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    Alberta

    Just wanted to say hi and I'm in Alberta.
    DX 2005 RRMS. Did 2nd round of Lemtrada Jan 2018. DX SPMS 2019

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      Canadian contemplating cataract surgery

      Hi there. I'm in Calgary, Alberta, am 68 years old, female, was diagnosed with MS 25 years ago. A few years back I was told I had cataracts and I find that my eyesight is getting worse. When I saw the optometrist this year, he said my cataracts were twice as bad as they were the year before. He didn't define 'twice as bad'. He said he wanted to refer me to an ophthalmologist. I asked for a referral to the Gimbel eye clinic, as they specialize in eye surgery and I've had good personal reports about them. I have an appointment for November 28, 2016, just under three weeks from now, and I have some questions.

      1. In the literature that the Gimbel clinic sent me, they referred to various types of lenses they could implant but I doubt that any other than the basic one would be covered by Alberta Health. I'm also under Blue Cross, in case this is relevant. I'd like to hear from anyone who has thoughts/information on this $$ subject.

      2. We ran into an old friend a few years ago who said he'd had cataract surgery and had gotten 'the new type' of lenses. He seemed miserable and was squinting in what seemed to be an effort to see properly. Any thoughts or information on this? I've worked in health care and know that the 'latest and greatest' might be the latest but not the greatest.

      3. I've been short-sighted and have had astigmatism since I was a child. Also, I had a bout of optic neuritis in 1989, two years before the MS diagnosis, and since then have have numerous short-term bouts of double vision. I think I was told that my optic nerve didn't appear damaged but my memory might be unreliable here. I've also had a bout with a small scotoma, which resolved completely, and I suspect I have MS-acquired defective colour vision in one eye but have never pursued this issue with an optometrist or ophthalmologist. I wonder if any of these would affect the result of cataract surgery.

      Would love to hear from anyone who's been through this and has advice, warnings, encouragement, whatever. Am getting cold feet. Lorraine.

      Comment


        I had cataract surgery on both eyes about 2-1/2 years ago. Mine were steroid induced, with possibly a few effects of years of heavy-duty immunosuppressants thrown in.

        I have compromised vision in both eyes due to more episodes of optic neuritis than you would probably believe. (I wouldn't believe myself how many episodes I've had if I hadn't been there for each and every one of them. )

        I'm missing more than half the visual field in one eye, with spotty losses of field in the other. Fortunately, my best-corrected visual acuity is still fairly good in both eyes, but my contrast sensitivity is significantly compromised. I have difficulty reading type that's gray or pastel, and trouble reading LCD displays that aren't black on white.

        I'm sure insurance works the same in Canada as in the US. Insurance covers only the basic, single-power lens implant, the minimum necessary to restore vision. The patient pays extra for premium multifocal lenses.

        As far as vision goes, the idea of being able to see far and middle and near with just the lens implant and without glasses can sound pretty good. But to deliver those different ranges, the optics can provide clear vision at only one distance. The other distances aren't as clear and the contrast is reduced. And some it can't be fixed even by putting glasses over the implants. And that's why a lot of people who thought their vision would be perfect with the implants are disappointed. Some of them are so disappointed that they have the expensive lenses removed and replaced with either a different brand of premium lens or the simple single-power lenses.

        Because both my visual acuity and contrast sensitivity are already compromised, any further drop in either one wasn't going to work for me. The simplest, one-power lens gives the crispest optics, so that's what I picked, and it was the best decision for me.

        The other best decision for me was to NOT have the implants set for distance. That's another thing that a lot of people think would be great if they had been nearsighted. But then those folks are surprised to find out that they can't see up close by themselves anymore. So instead of having to wear glasses to see far away, they then need glasses to see up close.

        Because I had been nearsighted all my life, I would have been supremely unhappy if I couldn't see up close by myself anymore. I had the lens powers chosen specifically to leave me nearsighted. I was already used to wearing glasses full time, so nothing had to change after surgery.

