Small Miracles

I happened to be out on foot during that heavy fog the other morning, doing chores. I was amazed by the transformation.

Suddenly my yard, my neighbor’s pasture, my road, all wore a veil of mystery.

If we’re not trying to drive somewhere, unfamiliarity like that can excite us, breaking through our normal failure to notice the most familiar objects, the ones we see every day. In a fog, we’re seeing them freshly, if blurred, and they surprise us.

It’s like the fog turns them into art.

Pretty miraculous accomplishment for a cloud resting too close to the ground.

When the cloud is in one of your eyes, however, it becomes a handicap. One that requires a different kind of miracle.

I had cataract surgery on my left eye in 2019, right before the Pandemic put us into isolation.

A year and a half later, I noticed diminishing sight in that eye. A new eyeglass prescription improved it somewhat, and they said I’d have to live with the partial improvement. By last October, however, I was having marked difficulty in reading. And when driving, it felt as though the left lens of my eyeglasses was fogged.

This is a symptom of “posterior capsular opacification,” quite common (20%50% frequency) after cataract surgery. It’s easy to fix with a follow up laser procedure.

And quick, once you’re sitting in the right chair.

Getting to that chair, however, requires an Olympiclevel course of jumps over bureaucratic hurdles. First, the doctors have to demonstrate another new prescription won’t solve the problem.

I couldn’t read past the E on the top line of letters the D.O. showed me, with or without a lens.

Okay. On to Obstacle #2: My surgeon’s first available appointment was more than a year away.

I was already functionally blind in one eye. Moreover, they’d seen the developing problem in 2021, when I received the new Rx for eyeglasses.

Why not fix it straightaway?

Medicare is why not.

According to Healio.com, a medical news aggregator, Medicare has noticed that the frequency of laser procedures to remove the effects of “opacification” does not correlate with documentation that the diminishing sight affects the patient’s daily life. Medicare “thinks” that too many of those laser solutions are done too soon. (Eyeglasses aren’t covered by Medicare. Those laser procedures are.)

They report, further, Medicare’s position that a lack of sharp vision is not sufficient reason for the procedure.

Old folks don’t need to see, it seems. And if their fuzzy vision causes a fall, a broken hip, a car accident, well—they’re old, right? Seventy, seventy-five is old. Right?

Thanks to the intervention of a friend on Facebook, I was able to reach my surgeon’s scheduler. Three weeks later (instead of 53), I experienced a true miracle.

It took less than 40 seconds in 21 exquisitely beautiful starbursts of red light from aYAG laser in the expert hands of Dr. Douglas Koch at Baylor College of Medicine. I have no doubt that, free of Medicare restrictions, he would have worked the magic much sooner.

What none of the Medicare hurdles takes into account are the many gradual restrictions that year of diminished vision placed on my daily activities.

Because they came on slowly, I hadn’t noticed—until they were removed by the laser— the effect on my balance, my ability to be self-sufficient on this small rural acreage, and especially to carry out the most basic necessities of my professional responsibilities.

I had not been able to read a balance sheet, book or manuscript in print form for more than a year.

Now I can, again.

Readers can contact Hale at bfhale2017@gmail.com