Enduring Face-Down Recovery After a Vitrectomy
I hope you're prepared for it. Otherwise, it can come as quite a nasty surprise after having a surgical procedure called a vitrectomy. I am speaking of face-down recovery, or face-down positioning, after retinal surgery. The thought of being face-down all day long, and—worse yet—sleeping on one's stomach, fills most patients with dread.
This type of positioning is essential for your surgical recovery after a vitrectomy, especially if you are having a macular hole repaired or your retina has detached. Your surgeon will insert a gas bubble in your eye to replace the vitreous that has been removed, and in order for this gas bubble to exert the right amount of pressure on the macula (the back of the eye), you have to be face-down. This constant pressure on the back of the eye helps the macula to bond and heal.
But it can be absolutely excruciating, boring, and stressful to spend an extended period of time this way.
Isn't there another way?
I had this same question. I thought, no way should anyone have to do this!
Well, in some rare instances, a patient may not be physically able to assume this position for a lengthy period of time due to musculoskeletal problems (osteoporosis comes to mind). It is theoretically possible that with a retinal detachment, you wouldn't have to do face-down positioning (because of the location of the tear or detachment), but the overwhelming majority of the time, you'll have to be face-down.
You will have a gas bubble in your eye following surgery, or, less frequently, silicone oil. The gas bubble will disappear completely within weeks, but the silicone oil will be there indefinitely, and will necessitate another surgical procedure to remove it.
If you’re going to have to do this face-down positioning, you need to know some good tips for surviving the ordeal. When I had my vitrectomy a few months ago, I had to spend three days in this position, so I speak from experience.
One positive thought, before I begin!
Before I list a few hints, you must know that you can use this time face-down to enhance your creativity. This is not a natural position, now is it?
Years ago, I remember reading that when a writer has a creative block, the best way to unleash new strains of thought is to spend all day lying in a hammock doing nothing! Well, you won’t be doing much during your recovery except watching TV half-heartedly or listening to music, so you might as well let your mind wander where it will.
For instance, my mind came up with a few absurd thoughts while I was face-down. I found myself wishing that I was one of those ancient Egyptians with their impossible anatomy. As an Egyptian, if I wanted to make my eye socket point down, all I would have to do is lie comfortably on my side. But then, what would I do with my feet?
- Rent vitrectomy recovery equipment. You may be able to get partial reimbursement from your health insurance on this. Check your policy for a durable medical equipment rental allowance. The vitrectomy chair is especially helpful if you want to spend time watching TV. It is cleverly designed with a mirror which enables TV viewing.
- Unless watching TV, I found the best and most comfortable position for me was putting my head down on one of those satin horseshoe-shaped pillows on top of my card table, which was just the right height. A padded card table is best, because it is easier on your elbows. If your table isn’t padded, you can easily figure out a way to make it padded.
- Make arrangements for someone to be with you all or part of the time. It goes without saying that you won’t be able to prepare meals, so you’ll need some help. You may be able to cope just fine not having anyone there while you are asleep at night. How much help you’ll need depends on how strict the face-down positioning is.
- Have an ample supply of drinking straws, especially if you like to sip on liquids throughout the day.
- For sleeping, a massage table would be very beneficial, since it has a hole where your head goes. If you can borrow one, you’ll probably sleep better.
- For that matter, hiring a massage therapist to massage your neck and shoulders would provide welcome, soothing relief for tight muscles.
- Rub-in analgesics like Ben Gay are helpful for your muscles. Long-acting patches like Tiger Balm provide longer relief.
- Stock up on books on tape from the public library, or have plenty of DVDs to watch during your recovery. Reading and web-surfing are more difficult, but they can be done, depending on the kind of positioning aids you have available.
- The tissues in your face will get puffy and swollen from being face-down. If you have a horseshoe-shaped form to put your head on, it may also come with a cold pack which you can keep in the freezer and get out from time to time. Positioning your face on the cold pack helps with the swelling.
- If you suffer from seasonal allergies, try not to schedule your surgery during times when you know you’ll have trouble. Having to be face-down will make your stuffy nose and watery eyes much more uncomfortable, and perhaps hamper your breathing.
- When your muscles ache, you can take over-the-counter pain relievers. If you’re miserable, your doctor can prescribe a muscle relaxant. That medicine will make you very drowsy and help you sleep. In fact, during the day, if you occasionally nap in your vitrectomy chair, it’s not a big deal. Just don’t sleep overnight in it.
- If you’re a man, you’ll have the easiest time sleeping face-down. If you’re a flat-chested woman, the same. In fact, if you’re such a female, for once in your life, you’ll be blessedly, blissfully grateful for such anatomy.
- If you’re prone to skin problems and acne, don’t worry too much about the pressure on your face. My forehead is a problem spot for breakouts, but I did not get any pimples following my time spent face-down. But if you’re concerned, just use lots of ice to relieve the swelling in your face.
- Have some good conversations with your spouse, kids, or temporary caregiver. Or, better yet, spend time talking on the phone with friends whom you rarely see. They won't be distracted, because eye contact won't matter.
It's worth it
As with all things, your best strategy is a positive attitude. Your face-down time will go faster than you expect. Mine was only three days, but the recovery time for this procedure may be as long as two weeks. Either way, you’ll have something to look forward to. When you go to the doctor and receive your “get out of jail card," you will be happy once again to be in the land of the upright. And you’ll know you did a good job to help your eye get well again.
This is a related article I wrote that you may find useful: