Research related to Fade ch 40

*****NOTE!!!! This entry contains major spoilers for Fade ch 40! Don't read if you don't want to be spoiled!!!*******





I'm on a livejournal group called little_details -- it's a pretty cool place where you can go and ask questions about specific things you haven't been able to find answers to in your research so far.

I noticed a request today that I happened to know a lot about due to recent research (about medical procedures that would follow the injury Boyd had in Fade 40).

I wrote a long reply with a compiled timeline of information based on what I'd learned in my own research and included some of the many sites and links I'd found. After I finished, I realized I didn't want to lose the information for the future, and thought it was possible someone out there might be curious about what DID go into the follow-up that isn't covered between Fade 40-42, and the epilogue.

Here it is below if you're curious.







SPOILERS BELOW! SPOILERS BELOW! SPOILERS BELOW! The spoiler tag isn't working for me for some reason so I can't hide it!!!!










ENUCLEATION. Note that the person was asking about what medical procedures would be expected following the loss of an eye. This was my response:



I was recently researching this actually and this is what I found, along with links to sites that have photos. The term you need is 'enucleation' for removal of an eye.

Once the person's eye is injured, the doctors will determine whether they can keep the eye or whether it has to be removed. I think the preference tends to be toward keeping it, however depending on the severity of the injury they might remove it. One reason they sometimes remove is people can have sympathetic reactions with their other eye, in which their good eye will go blind due to the bad eye being blind. Also, some people experience pain in their eye that never fully goes away. After a point, they have to determine whether quality of life is worth keeping their eye, when they can't see out of it anyway.

If enucleation is the way they'll go then this is the timeline (compiled from timelines/info from various sources)

**enucleation surgery takes 1-2 hours
**at the time of the surgery, they place an orb implant in place of the eye into the socket. This will never be removed. It is basically an orb which is about the size of the eyeball but doesn't go out as far as the normal eyeball did, so that a person can't fully close their eyelid on its own, and you can see a bit of white/red of the orb (depending on how recently their surgery was, I believe)
**most patients have a bad headache for 24-36/48 hours after surgery. they have to take a Tylenol every 4 hours to help

Note: He may have bloody tears for a bit after the surgery-- this is normal.

**the patient has to wear a compression bandage over his eye for 5 days (I have seen one or two sites that say 48 hours but I think that was for kids)
**he will have to have his eye checked 5-7 days, 1 month, and every 6 months after surgery.

what he's NOT supposed to do following surgery for 10-14 days:

**lift more than 10 pounds
**strain or rub his eye for up to 14 days following the surgery
**run the shower on his operated eye for at least 10 days
**bend forward to do things
**wash his hair with his head bent forward
**sustain any knock to the eye

he SHOULD wear glasses or an eye shield for protection when going out.

he will not be able to see full eye movement of his artificial eye in the mirror with monocular vision. the only way he could ever see that is if he videotapes himself straight on, looking in all the directions.

**He will have to take oral antibiotics for a week as well. also, later when he gets the pressure dressing off, he'll have to use eye drops and other medications for awhile-- including oral and topical antibiotics.
**2-6 weeks post surgery (and honestly most places said 6 weeks), he would be able to look into getting a prosthetic eye. those are usually painted to look like the normal eye. when a person is wearing it, typically people can't tell or might think they have a lazy eye. minor movement of the eye, like during conversation, works well, but larger eye movements like suddenly looking to the side might have a lag in the fake eye responding.
**the fake eye is basically like a really giant, really thick contact lens which is placed over the orb implant. that orb implant will never be removed.

Note that most places say to remove the artificial eye as little as possible, so as not to contaminate it. As far as I can tell, most people leave it in for long periods at a time. As a result, for instance when he wakes up from sleeping, it would still look like he has both eyes.

However, for times when he does remove the eye, it functions like a contact lens. The artificial eye includes the iris and pupil but also a large portion of the white of the eye-- it's larger than the opening in the eyelid and fits over the orbital implant. I would have to check again how it's stored when not in the eye but I think it was something similar to how contact lenses are stored.

((Note for ICoS readers-- Boyd leaves his artificial eye in a lot so in the epilogue, for instance, it was in when he woke up and walked over to Hsin. However, for similar reasons as are highlighted below, he often wears the eye patch when he's going to be in crowded areas or when he just feels like it. He does have scars on and around his eye from the knife wounds.))


ADDITIONAL NOTES:

some things people mentioned who have lost an eye and/or what the sites say is common:

**while enucleation is actually a very safe surgery, emotionally it's difficult for people to first get used to the idea of losing an eye
**eventually he will be able to drive-- outside of 20 feet, everyone sees as if they have one eye anyway
**he may experience some weird things at first, like thinking someone else is there when he sees his own hand reaching into sight from his blind side
**he will have to learn to turn his head a lot more often in order to account for the lack of peripheral vision on his blind side
**it's pretty scary/upsetting for people at first but they grow accustomed to monocular vision within the first few months
**some people take several months or a year to adjust to monocular vision, and have a hard time doing things like even going up steps etc because of lack of depth perception, but some people said they had zero problems and adjusted immediately
**some people never get over feeling upset about it but most people said that after awhile they don't even notice they have one eye, and most people who meet them have no idea they have an artificial eye either
**one guy said that usually he wears his fake eye when out but he will accidentally bump into people on his blind side-- he's found that wearing an eye patch makes people more sympathetic/less of a jerk because of this. (as a side note he mentioned he found it is surprisingly popular with the ladies. but usually he doesn't wear the eye patch)

There was also one teenager on a military site forum I found who said that he'd been fired from his jobs before because people learned he had one eye. He had stopped telling people about it and they assumed he just had a lazy eye and would get hired, but then later when they learned the truth he would suddenly "not be needed anymore." Whether there are extenuating circumstances to his situation, I don't know, because there are protections in place for those with disabilities, however we all know there can still be violations of peoples' rights regardless of said protections.


RESOURCES:
This is a really good blog entry by a woman who lost an eye-- she has visuals to show how she puts in her artificial eye: http://preppymeetsredneck.blogspot.co...

This explains what I said in more detail and also has pictures: http://www.rbsociety.ca/ntreatment.html

Check also http://www.beltina.org/health-diction... which, again, has photos and explanations of the surgery etc.

I recommend also artificialeyes.net for post-surgery information

Regarding stab wounds:

Article: http://lubbockonline.com/stories/1029...
Stab wound to the left eye and surgical repair: http://www.anatomicaljustice.com/cmi_...

These are stories of people who have had eye loss and could help you get a better idea for what your character would be going through: http://geelen.com.au/stories-of-eye-l...

The American Foundation for the Blind also has a message board which has a lot of information from people: http://www.afb.org/messageboards.aspx

This is a previous little details question which was related to stab wounds in both eyes and had good comments: http://little-details.livejournal.com...

There's also http://www.losteye.com/driving.htm -- that's where I got the information on driving but you can find more information at that site.

In addition, there are a number of sites out there which are for companies that make artificial eyes or eye patches, and they might have more forums, message boards, or About pages that have even more information. And there are a lot of surgical sites that show you in detail how enucleation surgery is performed, what to expect, and so on. I left out a lot of the links I had for miscellaneous real life stories and articles because I thought it might get to be too much.