye room.' I pleaded with the nurses to just page the ophthalmology resident, but instead I got to go through a new set of ER docs that barely knew how to use the eye equipment that didn't work. I told them their tools weren't working and that I was in a lot of pain. They gave me an oxycodone. It did nothing, so they gave me a shot of morphine. It made me sleepy but didn't help the pain, so they gave me another shot of morphine that made me fall asleep.
I believe I was asleep for an hour or two, but woke up with even more intense pain in my eye and head. Still high on morphine, I sat up to discover I was alone in the room with no call bell, but I heard my name. My friend's old girlfriend was a nurse on that night and she asked if I was OK. I said no and asked for the doctor. It turns out the eye resident ordered me an IV medication for eye pressure that the ER docs had been trying to get from the pharmacist for hours, but they were resistant to give it to me because it was really expensive. I was still in a lot of pain so the ER doc gave me the eye medication and another shot of morphine then told me it was 7:30am and the ophthalmology resident could see me down the block at the Eye Care Centre. So armed with a barf bag, in intense pain and super high on morphine my mom pushed me two blocks to the eye centre in a wheelchair.
He put some freezing drops in my eye and then poked me in the eye ten times quickly with a special pen to measure my eye pressure ( I threw up twice). Normal eye pressure is around 10-15mmHg. Mine was 48mmHg. He tried to look in the eye, but it was just full of blood. I couldn't see out and he couldn't see in. He said "we are going to have to tap it." He put more freezing drops in my eye and then put some type of metal butterfly device into my eye to hold it open. I threw up a couple more times and then I had to rest my chin on a little ledge and stay looking down and left as best I could while he stuck a needle in my eye to drain some of the fluid out. It was as horrible as it sounds, but it immediately took the intense head pain away that had been killing me for the last 12 hours. He prescribed me an oral medication to help the pressure and sent me home for the day.
Those pills became known as my zombie pills. They made me functionally useless. I spent most of the next 10 days in bed, sleeping and throwing up in various levels of pain. My mother and father in law tried their best to get food into me, but I could only muster a few Boost vitamin drinks and a bit of yogurt, none of which I kept down. The pressure in my eye would not stabilize. I went to the eye care centre every day carrying my barf bucket and ended up having my eye 'tapped' with a needle seven times. I developed a bit of a phobia of the procedure, but almost craved the relief it provided. Finally, the pressure seemed to stabilize and I started to wean off my zombie pills. The first day I go in for a check-up feeling somewhat OK and Dr. Ma tells me that the pressure is actually too low now, which isn't good because it can cause my retina to detach. He has me sign the paper work for him to freeze my eye and inject some gas into it to raise the pressure.
Freezing this time unfortunately didn't mean drops, it meant another needle. He froze my eye and then stuck another needle in to inject the gas. Well I immediately went back to intense pain in my head and feeling nauseous. He had injected too much and my pressure was back up in the 40s. Are you kidding me? So the one day I came in feeling OK, I got three needles instead of one. He had to tap it again. I left feeling violated. Dr. Ma was trying his best, but my eye was not cooperating. That was a Friday. He told me to come back on Monday to follow up. I did. He was on vacation.
Enter Dr. Maberly. Dr. Maberly was Dr. Ma's associate and as it turns out a high school student of my father's years ago. I was feeling OK at this point, but still had zero vision in my eye. It was full of blood so I couldn't see out and he couldn't see in very well. He was concerned that my retina was detaching but couldn't tell because he couldn't see in so he sent me for a series of eye ultrasounds over the next few days. The ultrasounds didn't hurt, but it is pretty creepy having someone move a gel covered probe all over the surface of your eye ball. It wasn't a needle so I didn't complain. After the third ultrasound on Wednesday Dr. Maberly decided that yes it looked like my retina was detaching. He pulled out the files of his patients that were scheduled for surgery the next day and had to decide which one to bump because my eye was more urgent. Shit!
I filled out more paperwork authorizing the surgery and showed up the next morning at VGH surgical daycare admitting again. I insisted that this time they give me general anaesthetic instead of local because the last time hurt and I was just worn out from having my eye poked and prodded. I am so glad they knocked me out because as I found out afterward this was a 'big' surgery. The resident told me in the following days that they pretty much did every retinal surgery you can do to someone to me that day. I had a vitrectomy, a scleral buckle and the insertion of another gas bubble, which meant lucky me got to lay face down for another 3-5 days afterward. The scleral buckle is literally a silicone band that they wrap around the outside of my eye that stays on forever and it made me feel and look like I had just been punched in the face. If my eyelids were any more swollen they would have split open.
