First Follow-Up Appt After Laser Treatments

[belyro]

Well, I have my first follow-up appointment after my laser treatments tomorrow. I know it's been a long time since I had them, but he was quite happy with my eyes at the end of my long-run of treatments, and said we could wait 6 months. That was actually last month, but we needed to move the appointment, so now it's tomorrow (Tuesday) in the late afternoon.

I'm really nervous. I have no reason to believe it'll be anything but good - he was very optimistic, and my bloodsugars have only been improving since then, but there's a lot riding on this. Not only the future of my ability to see, but also any decisions we make on starting a family. It's pretty scary.

[fgummett]

Best of luck :thumbsup: I wish you good news only :)

[belyro]

Best of luck :thumbsup: I wish you good news only :)

Thanks Frank! I'm hoping for good news only!

[mzteacher]

bethany...
good luck to you today!!! i hope you get all the news you are desiring....and best of luck with all that is riding on this day!!
susan

[belyro]

Well, the news is good! Not only did the doctor see no new problems (i.e. no new proliferation or hemms), he also said the old "bad" blood vessels (i.e. the neo-vascularization) were becoming inactive (I think he used the word "regressing")! YAY!

He wants to see me now every 6 months, but he sounded very optimistic that, barring the unforeseen, things should remain stable. Whew!

Thanks for thinking of me!

[morrisma]

Very good news. :D

[mzteacher]

congratualtions bethany...glad for the good update....i hope we hear some happy "family planning" news soon!!
susan

[gettingby]

That's awesome B !!!!!!!!!!!!!!!!
:party:

[RobiJo]

Awesome!!!! You can breath again for 5 1/2 months!
My next appointment is Monday... and I've had a tiny little floater on the left every so often... hopefully I get a good report too.

[notme]

I hate the eye appointments Beth! I am glad your news was good.... Yipppeeeee!!!!!! congrats!

[MARay237]

Good for You Beth !!!


now for starting on that family..................I'm sure that'll make Your Husband smile !!!!

[belyro]

Thanks everyone!!

[Stacman]

If you don't mind, would someone please clarify what kind of laser treatment you're talking about? For instance, for what purpose? Certainly it's not standard corrective surgery to improve the overall vision. So is it to repair leaky blood vessels in the eye?

[fgummett]

If you don't mind, would someone please clarify what kind of laser treatment you're talking about? For instance, for what purpose? Certainly it's not standard corrective surgery to improve the overall vision. So is it to repair leaky blood vessels in the eye?

Diabetic retinopathy - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Diabetic_retinopathy)

One of the (many) complications of Diabetes is retinopathy... which can be caused by a proliferation of extra blood vessels in the eye. These extra vessels tend to be fragile and bleed easily. Laser is often used to cauterize these little bleeders. If they do bleed you can get "floaters" or drops of blood that can get in the way of your field of vision. Or they can cause scarring on the retina and again loss of vision. Left untreated, this can lead to the retina detaching from the back of the eye and again laser can be used to try and fix the retina back in place.

All of us with D should be getting at least, an annual, fully-dilated eye examination by a specialist.

Retinopathy falls on the list of micro-vascular complications of D and you can do much to stave it off by reducing your A1c

[Stacman]

Thanks fgummett!

Fortunately, during my eye exam on Tuesday the retinopathy examination showed no damage caused by diabetes, even though I'm blind as a bat at the moment...

[fgummett]

Fortunately, during my eye exam on Tuesday the retinopathy examination showed no damage caused by diabetes, even though I'm blind as a bat at the moment...Glad to hear the no retinopathy... my eye specialist advised me to take a daily multivitamin to help protect my eyes... I'm not sure it helps but I don't think it can hurt. ;)

[belyro]

One of the (many) complications of Diabetes is retinopathy... which can be caused by a proliferation of extra blood vessels in the eye. These extra vessels tend to be fragile and bleed easily. Laser is often used to cauterize these little bleeders.

Just to clarify (and I realize I'm splitting hairs here)....

