Category Archives: Diary Entries

Thoughts on Organ and Tissue Donation

On Monday or Tuesday, someone is going to die.

A man, a woman, older or younger, black, white, Asian, Christian, Jew, Atheist, Gay, Straight…. someone will be lost.. Thanks to a 10 second investment, signing a donor card or answering a donation question, an eye will be harvested, sent to an eye bank and the corneal tissue delivered to Dr. Holland. The unselfish act of a total stranger will give me better vision, someone else life with a kidney, another dying person a heart or lung, perhaps.

I think that, if you are healthy and have not signed an organ donor card, you are committing a selfish act.

I was surprised to learn that 95% of Americans “support” organ donation, while only 38% are registered organ donors? I think it’s probably a combination of laziness, ignorance, paranoia and anti-scientific leanings. But mostly I think it’s the ridiculous opt-in system that we use in the US right now.

If you believe in heaven – donating your viable organs will look very good on your resume at the pearly gates check-in queue.

How many people die because people, rather than having some deep philosophical misgivings, simply forgot to sign their card? I’m a major advocate for opt-out organ donation nationwide and presumed consent.

Presumed consent, advocates argue, combines the principles of supply-side efficiency, respect for individual conscience, and individual’s positive, yet qualified, duty to promote the good of society.
-Organ Procurement and Transplantation Network

If someone is bothered by the donation of their organs, let them do the work of un-registering themselves. During that process, they will take an internal ethical journey, at each step justifying their position. I think many would reconsider after reflection.

More than 100,000 people are currently waiting for organ transplants, and close to 20 die each day because of organ shortages.
– National Institutes of Health

I’m also an advocate for preference of donors in receipt of organs/tissue should they need it. Excepting those with health issues that prevents donation, I think that when there are two people with equal need for a given organ, preference should be given to the one who has signed their donor card, such as it is in Israel

All major religions in the United States support organ, eye and tissue donation and see it as the final act of love and generosity toward others.

USA Resources:
Created and maintained by Donate Life America, contains important facts and information about donation and transplantation as well as details on how to become a registered organ, eye and tissue donors in each state.
Donate Life America’s Spanish web site, contains facts and information about donation and transplantation and addresses concerns that are specific to the Hispanic community. It also details how to become a registered organ, eye and tissue donor in each state.
Created and maintained by United Network for Organ Sharing (UNOS), is the organ transplantation information resource for medical professionals and the general public. UNOS brings together medicine, science, public policy and technology to facilitate every organ transplant performed in the United States.
Created and maintained by UNOS the site contains in depth national, regional, and state donation and transplantation data.
Created and maintained by UNOS, the Transplant Living Web site is the definitive information and education resource for transplant patients and their families.
The oldest transplant association in the United States, the EBAA is a nationally recognized accrediting body for eye banks.
The American Association of Tissue Banks (AATB) is a professional, non-profit, scientific and educational organization. It is the only national tissue banking organization in the United States, and its membership totals more than 100 accredited tissue banks and 1,000 individual members.
The Association of Organ Procurement Organizations (AOPO) is the non-profit organization recognized as the national representative of fifty-eight federally-designated organ procurement organizations, serving more than 300 million Americans.

Interactive Body (opens in new window.)

I am seeking the source of the terrific illustration above so I can provide credit. Is it your illustration? Please email me so I can attribute it.
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Posted by on March 4, 2011 in Diary Entries, Pre Surgery


Corneal Transplant Countdown – 1 week to go

Springtime in Kentucky by Scott Clark

Springtime in Kentucky is Coming

It’s been a good week.  The signs of Spring are all around Kentucky.  If there is a more beautiful place to be in the Spring than Kentucky, I’ve not found it.  Soon foals will be visible in the plank-wood fields in the rural parts of the state and Lexington’s downtown will get busier during the day as people come out.

I bought myself a present – a new commuter bike, and to get it, I made a short 350 mile roadtrip to Indianapolis, listening to an Audiobook (“Shopclass as Soulcraft”).  Knowing I may not be driving much for the next couple of weeks, I thought it would be nice to go on a short mission.  I was right, it was fun – and I got a great deal on the bike!

I have had mostly good days with the semi-scleral lens, wearing it for 11-12 hours daily – my absolute max.  I’ve done well on watching the clock and not forgetting (easy to do on good days, when your eye feels great.)

