June 13, 2000: Had appointments with both Dr. Smick and Dr. Everett.  Dr. Smick decided to refit the left (non-transplant eye) lens, saying that it was fitting too tight and that it wasn't moving around enough to get enough oxygen through fresh tears. This causes swelling of the cornea. I mention that my vision is great with the lens until I take it out, then it's blurry even with my glasses for the next couple of hours. Apparently, as long as the lens is in, we have a regular focusing surface, but the swelled cornea is an irregular surface. So, he'll order some different contacts, and we'll swap them when they come in. 
I then head over to Dr. Everett's and see what he thinks. He says everything looks great. He says he doesn't think he needs to see me anymore, unless I think I'm having a rejection episode. He also says that sometime over the next couple of years, I'll feel something caught in my eye, that scratches something fierce. That will be the stitches breaking. He says to call when that happens, so they can take them out. How long it takes to happen depends on how much of a certain enzyme I have in my eye, that causes the nylon to dissolve. 
I also ask Dr. Everett his opinion on the Keratoconus in my left eye, and if he thinks it will need a transplant anytime soon. He says if it does, it's in the 10-15 year range, with a strong possibility of "maybe never." He said there was no scarring at all, and only moderate thinning. As long as I can comfortably wear lenses that provide adequate correction, we'll stick with them.

June 20, 2000: The new lenses came in. The left one seems to fit better, because I can feel it moving with each blink, which wasn't happening before. The right one is the same shape, but a little stronger for better distance vision. I'm supposed to come back next week to see how they're working.

June 22, 2000: I notice that the new left lens seems to do the trick. No blurriness when I take out the RGP and put on my glasses.

July 25, 2000: Maybe I spoke too soon. While not as pronounced as before, I am still getting blurriness when I remove the new left lens. Dr. Smick wants to refit it again.

August 3, 2000: Pick up the 3rd lens. It's considerably smaller than the other 2, by 0.8mm, according to the doctor. I notice that if I'm in a dark room with light filtering in through a door or window, I can see the edges of the lens. More importantly, it's considerably easier to remove than the other two were.

September 17, 2000: For the last couple of days, I haven't been wearing my contacts, and I realize that it's because my right eye feels like I've been wearing them nonstop for the last couple of days. There are a couple of red areas on the conjunctiva, and I've been sitting with the drapes drawn because it's too bright outside. I do the math, and realize that these are rejection symptoms. Will call the doctor 1st thing Monday.

September 18, 2000: Doctor Everett isn't in today, but I make an appointment to see him tomorrow. Light sensitivity is getting pretty bad, and I have to leave work early because my computer screen is too bright to look at, even with my sunglasses on.

September 19, 2000: Dr. Everett says, "Boy, it's a good thing you came in when you did," which is never a good thing to hear. Actually, it's not all bad. He says that we do have early stages of rejection, but it hasn't gone far enough to do much damage. He puts me on Pred-Forte drops once an hour while awake, and switches me from Refresh PM ointment at night to TobraDex ointment. Which is great, because I was almost out of Refresh PM, and I can put off buying another tube. Interestingly, I have my best results on the Snellen Chart ever and can read 20/15 through the pinhole glasses.

September 21, 2000: Rejection looks under control. He says to stay on the drops and ointment until next week, when he'll see me again. To complicate matters, I tell him that I'm having a myringoplasty tomorrow (eardrum repair- it's a long story, I have lousy hearing, too). He says that the Tobradex should be good for up to 8 hours if I'm going to be sleeping that off.

September 26, 2000: Rejection seems to have cleared up. He cuts me back on the Pred-Forte to every other hour, and he'll see me next Tuesday, October 3.

October 3 & 24 (and into November), 2000: Things are still looking good. Cut the drops back to 4-a-day for 2 weeks, then 3-a-day, then twice, then once a day. I also switch from Tobradex ointment at night back to the non-medicated ointment. I should be able to start wearing my contacts again in December, just in time for ski season, which is good because I'd been having problems with my glasses fogging last year. 

I've also been getting e-mail, maybe 4 or 5 messages a week, from people who have had transplants, or are about to have transplants, or found out they may need one down the road. One was from my great-aunt, who I'd last seen when I was about 5, who had had a transplant because of Fuch's dystrophy. All the mail has been great. It's a great feeling that this page has helped people (only feeding my megalomania... bwah-hah-hah-hah!).

June 9, 2001: Okay, I admit, it has been WAY too long since I've posted anything. Many have people have emailed me asking for updates, so here we are....

I never did get to wear my contacts again last December, because about a week after I was weaned off the Pred-Forte, on December 23, I had another rejection scare. Dr. Everett was on vacation, so I saw Dr. Melissa Bell, who was in from PCLI's office in Lewiston ID, about 100 miles south of here in Spokane. She put me back on the Pred-Forte eight times a day for a week, then down to six, then four.

