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Adventures in Cuenca eye surgery and a delayed trip back to the States

On July 18, I was fresh from cataract and lens replacement surgery on both eyes, very happy with not needing glasses any more, getting ready to leave for the States on the 24th to visit family and friends.

chl david nelson logoBut . . . on the 20th I was back in surgery, having a sudden and ferocious infection removed which left me unable to see from my left eye. The doctor said that with eye drops (hourly, all day long) and time I would have full vision. I had his ok to travel, if I saw a doctor as soon as I got to the U.S. Even though I really wanted to go, at the last minute, good sense overcame my stubbornness about finishing what I planned and I canceled the trip.

Ten days after the second surgery, I can see a lot but only as if through a film and with no binocular vision. Yesterday, as I wrote this paragraph, it was only a black blur; today I can see the lines. The doctor thinks it will be another three weeks for full restoration of my vision.

chl eyesSo how do you put drops into an eye that you can’t see out of? I went next door to Piedad who, along with her niece, her niece’s friend, a carpenter who was doing some cabinet work, did the job. Piedad had enjoyed learning the English words “sit down” and telling them to me in a very firm voice along with a big smile. Someone suggested a mirror, which I had, so after a couple of days I learned how to administer the drops myself and relieved Piedad of the burden. As always, my friend Tom was there to make sure I took taxis (the doc had told me to stay inactive for at least two days after each surgery) and to run errands and to bring me dinner.

Yes, I was stressed. Preparing for travel is stressful anyway and then the eye issues on top had me really tense and anxious. But here I am, still in Cuenca, enjoying a new challenge, feeling on top of the world.

The tools used in these eye procedures are amazing. After a minuscule cut into the eyeball, a tool is inserted that destroy the cataract, then a new lens, made to my prescription, is inserted, and within 20 minutes or so it is done. To clean the eye of the infection, a blender type device that rotates at 5000 rpm is used.

I really would have liked to watch the surgeries. How about developing a device that would allow you to direct the vision of the other eye to wherever you wanted? I was slightly sedated but fully conscious during the procedures and would have been able to watch the action.

* * * *

We have more cell phones per capita in Ecuador than in any South American country, but most of us have no phone bills. We pick out a phone in the phone shop — and there are hundreds to choose from — then tell the sales clerk which of the two phone companies we want to provide service, and buy prepaid minutes for our account. When the minutes are used up, and very often you find out in the middle of a call when suddenly there is silence. You can check your balance any time. I don’t use the phone a lot so $20 of minutes lasts a long time.

Anyway, when I was talking to Tom recently, the line (since we don’t have telephone lines for cell phones, can you still say the line went dead?) went dead. Since I was sure I had minutes, it must be that my phone had a bug. Tom and I spent a lot of time and emails back and forth arranging a time to visit the shop where I bought my Ecuadorian smart phone. Melina happened to came by to see how I was doing and I asked her to listen to the recorded message that I kept getting: “you’re out of minutes” was the answer. An abashed, “oh”, apologies to Tom for all his time and effort spent, another $20 into the account and the phone works fine.

And now for my Sunday walk on the river.

Cuidense. And my love, Dave.

About the Author

Dave Nelson

David Nelson, spent 30 years growing up and getting educated in Oregon before moving to the Oakland, California and the East Bay area, where he practiced worker’s compensation law, representing injured workers, for 40 years. When he retired from his legal practice, he worked another nine years as a part-time gardener before moving to Cuenca.

  • Kenneth A. Merena Ph.D.

    People need to become educated about the incidence of hospital based infections that are encountered here in Ecuador. It is a world wide epidemic, but it is more prevalent in Ecuador than the United States.

    http://rwjms.rutgers.edu/global_health/health_fair/documents/AnitaBhamidipatiGlobalHealthPoster.pdf

    Hospital based infections are more virulent than community based infections and in general, are much more difficult to treat.

    http://www.mayoclinic.org/diseases-conditions/mrsa/basics/definition/con-20024479

    This includes, but is not limited to Methicillin-resistant Staphylococcus aureus (MRSA) According to the CDC, over 80,000 invasive MRSA infections and 11,285 related deaths occur every year in the United States alone.

    http://www.cnn.com/2013/06/28/us/mrsa-fast-facts/

    Many years ago, when I taught in Medical School, one of my assignments was to teach a course in maintaining sterility during surgical procedures. I know the subject fairly well and what I have seen in local Cuenca hospitals is appalling and explains much of the incidence of these Hospital Based Infections I have encountered. Personally, I have had 10 surgeries in Cuenca at 3 different Hospitals and due to my own personal experience with Hospital Based Infections, I take special precautions to avoid such infections.

    I won’t bore you with the protocol I use, but it is based in using the most effective disinfectants in the world to treat the operating rooms where my surgeries will be performed. These products are not available in Ecuador so I bring them in to the country from the U.S.

    My surgeons, Dr. Marco Carrión and Dr. Ivan Vallejo, are colleagues and extremely supportive in my personal efforts to avoid infection. Generally, they personally take charge of disinfecting my operating rooms for me prior to surgery.

    Last Thursday, I was scheduled for the 11th surgery on my left knee and I was taken into the operating room at Clinica Latino. Because neither Marco nor Ivan had arrived, one of the OR nurses began the disinfecting protocol. Within two minutes, another OR nurse entered and informed me that the surgery had been cancelled and I was taken back to my room without further explanation. Only then was I told that the Director of the Clinic had heard about the disinfecting protocol and he was furious and immediately cancelled my surgery. It seems that his machista ego had been offended by the implication that the disinfecting protocol normally used by Clinica Latino was lacking and in an irresponsible and vindictive move I have never seen in my entire career, he threw me out of the Clinic.

    Today I will be checking into the IESS Hospital where colleagues there have assured me that I will receive the finest care. When I get out of the Hospital, I will initiate action against Clinica Latino through official channels.

    Kenneth A. Merena Ph.D.

  • LadyMoon

    One of the gifts of living here is the community we have–both Cuencanos and Expats. Glad you had people who were able to demonstrate their loving and caring for you and all is going to be well, David! (Just read today on Facebook that there is a possible eye drop that dissolves cataracts in the works. My doc says I’ll probably never develop them…but knowing there are better procedures coming is a relief!) Take good care of yourself!

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