The Casual Blog

Tag: eye surgery

More cute cats (sorry), improving vision, getting fitter, web retail news, and tech trends

Isabel -- the mysterious one


This week Sally spotted this bumper sticker: Life is a little better with a cat. That isn’t a very grand claim, which is what makes it appealing. “A little” seems about right. Our three (Phoebe, Isabel, and Rita) have been good sports in serving as my models.



I’m happy to report that my vision, while still blurry in the left eye, really improved this week. That eye is actually providing some useful signals for the first time in a long time. Also, my eye doc cleared me to resume normal exercise, and I happily did so.



After consultation with the ski friends, we agreed this week that the big ski event of 2014 would be a return to Telluride, Colorado, in February, where I’ll try to keep up, or semi-keep up, with young Gabe. And so at my early morning gym sessions I began focusing on some ski-oriented activities – lunges, side lunges, side kneel lunches, squats, with weights one-legged extension balances, duck walk with two big bands, step up onto medium table and balance, and jump up (landing softly) on the medium table.

I bought a speed jump rope and doing a few dozen speedy jumps between these activities, then worked on core matters with various species of crunches, reverse crunches, planks, and side planks. Finally, half an hour of straight cardio. I’ve been doing 10 minutes on the treadmill (with an incline), a few minutes on the ski (sideways push) machine, a few on the stairs (escalator type), and then some intervals on the elliptical. If there’s time after that, I’ll do 10 minutes of stretching and foam rolling.

I like using a heart rate monitor during work outs, which can confirm that I’m working hard, or at times show I’m not working as hard as I think. I got one when I began going to spinning classes, when I worried that keeping up with super fit young teachers could cause me to drive my poor heart into an extreme and dangerous state. But it’s gratifying to take it up into the red zone from time to time, which for me is in the 160s. I usually feel great afterwards.

My Polar heart rate monitor finally wore out this week For some months it had been behaving erratically, but I didn’t feel good about throwing it out while it was still sometimes working, so I was glad when it finally quit. I immediately went Googling to vet the options. I had some interest in finding a model that didn’t require a band around the chest, but learned that such models are not as accurate and do not give continuous read outs. I settled on a relatively cheap one, a Timex T5K541Personal Trainer, that did the two basic functions that I needed (tell the time and tell how fast my heart is going). I bought on Amazon, where as a Prime member I get free shipping, and had it two days later.

This isn’t quite instant gratification, but it’s close. I put this type of Internet retail plus efficient delivery in the pantheon of life-sweeting innovations, right up there with pay-at-the-pump gas, cash machines, and the lickless stamp. Amazon is now familiar, but we tried a similar new service for the first time last week called

It does exactly what you’d expect. It has most of our preferred consumer products at normal drugstore prices, and can get them to us in two days. Shipping is free for orders of $35 or more. A bottle of Crew shampoo that I ordered had leaked a little in transit, but everything else arrived in a proper and timely manner. Ordering online made me realize I don’t particularly like chain drugstores, with all their household goods, toys, cards, and snack food. I’m perfectly happy to stay out of those places and just send out for the stuff. (For actual medical stuff, I do like my little neighborhood drugstore, Hayes Barton Pharmacy, where you still get the personal touch.)

Speaking of the constantly new, there’s a piece in the current New Yorker about the young tech entrepreneur scene in San Francisco. For those interested in tech business trends, this is a must read. (This link worked for me, but I’m afraid that non-subscribers will not be able to get it without paying.) The piece, by Nathan Heller, describes people who are starting one new business after another and working with a rock band, doing something arty, or going on meditation retreats in between their ventures. The very shape of business and finance is being transformed, getting smaller and faster. At the same time, the entrepreneurs are not only making money, but also having fun, and asking good questions about what makes life meaningful.

