Options in Cataract Surgery

This post doesn’t have an appealing title and will be a curious mixture of economics and technical data, so I wouldn’t blame you if you didn’t read it. However anyone who might be contemplating cataract surgery in future might find my experience helpful so here goes.

First of all, getting a cataract removed and a lens implanted is a lot like buying a car. You can go for basic transportation or you can start piling on the options. Every buyer is different and what I find of value another purchaser may not.

The very basic operation is covered by OHIP (my local government Medicare.) The options you pay for out of pocket. The majority of folks just go with the basics and that does the job. Lets get into details on the options.

To begin with I have a slightly more complicated lens situation (slight astigmatism – focal length is different in a different axis.) This is reflected in my normal eyeglass prescription. More about this later.

There are two parts to cataract surgery – pre-op eye measurements and the operation and implant.

Pre-Op Measurement

This is necessary because the eye surgeon needs to match the appropriate implant lens to your eye. The size of your eye and the curvature of your cornea is important. OHIP pays for an ultrasound measurement. There is a more accurate laser measurement that costs about $200 extra. The surgeon recommended this and so I went ahead and paid for it. This was the first option and in my mind a no-brainer if you can afford it.

The Implant

I had three choices of lens implant:

  1. Standard (generic) – this is paid in full by OHIP and in most cases works fine. You are going to need to wear eyeglasses for final correction in my case and the standard lens is a spherical one – some aberration can reduce contrast in night driving situations. I felt I could afford a bit better.
  2. Tecnis Monofocal Aspherical (about $250 extra for the set.) This gives improved contrast, is most similar to the “natural” lens it replaces and is better for night driving. You are still going to need eyeglasses to get pinpoint focus – due to my astigmatism.
  3. Tecnis Toric (about $1400 extra for the set.) This is the latest and greatest in implant optics and would in theory correct for both distance vision and astigmatism. Folks who go this way can get out of eyeglasses for most activities.

Now $1400 may seem like a lot but hey, I paid quite a bit more than that for hearing aids a year or so ago. Would it be worth it to eliminate glasses?

As it turns out I would (at my advanced age) still have to wear glasses for reading fine print. So the Toric lenses would not be guaranteed to get me out of them entirely.

Not needing glasses for anything but reading is a hassle as far as I am concerned. You either need a granny chain with the spectacles, or you go with zero prescription in the top and reading prescription in the bottom of a set of progressive lenses and wear them all the time. Besides that, after 30 years I sort of like wearing glasses.

And the clincher for me is that the best visual acuity does not come with the Toric lenses anyway. The aspherical Tecnis with an eyeglasses prescription will correct my vision right back to 20/20. I can live with that.

For some people who aren’t as worried about night driving the Toric lens might be the way to go. But I felt that I would get the best value and the best distance vision with the Tecnis Monofocal. So that was my choice.

And I think it’s worked out for me. I can already see much more clearly with my “bionic” eye and in fact have eliminated a pair of glasses I needed to see the computer screen. I won’t have a final eyeglass prescription until I get the second eye fixed but based on my first evaluation at the optometrist things are looking pretty good.

Your financial and life situation may be different from mine, but I feel I did well with the moderate upgrade in lenses and continuing on with eyeglasses where needed. Now you know the rest of the story.

 

 

Phaco-What?

Well I am now halfway there in the cataract surgery game. I had my left eye operated on last Tuesday and my right eye is scheduled to get fixed on December 5.

Compared to some surgery which shall remain nameless (prostate biopsy) the eye stuff is pretty benign. The worst part by far is wearing the eye shield afterwards – the tape the hospital gives you is like crazy glue. The eye drops aren’t too bad aside from some really nasty ones you get just prior to the surgery itself.

I went to the Smiths Falls hospital for my eye and I am glad I did. The drive is far more convenient than going into the city and the staff there are very kind and efficient.

After I paid for my Technis lens upgrade (better contrast at night) I went up to the surgical floor. They have special chairs where they work on you and then you are just wheeled down to the operating room in the chair. The back reclines, they put you under the microscope and start a process called phacoemulsification on your cataract. This involves a tiny ultrasonic probe that they use to break up your old lens and suck it out. Sounds gross but aside from bright lights you don’t experience anything. Then they unroll a new bionic lens in its place and you are done. Total time 15-20 minutes.