        So if you want the highest possibility for the clearest optics and best vision (which will include wearing glasses for one or more distances) rather than the convenience of not having to wear glasses at least part time, choose the simple, single-power implants. If the convenience is more important than the sharpest vision, you can choose one of the premium multifocal lenses.

        Cataract surgery is the most commonly performed elective surgery, and the complication rate is pretty low -- less than 2%. There shouldn't be any problem with double vision since double vision comes from miscoordination of the muscles outside the eye and a lens implant is a purely optical element inside the eye.

        Nothing you've mentioned would affect the results of the surgery. If you have a scotoma or reduced color vision before surgery, you'll still have the same issues afterward. Continuing to have the same issues is different than pre-existing conditions affecting the results of the surgery.

        There is that slight chance of complications that are a result of the surgery. If there were to be any inflammation inside the eye that might affect the optic nerve or other parts of the eye, it would fall under the 2% or so rate of complications. Occasionally there is inflammation of the retina after surgery, which is a known and expected possibility that would not be related to MS. Neither one of those happened to me.

        Cataract surgery is pretty simple. A few weeks after the surgeries I got new glasses and haven't really thought about the implants much since then.

        When you're ready for surgery depends on you. You'll know when your vision has gotten bad enough for you to assume the low risk of complications. If you haven't gotten to that point yet, then there's no hurry to have surgery. You don't have to have surgery until you're comfortable with the idea.

        You might try googling around forums about cataract surgery and see what other people say. Then you'll have more information to talk with the ophthalmologist about.

        Comment


          Canadian contemplating cataract surgery

          Hello jreagan 70. Thank you so much for taking the time to send me such a detailed reply. It's very much in keeping with what I've been thinking. The optometrist I'd seen a couple of times had been recommended by the Gimbel clinic, not by a patient, maybe because his office is fairly close to where I live.

          I found this optometrist to be a brisk, uninformative know all. Anyhow, when he said he'd like to refer me to an ophthalmologist, I named the Gimbel clinic because I know that when the time comes that I want cataract surgery I'll want it to be done by them. I am not ready to have such surgery yet but the literature I subsequently received from that clinic suggests they assume I've agreed to get on the queue to have it. As I type this, it's a Sunday, but next week when the clinic is open I'll phone the Gimbel folk to clarify any misunderstanding.

          I find the MDs here, and in this case perhaps one optometrist, to assume that we're mere 'things' and that the doctor knows best...I beg to differ, but I mustn't get started on THAT rant.

          When the time comes to have the surgery, I'm with you in wanting the simplest possible artificial lenses. I've been near-sighted since I first had glasses at the age of nine and am used to seeing just fine without them. In fact, in my twenties I didn't even own a pair of glasses and nowadays most of the time I don't wear them. Even when we go out visiting, I look for the nearest opportunity to take them off. Of course when I used to drive -- that seems to be in the past now -- I would wear my glasses.

          I agree that my bouts of double vision, which began long before I was told I have cataracts, will continue, as well as any other MS-connected visual oddities. And I think that Alberta Health will pay for the basic surgery and another plan, Blue Cross, will pay 70% of the cost of any associated prescriptions.

          Again, thanks a lot for taking the time to send your thoughtful reply. It's in keeping with what a wise lady, my late MIL, used to say about unpleasant possibilities: 'put it off as long as possible'. Lorraine



          Originally posted by jreagan70 View Post
          I had cataract surgery on both eyes about 2-1/2 years ago. Mine were steroid induced, with possibly a few effects of years of heavy-duty immunosuppressants thrown in.

          I have compromised vision in both eyes due to more episodes of optic neuritis than you would probably believe. (I wouldn't believe myself how many episodes I've had if I hadn't been there for each and every one of them. )

          I'm missing more than half the visual field in one eye, with spotty losses of field in the other. Fortunately, my best-corrected visual acuity is still fairly good in both eyes, but my contrast sensitivity is significantly compromised. I have difficulty reading type that's gray or pastel, and trouble reading LCD displays that aren't black on white.