Stuart -- the best dog

Stuart — the best dog

Eye surgery, yet again, and some bluegrass and big cats

Looking southeast at dawn, September 29, 2013

Looking southeast at dawn, September 28, 2013

On Monday at 5:15 a.m. Sally took me over to Duke Eye Center in Durham. It was my third eye operation in the past 10 months, and the routine was familiar. Again the hospital gown didn’t quit fit, and again they checked the various systems (temperature, blood pressure, reflexes, etc.). There were several checks to make sure they were working on the right eye – that is, the left – and checks to make sure I had no allergies or other ailments. As my preop nurse observed, I was a very healthy man, except for the eye.

The operating room was cold. I asked my nurse anesthetist if this was purely for hygiene, and she said it was also good for the surgeons not to get too hot. That sounded reasonable – I wouldn’t want them dripping sweat. As they got me situated and draped my face, I asked if they were planning to listen to music (which they did last time), and someone asked if I cared to hear anything in particular. I said that some Brahms would be good. There was no reaction, which I think meant this was not a choice they expected. Anyhow, there was no Brahms, or anything else. This was mildly disappointing, but at least they didn’t put on anything awful.

It is odd to be conscious when there’s work going on inside your eye. I could hear everything, and feel movement, but it was not painful. From time to time they asked how I was doing, and I gamely said, good, good. The surgeons’ comments mostly related to the job at hand, and there were no indications of unusual difficulties. The surgery took almost two hours. The nurse anesthetist held my hand, which I appreciated.

Dr. M and me

Dr. M and me

At my check up the next morning, Dr. Mruthyunjaya said that things had gone well both for the retina repair work and the cataract removal and lens replacement by Dr. Vann. My performance on the eye chart was not good (couldn’t see any letters), but I could distinguish one finger from two at three feet. It will be some weeks before healing is complete and it’s clear how much vision I’ll have in the left eye. I’ve gradually come to terms with the likelihood that it won’t ever be the same. There’s an irregularity in my macula that’s here to stay. I’ll cope.

Dr. M also enjoined me from vigorous exercise for two weeks. I tried bargaining about this (how about just the elliptical?) but he held firm. And so I missed yoga on Tuesday, my regular gym workout on Wednesday, my personal training with Larissa on Thursday, and my spinning class on Friday. I missed the movement, the stress, the relaxation, and the pleasant endorphin effects afterwards. And I missed my teachers, classmates, and adjacent strangers. The activity and the people are a part of me, and I look forward to getting them back.
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On Saturday I drove out to Cary and took some pictures of ducks at Bond park, then came back to Raleigh for a walk through the IBMA festival, which we’re told is the biggest bluegrass conclave on the planet. We’re on a run in Raleigh with street fairs – in previous weeks we’ve had motorcyclists, SparkCon, and the Hopscotch music festival – and its great to see all the activity. For me, a little bluegrass goes a long way, but it was nice to hear a little, and do a bit of people watching.
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On Sunday, we drove out to Chatham County to Carolina Tiger Rescue, where we saw tigers, lions, cougars, servals, and caracals, as well as an ocelots, a bobcat, a binturong, and kinkajou. It was worth the trip. They were beautiful animals.
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How important is an afterlife?

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A short essay in the NY Times today proposed an interesting thought experiment: imagine that you knew all humanity would cease to exist in 30 days after your death. Would your view of your life’s significance change? Samuel Scheffler of New York University thinks the answer is yes. Even those of us who can’t take seriously the view of an afterlife in which our own consciousness continues after death still believe in another sort of afterlife – that is, that after we die the human race will continue for a good long time. If that were not the case, would anyone bother to seek a cure for cancer, or to make great art? Big projects, and especially ones that we know might not be completed in our lifetimes, depend on the assumption that the human race will continue.

Scheffler notes that even the most selfish and narcissistic of us almost certainly share this basic concern for continued human existence, for the selfish aims would also lose most of their meaning otherwise. He wraps up his elegant essay by noting this foundational assumption gives us a powerful incentive to address the very real threats to continued human survival – climate change, environmental degradation, and nuclear proliferation. The incentive isn’t just the abstract sense of duty to future generations, but our present reliance on those future beings to give life meaning now.
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My eye surgery is scheduled for 6:00 a.m. tomorrow. I’ve managed not to think too much about it, but for the last few days I’ve felt unsettled. The operation on my left eye (my third in the last 10 months) will involve two procedures and two surgeons. One is my rockstar retinologist, Dr. Mruthyunjaya, who will remove the silicon oil in my eye and do some retina clean up, and the other, Dr. Vann, will work on what he described as “a big, honkin cataract.” I’m confident that the surgeons know their business. I’ve been touched by the kind support of friends and colleagues. It should go all right. I hope.

