Getting Back to the Old Me

I found out on Monday that I am officially ready for eye surgery. Thyroid eye disease can be a nasty little bugger, and often times, people must wait years until the disease “calms down” enough before they can have surgery. I am fortunate in that regard because I only developed moderate TED in July 2011, so 13 months ago, and it “calmed down” in October. I’m not fortunate to have TED, as many people experience no eye involvement with Graves disease, but my eyes started changing soon after I was diagnosed. I always had deep-set eyes that I was somewhat self-conscious of because, from a profile view, my eyebrows almost “stuck out.” Within a few months of my Graves diagnosed, my eyes began bulging not to the point that it was noticeable to anyone but me, but enough that my eyes now lined up with my eyebrows from a profile view. Unfortunately, a year later, my eyes bulged to the point that I became unrecognizable to people who hadn’t seen me in a few years. This was devastating, and extremely painful—both physically and emotionally. Now that the physical pain is gone and the swelling is under control, my surgeon is ready to operate.

The official name of the procedure I’m having is a bilateral (meaning both) orbital decompression. An ENT surgeon will enter through my nose to remove the medial wall (between my eyes and nose) on both sides, and part of the orbit floor (the bone under my eyes). My oculofacial surgeon will create a small incision on the outside of both eyes to remove the lateral (outer, near my temples) walls. He told me the scars would fade into my wrinkl…oh yeah, I don’t have wrinkles. Anywho, they will be tiny little scars that probably only I will notice, and since this whole TED thing required steroids that caused acne, I rarely leave the house without makeup anyway so I’m sure the scars will be nearly invisible. The point of the surgery is to create more room around my eyes so that they can go back into my head where they belong. Normally, this can be achieved by only removing fat, but since mine is pretty significant, they need to remove bone. You don’t need that bone anyway.

Since two surgeons will be operating on me, so the surgery is almost two months away on Sept. 25. I’m ready today but I still need to meet the ENT, see my primary care doctor just to ensure everything else is working properly and my ticker isn’t going to give out on the operating table.

I have never told my co-workers or boss about Graves or my eyes. But now I have to. So last week, when I officially got the surgery date, it was a convenient coincidence that my boss wanted to know if I was taking any vacation time and if not, why not? It’s summer and pretty quiet here with no students on campus, so better now than during the semester. Too bad I don’t get a real vacation now that I have to use my sick time, personal days, and two weeks of vacation (in that order) for surgery and the lengthy recovery.

Thank goodness, even though I went into my boss’s office shaking, she was more curious than anything else. Concerned, too, and that’s probably because her daughters are only a few years younger than me. It turns out a former colleague had Graves and TED but quit shortly after their diagnoses and onset. Strange, because a former colleague at my previous job had Graves also. That’s three PR people who have it, and I’m sure many more. They say it’s caused by stress, so no surprises there. PR is hardcore.

The recovery is supposed to be pretty intense. Aside from all the risks surgery carries, and the pain and swelling and the fact that I will look like I got into a brawl, there is a 50/50 chance that I will develop double vision (strabismus) regardless of any precautions the surgeons take. It just happens. If I do, and it doesn’t go away after two weeks like many double vision does, then I will need eye muscle surgery after about three months. It’s a fairly simple procedure. If I don’t need that, the next surgery will still be three months later to lower my eyelids. Since my eyes have been bulging for more than year, the eyelids have stretched over them. Once my eyes go back to normal, the lids will still be "stuck" up over where the top of my eyeballs would hav been, and I will still look surprised all the time. If I need the eye muscle surgery, the lid surgery will be three months after that, so we are talking six months worth of surgery and recovery at minimum, or nine months to a year if I need all three. I planned for this, and I’m freaking ready.

I took a full week off, and we are going to play the rest by ear. Maybe I will work the second week doing half-days or working from home or some sort of part-time arrangement, and then I will still come back to work on Day 15 bruised and swollen but probably OK to work and drive, unless I get that double vision. That’s a bridge I don’t plan to worry about until it comes time to cross, but I have to make at least tentative plans in case that happens. If it does, I won’t be able to drive, and will rely on my dad mostly. My boss passes me on her way in, so we could probably work something out for most days, and my dad gets out of work before me but doesn’t work too far from here, so it would just be those days where other people have appointments or meetings and I maybe need to work from home or something. Again, that’s a bridge I’ll cross when I get there.

Here is the photo my surgeon is going to use as a reference. He said, “You look adorable here.” I took that to mean I don’t look adorable now. Nah, he is the most genuine person I have ever met in the health care field, so what he meant is that although people say, “Your eyes look fine,” or, “But you have such big, pretty eyes,” that the changes since TED are significant and severe, and this surgery is medically necessary (if it wasn’t, insurance wouldn’t cover it). On a somewhat unrelated note, I agree with the surgeon. I like this photo of me. I used to be very comfortable in my own skin. I never thought I was hot (too plain) or gorgeous (too flawed), but I thought I was pretty and like the way I looked. Because this is “the look” we’re going for, I think it would be helpful if I cut my hair to be about the same length, and did my best to lose any excess weight I can before surgery. My thyroid levels are a whole other issue, and I have little control over my weight and metabolism right now while we are still sorting everything out, but I have decided to really cut out junk. I’m still going to eat dairy products and red meat and carbs, but I’m going to try and eat as little processed food as I can, while still allowing myself to eat whatever I want for two meals a week, which is probably going to be my Dunkin Donuts on Friday mornings and a dinner out with friends or family. Otherwise, I’m eating lean protein, fruits, vegetables, healthy starches, dairy (ice cream is my weakness), and lots of water, and less coffee. The reason I’m going to cut my hair is not just because I want to look like this, it’s also because my hair is really long and there won’t be a female presence in the days after surgery (more on that later) to help me with it, so the less I have to deal with, the better.

That was my headshot at my job on Sanibel Island. It was taken in May 2009, about nine months before I was diagnosed with Graves but probably only a few weeks before the Graves started (I began noticing symptoms in July that I attributed to all sorts of other causes until I was diagnosed and realized all the symptoms were Graves symptoms). Here is my headshot for my current job, taken in February 2012. Drastic difference. No, I have not colored my hair. But it was definitely lighter when I worked on an island every day, and the lighting in the recent headshot was really odd. And, I was squinting as hard as I could here. I always do in photos now.

So, for an accurate look at my eyes, I leave you with this - a photo comparison of my eyes in May 2009 versus August 2012, a little more than years apart. I'm not squinting in the first photo or trying to open my eyes wide in the second photo, just smiling.