          I'm sure insurance works the same in Canada as in the US. Insurance covers only the basic, single-power lens implant, the minimum necessary to restore vision. The patient pays extra for premium multifocal lenses.

          As far as vision goes, the idea of being able to see far and middle and near with just the lens implant and without glasses can sound pretty good. But to deliver those different ranges, the optics can provide clear vision at only one distance. The other distances aren't as clear and the contrast is reduced. And some it can't be fixed even by putting glasses over the implants. And that's why a lot of people who thought their vision would be perfect with the implants are disappointed. Some of them are so disappointed that they have the expensive lenses removed and replaced with either a different brand of premium lens or the simple single-power lenses.

          Because both my visual acuity and contrast sensitivity are already compromised, any further drop in either one wasn't going to work for me. The simplest, one-power lens gives the crispest optics, so that's what I picked, and it was the best decision for me.

          The other best decision for me was to NOT have the implants set for distance. That's another thing that a lot of people think would be great if they had been nearsighted. But then those folks are surprised to find out that they can't see up close by themselves anymore. So instead of having to wear glasses to see far away, they then need glasses to see up close.

          Because I had been nearsighted all my life, I would have been supremely unhappy if I couldn't see up close by myself anymore. I had the lens powers chosen specifically to leave me nearsighted. I was already used to wearing glasses full time, so nothing had to change after surgery.

          So if you want the highest possibility for the clearest optics and best vision (which will include wearing glasses for one or more distances) rather than the convenience of not having to wear glasses at least part time, choose the simple, single-power implants. If the convenience is more important than the sharpest vision, you can choose one of the premium multifocal lenses.

          Cataract surgery is the most commonly performed elective surgery, and the complication rate is pretty low -- less than 2%. There shouldn't be any problem with double vision since double vision comes from miscoordination of the muscles outside the eye and a lens implant is a purely optical element inside the eye.

          Nothing you've mentioned would affect the results of the surgery. If you have a scotoma or reduced color vision before surgery, you'll still have the same issues afterward. Continuing to have the same issues is different than pre-existing conditions affecting the results of the surgery.

          There is that slight chance of complications that are a result of the surgery. If there were to be any inflammation inside the eye that might affect the optic nerve or other parts of the eye, it would fall under the 2% or so rate of complications. Occasionally there is inflammation of the retina after surgery, which is a known and expected possibility that would not be related to MS. Neither one of those happened to me.

          Cataract surgery is pretty simple. A few weeks after the surgeries I got new glasses and haven't really thought about the implants much since then.

          When you're ready for surgery depends on you. You'll know when your vision has gotten bad enough for you to assume the low risk of complications. If you haven't gotten to that point yet, then there's no hurry to have surgery. You don't have to have surgery until you're comfortable with the idea.

          You might try googling around forums about cataract surgery and see what other people say. Then you'll have more information to talk with the ophthalmologist about.

          Comment


            Hi,
            Just found this thread and haven't read all the posts.
            I just wanted to say though that it is possible to have one eye done for distance and one for near.
            As long as you brain can adjust. A trial with contacts etc prior to determine if this is a viable option for a person needs to be done.

            I did this and have my right eye for distance and left for close up. after about a month i didn't even notice the difference. that was 7 years ago. This meant i didn't have to wear glasses ever.

            Just my experience hope it helps.

            Comment


              Hi from Calgary newly diagnosed 36 y/o male

              Just wanna say hello I'm a 36 y/o named Anthony from SE Calgary just got diagnosed with RRMS almost a month ago. If happened at the new South Calgary Health Campus. Still processing it all it's hard.

              the hospital is excellent and the MS clinic there has a wait time of 3-6 months initially but wen I came back to emergency with renewed symptoms and new neurologist said he'd fit me in this month. I'm stable right now slowly recovering but have a lot of questions.

