[NAGDU] {Spam?} Cataracts, Surgery, and Having a Guide Dog -- LONG

[Tracy Carcione]

Hi Lissi.
I think it's great that you added guide dog training to your dog's other
training, and that, as a result, you feel confident to go out at night
when you can't see well.  And that you have the smarts to use your cane
when you can't see and aren't using your dog. Lots of people can't get
past their ideas about blindness to even pick up a cane until they get
hurt.
Far from being offended by your efforts, I'm impressed.
Tracy

> This is long. I'm sorry. I tried to make it shorter but I failed
> miserably. Please feel free to skip over it because it's long and probably
> whiny.
>
> I know I don't post much but I really need help with figuring something
> out, so I hope it's OK I'm posting this to the list.
>
> I have progressive/degenerative myopia, with only light perception vision
> at night and in dim light. My dog and I trained with and graduated from a
> service dog training program as a team a while ago. And, since I have
> trained working dogs before, and because I've studied guide dog training
> for years ( I originally wanted to become a guide dog mobility instructor,
> but continued studying when I was told my vision might progress to the
> point of legally blindness). So, I trained my dog's guide work and he's
> now been working beautifully for months. I can go out after dark again,
> and I've gained a lot of confidence and independence because of him.
>
> My near-total loss of vision in dark conditions has always been attributed
> to the fact that I have a high-degree, progressive, not-fully-correctable
> form of myopia (it's considered an eye disease, different from simple
> nearsightedness, as it usually leads to other vision changes and loss, and
> it typically reaches a point where it can no longer be fully corrected).
>
> Yesterday, I had my first appointment with an ophthalmologist in a
> different practice than my normal one; he was my second opinion because I
> never felt like the other doctor took me seriously.
>
> So, the new doctor found that, in addition to progressive/degenerative
> high-degree myopia, I also have two other things going on: one is
> something new, but minor, called "convergence...something", which can't be
> corrected but isn't a big deal. The second thing he found was that I've
> developed unusual forms of cataracts in both eyes. He said these cataracts
> are responsible for at least part of my near-total loss of night vision,
> my partial loss of color vision, the problems with severe glare, etc.
>
> When I asked him if it was a matter of having a simple surgery (like
> almost everyone does at some point in their lives, at least in the U.S.),
> he paused, then said carefully that I wouldn't have the same outcome as
> most people do with cataract surgery. Most likely, I'd lose close & mid
> range vision to a low or mid partial level that may or may not be
> correctable. He doesn't know if the myopia would continue to progress;
> but, he said the surgery might help, at least for a while, with regard to
> my long distance visual acuity.
>
> He told me having surgery would help eliminate some of the issues with
> glare, and would improve my night vision to an extent. He's not entirely
> sure that these cataracts will stay fully within the lens of the eye,
> because they're different from typical ones; they are a lot like cortical
> cataracts, but aren't age-related, (I'm in my early 30's), but they can
> form in or around the lens, and sometimes invade surrounding tissues.
> They're totally benign, thank goodness, but the dr said surgery may not be
> able to stop the later development of more of these in the area that would
> surround an artificial, implanted lens. He said my insurer wouldn't pay
> for surgery right now, anyway, since the cataracts need to be larger
> before they'd even consider it. My insurer's criteria for surgery isn't
> related to functioning, but by objective measurement.
>
> Last night, I decided that since I only had cataracts, I had no reason to
> have my dog work as a guide anymore. I'd planned to simply stay at home at
> night, stop working my dog as a guide, and undergo surgery whenever that
> will be (it could be six months, or it could be a couple of years). I
> decided that, since cataracts are treatable, it was an insult to people
> with eye conditions that aren't treatable to ever consider letting my dog
> guide again, and that it would be wrong of me to stay on guide dog lists
> like this one.
>
> I finally slept, after two days on two hours of sleep, and hope I'm
> thinking more clearly today.
>
> After what my doctor said, I don't even know that I want to have surgery,
> primarily because of the drawbacks and the likelihood that it would do as
> much harm as it would do good. He was clear that having surgery will
> destroy the vision I rely on most (near-to-mid range), which may not be
> able to be corrected at all.
>
> So, do I sound like a horrible person for not jumping at the chance to
> wait and have cataract surgery? What if I decide not to have it? Do you
> think I'm almost obligated by social norms to have the surgery, no matter
> how it impacts my vision, and whether I want it or not?
>
> I mean, would any of you -- people who are REAL guide dog handlers, people
> who have their dogs due to far more significant and much more valid
> reasons for vision loss than I have -- consider it selfish or wrong of me
> to choose against surgery under these circumstances? Would you personally
> be offended if I continued to allow my dog to work as a guide at night,
> and if I were to keep using my cane in dark/dim conditions, at least for
> the time being (until surgery was possible and I made a decision)? Would
> you think of me as abusing the system? Would I be abusing it? If I don't
> have the surgery, will I seem like an ungrateful idiot?
>
> I know that, without the surgery, I'd become legally blind both day and
> night sooner than I would from progressive myopia, alone. But, not having
> the surgery would mean I'd be able to retain a fair amount of the type of
> vision I use most -- close/mid-range vision, despite being legally blind.
> (I only qualify for certain types of surgery due to the other conditions,
> so there is no way to get around the side-effects on my near vision). But
> if I allowed the cataracts to progress in order to preserve near vision,
> would you regard me as someone who should NOT ever be considered blind,
> and as someone who should NEVER be allowed to apply for a guide dog,
> because I didn't have the surgery?
>
> I'm rambling. A lot. I hope maybe some of this made sense. If anyone might
> have any advice or thoughts here -- even if it's to say I'm a total idiot
> for ever thinking I had a reason to teach my dog to guide, that I had no
> reason to ever have had O&M training at all, or to say that I'm a complete
> jerk for using a cane to navigate at night before my dog was fully trained
> -- I'll be grateful to you.
>
> Having thought for years that my night vision, or lack of it, was due to
> one thing, it's really confusing to suddenly learn that oh, it's also
> probably because of something that surgery might help, but that same
> surgery would be done at the expense of other aspects of my vision that I
> value more.
>
> Help? Please? Thank you if you made it this far! I didn't mean to re-write
> War and Peace on the listserv, but I just did, so I'm sorry if I broke the
> list in doing so. Haha!
>
> Thank you!
>
>
> Lisie and her funny sweetheart of a dog (who keeps trying to get his mommy
> to stop typing and get his leash for a walk)
>
>
> Sent from my iPhone
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