Tuesday, June 21, 2016
Periocular Injection Today
When Anna was first diagnosed with uveitis (probably over 15 years ago---the years are started to mesh together), I remember reading and researching a LOT about treatment options. And there was a time (over 10 years ago) when her pediatric rheumatologist told me about another one of his patients who had a steroid injection straight in the eye in order to get some stubborn eye inflammation under control. At the time, I could hardly even think about such a procedure. I did ask her ophthalmologist about it then, but he was not a fan of the concept (the Intraocular pressures can rise to an unacceptable leven, and there is no way to go in and get the medication out). Besides that, he doesn't have the ability and necessary instruments to do such a procedure in his private practice.
How can anyone even stand to get a needle into their eye? How could a parent even stand to be in the room while anyone did that to their child? Well, this morning, Anna did have a steroid injection into the back of her eye, and I was in the same room. (They didn't ask me if I wanted to be there, and what type of supportive parent would I be if I asked to be excused to the waiting room?) While I watched the prep (which took a lot longer than the actual injection---numbing the eye with anesthetic drops, and then a swab of anesthetic until Anna said that the eye no longer felt scratchy), I did not watch them (the doctor, who held the syringe, and the resident, who pushed the steroid into the eye) as they did the actual procedure. I closed my eyes and prayed for their hands to be steady.
Anna knew the risks. The ophthalmologist (Dr. M) reminded her of them at our last visit with him, when we told him of the possibility if the macular edema was still present at our appointment today with the retina specialist. Dr. M would not have chosen this route. But Anna truly trusts the retina specialist, and she wanted to avoid oral Prednisone, which messed with her mind two years ago, even though it calmed down the macular edema. And this current macular edema has lasted for several weeks now. She's ready to have better vision in her left eye again. The retina specialist today assured Anna that if her pressure rises, we can counter that with different drops. About halfway through the prep, she asked Anna if she was okay (Anna was), and Dr. N. told her that if really wanted, we could stop, and reschedule it to be done "upstairs" and under sedation. (We were doing this in the clinic, without any sedation.) Anna was just ready to have it done and over with.
And the verse and song God has given us these past few days? Psalm 3:3 (see the picture at the top of this blog post). I was feeling the Lord being a shield around us today, giving us peace and a "let's do this attitude" instead of fear. I am so thankful for specialists like Dr. N. And I'm thankful that she sees adult patients as well as pediatric, so Anna can stick with her instead of "aging out" as she is doing with her pediatric rheumatologist, whom we greatly respect.