Warning: this video is pretty graphic as you can probably tell from the picture!
I woke up in the recovery room to a machine beeping and a nurse encouraging me to take deeper breaths because the oxygen saturation of my blood wasn't high enough. I was really sleepy and in pain so it took a few hours and an oxygen mask to get me up and going, but I did and they sent me home for my face down sentence part two. Unfortunately this one had the same result as the first one. I tolerated the position for about 48 hours before the pressure in my eye and face just could not tolerate anything but laying on my side. I knew it was in the best interest of my future vision to try and stay face down, but the pain always became too much to tolerate and my mom ended up with another series of 2am phone calls to the residents.
I felt about as good as I looked!
The pressure in my eye climbed back up into the 40s and my quality of life became inversely proportionate to that number, pain started in the 30's, nausea and intolerable pain in the 40s. My eye hurt, my head hurt more and I was extremely nauseous. I went into the eye care centre every day for the doctors to poke me in the eye and monitor the pressure. Although I became almost phobic of having my eye tapped with a needle, I craved the relief it provided, but this time the docs told me that they can't tap it because the relief would only last about a day (it didn't stop them last time). The treatment of choice was to double my dosage of the zombie pills which felt to be the equivalent of giving me a frontal lobotomy. I slept on my mom's couch all day and stayed awake all night in pain. I discovered that if I lay on my side exactly two feet from a fan blowing on my face, it would give me mild relief, but if I got too close, or stayed there too long, the bones in my face would deeply ache.
I endured the better part of a week only being able to tolerate being horizontal and throwing up every time I rolled over. I had already missed my son's 6th birthday back in August, now I was lining up to miss my daughter's 3rd birthday too. My wife brought the kids over to visit me on Hailey's birthday, but I could only muster sitting up to see them for a few minutes at a time and had to rush off to throw up a few times. I didn't want them to see me like that, but I missed my family so it was worth it.
After stumbling back in to see Dr. Ma in this state he referred me right away to a new young glaucoma doctor named Dr. Schendel. I must of looked like a homeless heroin addict when he first saw me. My hair was long, my face was gaunt with a scraggly beard and I couldn't tolerate sitting up for him to assess me. He tried his best and decided to switch my zombie pills for a different medication and see him again in two more days.
Long story short, the new pills had less side effects, but didn't make my eye any better. I dragged my body back to the eye care centre scaring all the old people with my barf bucket and need to lay down in the waiting room. Dr Schendel saw me and decided we needed to do surgery that day. He worked hard to find me some OR time and an anaesthesiologist at VGH that day. He sent me home and said that he would call if he could get a time. In the end he couldn't secure a time so he decided to admit me through the ER so I could get any time that came up. My mom ended up taking me to the ER on her 65th birthday where I waited for two hours on an old dental chair and then three hours on a tiny cot. Around 10:30pm they brought me up to the pre-op area that I had gotten to know all too well. Again I requested a general anaesthetic because I just needed a break from the pain.
I woke up in the recovery room and this time I was breathing OK and I immediately felt a sense of relief. The pain in my head was gone, I wasn't nauseous and I felt somewhat functional. The moment I had been waiting for had finally come. I was less concerned about my vision, but just wanted to feel OK for the first time in a long while. I hadn't been able to keep any food down for days and hadn't drank anything the day before because I was having surgery so I went home and enjoyed a Gatorade and a sandwich. It was amazing. Dr. Schendel had implanted an Ahmed valve on the upper right side of my eye that has a pressure sensitive valve inside it. If the pressure gets too high inside my eye, the valve will allow fluid out. It is a technology that changed my life.
This video is an animation so don't worry it's not as gross like the first two!
My eye: look from 10-11 o'clock...that is the valve
I rested for one day at my mom's and then decided it was time to move back home and be with my family. My eye and head were feeling better but my body had an incredibly ill feeling. I had subjected it to countless amounts of Tylenol, T3s, Advil, oxycodone, morphine, zombie pills, gravol, one local and two general anaesthetics, not to mention endless vomiting. My liver, stomach and kidneys hated me, but my eye and head felt relatively better so I was happy even though I still couldn't see much. It was nice to be home. I read books to my kids wearing my squash goggles. I visited with my wife to try and let her know her husband was coming back. I helped walk my kids to school which made me realize that I hadn't walked more than one hundred meters in over two months, so three blocks felt really far. I weighed myself and discovered that I had lost 25lbs. I was weak, but I was home and it seemed like things were looking up.
