So sorry for my much longer than anticipated absence! We did bring our computer in for repairs, and for some reason the process was unbelievably slow! I’ve felt so disconnected!
Anyway, since we last “talked”, the hubby and I have been doing a lot of thinking. (In case you missed this, I’m referring to thinking about my eyes and the potential for another baby.)
One thing you should know is that my husband and I like to understand things. We like to analyze things. We like to know the chance of this and the probability of that and the potential outcomes. (I’m an accountant/auditor and he’s an analyst – it fits.) In all fairness, I’m much worse than him with respect to this, but when it comes to something as important as my sight and our future family planning, he’s all over it too.
The problem is, neither of us can predict the future (I know, go figure), and neither can our doctors. So the best we can do right now is ask a lot of questions and then digest the answers…which usually results in more questions.
So my last appointment with Dr. Ophtho resulted in a list of questions which I was finally able to ask him this week. (Please note that his answers are heavily paraphrased by me. They are not to be taken as medical advice if you happen to be in a similar situation to me. Remember, I easily could have misunderstood something – but hopefully didn’t.)
Q: Does my most recent (and somewhat significant) bleed cause any additional concern in terms of a pregnancy in the near future?
A: No, there’s no reason to believe that this bleed is any different from any of the smaller ones that have been happening as a result of the vitreous causing “traction” on the leaky vessels.
Q: Can bleeds lead to scarring? (He has previously informed me that scarring can lead to permanent damage, generally in the form of retinal detachment.)
A: Not really. Scarring is more of a risk when the leaky abnormal vessels “heal”. It relates more to the proliferation process than the hemorrhage process.
Q: Other than proliferation, are there other considerable pregnancy related risks that may result in permanent damage to my eyes? (As you may recall, he has told me that he feels my risk of additional proliferation is low because of the current stability in that regard as well as the amount of laser treatments I have had previously to protect against more proliferation.)
A: Not really. The risk of more bleeds is there, but these can be treated with a vitrectomy subsequent to the pregnancy.
Q: Speaking of vitrectomies, is it possible to have more than one if I would get one and then bleed again?
Q: What would my restrictions be re: lifting (i.e. thinking of a baby and a toddler here) if I did need to get a vitrectomy?
A: No lifting for 1-2 weeks after the surgery.
Q: How risky is a vitrectomy?
A: In Type 1 diabetic patients with retinopathy requiring a vitrectomy there is a 1% incidence of blindness in the treated eye subsequent to the operation. This is due to complications such as glaucoma, etc.
Q: So what do you think about that level of risk?
A: I think it means your odds are very good (i.e. of having a successful vitrectomy).
Q: So, to clarify, you feel that it’s okay if I get pregnant?
A: Yes, I don’t feel that it would be foolhardy.
And that was that.
The riskiness of the vitrectomy is the thing that sticks with me the most. 1%. 1 in 100. Good odds, but good enough?
I guess it doesn’t necessarily mean that I personally have a 1% chance of going blind in one eye. That 1 person in 100 may have other factors that pre-dispose them to this particular complication. (Right?) Also, because I don’t have a 100% chance of needing a vitrectomy, my chances of not going blind in one eye (or both, heaven forbid!) are well over 99%. And at the end of the day, I might sometime need a vitrectomy even if I don’t get pregnant, so is this really a reason no to have another baby?
So it really sounds like it all comes down to blood pressure. Not that blood pressure is the be all and end all of the will-my-eye-bleed issue, but it’s the most likely complication, with the greatest likelihood of causing a bleed. So. Blood pressure and the means to control it are clearly a focal point in this looming decision.
Of course, blood sugar is also a factor. If I were to get pregnant again, for both my health and the health of the baby (particularly if said baby needed to have an early arrival like our daughter did), my diabetes control would need to be impeccable. Can I do that? That’s something I really need to find out before we go ahead with anything baby related.
So that’s my short-term goal: impeccable diabetes control. A bit lofy, no? 🙂
As for the long-term goal….we’ll see.