After surgery everything was blurry but after one day I could already see a lot better. I note how much whiter and more colorful the world looks in my left eye now. I can hardly wait to get my right eye fixed.

Blame It on the Bossy Nonna

8 year old wisdom: “You’re so bossy Nonna, you boss me around all the time.” This was Teddy recently when his Nonna made him quit playing Hot Wheels on the PC and come to lunch.

And Nonna admits that she has always been “a little bossy.” Her own mother agrees – and she knows best.

Today as Maria celebrates her birthday all of us bossees must agree that she does it out of love and concern for us. It’s her Meyers-Briggs ISFJ personality. Plus her teacher experience. Plus her concern we are all healthy and safe and happy.

I mean it’s not as if she doesn’t walk the talk. She’s always ready to help out – her peers, her siblings, her mother, Sarah and Dave, her grandkids, in the community and of course me. Sometimes she gets frustrated that it seems to be “expected” or taken for granted. But then she’s on to the next service opportunity. Go figure.

So my dear Happy Birthday. We all love you and appreciate you. Even a certain ginger tabby four footed bundle of love that cares for you more than anyone else. But he won’t be bossed around either.

Social Media and Me

I just finished paying for my online hosting service and domain registration so I guess this blog will continue for another year, God willing. That got me thinking about social media in general and how my online activity and presence may have changed in the past 20 years. My conclusion – it has and it hasn’t.

A lot of what I do online hasn’t changed from the way I did things 20 years ago. I still belong to a number of text based technical and specialty forums where I type posts just as before. I don’t have a smartphone so I don’t take photos with it and immediately post online. (I use a real camera although it’s digital now.) As a result I don’t have an Instagram account. I have discovered YouTube but I don’t make videos so mostly I just learn how to fix stuff or listen to YouTube music. I do a little bit with Reddit.

My main social media outlets are Twitter, LinkedIn and Facebook. Twitter I find limiting and rather juvenile so I just link my blog through it. LinkedIn keeps me in touch with former work colleagues and Facebook is great for old and new friends, relatives etc.

I used to program a website with HTML as my personal “brand presence” on the Web, but that sort of activity has largely been supplanted by WordPress software or any of the many blogging sites out there. My blog is hosted on my own domain by a web server company and it’s all basically point and click. It sounds a lot more complicated than it is. I have a WordPress theme and all the spam filtering and other tools I need for a website are close at hand. If I didn’t want to do that I could just register at a blog site and type away. I try not to do “fake news” and I don’t advertise or charge anything. I hope some of my online friends and family enjoy what I have to say.

So that’s my Social Media presence. Not very flashy, but I hope to continue for a while.

Another Sweet Girl

I have been really blessed with each of my grandchildren. There’s Teddy – smart at math, science and literature. He’s like his grandpa in that he can really get into some subjects while others leave him cold. There’s Veronica – sweet and kind and affectionate but looks after her siblings like a tiger. And finally Susannah – who’s always been the baby but now as she approaches birthday #4 is becoming another sweet girl.

I would say in a lot of ways ways Susannah is most like her mother of the 3 kids. She was an early talker and is the most precocious one. She wants to be in there doing everything the older kids do. She has her mother’s indomitable determination but also can exhibit a wicked temper like grandpa did as a youngster. She takes herself pretty seriously and you can’t tease her too much. She’s very quick to see if you are telling her something that doesn’t make sense. Her babyhood days are definitely behind her as she becomes a little girl in her own right.

Like the two older kids she is getting into martial arts. This family will wipe the floor with any offenders for sure.

Sarah has taken all the kids into the optometrist as they grow and it looks like Susannah will be the first one to get eyeglasses for some early childhood nearsightedness. The parents are hopeful she’ll grow out of it but for now the other kids are very jealous. I hope she feels special.

Susannah’s having a “Mary Poppins party” today and we’ll be down to see her on her calendar birthday October 16. Happy birthday my other sweet girl.

 

Family Fog

I remember how sad I was when my Grandpa developed cataracts in the 1950s. His world got cloudy and blurry and then totally dark. He lived for 10 years this way.

And so it has come to pass for me – something I expected and now it’s here. My family has a history of cataract disease – my Grandpa, uncle Rocky, my Mother, and my Sister have had a bout of it. Now it’s my turn. But times have changed, thank God.