By the time I saw Dr. Everett again in January, he said he wanted to wean me off the drops much more slowly this time, and probably keep me on some kind of maintenance drop. By the middle of May, I switched from a drop of Pred-Forte twice a week to a drop of Alrex twice a day. Alrex is about 1/10th the strength of Pred-Forte. After three weeks of twice-a-day Alrex, I'm down to once-a-day, and I'm slowly easing my way back into my contacts. I'm up to about 10 hours a day, now. Dr. Everett wants to see me again in mid-July, and he says we'll probably go down to Alrex every other day, and keep it there indefinitely.

Here's hoping there's nothing exciting to post for another 7 months.

January 9, 2002: Wow, seven months TO THE DAY. Went to see Dr. Everett today, and as usual, everything is going well. I'm down to a drop of Alrex every other day. I'd quit wearing the contacts back in August or so, and I'm now trying to work back into them. Dr. Everett said that since I'm doing that, I should keep on the every-other-day Alrex routine to keep my eye calm while I'm wearing the lenses. I read 20/30 with my glasses and 20/20 with glasses and the pinhole thingy. Pressure is 17mm, so everything seems pretty normal. Back in 3 months, he says.

Something earlier visitors to this site may have noticed is the new address. My previous host, USWest/Qwest, decided to get out of the consumer internet service business and tried to sell me to MSN, so I needed to move. Since I do tech support for e-mail software, I'm familiar with ISPs, and this change was one I didn't want to make. Don't get me wrong, I like MS software and recommend it heartily, but the ISP is a horse of a different color altogether. I'd have had to change the address even if I'd stuck with MSN, so , I got a different ISP and registered my own domain. Hence, wirtznet.net. The site is now hosted directly out of my own apartment. For you techheads, here's the specs of the server:
Gigabyte GA-7ZX KT133 motherboard
AMD Athlon 1Ghz (10x100FSB)
512MB PC133
GF2MX400 32MB video card
Maxtor 20GB 7200RPM HDD
WinXP Pro with IIS
 

I plan on adding a RAID card for mirroring. And no, there's not enough traffic for me to want a dual processor or SCSI setup. This was just one of my spare machines that I used the least often, so my mucking about was least likely to necessitate rebooting. I do plan on migrating to 2K or .NET server (when .NET comes out), but this is fine for now. And don't email me saying I should try Linux & Apache. I tried it, and decided Windows worked well enough not to justify learning a whole new OS.

So, anyway, there's my tech rant. I hope now that I'm hosting the site myself that I'll update it more frequently.

But don't hold your breath.

January 23, 2002: I'm sorry if anybody has had problems connecting to the page lately. I'm still getting the kinks worked out with this self-hosting thing. I did some upgrades to the server machine, adding a RAID card (Tekram DC-200) to mirror the Hard Drive, and switching from WinXP Pro to Win2K Server. It shouldn't make any difference to the surfer, but it makes it easier to administer the page remotely. I've needed to reboot the machine occasionally because my ultra-cheap mechanical KVM switch will occasionally cause me to lose mouse function. That will cause an outage of 3-4 minutes. If it's going to be any longer than that, I'll switch the DSL modem to a backup machine that also has the page. The only other outage I'm aware of is when my ISP went down from 1am-10am last Sunday morning, but that wasn't my fault. Anyway, if you notice any extended problems with the site, drop me an email.

March 2, 2002: Well, I knew this day was coming, but why did it have to come on a Saturday?
I woke up this morning and my transplant eye felt particularly scratchy. I got up and used some artificial tears to flush out any dried-up remains of the night-time ointment I use. After getting nowhere with using 2 of the single-use vials, I began to get an idea of what was happening. I got out a flashlight and stuck my nose against my bathroom mirror and confirmed my fear: my suture had broken. In the bottom outside corner of the eye, I could see the reflection of a tiny bit of the thread poking out of the cornea, right at the outer apex of the zigzag. The below picture is from the surgery video, and I "enhanced" (drew on) it to make it easy to see where the stitches were and where it broke. The white line is the part that was poking out and hurting my eyelids.

Since it was Saturday, I wasn't sure what to do. First, I put in some of my night-time ointment to see if this was something I could tolerate until Monday. Oh no. The ointment only seemed to make it worse. It hurt every time I blinked. So, I called Dr. Everett's office in case they had an emergency contact. I got an answering service, and the lady who answered asked me to spell "suture" because she wasn't familiar with the word. O-kay. Anyway, she had a PCLI technician call me, who determined I needed to see the doctor today. Dr. Everett called me a half-hour later and said he'd meet me at his office in an hour and a half. When we got there, he had his kids in tow and a ski rack on his roof. I was greatly relieved when he said they were on their way up to the mountain, and I hadn't brought them down from it.