I took a walk this morning along the boardwalk that goes out over the small lake off of Raleigh Boulevard, where from time to time I’ve seen herons, kingfishers, various ducks, and lots of turtles. I wanted to try out my new Sigma 150-500mm lens with my new Manfrotto monopod, but there weren’t many water birds to see this time. The lens is a four-pound behemoth, challenging to handle, but the magnification is dramatic, and the image quality seemed generally good. I started to get comfortable with it, and look forward to taking many more and better pictures of birds and other wildlife. These are a start.
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Some good news re my eye, and seeing the beautiful Giselle

On Tuesday it was time for another checkup at the Duke Eye Center to see how my left retina was faring. I’d noticed recently that I was seeing better out of that eye – still blurrily, but enough to be of some practical use. But I’d been cautioned by my rockstar retinologist, Dr. M, that because of the scarring from my first operation, there was considerable uncertainty as to how the healing process would progress, and the weeks just past would be a critical phase. I tried not to think about it.

At the appointment, after a four-hour wait (aargh!), I was pleased to find that I could read some of the letters on the eye chart (which I could not at the last visit) and tell with confidence how many fingers the PA was holding up in front of me.  After studying various images of my eye and peering into it with his magnifying instruments, he said, “I like what I’m seeing.”  He told me we’ll need to operate in a couple of months on my new cataract and do a bit of clean up work, but it looks like my vision will improve.  This is good.

On Friday I saw the Carolina Ballet’s last ballet of the season, Giselle. This is one of the most famous works in the canon of classical ballet, but I’d never seen it, and was excited to finally make its acquaintance. The production was beautiful, and also unexpectedly touching.

The ballet is a simple, then tragic, then supernatural love story. Giselle is a sweet peasant girl who is loved by a fine peasant boy but wooed and won by a stranger who turns out to be a Count in disguise. When she finds out that the disguised Count is engaged to an elegant royal lady, she goes mad (very like Lucia), and dies. In the second act, she joins a large group of other deceased jilted maidens, known as the wilis, who dance beautifully together and wreak vengeance on cads such as the Count. But it turns out that the Count really loved Giselle, and she comes to his rescue at the end. Happy ending! Well, sort of – Giselle’s still deceased. You’ve got to get into a romantic frame of mind to enjoy this, but you almost can’t help it.

Lillian Vigo was a beautiful Giselle. At her best, Vigo is masterfully elegant, particularly in adagio passages, and she was lovely this evening. She has the most amazingly graceful long arms! She was sweet and vulnerable, engaged and engaging. It is amazing how much emotion a human body can convey without speaking!

Richard Krusch was a surprisingly complex Count Albrecht, by moments either outgoing or withdrawn. Krusch is a marvelous dancer, but he he can at times seem remote. This evening, he seemed completely and intensely present, and stunning, not only in his athleticism, but in his human engagement.

I also admired Cecilia Iliesiu at Myrtha, Queen of the Wilis. Ilesiu is powerful in every respect; she commands the stage. She immediately established that the Wilis were no joke — even if they have a funny name, they were not to be trifled with. The wilis were numerous and gorgeous in white gowns. The effect of 20 ballerinas in tight formation, hovering on pointe, is both pretty and kind of scary.

On Sunday afternoon I went to see Giselle a second time. I wanted to see Lola Cooper, our pointe shoe sponsoree and friend, perform the peasant pas de deux. It seems quite technically demanding, and Lola rose to the challenge. I thought she looked wonderful.

