Cataract Surgery coming soon Questions on Current Medications Im on! HELP!!

[marysano57]

Hello.  I am new to this group and Ive been looking everywhere to find answers to my questions. Best to read about people who have been thru it.  I am 64yr old (lady) and had been informed around 11yrs ago that I had beginning cataracts.  I panicked as I was still young! I was also told my insurance would not pay for it because it was not "ready" .  Ok, so the first Dr. said "dont worry yet, you are not special, everyone gets them"  then several months later I need a new pair of glasses, again "nothing special"  and 2-3 times a year a new pair of glasses (the lions club loves me)  Well, now 4 Cataract specialist later Plus,  4 cardiac stents later and a 7months ago heart attack I find that I can barely see, especially out of my right eye and the Cardiac Meds I take for my "new"  heart attack(and yes the new meds made my eyesite even worse) anywy the meds,,, may not mix with my necessary Cataract surgery - yes I will use the laser for an extra $3200 dollars plus Medicare - but I am having a slight problem with my Eye Surgeon who is supposed to be great - and my Cardiologist agreeing on when I should stop medications.  My question to ANY and EVERYONE is this.  While I know everyone is different I literally take 11medications for my heart failure and other issues, with the emphasis on Aspirin, Plavix, Entresto (ABS drug) and Imdur which is a long acting nitroglycerin.  Thats 4 drugs that can effect the bleeding time and of course my heart failure.  At one point the Dentist said STOP taking those drugs 3 days before HE (the dentist) worked on my teeth - at another point I had the hospital tell me Stop taking these drugs 10days before a Thyroid Test (FNAspiration) and NOW my Opthamologist doesnt even want to talk to ME about it - he says his "anesthesiologist" will contact me.  ??  When?  The day b4 surgery, which is less then 3 weeks away?  I called my Cardio again, who refers me to his Nurse to "talk to" and SHE tells ME to have the Optho Call HER!  OMG!  What should I do?  Get another Eye Surgeon.  Id say OK,  except this is my 4th including 2.5yrs at Hopkins Wilmer Clinic (Joke over there,  forget about them)  My Eye surgeon just keeps repeating how great he himself is, especially with the laser which he insists on using as with my cataracts I am a neg -15 in one eye and a neg -11 in the other, and yes I do see prism, double vision and all those things they say.  I am Worried if I stop my Heart meds too soon,  and being my eye surgeries are already scheduled 10dys apart that brings me 20days without my heart medication, on the other hand if I only go off meds several days (like the dentist said, oh and in his case I didnt stop bleeding for 5-6 days)  Im afraid of capillary bleed,,,,  or worse vitreous clots.  Anyone have any suggestions?  My luck is not the best.  I cant get anyone to agree on whats best for me..  Im getting ready to call the whole thing off even tho I cant drive anymore and can barely see the tv WITH my glasses, which Im told cannot be made any stronger.  I can Read if the book is 2-3 inches from my face but thats about it.  I know the laser will prevent a type of "cutting" they do by scalpel but the docking system for holding your eyeball still has a suction im worried about it sucking my blood out of the capillaries and into the vitreous.  Anybody?   I certainly do not have any EXTRA Money for the side effects that can go wrong! Thanks for reading my novel. Any conversation is appreciated!  Thanks again

[John C Hagan III, MD, FACS, FAAO]

Cataract surgery is rarely an emergency. This forum appeals to people having problems. There are scores of posts of people that rushed into cataract surgery and wished they had taken their time to find out their options.  I cannot give you definitive advice so these are generalities.

1. READ THIS CAREFULLY AT LEAST TWICE:  https://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You--2019-2020-Update  ;
2. Consider post-poning your cataract surgery until you get the answers your want.
3. Generally speaking we would not stop any of your medications. Even in people on full anti-coagulation (warfarin), if the person's personal physicians feel that stopping the anti-coagulation mediation would increase the risk of heart attack, stroke, thromboplebitis then we do the surgery without stopping the anti-coagulant.
4. Please read the section about some offices that are geared from check in to make patients "upgrade" to premium lens, femtosecond laser, ORA technology.   The femtosecond laser and ORA technology have not clearly demonstrated a benefit over standard phacoemulsification.  My wife had cataract surgery several years ago and we passed on everything and just did spherical IOL covered by our insurance. My wife is very happy with the result. For patients with a lot of astigmatism a toric lens is a good investment.  
5. If you have trouble communicating with the eye surgeon and the staff for important pre-operative questions, imagine what it will be like for post surgery communication.
6.  Ultimately you will need to make hard decisions about whether to stay with the surgeon that is so enamored with himself/herself, and demands people for out of pocket for the laser or step back and try and find a surgeon you trust and can communicate with.