336 Hours of Looking at the Floor
November 14, 2013 12:49 AM
My mother will undergo eye surgery soon and her recovery involves at least two weeks of keeping her head tilted forward, even when she's sleeping. Please help me help her through this time.
My mother was recently diagnosed with wet age-related macular degeneration (wet AMD). Essentially, blood leaked from the choroid and formed a clot below the macula, which exhibited itself as a blurry spot in my mother's eye that gradually worsened. Because she left it untreated too long, the blood dried and has probably caused some permanent vision loss. After unsuccessful attempts to ameliorate this through Lucentis, which is injected directly into the eye, the ophthalmologist showed us that the blood clot has actually increased and recommended a vitrectomy with TPA. What I understand is that, along with some lasering to the area, an air bubble is injected into the eye that will gradually push the clot down out of the path of vision, in hopes that partial sight is restored. The blood clot is then reabsorbed by the body.
The idea of this procedure terrifies my mother enough. However, we are all dreading the recovery process, which requires her to keep her head tilted forward for at least 2 and possibly 3 full weeks, until the air bubble gets absorbed as well. This is to allow the bubble to sit at the back of the eyeball and push the clot down properly.
Suggestions we were given:
-you can sit at a desk with your forehead resting on your arm (like one would sleep on a tray table in a plane), then place a laptop/tablet/phone on the ground below and watch movies or browse the Internet that way
-sleep sitting upright with your head tilted forward
-assume a normal position for 10-15 minute meal breaks
And, with some insisting from my mother, we got a reluctant "yes, I suppose you could sleep on your stomach" provided you are actually face-down.
I'm not looking for things to pass the time so much as how to help her adhere to her Face Down recovery. Since she lives alone, we've offered her our place to spend her entire recovery so that we can oversee her, because she can be rebellious, especially when she doesn't necessarily grasp the rationale behind why such a position is required. However, she refused the offer and instead requested that we come visit her every day, which is a little more difficult for us and leaves us in a place where we can't be sure she's sticking to it 24/7. We've discussed some basics about how to make this more manageable, but I would appreciate insight from others who have dealt with this themselves or with a loved one. (I've seen these two.)
Distilled: How did you or your loved one cope with your weeks-long Face Down Recovery? Was there something you would do differently? What words of wisdom helped you understand the science or make peace on such a mind-numbingly boring and, on the surface, not-obviously-helping task?
Thank you all.
My mother was recently diagnosed with wet age-related macular degeneration (wet AMD). Essentially, blood leaked from the choroid and formed a clot below the macula, which exhibited itself as a blurry spot in my mother's eye that gradually worsened. Because she left it untreated too long, the blood dried and has probably caused some permanent vision loss. After unsuccessful attempts to ameliorate this through Lucentis, which is injected directly into the eye, the ophthalmologist showed us that the blood clot has actually increased and recommended a vitrectomy with TPA. What I understand is that, along with some lasering to the area, an air bubble is injected into the eye that will gradually push the clot down out of the path of vision, in hopes that partial sight is restored. The blood clot is then reabsorbed by the body.
The idea of this procedure terrifies my mother enough. However, we are all dreading the recovery process, which requires her to keep her head tilted forward for at least 2 and possibly 3 full weeks, until the air bubble gets absorbed as well. This is to allow the bubble to sit at the back of the eyeball and push the clot down properly.
Suggestions we were given:
-you can sit at a desk with your forehead resting on your arm (like one would sleep on a tray table in a plane), then place a laptop/tablet/phone on the ground below and watch movies or browse the Internet that way
-sleep sitting upright with your head tilted forward
-assume a normal position for 10-15 minute meal breaks
And, with some insisting from my mother, we got a reluctant "yes, I suppose you could sleep on your stomach" provided you are actually face-down.
I'm not looking for things to pass the time so much as how to help her adhere to her Face Down recovery. Since she lives alone, we've offered her our place to spend her entire recovery so that we can oversee her, because she can be rebellious, especially when she doesn't necessarily grasp the rationale behind why such a position is required. However, she refused the offer and instead requested that we come visit her every day, which is a little more difficult for us and leaves us in a place where we can't be sure she's sticking to it 24/7. We've discussed some basics about how to make this more manageable, but I would appreciate insight from others who have dealt with this themselves or with a loved one. (I've seen these two.)
Distilled: How did you or your loved one cope with your weeks-long Face Down Recovery? Was there something you would do differently? What words of wisdom helped you understand the science or make peace on such a mind-numbingly boring and, on the surface, not-obviously-helping task?
Thank you all.