But the calendar is ruthlessly counting down the days until I go in for my DALK procedure.   I’m apprehensive about it, but reason with myself that I’m already functionally blind in my left eye. It’s not as if I have great vision and am treating some invisible condition with a risk of losing what I have.  The overwhelmingly likely scenario is a successful procedure next week.   So, let the days come and I’ll check in again in a while.



The “7” photo to the left is by Alan Campbell.  The field is by me.
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Posted by on March 1, 2011 in Diary Entries, Pre Surgery, Surgery-Story


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2 Weeks To Go – Pre-surgery Physical

Had my pre-surgical physical today in Lexington at Baptist Family Medicine Clinic – with my long-time family MD. No surprises. I am healthy and should be good to go. Blood test, a few questions, and I was out of there. Scale was friendly – showing I’d dropped 11 lbs. Blood pressure was completely normal – nice considering my family history of high blood pressure.

The staff were quite interested in seeing the photos of my cone taken (previous post) the day before. Oddly, my physician was having trouble with dry eye, and I was able to give her advice and tell her about how semi-scleral lenses help with this – talk about role-reversal.

It is now 2 weeks from my surgery.   I’ve been studying the various means of anesthesia – as evidence on right demonstrates.

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Posted by on February 23, 2011 in Diary Entries, Pre Surgery, Surgery-Story



Keratoconus and Eye Rubbing – Which came First?

Scott Clark on Motorcycle

Scott out making his eyes itch, among other things.

The idea that Keratoconus is caused by eye rubbing has been around a while.  I’ve talked with 5-6 corneal surgeons and they’ve had differing opinions on it.   There was consensus that one should be more safe than sorry and advise kids to avoid hard eye rubbing – and to treat the underlying condition.   My daughter’s itchy eyes are treated with Patenol, and I advise my kids to avoid doing it.  I asked them to report it to me when they have itchy eyes and I guaranteed to help them get rid of the symptom.  When I was a kid, I rode motorcycles a lot.  In the dust, dirt, mud, fields of corn, fields of grain, fields of dreams.  But I don’t recall rubbing my eye that much.. but why would I?

“For example, a case control study of 120 subjects with KC involved assessment of potential risk factors, including atopy, family history, eye rubbing, and contact lens wear. In the univariate analysis, there were associations between KC and atopy, family history, and eye rubbing. However, in the multivariate analysis, only eye rubbing was still a significant predictor of KC.” – Charles W. McMonnies, M.Sc., University of New South Wales, Kensington, Australia  (see more)

Here are some other articles/citations on the issue:

This quote from one physicians’ advice puts it in plain English:

Keratoconus has been associated with eye rubbing and eye allergies. Don’t rub your eyes!!! It is believed that eye rubbing can help to distort and thin the corneal surface. To help you with not rubbing your eyes you can use eye drops that lessen the symptoms of eye allergies. Some of these are available over the counter and some need to be prescribed. A good over the counter anti-histamine eye drop is “Zaditor”. Cool compresses help. There is also some evidence that using cooled tea bags and even cucumber slices help to calm the symptoms of eye itching.  – Dr. Jon Vogel

I may extend the list of links above if I find anymore.

Tomorrow:  My pre-surgery physical.


Posted by on February 22, 2011 in Diary Entries, Interesting Stuff


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Keratoconus can make the cornea ultra-sensitive

Cornea PainYesterday, I had a bad “removal” event with my lens.

When taking out my semi-sclarel lens, something didn’t go right.  Either I didn’t pre-lube it enough or just had a bad angle.  The removal does something to the nerve endings of the cornea and “whap” – pain!    I can pretty much count on it hurting for 12 hours, so took Benadryl to sleep last night (knocks me out.)

I hope that this will not be the case after the new cornea is healed.   It’s unpredictable.  I had to cancel meetings at work today because I get these stabbing stinging pain out of nowhere – and makes me look like a turets syndrome patient as I flinch and curse.

I wish there was some kind of anesthetic drops that wouldn’t dissolve my cornea even more, but for now, it’s going to have to be Tylenol.  Perhaps my cornea is protesting it’s last few weeks?

Image: “Pain” by iprozac on Flickr
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Posted by on February 21, 2011 in Diary Entries, Pre Surgery, Surgery-Story


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Surgery Countdown – Less than 3 weeks

"19" by Lincolnian on FlickrWell, as the days tick by, I’m becoming more acutely aware of my forthcoming date with Dr. Holland.  I’ve began to plan things a bit for those 2-3 weeks after the surgery when I’m certain not to be at my best.