  • When Grandpa had the problem in the 1950s his case was hopeless. Inoperable. He could not have survived a 48 hour stretch of immobility in bed, his head restrained in a bunch of sandbags. Not in his 80s. So he went blind as so many other generations before him went blind.
  • My Uncle faced a serious operation in the 1970s but he made out alright. They removed the cataracts and his lenses and he lived the rest of his life with Coke-bottle glasses. But he could see.
  • By the time my Mother had this operation in the 1990s it was still surgery with stitches but they could put in a replacement lens. She had to be careful for a while but she was fine.
  • My Sister had her eyes fixed a couple of years ago with a pair of day surgery visits. That’s what I hope is in store for me. I don’t want my grandkids to worry the way I did about my Grandpa.

I had my consultation with the eye doctor this week. he asked me to describe my situation.

“Difficulty with reading road signs. Can’t drive at night. Glare bothers me.”

He chuckled. “An impressive list of symptoms.”

After he looked in my eyes with a bunch of bright lights he said: “Yep. You have cataracts all right.” No kidding, Sherlock.

Bottom line, I’m heading in on Nov. 7 to get my left eye fixed. If that works my right eye follows a month later.

I didn’t go for the deluxe Toric lenses. That may have corrected my distance vision but I would still need glasses to read. Instead I went for a minor upgrade (Tecnis lenses) to give me better contrast in night driving. Up here you need all the night vision you can get with deer all over the place. I’ll still have to wear glasses to drive a car, but after 30 years I don’t care anyway.

So that’s my story and I’m sticking to it.

 

 

 

A Twitchy Experience

I used to be a fan of streaming videos on YouTube, but all that has changed lately. I have become addicted to live streaming on a site called Twitch.

Twitch is now owned by Amazon and I got a free subscription to it because we have Amazon Prime for home shopping.

One of my favorite YouTube video makers switched over to Twitch and I followed him there. On YouTube he made a series of videos where he played a video game called Minecraft. However on Twitch he and his friends often live stream another game called PlayerUnknown’s Battlegrounds (PUBG for short.)

PUBG is one of those multiplayer shoot-em-ups that are so popular with Millennials today. It is called a Battle Royale game – 100 matched up players parachute onto a god-forsaken Russian island where they have to find guns and armor and then shoot it out to the last person. It is frightening as heck for a new player – these folks are swept away in the first few moments after they land. The playing terrain keeps getting smaller and smaller and you have to keep moving or die anyway.

I would never be able to play this game well. but like many other voyeurs I find it very addictive to watch some one else go through the ordeal. There are various strategies you can try out. My favorite player doesn’t take it too seriously. He rides around in a car trying to run over other players, or circles the island on a motorcycle. He even tries a totally passive strategy where he hides and lets everyone else kill themselves. Once in a while he wins but most of the time he is happy to make it to the top 10.

He has a colleague who plays the game in squads of 4 or in duos. This guy is more skilled and aggressive and often serves as a team leader. He takes the game more seriously but doesn’t win all that often either. However he is very funny and makes lots of sarcastic comments about his opponents. Great mindless entertainment.

The other day neither of these streamers was on so I searched for who else I might spectate. And I discovered a whole other universe. The world of the professional PUBG gamer.

These guys have huge followings and when it comes to the game they have it all – skills, strategy, instinct.  They are Stone Killers. Assassins. They play in duos usually – a guy at the top of the game’s food chain can’t trust more than one partner to be good enough. They expect to win every game. They have attitudes like professional wrestlers. They know how to find the best weapons. They stalk other players like tigers. They are at the top of the PUBG leaderboards when it comes to wins.

Fortunately for new players the software that matches up a field of 100 players tend to seed these killing machines into very competitive games. A noob wouldn’t last a minute with these guys. I mean a duo like this will get at least 25-30 “kills” in a single game. They have the best playing equipment. They wear earphones to catch the slightest sound. They know all the tricks.

It’s hard to believe but folks like this actually make a living by streaming video game footage. Their fans subscribe to their channels for a small monthly charge and donate lots of cash to them. They play in tournaments and stream that on Twitch. Not your father’s video game experience to be sure.