My experience may be different as I am blind in the other eye so the surgery left me completely blind for a few weeks. I do remember as I slowly regained sight reading every post and comment on these metfilter sites one letter at a time on a G1 screen held a few mm from my eye to pass the later time.
posted by stuartmm at 1:23 AM on November 14, 2013
posted by stuartmm at 1:23 AM on November 14, 2013
Would something like this forward-facing massage chair help her be comfortable at the right angle? You could then get one of those claw-type clamps to hold an iPad under the chair or even something as daft as an adjustable TableMate to angle a laptop/book at the right height nearby.
For sleeping upright, it sounds like she will need a mountain of pillows with her bed near a wall and a body pillow behind her so she doesn't roll over in her sleep, and maybe those U-shaped travel pillows to get comfortable. I would get them now and have her trial run the sleeping position so she feels confident about it before the surgery.
posted by viggorlijah at 1:37 AM on November 14, 2013
For sleeping upright, it sounds like she will need a mountain of pillows with her bed near a wall and a body pillow behind her so she doesn't roll over in her sleep, and maybe those U-shaped travel pillows to get comfortable. I would get them now and have her trial run the sleeping position so she feels confident about it before the surgery.
posted by viggorlijah at 1:37 AM on November 14, 2013
If you could rent/borrow a massage table with a face rest, that would make lying on her stomach a lot more comfortable.
posted by Jacqueline at 2:24 AM on November 14, 2013
posted by Jacqueline at 2:24 AM on November 14, 2013
A coworker rented some kind of headrest from a medical equipment company for this; I think there were mirrors too. And she listened to lots of audiobooks.
posted by songs about trains at 4:51 AM on November 14, 2013
posted by songs about trains at 4:51 AM on November 14, 2013
When my grandmother went through this, she also refused to stay with anyone. It did require us to set up a visitor who spent waking hours with her. During my day, I did have to remind her multiple times to keep her head postioned properly. She would forget or get bored/uncomfortable. We did buy her some of those hand held video games which would keep her busy and distracted (bingo, hangman, jeopardy etc).
posted by maxg94 at 6:12 AM on November 14, 2013
posted by maxg94 at 6:12 AM on November 14, 2013
I went through this with both eyes, and it was easily the worst part of the recovery. I don't think I could have gotten through it if my sister hadn't been staying with me, even though I'm as stubbornly independent as they come. I was very lucky that she was available.
Are you phrasing it to her as "We want you to stay with us so we can help you," or as "We want you to stay with us so we can make sure you're following doctor's orders?" Because I know that if my sister had said the latter, I would have refused her help no matter how much I actually needed it.
'Cause the truth is, she DOES need it, no matter what her personality is; basic self-care and getting through the day in an unaccustomed body position is hard work. Just remembering to stay in the position is hard work, no matter how much you want to, just because of decades of habit. The best, most docile patient in the world is going to slip up multiple times a day, with the best will in the world.
I spent a LOT of time wishing I had the money for a massage chair like the one viggorlijah linked to, so if you can make that happen I bet it would be a blessing. I made do with a pile of firm pillows that needed constant readjustment. Lots of listening to daytime TV, lots of books on tape, lots of distractions, lots of napping, lots of letting the days run into each other while trying not to count them.
(I was recovering from other injuries at the same time, so that may make my experience less relevant.)
posted by The Underpants Monster at 6:40 AM on November 14, 2013
Are you phrasing it to her as "We want you to stay with us so we can help you," or as "We want you to stay with us so we can make sure you're following doctor's orders?" Because I know that if my sister had said the latter, I would have refused her help no matter how much I actually needed it.
'Cause the truth is, she DOES need it, no matter what her personality is; basic self-care and getting through the day in an unaccustomed body position is hard work. Just remembering to stay in the position is hard work, no matter how much you want to, just because of decades of habit. The best, most docile patient in the world is going to slip up multiple times a day, with the best will in the world.
I spent a LOT of time wishing I had the money for a massage chair like the one viggorlijah linked to, so if you can make that happen I bet it would be a blessing. I made do with a pile of firm pillows that needed constant readjustment. Lots of listening to daytime TV, lots of books on tape, lots of distractions, lots of napping, lots of letting the days run into each other while trying not to count them.
(I was recovering from other injuries at the same time, so that may make my experience less relevant.)
posted by The Underpants Monster at 6:40 AM on November 14, 2013
If you can't swing buying or renting a massage table or chair, think about getting an adjustable face rest meant to fit on a massage table. You'll want one that has two adjustment points- angle and lift. You can position it so she can lie face down on a bed or take the cushion off and use it at a table instead of her arm. (You may have to get very creative to get the face rest to stay in position on the side of the bed. I'm thinking a small piece of plywood over the 'arms' of the face cradle and then memory foam over that for comfort. This assumes the mattress is too think to just stick it between the mattress and box spring.)
posted by PorcineWithMe at 6:52 AM on November 14, 2013
posted by PorcineWithMe at 6:52 AM on November 14, 2013
Similar question and answers at Making Light, mixed in with a startling variety of other topics.
posted by Bruce H. at 10:13 AM on November 14, 2013
posted by Bruce H. at 10:13 AM on November 14, 2013
When recovering from detached retina surgery I had terrible neck pain from keeping my head tilted forward. I found being face down much easier on my neck. Also, being face down, or really just looking at the floor if I was upright, I was assured I was doing the right thing. I found it hard to maintain just the right angle. Most of the day I laid face down on two stacked sleeping mats and put a pillow under my forehead and listened to youtube playlists or TV. Same position for sleeping. It was too hard to go about my daily routine so I tried to enjoy the rest period.