In my case, the laser treatments for Proliferative Diabetic Retinopathy were not to cauterize bleeders, they were essentially to kill off the less important parts of my retina so that these parts wouldn't need as much oxygen, and the oxygen in my eye can be directed to the important central part of my eye (i.e. the macula). This is why people who have this type of laser treatment often lose some of their peripheral vision. The result of the treatment, if all goes well, is that the brain sees that the macula is getting enough oxygen and stops sending signals to produce new (weak) blood vessels - i.e. proliferation.

Sorry to nitpick. :o

[xMenace]

Bethany, I think it is important to understand what's happenning. There is a significant sacrifice made, and the more you know about it, the better decision you can make. Though IMO the decision to get it is a no-brainer.

It's an interesting condition. Here's an explanation in point form.
- eye vessels are tiny and most susceptible to damage
- vessels grow from optic nerve and branch out around the eye
- damaged vessels result in the periphery not getting enough food
- starving tissue releases proteins that tell the brain "feed me!"
- body responds by growing new blood vessels to supply dying tissue (neo-vascularization)
- vessels do not grow around the eye but into it never reaching their target.
- eyes don't get fed
- vessels grow
- repeat: proliferation!
- vessels are unsupported and weak
- vessels eventually bleed
- scar tissue builds on retina
- scar tissue is inherently unstable and damages weaker retina resulting in tearing
- by now it's pretty hard to see

Because of their position in the optic nerve and macula, zapping them is too dangerous. The most useful central vision areas are immediately damaged by doing this.

The standard way to stop this cycle is to kill off the starving tissue - it will die anyway - using a technique called pan-retinal photocoagulation. This sacrifices some peripheral vision for prolonged macular health. After killing a bunch of tissue, the proteins stop, and the new vessels shrivel up, hopefully. Sometimes they don't and end up bleeding anyway. My laser started in 1994 and I hemmed in 2006 followed by a vitrectomy.

These pics show the pattern.
http://medweb.bham.ac.uk/easdec/eyetextbook/dr.htm15.gif
http://www.studentmess.com/archive/image/ophal1%20(12).jpg

photocoagulation - Google Search (http://www.google.com/search?q=photocoagulation&rls=com.microsoft:*:IE-SearchBox&ie=UTF-8&oe=UTF-8&sourceid=ie7&rlz=1I7SUNA)

[fgummett]

In my case, the laser treatments for Proliferative Diabetic Retinopathy were not to cauterize bleeders, they were essentially to kill off the less important parts of my retina so that these parts wouldn't need as much oxygen, and the oxygen in my eye can be directed to the important central part of my eye (i.e. the macula). This is why people who have this type of laser treatment often lose some of their peripheral vision. The result of the treatment, if all goes well, is that the brain sees that the macula is getting enough oxygen and stops sending signals to produce new (weak) blood vessels - i.e. proliferation.

Thanks Bethany... I am so glad you did clarify this. I was only going by what little I know and I was hoping someone who knew more would jump in. I realised even as I wrote the above that it sounded clinical and all too simple... not really doing justice to the reality or seriousness of retinopathy at all. I learned from what you have shared as well. Thanks and to John as well :)

[xMenace]

I was only going by what little I know

As Bethany and others can attest, it is a very stressfull situation. When it was my turn, my optho told me most of this. I was shocked that I was going to possibly lose some vision. I had no knowledge of this condition and I had two days to make a decision about it. The look of panic when I asked if I really needed this is imprinted firmly in my brain. It was gut wrenching. I now know a lot more about the procedure and retinopathy in general.

[RobiJo]

I didn't know anything about retinapathy or treatments either. I'm not sure that if I'd have known I would have changed my irresponsible college years or not, as hindsight is always 20/20 or even 20/10! I agree with John that it was an extremely stressful time and very scary. I still can't speak about it verbally without choking up, and it's nice to have folks in an online world that know exactly what I mean. I wish I would have found this forum during the process instead of after, I could have used the information then. But as it goes, better late than never.