Growing up I had a choice of real life careers. I don’t think I would have ever in my wildest dreams think that someone could have a career like this. Virtual mayhem. Go figure.

 

 

 

Life Begins for Sarah

 

They say life begins at …well you know. So for Sarah life begins tomorrow (October 2, 2017.)

I won’t say how old she is but she was born the year Elvis died and NASA launched Voyager 1 and Voyager 2. You can look it up.

We will be looking after our grandkids for a few days while she and Dave celebrate her milestone in New York City. It’s been a long time in the planning but they will get to see Hamilton. Not the city, the hip-hop history lesson.

Doesn’t seem all that long ago she looked like the pic above. Now her younger daughter is older than that. Life is what happens when you are busy making plans.

She hasn’t stopped planning though. Now she is busy with raising 3 active youngsters and even giving them one year of homeschooling (maybe more.) She is active spiritually in the Good Shepherd catechetical program for little kids. Active in her parish community too. I’m proud of her.

So my dear child of God, I wish you a happy birthday and many more. Always your Dad.

 

Then and Now

It’s been 20 years or so since Sarah started university (21 actually) and it was around that time that both of us got online – me at home and she at Guelph. Internet experiences have sure changed a lot – especially for me as a home user. Let’s take a look.

Equipment to Get Online

  • Then – essentially a desktop or tower with a heavyweight 15 inch CRT screen.
  • Now- you name it – desktops, laptops, tablets, TVs, smartphones, door locks, washing machines, refrigerators…oy.

Connection

  • Then – a slow dial up at 28.8 Kbps at home; Sarah was connected to the University Internet backbone via wire. She got a blazing 1.5 Mbps.
  • Now – pretty much wifi over your local network. Speeds of 25 Mbps are routine. If you’re wired in you can easily get 130 Mbps with my ISP’s service. If I wanted to pay for it I could get gigabit speeds.

Communication

  • Then – mostly text based. We had email of course using a standalone client. Online we had forums and bulletin boards. You could make your own website if you were tech savvy and learned HTML.
  • Now – it’s the age of social media. Facebook, Twitter, Instagram, YouTube, blogs, vlogs, WordPress – all making online presence easy and full of content. Point and click – you’re an Internet star. This blog – with a custom interface and my own domain – needs less than half the work my old website required. And frankly it is pretty much old school compared to what the millennials are posting today.

Browsing

  • Then – the browser heavyweights were Netscape and Mosaic. Internet Explorer was just starting to become popular. You could still pay for browser software back then.
  • Now – IE has morphed into Edge and Netscape became Firefox. Google Chrome has come out of nowhere to dominate. If you use a tablet or smartphone you probably use an app to access your favorite site like Facebook.

Websearch

  • Then – remember hierarchical hypertext search engines like old time Yahoo! ? Remember Excite? Remember Altavista? Gone like a soldier in the Civil War (Bang! Bang!)
  • Now – all you need to know is Google or maybe Bing if you feel masochistic.

Privacy and Security

  • Then – The Age of Innocence – maybe you ran McAfee scans once in a while to check for viruses.
  • Now -The Age of Paranoia – everyone’s out to infect you, scam you, make you part of a bot army, encrypt your data for ransom, hijack your browser, spy on you, steal your ID. You have firewalls, antivirus, antimalware, antispyware, antiphishing, VPNs, incognito browsing – and you still worry about it. Madness I say…madness. That reminds me – I should go check the spam filter on this blog. Only 8 spam comments. Pretty good for something this obscure. How do they find me?

Music

  • Then – There was ricky-tick electronic stuff called MIDI which you could embed on your site to annoy visitors. MP3 was just coming into its own but you needed a lot of bandwidth and storage to get music that way. It was also illegal to pirate music, as many downloaders found out.
  • Now – stream, baby, stream. Spotify is amazing. I don’t think I’ve listened to a DVD in months. Not only can I play an entire album from 1967 by The Doors, I can play it anywhere in the house. “Break on Through to the Other Side.”