It’s interesting how different dancers can discover and express very different aspects of the same role. I thought Jan Burkhard was superb as Giselle. Her dancing was fully realized and wonderfully expressive, ranging from sweet tenderness to the agony of madness. It was really moving — I got goosebumps. I came away with a new respect for her range and depth. In this performance I also particularly enjoyed Marcelo Martinez as the Count, who took some real chances and was thrilling, and Lara O’Brien as Myrtha, who was regal and mysterious.

No illusions, but not disillusioned

At my post-surgery eye checkup on Thursday, after being scanned, poked and peered at, I was happy to hear Dr. Mruthyunjaya declare, “I like what I’m seeing.” My retina was back where it was supposed to be. This doesn’t mean everything will be just fine. Vision in my left eye is quite blurry now, and it will be some months before we’ll know how much there will finally be. The likeliest answer is substantially less than before. But as Dr. M’s fellow, Dr. Martell, pointed out, even if there’s a lot of blur, it could still help with peripheral vision, and serve as a backup in the event of a right eye catastrophe.

Anyhow, it is what it is. The Nigerian novelist Chinua Achebe died this week at age 82. I have not read his work, but the Times obit made me think I might like it. It quoted Nadine Gordimer as saying he was “a writer who has no illusions but is not disillusioned.” A good way to be.

I was also happy that Dr. M cleared me to resume exercising, though he suggested I wait another week before my next killer spin class. So early Friday morning, my usual spinning day, I happily did a functional fitness routine and a half hour on the escalator stairs. The stairs are a relatively new machine at O2 Fitness, and they are remarkably effective at pushing up your heart rate. As usual, while sweating away I listened to some opera (the incredible second act of Mozart’s Marriage of Figaro) with my MP3 device and read on my tablet device.

I reread some on the ideas of Jonathan Haidt in The Righteous Mind: Why Good People Are Divided by Religion and Politics, whose name is pronounced “Hite,” as I learned this week when I heard him give a lecture at Duke. My earlier thoughts on Haidt’s theory are here, but I’m still processing his big ideas, which point dramatically away from traditional political theory and its reliance on rationality. His TED talk on the differences in ethical systems between liberals and conservatives is a nice introduction to his theory.

As Haidt observes in the TED talk, there are two types of people: those who like new ideas and experiences and those who prefer the safe and familiar. He notes that the latter are the people who like to eat at Applebee’s.

On Thursday Sally and I tried for the second time to eat at a new restaurant in our neighborhood, Dos Taquitos, and again failed. The place was cheerily hopping but the wait time was too long for us, so we went down Glenwood Avenue to the uncrowded Blue Mango for some Indian food. We had a delicious meal featuring masaledar allo gobhi (cauliflaur and potatos) and eggplant bhartha. We couldn’t finish it, and I asked for a take-home box, which I carefully prepared and then accidentally left on the table. Darn!

For more new musical ideas, I had a piano lesson with Olga on Saturday morning. It was invigorating! I played Liszt’s Liebestraum (Dream of Love) No. 3, a famously beautiful piece (here played wonderfully by Evgeny Kissin). She gave me a massive compliment, and I quote: “Wow!” She thought I’d vastly improved, and was getting a richer sound. But of course, it can always be better. We worked on getting a more stable connection between the body and the instrument, including not just the fingers, but also the back and the core. She showed me on a type of touch involving a very relaxed hand with mostly arm movement. She also gave me some new ideas on pedaling, including using a slow, slightly delayed release. As she noted, it makes magic.

More eye surgery, healthy habits, a gay marriage revelation, a new veggie restaurant, and the shame of the processed food industry

This week I had eye surgery to repair the effects of scar tissue from my previous eye surgery, with the understanding that there would probably be more surgery needed in future. And so in the space of a few weeks I’ve gone from an adult in remarkably good health with no history of hospitalization to a fairly experienced consumer of modern American medicine. There are, of course, some negatives, such as worry, fear, and pain, but I’m trying to stay positive. It’s a learning experience.

Most of my healthcare team at the Duke Eye Center, including nurses, orderlies, anesthesiologists, and doctors were surprisingly cheerful and supportive. The anesthesia was designed to keep me partially conscious, which it did, and so I was able to listen to the conversations of the team and the music they listened to (vintage rock, unfortunately). I was instructed to let them know if things hurt, and I did speak up a couple of times when it got fairly intense.