              What can I expect from Alberta health care and blue cross plan I have wen they assess me in the clinic for a MS treatment plan? Which meds are their first line options and who covers the costs exactly ? There's a new one I reading about overbid Thad Canada is approved and it has good reviews. What are they gonna throw at me. I don't understand any of it till I'm Admitted into the clinic, until then I'm in PT next to continue my recovery but I'm highly anxious but grateful for our Alberta health care, that's for sure I'd be financially crippled otherwise cause I'm far from wealthy.

              any insight for a newly diagnosed 36 y/o who is a little scared.

              -All the best

              Comment


                Hairdressers for MSer who gets tired and twitchy

                Hello all. I'm in Calgary and am wondering what others here do about hairdressers. I haven't been to a hairdresser in years, used to go to a very good one but I couldn't go to see him now. I know that, because of the way MS affects me, all the noise, the smells, all the fuss at his salon would make me twitchy and I'd start to feel ill and exhausted.

                My hair is turning white at the front, except some of the white is turning an ugly yellow and I would like professional advice on how to 'fix' it. I may have MS but I don't want to look awful. Any suggestions, nice, helpful competent hairdressers in a calm environment?

                Lorraine

                Comment


                  Hi! Newly diagnosed (but now know I've had MS since 2013). I'm in London, Ontario. I'm looking for thoughts and advice from anyone who has experience with the Ontario Trillium Drug Benefit plan.
                  "Ring the bells that still can ring. Forget your perfect offering. There is a crack a crack in everything. That's how the light gets in.
                  ~Leonard Cohen


                  DX March, 2022. Ontario, Canada

                  Comment


                    Small town Ontario checking in!

                    Should start immunotherapy? My Neuro is very insistent after my last MRIS results, they weren't good. BUT I was diagnosed with Lyme disease and a coinfection, Babesiosis in the States a few years back. Lyme had initial treatment but nothing for the secondary infection. Canadian health doesn't accept this diagnosis as it doesn't repeat with our tests (Canadians are behind in this kind of testing). If I start an immunotherapy it could trigger a lot of Lyme/Babesia symptoms, some can be life threatening. If I don't start immunotherapy, my neuro says I'm looking at disability within the next few years. I am frozen with indecision but time keeps on moving forward. What do I do?

                    Can anyone help? Offer advice? Have any experience with this?

                    Comment


                      Originally posted by isthereadog View Post
                      Small town Ontario checking in!

                      Should start immunotherapy? My Neuro is very insistent after my last MRIS results, they weren't good. BUT I was diagnosed with Lyme disease and a coinfection, Babesiosis in the States a few years back. Lyme had initial treatment but nothing for the secondary infection. Canadian health doesn't accept this diagnosis as it doesn't repeat with our tests (Canadians are behind in this kind of testing). If I start an immunotherapy it could trigger a lot of Lyme/Babesia symptoms, some can be life threatening. If I don't start immunotherapy, my neuro says I'm looking at disability within the next few years. I am frozen with indecision but time keeps on moving forward. What do I do?

                      Can anyone help? Offer advice? Have any experience with this?
                      Hi there. I just saw your message and I have some thoughts. I don't know if I can be helpful but here goes: I was diagnosed 31 years ago and at that time MRIs were merely diagnostic, not prognostic. Maybe they've become more sophisticated now? How can the MD tell you that you're on the way to disability? Can you help me to understand that? I've have exactly one MRI, in 1991, to diagnose me, and then no more. I'm not disabled, walk without any kind of mobility aid. My stamina has been poor from the beginning and that's about it.

                      I can see that you're kind of stuck. Maybe you've made a decision already? In my day, it was understood that there wasn't an exact correlation between symptoms and MRI findings. I was told that some had no symptoms yet really 'messy' MRIs. Have neurologists become more definite in their utterances but not truly any more knowledgeable? I'm here if you'd like to discuss. I have no hard and fast opinions. Mandalababe.

                      Comment

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