Video

  • Then – sure thing, Sherlock. Even the college kids didn’t have enough bandwidth for video. Hardware wasn’t fast enough to render it, storage wasn’t big enough to store it, codecs weren’t mature. You want video in 1997? Go to Blockbuster and rent a cassette.
  • Now – did I mention stream,baby stream? YouTube, Hulu, Amazon Prime Video, Netflix rule the Web. The US is ahead of Canada which seems strangled by regulatory red tape and the telcos / cable guys – but we do OK. Even the social media is obsessed with video – which you can make on a smartphone. It’s a new world out there.

Photography

  • Then – shoot your 35 mm film, get it developed and prints made. Put the print in a photo album. Stack up the albums in your basement.
  • Now – capture your photo in digital with a smartphone camera. Attach it to a message, or post it on Facebook or Instagram. Never make prints of anything. If you want to backup your photos locally you can put a zillion of them on today’s storage media. Maybe if you are a dinosaur like me you’ll have an actual digital camera.

Banking and E-commerce

  • Then- you’re kidding right? Try telephone banking if you are desperate.
  • Now – everything goes from paying your tax bills to buying a new pillow from Amazon.

Who’s Online?

  • Then – university students and some geeky early adopters. The vast majority got their news, did their everyday work, made financial transactions the same way they would have in 1950.
  • Now – A tiny minority (mostly in their late 80s) still live an off-the Net analog life. They find it increasingly difficult to do so in an era of 24 hour online access and activity.

I could go on but you must have gotten the idea by now. The last 20 years have revolutionised our everyday life. And artificial intelligence hasn’t even gotten started. Wow.

 

 

 

 

My First Build

It’s rather strange that after more than 40 years of working with computers, I didn’t actually build one myself until I was a senior citizen. And even that build was a bit unusual. To begin with I didn’t build it to run Windows. Second, my pre-construction planning wasn’t the best. Third, I added to it as time went on. But I was certainly happy with how it turned out. Even today as this home built desktop turns 4 (pretty old in computer terms) I continue to use it and be happy with it. It was a long and winding road though.

My story begins when I inherited an old XP based desktop after my parents passed away in 2009. I still had the old box in 2013 but by then XP was obsolete. I decided to rebuld the desktop with new components, reusing the case and power supply. The old machine had AMD based technology so I decided I would go that way again. Most of the basic parts came from Newegg – a well known supplier of computer hardware.

However as I began to disassemble the older system it was immediately apparent that the case and power supply were going to be woefully inadequate. The old case was big and heavy but was a bear to work inside. The motherboard was mounted in a way that I didn’t want to duplicate in a new build. The power supply was antiquated and weak. And the case lacked proper cables to connect things up.

So I had to do some scrambling before building. I went to a local computer store where I got a new case and power supply. My case (shown above) was more brutalist / gamer oriented than businesslike but it was the right size to fit on my desk, and featured 3 dimensional (convex) side panels that made it easy to run wires behind the motherboard. The power supply was modular – I only had to run the cables I needed and did not have to stash a bunch of unused cabling somewhere inside. Off to a better start now.

I splurged a bit on the motherboard – got a higher quality one than I arguably needed but it gave me all the modern features and future proofed me a bit.

The build was pretty easy. I used the stock cooler for the processor (didn’t try to fit anything difficult.) The processor I chose was called an APU – it combined graphics and computing technology in one chip. I didn’t have to put in a graphics card.

I added a hard drive and optical drive. I got 8GB of fast memory. After I screwed it all together and connected up the cables everything worked the first time. Amazing. I installed Linux and was off to the races.

But that wasn’t the end of the story. I installed in a wifi card to communicate with my router upstairs. I decided I’d be better off with 16 GB of RAM so I got another 8GB stick for dual channel operation. And solid state drives were coming down in price, so not long after that I added one to boot the operating system. I used the mechanical drive for storage of photos and documents. That was the first SSD I ever had. There was a convenient spot to screw it down in the bottom of the case. Cooler Master is a very thoughtful case maker. That SSD addition completed my build in 2013. Not well planned but it worked great.

A couple of years later I found that my graphics solution wasn’t all that well supported any longer by AMD – even in Linux – so I put in a newer discrete graphics card. This improved performance again – to the point that even with essentially four year old hardware my machine is fast and powerful. I expect with Linux I’ll be able to extend its life for another 5 years or so.

I was sorry I couldn’t honor the memory of my parents by re-using their old computer case. But I think of them every time I turn my first computer build on and hear that satisfying “beep.”

Older posts