The operation involved removing scar tissue from my left retina and eye wall and reattaching the retina to the wall. It was an extremely delicate procedure and took about three hours. When Dr. Mruthyunjaya checked me the next day, he was pleased with the initial results, but noted that it would be some months before we’ll know how much vision I’ll have with that eye. At some point I’ll need cataract surgery as well. But that day I was able to see the top couple of lines of the eye chart, which was an enormous improvement from last check, when I couldn’t make out any letters at all.

Healthy Habits

I was banned from all strenuous exercise for at least a couple of weeks and possibly more. I’m not sure Dr. Mruthyunjaya appreciated that this was a fairly harsh sentence for a person like me, with a big exercise habit. Getting to the gym or other physical activity most every morning is something I just do. It makes me feel better for the rest of the day and is part of the long-term plan of staying healthy and happy. But I don’t think about the pluses and minuses at 5:15 a.m., which would be way too much work. It’s taken a long time to get to the point where exercise is almost automatic, and does not feel like dreary work. I don’t want to lose the habit.

With this partly in view, I decided to recommence my computer programming studies during the newly freed up early morning. I signed up with Codeacademy for their free online Python course. It should keep me in the habit of getting up early. So far, it’s been interesting and mostly fun, though also frustrating at occasional junctures when I get stuck. I’m thinking of it as a lot like learning Spanish: an exercise that at a minumum serves to stimulate the brain in a healthy way, and could turn into a skill that could come in handy.

Gay Marriage Switcheroo

Speaking of brains, in the news this week was a report that Senator Rob Portman, a Republican, had decided to switch from an opponent to a backer of gay marriage. His reason? His son came out as gay. I had two reactions to this:

1. good
2. you’ve got to be kidding me!

As to 1, I’m happy that Senator Portman has seen the light, and come to view gay people as entitled to the same civil rights as everyone else. But as to 2, coming to this view really shouldn’t depend on having a gay child!

All of us place special weight on the welfare of our loved ones, but that isn’t a very reliable starting place for broader moral reasoning or policy making. Otherwise, those with healthy families would have no concern for the less abled, and those in a majority race would ignore the rights of minorities. This would be a morality with severe myopia. I wonder how much conservative family values blather is accounted for by such myopia.

I don’t mean to be too hard on Senator Portman, who must surely possess more-than-usual courage to take issue with the conventional and rabid views of his party. We could all benefit from exercising our empathy muscles. Here’s a suggestion: what if we all spent five minutes a day imagining that a specific human in a group we generally dislike is our dearly beloved child? Our imaginations could extend the diameter of our circle of caring and feeling. This would be a good thing. I’ll go first, and try to think loving thoughts about a rightwing fringe Republican.

Trying a New Vegetarian Restaurant

Last night Sally and I tried Fiction Kitchen, Raleigh’s new vegetarian restaurant on Dawson Street. It was full when we got there, with a wait time of 45 minutes, which would exceed our usual supply of patience, but we found a place to stand near the bar and had some Chardonnay. The vibe was hip-funky, similar to Poole’s, but with a younger, edgier crowd — think tatoos, grad students, gays and lesbians, interracial couples, and even a few babies. Oh, and one middle-aged guy with a strangely red left eye swollen half-shut. The place hummed with the sound of many conversations.

The food was creative, with an emphasis on local seasonal ingredients. For appetizers, we had the wintery spring rolls with spicy peanut sauce and seasonal fritters, which had NC apples, spices, and bourbon-agave. We split two entrees, the sweet potato sushi rolls with sashimi tofu and braised tempeh with pesto grits. Every bite was tasty.

Shameful Goings on in the Processed Food Industry

It was really cheering to see a new vegetarian business in Raleigh doing so well. As regular readers know, I’m a big proponent of healthy, ethical eating, which is another habit that’s good for humans, and also fun. But there are powerful forces promoting unhealthy food. For evidence, see an op ed piece in today’s NY Times, by Michael Mudd, a former honcho with Kraft Foods, titled How to Force Ethics on the Food Industry.