He sat me down in front of his scope and verified that the suture was, in fact, broken. I'd have felt pretty stupid if it had just been an eyelash. He put in some numbing drops, then went and got his tools out of the autoclave. I asked if these were his medieval instruments of torture. He said I didn't want to see what he was using until he was done. Too late. It was a scalpel and a pair of tweezers. I'd been wondering how he planned on doing this. Was he going to use the tweezers to unthread the thing? No, he first used the scalpel to cut the suture apart, then removed the pieces with the tweezers. This process took about 25 minutes, almost as long as the transplant itself. Hey, when a guy has a scalpel and tweezers that he's using on your eye, you want him to take his time.

After the stitches were all gone, he put in some Ocuflox (antibiotic), Alrex (anti-inflammatory steroid) and a fluorescent dye. He then used the black light scope to check for leakage. That was a word I'd just as soon not have heard in connection with my eye.

 So, I'm taking the Ocuflox and the Alrex each 4 times a day until I see him again, which will be in a week. I thanked the doctor for helping me on a Saturday and wished him and his kids a fun day in the snow, and went about my Saturday. That was a mistake, because the numbing drops wore off as I was in the middle of eating a cheesesteak at Bruchi's, after shopping for comic books. Fortunately, I was able to get home in one piece, where I took one of the horse tranquilizer pain pills I had left over from my last ear surgery. That knocked me out cold and much of the pain had subsided by the time I woke up 5 hours later, just in time for more eye drops. Just putting in the Ocuflox feels like I'm stapling my eyelid to my forehead. I expect that to get better.

March 8, 2002: Went back to Dr. Everett's to check on the suture-free eye. The drops quit stinging by Sunday afternoon, and the eye feels about as "natural as it has since before the surgery.

We take a topography to compare it to before the sutures broke.

4/25/00	3/8/02

Like the last time I posted a topography, the disclaimer is that the scales are slightly different, 33-61 on the left, and 39.5-53.5 on the right, so the reds on the newer one would have been yellow on the older one. However, you can see that the blue areas on the newer topography are a new development.

Overall, I've gone from 3/4 a diopter of astigmatism to 2 3/4 diopters. He says we can expect it to fluctuate wildly over the next few months, increasing quickly and slowly falling back down.

I can quit the Ocuflox, but I'm to continue the 4-a-day Alrex for the next 3 weeks.

March 28, 2002: I can go back to Alrex every other day, now. I ask him about something Dr. McNeill (the surgeon) had mentioned when I last saw him: the possibility of getting Lasik on the transplant eye. He tells me it's something they're doing more commonly on transplants than they used to. He said it's trickier than on a normal cornea, but might be a good thing for me, because of the huge difference in prescriptions between my eyes. He told me about another patient of his who went from 20/40 to "How many fingers" when his suture broke, and they did Lasik on him with pretty good luck.

We take another topography, and Dr. Everett says he's surprised how little it's changed. He says We could probably do Lasik "in another 6 or 8 months." Wow, that'd be cool. My left eye is probably still good enough to pass a driver's test on its own, and if the other one can be brought in line with that, I could make it around the house, maybe even work or read a little without glasses.

To be sure, I'd still need glasses for my best vision, but this holds great potential.

November 9, 2003: OK, it's been awhile since I posted an update. My usual excuse was that nothing had changed, but I guess I left a little bit of a cliffhanger there a year and a half ago. Did I get Lasik? No, mostly because of the cost. I swore off contacts because the last 3 pair never got to the point where I could wear them every day for more than a few hours. So, I'm back to where I wanted to be when the whole thing started 15 years ago: I'm happy to be wearing glasses that correct my vision. This summer, I got a pair of prescription sunglasses, and they're form-fitting enough to my eye sockets where I think I'll be able to use them for skiing without goggles. Like I found before, the goggles that go over my glasses are fogproof as advertised. However, my glasses underneath them are not, making the whole thing useless. last time I went skiing, it was raining buckets and I just went without glasses or goggles or contacts. It was interesting, but I think I saw better than I would have had I used corrective lenses and dealt with their resultant fog.

January 1, 2005: Vision's been steady, which is why I haven't posted updates in the last year, but I was channel surfing and ran across a program on The Research Channel about cornea transplant surgery that was very interesting. It told the story of a man who needed a cornea transplant, but before they could do the surgery, his wife of 25 years died suddenly of a brain aneurism. You guessed it, he got one of her corneas. The program also talks with a surgeon and the director of an eye bank. Best of all, they have the whole thing available for viewing on their web site. I learned a whole lot from it, and I wish I'd been able to see it before my surgery, so I'd have a better idea of what to expect.

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