  • getting a physical.
  • informing clients of my absence.
  • scaling down work schedule for the period.
  • scheduling time to have work done on my commuter bike (since I won’t be able to ride for 20-30 days.)
  • getting as many “heavy lifting” tasks done as I can before hand.
  • looking around for some clear glasses I can use to protect my eyes.

My KC eye has been awful at night lately… not so bad during the day.   At night, it’s constantly dry – I am awakened 3-4+ times nightly, and pour lubricant into them.   Sleep deprivation has caught up with me – I nearly fell asleep in a meeting, and the double espressos are not enough.  I wonder how I’ll sleep after the surgery?

I’m having more migraine also – which may or may not be sourced to the KC vision/strain.  Thank goodness for Imitrex.  I just read the really amazing story about Serene Branson’s on-air voice problem during the Superbowl… it turns out it was migraine-aura related, not a stroke.  I wonder if this will raise awareness of migraine and its debilitating effects.

Have been thinking about how the brain reacts to poor vision in one eye, and how it might re-learn to use that eye after surgery.  Heard an interview on NPR about how our senses are mapped onto the brain.  Quite interesting.   I wonder how KC patients’ brains re-map themselves before and after cornea surgery?


photo: “19” by Lincolnian on Flickr
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Posted by on February 18, 2011 in Diary Entries, Pre Surgery, Surgery-Story



Keratoconus’ Effect On Life #1

As I look down my Facebook events a moment ago, I see the following:

Not attending
Not attending
Not attending
Not attending

Almost imperceptively, Keratoconus has given me an impulsive “can’t go” reaction to everything that happens after 8PM.   I know my eyes will be hurting and dry by then, and will want to stay home.

I even project this onto others… “You can’t possibly do that drive in a single day!” I’ll say.  The reality is that I’ve simply forgotten that it is possible to remain active for longer than 10 hours.

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Posted by on February 13, 2011 in Diary Entries, Pre Surgery


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Keratoconus and sleep

Short 3am diary post from bed. Three nights now the KC has interrupted my sleep.

I’m getting low quality sleep and hope that this improves after surgery. Lubricant just doesn’t last long enough and I awake to a dry eye.

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Posted by on February 12, 2011 in Diary Entries, Pre Surgery



Cornea DALK Procedure – 30 Days and Counting

Well, as of this morning, I’m 30 days away.  In the next 2 weeks, I’ll be getting a full physical from my family doctor to be sure that there are no issues with the surgery (I don’t expect any.)  I have began to notify my clients of a 2 week period of low productivity, and a full week out of the office.

I still feel overall excited, with a tinge of anxiety.   I only question the idea of the transplant when I have a “good day” with my semiscleral lens, like yesterday (11 hours of wear time, very little discomfort.)   But all I have to do is close my 20/20 right eye to see that I still have a problem.   I am also hoping for the DALK not to be converted to a PK – but I need to be ready for that.  The doctor said the DALK would be lifetime, with little chance of rejection, but it all depends on what he finds on the lower membranes.

Today, I have to go to the dentist – likely for a root canal.  I’m a nighttime grinder, and I’ve damaged some of my teeth.  I don’t want the teeth hurting or be on any conflicting pain medicines near the surgery, so getting it taken care of now.  Not looking forward to it – I hate going to the dentist

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Posted by on February 9, 2011 in Diary Entries, Pre Surgery, Surgery-Story


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Nerves are Normal When Considering Cornea Transplant

Planning to head up for my second consultation with Dr. Holland tomorrow.  I’m looking for answers to a few more questions, and a bit of reassurance I think.

It’s normal to have ups and downs when considering this procedure.  And it’s normal to experience a whole spectrum of emotions – from sadness, worry and even excitement.

For a while, I felt silly for feeling nervous about the whole corneal transplant thing.  I mean.. it’s an “outpatient” procedure.  But, for most, it’s unlike any other thing that’s happened in one’s life.  Yes… a knife, on your eye.  At first that sounds scary as hell.  But we all must remember that corneal surgeons use a microscope, precision tools and years of practice.  To you, it’s one of the biggest things that has ever happened (especially for younger patients,) but to the physician, it’s rather routine.

I think most cornea doctors realize that this is very important, and my experience has been that they are more than willing to talk with you in depth about it, as many times as you want.  If your doctor seems rushed or doesn’t answer your questions – by all means find another.

I will post my questions, with the answers, later this weekend.

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Posted by on February 2, 2011 in Diary Entries, Pre Surgery, Surgery-Story


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