A few days later it was time to see Dr. Ma again. I strolled into the eye care centre and all of the staff that had so graciously been helping me through the past few months independently commented on how much better I was looking. It was the first time I had shaved in a while and even cared remotely what I looked like, but it was nice to hear some positive encouragement. I felt like I had made it through. Dr. Ma came in and looked at my eye. He said the retina and my optic nerve were looking good, but we should do a scan of the back of the eye to make sure. I don't know why, but I was actually expecting good news. As it turns out, I still had a significant hole in my macula, the centre of the retina responsible for detailed vision. If this hole didn't heal together, I would lose the center of my vision and it was unlikely to heal on its own….."so we are going to need to do another surgery." …Shit!
Dr. Ma kindly gave me a week off to recovery from the previous three surgeries and spend some time with my family before he went in again. That week felt like a physical vacation, but a mental nightmare. I enjoyed reconnecting with my family, but I still had no functional vision for everything I had been through and the thought of a fourth surgery was emotionally defeating. I didn't have much left in me, but I had to do it to try and save my eye. I started to feel physically better over the week being able to eat again, which helped my confidence and mental state heading in for number four. This time he did another vitrectomy, a membrane peel and filled my eye with a different type of gas so I could attempt to lay face down for 7 days. I agreed to a local anaesthetic this time and thankfully it didn't hurt, but it was strange listening to them talk about what they were doing the whole time as I felt tugging, saw flashing and heard gas escaping from my eye.
Warning: this video has graphic anatomy too. I was awake for this one!
The recovery from number four was a very different experience than the first three. I wasn't in pain. I wasn't throwing up. It was strange for me and my mom who had to watch me go through it all. I moved back in with her because I had to lay face down for a whole week and that just doesn't work in a house with a three, four and six year old. Imagine spending 90% of your time lying face down for seven straight days. It was a new mental and physical challenge, but it didn't involve pain or needles in my eye so I was up for it. I rigged up a few different stations on my mom's couch and floor and my iPhone became my entertainment center. Days were long and boring, nights were long and uncomfortable, but I did it, 168 hours of looking at the floor. As soon as it was over I moved back home and hung out with my wife and kids to try and bring some normalcy back to our lives.
I started enjoying life again and started looking at the reality of getting back to work. Three months off when you are self-employed is a very costly venture especially when your disability insurance doesn't kick in until 90 days (I was about 75). I had friends and family encouraging me to take it easy and not rush back, but I felt that I could do it and wanted to get on with my life even though I still had a big gas bubble floating around in my eye. Imagine a black marble jiggling around in the bottom of your vision as you move and if you look down it floats up right into the center of your eye. It was annoying and made me a bit sea sick as I walked, but it slowly got smaller every day and finally disappeared in my third week of work. I returned to my work as a physiotherapist just under three weeks after my fourth surgery. It was a bit surreal to be back on my feet and trying to help other people with their pain instead of just trying to deal with mine. I received amazing support from my clients, my staff and my family in my return.
I am currently in week four of my return to work and I have to say, so far so good, even though my vision is still functionally pretty useless. I tell people it is like looking through Tupperware, there is no acuity and I get a fair bit of double vision. The doctor says it will take about a year for the eye to heal and my brain to more effectively use what vision I do have. In the mean time I have four different types of medicated drops to put in my bloodshot eye throughout the day. I am not overly optimistic that I will get a lot of vision back in my eye, but I have accepted that it is what it is, and I will make the best out of it. I need to work on my depth perception, but I am comfortable driving, working and being so things are going to be OK. Sports have traditionally been a large part of my life so I will have to figure out what I can and can't do, but I will figure that out with time. Life goes on.
I would like to thank:
- My wife for supporting me as a single mother for three months.
- My mother and father in law for taking care of me when I was so sick.
- My father for driving me to & from appointments & picking up medications for me.
- My business partner Harry for keeping the clinic running in my absence and treating many of my clients.
- Our close family friends that supported my wife by bringing meals to the house to give her a small break.
- The whole team at Dr Ma and Dr Maberly's office for being so compassionate and sympathetic in my time of need.
- Dr Schendel for making me a functional human being again.
- Everybody that works at the Eye Care Center in Vancouver. I met a lot of you and I woke a number of you up at 4am in the morning and I was always impressed with your level of care.
WEAR EYE PROTECTION!!!!!!!!!!!