Caving to Cataract Surgery – the Devil’s in the Details

March 29, 2024 Claire Sachs

With any medical procedure, there are a ton of logistical details that come with it, along with whatever emotional burden you are already carrying.

Routine outpatient procedures are no different. Making sure you check all the boxes so you don’t inadvertently screw everything up is a chore and a half. (This is different from intentionally screwing everything up. You have no idea how difficult it has been to not self-sabotage, given my talent for it and my near two decades of delaying tactics.)

In this case, it’s not a lot of things. But it’s enough that I can’t procrastinate as I usually do.

Other than scheduling the seven doctors’ appointments I will need over the next six weeks, I also have the prep stage, which involves medication and lifestyle. I need to get three different sets of prescription eyedrops -- I hate eyedrops. I need to take one starting two days before the surgery, one the day of, and the last is a steroid to help with swelling in the days afterward. It’s not as simple as it sounds.

The first hurdle was that my doctor’s office gave me a set of documents for a different patient. A 47-year-old woman can’t walk into a pharmacy with prescriptions for an 83-year-old man from a different state and expect to have them filled. Time was already getting tight, so I had to get the doctor’s office to call it in. No mean feat on the Friday afternoon when I realized the mistake.

The second hurdle was that there is a shortage of one of the prescriptions and the only warning I got was a text that it was “delayed”. Luckily, before I could have a major meltdown, the surgery center called to discuss my insurance, something the doctor’s office apparently hadn’t communicated. Since I had her on the phone, I asked the staffer after we had straightened out the insurance. She assured me that there would be some I could take at the surgery center when I arrived.? That was a relief, but I am still going to have to call the doctor’s office to make sure they know. (See how not self-sabotage-y I’m being?)

As long as I can confirm the surgery center availability of the eyedrops I don’t have, that part of the set-up is done.

Then there is the diabetes part. As with most surgeries, you have to fast from food, water, and all medication beforehand, for something between eight and 12 hours. Of course, I can’t be without insulin, but that is exempted since it is a hormone everyone else has naturally. Also, going that long without it would make me extremely sick, so there’s that. It’s still a problem because it leaves a large window for my blood sugar to drop with no option to treat it.

The artificial intelligence that controls my continuous glucose monitor-insulin pump setup should be able to handle it, but if I’ve learned anything in the years I’ve been on this closed loop system, it’s that tech is far from foolproof. I think the only option I have is to tell it that I will be exercising starting 12 hours before the surgery. It’s the only way to elevate the target blood sugar (to 140 instead of 110), and hopefully avoid the need to break the surgery rules.

All of that, plus calling my insurance company, was all crammed into this week when I still have unimpaired vision. (I wanted to make sure they knew it was coming, like you do with your credit card companies when you go abroad, and I wanted to make sure I knew how to submit for reimbursement, because my surgeon and her staff are out of network.)

I can’t wait to see what next week will bring. Hopefully there won’t be as many hurdles while I try to avoid walking into walls with a pirate patch on my eye to keep myself from rubbing it.

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