My husband also spent time recovering from a detached retina. He slept face down on a futon that allowed him to position himself so that he could rest his head on a pillow that was on a chair next to the futon. He was afraid he wouldn't be able to breathe well enough without more air flow! He was very motivated to keep his head down to prevent a cataract from forming on the lens of his eye. He ended up with a cataract anyway even though he was vigilant! He was very good about reminding me to keep my head in the right place also!
Maybe you could demonstrate the concept with an air bubble in a jar of water.
Best of luck!!!
posted by goodsearch at 12:37 PM on November 14, 2013
My husband also spent time recovering from a detached retina. He slept face down on a futon that allowed him to position himself so that he could rest his head on a pillow that was on a chair next to the futon. He was afraid he wouldn't be able to breathe well enough without more air flow! He was very motivated to keep his head down to prevent a cataract from forming on the lens of his eye. He ended up with a cataract anyway even though he was vigilant! He was very good about reminding me to keep my head in the right place also!
Maybe you could demonstrate the concept with an air bubble in a jar of water.
Best of luck!!!
posted by goodsearch at 12:37 PM on November 14, 2013
My mother in law had this very surgery performed last year, so I am thirding, fourthing what others have said above about the massage table and chair. We went on Craigslist and purchased a second hand massage chair, which she used every day for two weeks. The chair has made its way around her retirement community as others have had the same or similar procedures performed.
YMMV, but my mother-in-law was actually sedated by the pain medication for the first week, and spent a lot of time sleeping, which obviously mitigated her discomfort to a certain extent. Good luck! My MIL was quite nervous prior to the procedure as well, but as with many things, the anticipation is actually worse than the event itself.
posted by msali at 1:02 PM on November 14, 2013
YMMV, but my mother-in-law was actually sedated by the pain medication for the first week, and spent a lot of time sleeping, which obviously mitigated her discomfort to a certain extent. Good luck! My MIL was quite nervous prior to the procedure as well, but as with many things, the anticipation is actually worse than the event itself.
posted by msali at 1:02 PM on November 14, 2013
I bought myself a massage chair before my vitrectomy in preparation for lying on my face. When I woke up from the operation, they had used silicon oil instead of a gas bubble as a tamponade, so I had to lie flat on my back for seven days.
It was pretty unpleasant, but I coped by listening to TV comedies that I had already watched, and podcasts.
Then we sold the massage chair to a massage school!
Best of luck to you and your relative!
posted by mgrrl at 2:06 AM on November 16, 2013
It was pretty unpleasant, but I coped by listening to TV comedies that I had already watched, and podcasts.
Then we sold the massage chair to a massage school!
Best of luck to you and your relative!
posted by mgrrl at 2:06 AM on November 16, 2013
Not eye surgery, but back pain which required me to spend a lot of time upright... Sitting backwards in a straight back dinner chair which is approximately shoulder height and letting your head sort of drape over the back is not too uncomfortable, and can probably be managed in more places than a massage chair.
posted by anaelith at 2:31 PM on November 16, 2013
posted by anaelith at 2:31 PM on November 16, 2013
Thank you everyone for your insights. The procedure went smoothly and my mother recovered decently enough for a while. Unfortunately she developed another clot in the same eye a few weeks later, which if not helped by the injections this time may require surgery again. She had a lot of neck pain and the position exacerbated her insomnia, so I don't think she slept too much during the next couple of weeks. She was quite upset by the development, mostly because she was so miserable during her recovery the first time around. We had looked at special "Face-Down Recovery" chairs, but the rentals were steep (about $600 for two or three weeks, I believe). We ended up buying a used massage chair, which was not very adjustable and turned out to be too big, so it wasn't ideal. If surgery is necessary I think she may see the appeal of getting a device specifically designed to hold her head at the correct angle and comfortably so this time, despite the high price tag. The doctor told her that just being flat on her stomach was incorrect, so a massage table or horizontal position is out. She was also concerned that she should not have been using her iPad so much during her recovery and that it might have led to the new damage, but the doctor assured her it was out of her control. All of your experiences did help me understand hers and for that I am grateful.
posted by therewolf at 12:07 PM on December 27, 2013
posted by therewolf at 12:07 PM on December 27, 2013
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posted by stuartmm at 1:01 AM on November 14, 2013