As a former insider, Mudd seems credible when he characterizes the business of large food processors as “enticing people to consume more and more high-margin, low-nutrition branded products.” He describes how “relentless efforts were made to increase the number of ‘eating occasions’ people indulged in and the amount of food they consumed at each.”

According to Mudd, “Even as awareness grew of the health consequences of obesity, the industry continued to emphasize cheap and often unhealthful ingredients that maximized taste, shelf life and profits. More egregious, it aggressively promoted larger portion sizes, one of the few ways left to increase overall consumption in an otherwise slow-growth market.”

Mudd also describes the food industry’s clever PR efforts to deflect attention and regulation, such as attributing the obesity epidemic to other factors. There are, of course, multiple factors, but none with the same despicable level of conscious intent. At the same time, they contend they are giving the victims “what they want.” These wants, of course, are the product of advertising and food engineering. (There was a very interesting piece in the Times magazine by Michael Moss a couple of weeks ago on the dark art of synthesizing junk foods that are almost irresistible.)

For solutions, Mudd proposes federal and state taxes on sugared beverages and snacks that undermine health, which would generate funds for education programs and subsidize healthy foods for low-income people. He also recommends mandatory federal guidelines for marketing foods to children and better food labeling. This makes sense.

Snapchat, engineered forgetting, and a status update on my left eye

Snapchat is one of those ideas that sounds either silly or useless, and then turns out to be brilliant. It’s an app that allows sharing of photos that after a few seconds automatically disappear. It’s like engineering in a very human characteristic — forgetting.

We tend to forget how important it is that we are forgetful. We know we don’t remember everything, but tend to think of this as a bug rather than a feature. But think how social life would be different if we all remembered everything. How could we talk if we knew every word would be preserved forever? Every stumble, every foolish idea, every faux pas, every little falsehood? Who could bear to be accountable for each and every interaction?

Until the digital age, our basic problem was how to remember the things that mattered. Preserving memories was difficult, while forgetting happened naturally. As the digital age has progressed, this ordering has been turning upside down. Anything that can be digitized and send through the internet (words, images, sounds) is easy to save and hard to discard. Inevitably among the frozen perceptions are ones we’d rather forget.

We’ve only recently started to understand that this is not a trivial problem. We know or should know that change is constant and inevitable. Our ideas and opinions change, and the things we love today we may love much less of in years to come. This is one of the reasons that tattoos are generally a bad idea. There’s an element of risk every time we express ourselves in digital form — a risk that we’ll change in an unforeseen direction, and our expressive gesture will be something we come to regret.

If teenagers just can’t resist the urge to send naked pictures of themselves on the internet, it would be great for their present and future selves if they could avoid the potential of embarrassing themselves before an audience of billions. If Snapchat achieved no more than that, it would be a good thing. But it could point the way towards more nuanced and flexible digital communications. Lowering the stakes for our internet lives would open new possibilities for creative expression.

In writing posts for the Casual Blog, I try to imagine whether a future self, quite different from the current one, could comfortably coexist with this record, including parts that may be disagreeable. Of course, if my future self were really hateful, I would want nothing to do with him, and my current self wouldn’t mind unsettling him. It’s strange to think of battling a future self, but to some extent, each fixing of a position does so. It could even prevent the development of some aspects of the future self. Is that good or bad? Is there any way to know?

For friends who are following the saga, I’ll note that this week I got scheduled for additional eye surgery to be done in March. The operation on my left eye last November has not healed properly, and scar tissue on the eye wall has left me with very limited vision. At last test with the eye chart, I couldn’t see the topmost E.

This has made all the activities of daily life that involve depth perception (like moving or eating) or seeing things on the left side (like driving or going to parties) more challenging. The good news is that my original retina surgeon has passed me on to Dr. Prithvi Mruthyunjaya, a professor at Duke, who appears to be a rock star in this area, and who is experienced in the unusual procedure I need. I’m looking forward to recovering.