Final Retina Ablasio Surgery Experience Part 14 - Just Menong

Retinal ablation is the release of the retina so that it causes sudden vision disorders. Early symptoms are usually characterized by the presence of fibers that fly in the eye. This fiber can only be seen by the patient. Based on the experience of retinal ablation surgery, retinal tears will occur differently in each patient. Some suddenly lost vision or still survived even if a fiber appeared.

In total, Zauji is already in the operating room as much as 7x, from the installation of 1300 cSt silicon oil, 5000 cSt, scleral buckle, CF6 gas, and HD silicon. After the installation of silicon HD, much 'drama' occurs, but all can be overcome, and Zauji is only recommended for control every month.

Routine Control at Cicendo Hospital

It has been almost two months since Zaji has exercised control over Cicendo Hospital. The monthly control that was originally done in the fourth week of June was delayed because we and our family got a 'turn' confirmed for Covid-19, so that post-Covid recovery became the main choice.

After no longer experiencing symptoms and antigen swabs are confirmed negative, we begin to reschedule our routine controls by previously extending referrals in phases 1 and 2 first. Because it has become a permanent patient, the extension of the referral in Faskes 1 does not take long. The results of the examination at Faskes 2, Mitra Anugerah Lestari Hospital (MAL), showed there was a decrease in visibility. This is in accordance with what Zauji has felt since being exposed to COVID-19. The long visibility is reduced, but, alhamdulillah, it is not blank at all.

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The monthly routine check falls on Wednesday so that we can meet with Prof. Dr. Arief S. Kartasamita, Sp.M.K., at the pavilion clinic. Qodarullah, that day we met again with Dr. Made Indra Widyanatha, SpM (K).

Visual Examination

The results of the visus examination showed an increase in right eye pressure, which reached 27, and a significant decrease in vision, as conveyed by Doctor Novi at MAL Hospital. Thank goodness the left eye is in good condition.

This time the examination was done differently; Doctor Indra stated there was a trace of diabetes in the right eye of Zauji so that it was possible to decrease vision due to diabetes. During exposure to COVID-19, Zauji’s blood sugar did rise dramatically, even though the food intake is only 3–4 years of eating. Doctors recommend blood tests (fasting blood sugar, PP, and HbA1C blood sugar) and optical coherence tomography (OCT).

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Because we are not prepared (Boris is not fasting 10 hours as a condition of blood tests), we also do not prepare more funds. Actually, Zauji is scheduled to control in the regular poly of BPJS next week, but in order to be able to consult more, we decided to consult in the pavilion clinic, and of course, all costs are borne independently.

The cost of a blood examination is 500 rb, while the OCT is about 600 rb. Doctors do not force you to do an immediate examination because, of course, the cost needed is not small. But with consideration, the results will be directly consulted with consultant doctors such as Dr. Indra. Finally, we decided to do a second examination at the pavilion clinic.

Laboratory and OCT Examination Results

We came back the next day. Blood tests are done 2 times, 1x fasting blood sugar, after which Zauji has breakfast with the provisions we bring, and then we do a blood sugar check again 2 hours PP (postprandial = after eating). While waiting for the results, Zauji conducted an optical coherence tomography (OCT) examination.

Although the time still shows less than 8 o'clock, the waiting room of the laboratory is filled with patients and families who are waiting for the queue or examination results. Some of them do antigen swabs as a preoperative requirement.

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The OCT examination was conducted by nurses who had known us for almost two years. While doing the examination, we exchanged news. The examination is repeated because Zauji has difficulty focusing the right eye on the point of the tool. This is normal for patients with decreased vision (residual damage to the retina or papilla). The results of the examination are printed on sheets of paper.

Since it was registered the previous day, we only reported to the registration section. From the results of the lab examination, Zauji's blood sugar (10 hours of fasting and 2 hours of PP) is not too high for diabetic patients (<200). The HbA1c score is also in the number, which is quite good for Zauji, who had reached the value of 12, above 3 years ago.

I also said during the recovery after exposure to Covid-19, Zauji has not been on a diabetic diet again because our target is to restore the condition first so that carbohydrate intake has not been replaced back into brown rice. In addition, sports and shaum sunnah, which is usually done by Zauji, we also skip for almost 1 month.

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The OCT results show there are parts of the retina that have not been attached back even though the HD silicon has been installed for more than 1 year. This is possible because the nerves of the eye are already stiff. The evacuation of silicone is not the right choice because it is feared that the retina that has been attached will be released again. Currently, despite a decline in vision, Zauji’s condition is in a stable state, so it is not a wise thing to ‘brabble’ about the condition that already exists.

Results OCT Left Eye

Results of OCT Right Eye

Delaying Silicon Evacuation

In the interim, monthly routine control is the best option to observe Zauji's condition, especially his eye pressure. Currently, doctors only give the prescriptions of Timol and Glaucen to lower the eyes and remind Zauji to always control blood sugar.

The sky is the only hope. Whatever God gives, God willing, is always the best. Although humans give gifts in the maximum way—the best doctors, the best hospitals, the best equipment, and the best medicine—if God has not willed... hopefully it becomes a way of goodness and charity.

Thank goodness I's a thing.

Gratitude in all circumstances. The experience of retinal ablation surgery may lead us to him. God willing, we will do an EG examination to find out the condition of the retinal nerve.