Feb 2023

Returned home after spending 2 weeks with the parents. Dad continues to make solid improvement in spite of the OT/PT staff neglecting their responsibilities but that’s a whole other topic. Mom continues her slide down the Alzheimer’s/dementia spectrum and unable to grasp the requirements for Dad to return home. Each is lost without the other but the disruption to the daily schedule is far more impactful on Mom.

Completed the 2023 Tour de Zwift and even initiated a few threshold/VO2max interval workouts. Neglecting those energy systems for most of the past year is very evident when attempting to return to that effort. Started prepping for the initial PBP ramp-up and the middle of the month includes Vuelta Puerto Rico and the final two events of NEFL’s Brevet week. 

However, a rough first two months of 2023 took a precipitous turn for the worse (never been a fan of the saying, “can’t get much worse,” because it invariably can). Sometime between finishing a trainer workout and heading into the office, lost nearly 90% of the vision in the left eye. No pain, no traumatic event, warning or anything. Fine one minute, not so much the next. Couldn’t feel anything different but vision was like looking through an opaque water bubble. The only visible portion of the visual field was the upper left corner. Don’t know what I was thinking but should’ve reacted differently and much quicker. Any loss of vision is considered a medical emergency and should have immediately gone to the ER. Instead, went to work, purchased some eye drops and thought the issue would resolve itself overnight. Wasn’t better the following day, still no pain or discomfort, but able to make an optometrist appointment for Saturday. Again, warning klaxons should’ve gone off in my head but all was silent as the day progressed and even prepared a delicious family dinner – lamb chops with a fig sauce, scalloped potatoes, and roasted asparagus with Hollandaise sauce. Dessert was a margherita cake. Everything was quite tasty!

The plan for Saturday was to head to the local bike shop to retrieve the Synapse following the optometrist appointment as it was time to head south for 5-6 weeks of cycling time on Tuesday. Well, that plan was quickly squashed when the prognosis was delivered – retinal detachment. Kudos to MyEyeDr for coordinating a follow-up same day appointment with an ophthalmology practice that specializes in repairing retina detachments. Headed straight to the second eye appointment for the day as the year’s cycling calendar slowly crumbles to pieces. Detachment confirmed as 3 tears were identified. 

Learned lots about a medical condition that never even considered. Tears are far more common, about 10% of the population with many not even knowing it, while the year detachment rate is only 1 in 10,000. There are 3 types of detachments with rhegmatogeneous being the most common. Aging causes the vitreous to change consistency and shrink or become more liquid. The vitreous can separate from the retina and pull hard enough to cause a tear. Left untreated, the vitreous can pass through the tear into space behind and push retina away from the layer of blood vessels at the back of the eye. Permanent blindness can result if not corrected. Spontaneous detachments are not uncommon but warning signs include floaters, black spots in field of vision, flashes of light, and blurry vision. Risk factors include the following: aging (> 50), previous detachment in one eye, family history, extreme nearsightedness, previous eye surgery (cataracts). Count me in with 3/5.

Corrective procedures include pneumatic retinopexy: gas bubble to replace vitreous; vitrectomy: removal of vitreous and replaced with air, gas, or oil bubble. Eye will produce vitreous over time and the air or gas bubble will be absorbed. Oil must be removed later; and scleral buckle: a band of rubber, plastic, or silicone sewn around eye to change shape of eye – pressing it against the eye wall. Lucky me, had all three (N20). The air or gas bubble requires maintaining a face down position for as much of the day/night as possible for a week or more to help ensure the optimal position for the retina to reattach. Air or gas bubble also precludes air travel as changes in atmospheric pressure could cause the eye to burst. Doc was considerate and only required 7 days. Comfort Solutions provides devices – similar to a masseuse chair and ancillary pieces for the end of the bed or sitting at a table that facilitate the position without placing a strain on the back of the neck muscles. Not very comfortable and certainly not enjoyable way to spend a week. A bonus accessory is a hinged mirror that allows for TV viewing in a face down position.

Lots to digest after the quick introduction to retinal detachment. The initial plan of picking up the repaired Synapse changed to a photo opportunity and instructions to have the fork painted the same color. Looks pretty sharp – and it’s one of a kind! I wouldn’t be traveling or riding my bike any time soon. Vuelta Puerto Rico and the last 2 events (400K and 600) of the NEFL Randonners Brevet Week were crossed off the training calendar. Barely hanging on was the Golden Falcon 1000K and Florida GF while the Cloverleaf 1200K seemed feasible. Surgery was scheduled for Monday and additional recovery details would come afterwards.

Procedure lasted around 2 hours and everything went well – actually had 7 tears. Scary stuff. No activity for the first week – face down position as much as possible; sleep on right side only. Prescribed two different eye drops, anti-nausea pills and Oxy. Walked out with an eye guard and lots of white tape; a different kind of pirate. Eye pain wasn’t an issue but sore, raw throat from the anesthesia was the bigger problem. The Missus unboxed and assembled the masseuse chair – primary position for the next week and the long week commenced. Initial post-op was the following day when the patch, eye guard, and tape were removed. First look was a little surprising considering the procedures – swelling was minimal; more like a lazy eyelid. Eyedrops were the only ongoing treatment; other than a reminder about being facedown as much as possible. Time passed slowly and the face down position increased the swelling and closed it completely. Even the right eye became a little puffy. Doc was pleased with the swelling – an indication the posturing direction was being followed. Prescribed a couple more eye drops and a round of steroids to reduce the swelling.

The days seemed interminable; tried to work some but not very effective or productive. Not a comfortable position, couldn’t concentrate, and reading wasn’t easy. Climbing on the bike, even the trainer, wasn’t an appealing activity. Finally, the 7-day face down position ended and felt more like a human. Returned the torture chair to Comfort Solutions. What a name – like placing a pillow on a bed of nails. Comfy now? The swelling reduced and eye re-opened; now with a red ring around the iris. Upright position also meant a little activity was allowed – an easy 15-20 walk once a day. Made steady progress – actually able to see, ironically, in a face down position. Similar to opening the eyes underwater. Clearest when looking straight down and images get progressively blurrier as the head is raised. Entire visual field is visible and able to discern number of fingers being displayed in a face down position. Not enough acuity to read or distinguish fine details but much better. The underwater clarity line slowly raised, passing the number of fingers displayed test when head is almost in normal, forward-looking position. Scrapped PBP and all of the qualifying events leading up to it – NEFL Brevet week, Golden Falcon 1000K, FL GF, and NVR Cloverleaf 1200K. Just too much uncertainty with the recovery: no outside riding until gas bubble is absorbed; potential for additional procedures depending upon restored vision, likelihood (near certainty) of cataract development and subsequent removal. Almost a return to the exercise withdrawal, borderline depression feelings that followed the guardrail incident. Primary difference this time is the unknown. TPF recovery was confined to waiting for the bone to heal. Once done, no real concern of relapse or spontaneous breaking. Not the same with retinal detachment.

In addition to the 20-minute walks, short drives are allowed as local laws are 20-40 vision in at least one eye. Depth perception is nonexistent and adds a little challenge to routine tasks. Still able to maneuver around the kitchen and even added a few new items to the menu: salmon Nicoise with orzo and red velvet cake with cream cheese frosting. No, they were not part of the same meal.

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