Orbital Floor Surgery, Take Two

Last modified on May 17th, 2007

As I said in my last entry, I am now at home recoupering from what is hopefully my last surgery to correct the damage from November. I’ll go through a quick walk through of yesterday. I woke up around 10am and basically just tried to kill some time until I was supposed to be at the hospital. I was originally going to take a cab down there at around 12:30pm, but it was such a nice day out that I decided to just walk the whole distance myself. Surprisingly, it only took me a half hour.

Once I got there, everyone was immediately friendly. Even though I had to answer a pile more questions that I had already answered before, it didn’t really bother me as things were finally about to be finished. Everyone was on time thankfully, and at 1:15pm I found myself getting changed in the Jim Patterson Pavilion at VGH. And let me say — VGH, at least the new areas that I was in, is a far nicer hospital than St. Pauls. It just seems far more modern and inviting than St. Pauls, and it was almost comforting haing out there. Oh and this time, I didn’t strip naked in front of the nurse, so I learned my lesson.

My actual surgery was scheduled for 3:15, and thankfully this time I brought a real novel to help pass the time. Over at St. Paul’s, I spent most of the time waiting for surgery in a really uncomfortable recliner wearing a surgery gown, but at VGH I had a full bed in a semi-private room, which was really nice. While I was reading, a nurse came over and covered me with blankets, which was a nice gesture that made me feel right at home. I could have almost slept, but people kept coming by and doing various things (such as put in my IV, go over my history, put those little tags on my wrists, etc).

Finally my surgeon comes in and talks to me about everything. He asked me to put my head back as he examined my eyes once more. He said he went over my CT scan, and said my fracture went really far back into my eye socket, more than normal. So instead of trying to correct it using the implant that was in my eye, he would take it out and start over. Another thing he said is that in his opinion, my eye wasn’t just vertical misaligned, but also misaligned front-to-back (which an eye doctor said wasn’t the case a few months ago). And even though he talked to my other plastic surgeon and the eye doctor, he disagreed with them and said just looking at me it was apparent to him, and that he was going to correct it (so maybe having the best guy in the province is a good thing).

So, the plan was to raise my eye a few millimeters, and also bring it forward slightly by sliding the implant pretty far back into my eye socket (you can go about 4cm back before you hit the optic nerve).

Next I met the anesthesiologist who, like his St Paul’s counterpart, was a really nice guy. He was surprised I hadn’t had any food or water for breakfast since my surgery wasn’t until 3pm, but he was happy I hadn’t since it made his job easier. But at that point, since I hadn’t had anything to drink in about 18 hours, I was completely dehydrated, enough that they hooked up a saline IV to make me feel better. They were so busy at the hospital that the anesthesiologist offered to wheel me into the OR himself instead of an orderly, which is probably something that doesn’t happen very often at any hospital (since anesthesiologists are pretty far up the totem pole). We actually had lot of fun since he didn’t really know how to drive my stretcher and we kept whacking into things.

The OR seemed a bit less high-tech than the one at St Paul’s, but that didn’t worry me. They started stripping me nearly naked, hooking up tubes, etc, and pretty soon I had the first cocktail injected into my IV to help relax me. At that point I was pretty out of it, just sort of passively aware of people getting ready around me. Next, I was asked to think of somewhere I really wanted to be, somewhere warm and happy. Next thing I knew, I woke up in recovery.

At this point, after checking my eyesight and verifying I still had two eyes, I really wished I had a camera. As I looked forward from my bed, in pain, I realized I had a sweeping 180 degree view of the entire downtown core from my bed, and it was really pretty. It took about 10 minutes for someone to notice I was awake, and once they did notice, my surgeon came over to talk to me. He said they replaced the implant, but that I had quite a bit of scar tissue that had formed in my eye socket. So, once I was back on my feet, I was going to have to work at eye exercises to break it all down. But, he seemed happy with the surgery.

It’s a bit disappointing (in general) that the doctors talk to you as soon as you come to, because to be honest, I don’t really remember much of that conversation. It’s hard enough to keep your eyes open at that point. They are really busy though (my surgeon is in Prince George today doing surgery), so I understand they don’t have much time, but it would be nice if someone wrote some of that down for you for when you have your senses back again.

I was in more pain than last time, and in general, felt like complete shit. I’m not sure if they kept me under longer or what they did differently, but surgery kicked my ass in a big way this time. I had to get them to give me three separate injections of pain killers to stop the pain in my eye socket and put me at ease. Plus, I was so nauseous that they hooked up a bag of gravol for my IV so I wouldn’t barf.

About an hour later they moved me back into the peri-operative area where my dad was finally allowed to come hang out with me. I was really out of it at this point, and didn’t even really feel up to talking. But he just sat next to me, putting his hand on my knee from time to time to let me know he was there. They gave me a couple T3s at this point to help with the pain. At this point, based on my last surgery, I would have gotten up and gone home, but I didn’t really feel like I could talk, let alone walk, so I just stayed for 45 minutes to an hour longer until I felt like I could at least hop into a wheel chair.

I spent the night back at home, chatting with my dad and listening to music. We put on Pan’s Labyrinth to watch, but after about ten minutes I realized it was a lost cause, and we turned it off so I could pass out and go to sleep.

My dad and I were both really impressed with the hospital staff at VGH. Everyone went out of there way to be friendly, and even crack the odd joke or two. Those little gestures make all the difference when you’re stripped naked, and sitting there worrying about your pending surgery. We stopped on our way out to thank the nursing staff personally for making it easy on everyone, and it was a nice experience based on everything I have been through in the last six months (see, I don’t hate all you medical people).

So, here we are. The surgery disrupted my infraorbital nerve, which means my entire left side of my face (my left cheek, nose, lip and gums) is completely numb again. If you held a lit cigarette against it, I’m sure I wouldn’t flinch. This happened with my last surgery, and hopefully over the next few weeks it will slowly come back in a series of pins and needle sensations as nerves start going active again.

The incision is a bit different this time, and it looks like they didn’t recreate the old one exactly (perhaps on purpose so they could see more inside of there), which will mean I have two scars instead of one, but oh well. Instead of having steri-strips on my wound, this time they just covered it with polysporin and left it exposed, which is a bit weird since last night it was dripping a bit of blood and creeped me out. However, they say it heals better this way. The vertical position of my eye seems better, but I’m trying not to get my hopes up so early in the recovery, since the swelling and everything distorts how everything looks for a while. The double vision is about the same, but it actually hurts to look in those areas now, where before it didn’t. Which actually makes me happy, since I think it means those muscles are no longer trapped on anything, and are free to move again (but sore from scar tissue and lack of use). But he said hopefully the double vision will resolve slowly over the next few months, if all goes well.

Here’s a shot from this morning comparing the result (on the right) with a before shot taken about a week ago.

At least to me it looks quite a bit better, excluding that big bloody gash under my eye. Next Thursday I’ll get the stitches out, and will get to clean everything properly and see what it really looks like.

Once again, thanks for all the support. Hopefully I’m on my way to having all of this behind me.

14 responses to “Orbital Floor Surgery, Take Two”

  1. Brennen says:

    hey man glad to see you on your feet. Tom if you read this you’re awesome! Thanx for taking good care of my pal. duane, you still ain’t as good looking as me, but gettin better every time.

  2. Rosie says:

    Looking good! Hope your recovery is speedy!

  3. Beth says:

    Glad to hear that you made it through your surgery OK (even though it wasn’t the most fun thing you’ve ever done!)… it’s all going to be getting better from here on in, right? Hope you are feeling all better soon!

  4. rahim says:

    Hope you have a successful recovery!

  5. dragos says:

    Hey, speedy recovery and hope to see you soon!

  6. Keira-Anne says:

    Thanks for filling us in on your experience, Duane. It was actually really fascinating to read about. Glad you’re starting to feel a bit better and that things are looking up.

  7. Maggie D'Ambra says:

    I was glad to find this as I am facing surgery for a blow out of the orbital floor, and some of things I read have been pretty scary, this made me feel a little better. Exactly how long was recovery and how is your scar now!

  8. carlos says:

    i have had 3 surgerys tp repair orbital floor fracture since the doctors in my country are really bad.(nicaragua). The 3rd one was in bascom palmer miami the best eye hospital, i hope it is the last one. After the third i had same sympto,s as you so iam happy about that. it hurts when looking up or down. it is only the third day after surgery.

  9. Vipin says:

    It was encouraging to read about your third brave surgery. I am also suffering from orbital floor fracture and like you my fracture is also in the posterior of orbit. I have diplopia in the extreme upgaze. My problem is that I feel that I have developed ocular cardiac reflex resulting in bradycadia and is affecting my heart.
    Did you have first surgery within 14 days of injury as doctors tell me that it is ideal to have it within that period. After that it become difficult. I do not know what is my fate. I am Toronto.
    What is the name of the doctor who operated on you third time ?

  10. Duane Storey says:

    I haven’t had my third surgery yet, but it’s coming up in July. The doctor is in Vancouver, but he actually just retired. I think this is basically one of the final surgeries he will do.

    I had my first surgery around day 20 I believe. The second surgery was about six months after that. It will have been around 4.5 years since my second surgery by the time I have my third surgery, but I’m hopeful it will finally be fixed.

  11. Vipin says:

    Hi Duane,
    All the best for your surgery in july.

    Please email me the name and contact number of the doctor in vancouver as I am desperately looking for a good doctor.

    Best regards

  12. Jasmine says:

    I have had two surgeries myself and still enophthalmos, no double vision and eye is moved back. First surgery day 15 and second was to remove first implant from misplaced implant, headaches, severe pain, misaligned eyes and diplopia, 3 weeks after first. Now 5 weeks postop and doc suggests to wait few months to bring eye up and eye. What was your experience third time?

  13. Duane Storey says:

    Third time was really good. But the root of my issues was they never properly repaired my cheekbone which means my eye socket is slightly larger now. But it’s mostly ok.

  14. Mike says:

    Hey Duane, I went through a similar experience lately and have been stressing about everything. I underwent a left orbital floor repair on June 1st, but now that the eye has settled I’m slightly enophtalmic, and it bugs the hell out of me. I’m curious what happened after your second surgery, as that picture looks perfect, but I’m assuming your eye further settled. I’m hoping you have everything solved by now, and was curious to get a little more info on what exactly they did.

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