Wednesday, July 5, 2017

Michael L. Roh, M.D Treats Retinal Detachment on Client Keith Torkelson for Brand New Day


Charter Information

Publication ID – Brand New Day Specialist – Eyes – 9.1.3

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Michael L. Roh, M.D Treats Retinal Detachment on
Client Keith Torkelson for
Brand New Day

Date Chartered: July 5, 2017

Blog Used for Publication – Brand New
Picture Prefix – Michael L Roh for Keith Torkelsons Retina_
Updates Posted Separately

Inspiration – OCHCA-BHS Director Mary Hale & The Blind


Critical Period - Days 1-12



Doctor Rol - Ophthalmologist (Retina Specialist)


Michael L. Roh, Ophthalmologist (MD) Treats Keith Torkelson – Progress Notes for Brand New Day
Click this Link for Progress Notes After the First 12

 
Model of the Retina Repair Surgery
"1-2-3 Method"Results Up Front – Day-12

20170704-TU: Day-12 I Would Report to Doctor

Orange County Ophthalmology Medical Group (OCOMG)
Consumer Art - Independence Day
 

Our ophthalmologist is and has been Michael L. Roh, M.D.  Doctor Roh took over for Doctor Boyce via doctor Taban when the retina was involved.  This is the eleventh day for our retinal detachment crisis.  The issue is with our left eye. As we discuss later OCOMG maintains a patient portal.  One of its’ features is texting the staff.  We tested it on Day-03 and due to no response we conclude that the texting feature is not fully operational.  By any means we would like to with Doctor Rol today.  We would like to update him by sharing some of our challenges and concerns.  The image we created and inserted below indicates that when in a sitting position the Gas Bubble (GB) is on the bottom and takes up about 1/3 of the visual field.  Above the Gas Bubble is a blurry area that yesterday improved as the day went on.  The new and improved features this morning are about ten or so black dots in the top third.  By noon there are more dots.  The variation in perceived size of the same object may be associated with difficulties in driving. Note: We believe that in the optical reality our mapped areas are flipped vertical (inverted).  We are trying to keep our spirits high.  We are trying to focus about the positives.  We are thanking the King of Kings for help.  Doctor Rol started the spiritual approach off and rolling by implicating it would take “luck” to resolve our visual issues.  Our hopes are that as the bubble decreases in size more healthy receptors are uncovered leading to improved focus.  There is a chance that our cataract treatment lens prescription may be off now.  Next in Day-12 we plan to address our DriveAbility.


20170704-TU: Day-12 – Need Spirit

Thanking The King of Kings

Whispering I Love You
By Keith E Torkelson
July 4, 2017

(Source December 10, 1997)

Unable to put into words
The ways I love you

Feeling your divine rhythm, I quietly meditate
Our permeating connection

Your warm embrace
Now I’m able to pray to you

Not mine, thy will be done
Oh, holy, holy
King of kings

Descend to this earth and remain
Night and day, every day
Reign gently upon my journey

That I might grow to my fullest
With deafening sound
I whisper I love you

Edited: June 17, 2017 by Lanaii A Kline
Published: July 4, 2017


Discovery About Onset (Reset Chronology)
20170606-TU: Doctor Ann Inman Our Optometrist’s Exam - Assess Floater – Frustration
On Tuesday the Sixth of June we saw our optometrist Dr. Inman for a routine exam and to assess a floater in our left eye.  We were so happy that our vision was improving.  She stated that the floater was over our optic nerve and that if it got worse to see our ophthalmologist Dr. Boyce.  She gave us no indication to be vigilant about any graying areas that might indicate a retinal tear or detachment.  Within the same month we suffered a retinal detachment crisis.


20170623-F: Day-01: Distraction – Onset & Inception
We were being vigilant about our “floater” and did not think the graying in my left eye was significant.  Our sister told us the floater may go away.  I was not told to watch carefully for decreased vision just the progression of the floater.


20170624-SAT: Day-02: Laundromat
I drove to the Laundromat in the morning and did not notice any decrease in driving capacity.


20170625-SUN: Day-03: Gains Momentum Fast
I notice a significant loss in vision.  I accessed the ophthalmologist’s patient portal and sent a message.  I am still unsure that the emergency room would have been an option.  I know if I went and were sent home again that my sister (helper) would criticize me for spending unnecessary money.


20170626-M: Day-04: Unapproved Appointment Made
We got our insurance approval by phone in the morning the day of our first examination.  Suspected a Dislocated Intraocular Lens AKA Decentered IOL.


20170626-M 950: Day-04 - Transaction Notes
I report date of onset – nature of problem – no injury – report 80% blindness in Left Eye.  Rachael says Boyce off till middle of July – will address with her office administrator – will call back.


20170627-TU: Day-05: Driving Crisis
On the day of my appointment I was faced with a driving crisis.  I left early as is the usual case for me.  On the way to my first errand I discovered that I could not judge distance anymore.  In particular it was the oncoming traffic that I was having trouble with.  I got to my second spot and determined that I needed to drop the car in order to eliminate my risk of a car accident.  Hint: When you are blind en ought to have an ophthalmology appointment give up the car until you can see 33% or better in the injured eye.  Take the bus or get rides to any follow up appointment because they will dilate one or both eyes.
 


20170627-TU: Day-05: Examination 1 (Tentative Diagnosis)
Doctor Taban’s Tentative Diagnosis is Left Eye - Retinal Detachment.  Our cataract doctor, Doctor Boyce, was out of the office on vacation.  Therefore we were referred to his partner Doctor Taban.  Doctor Taban referred us after making a tentative diagnosis to Doctor Rol a group member and retina specialist.  Lastly we did not receive approval from Brand New Day, our insurance carrier, till the morning of the exam.


FYI: Ryan Taban, Orange County Ophthalmology Medical Group




20170627-Tu: Rating: 5.0 of 5.0 Stars and with ‎1 review

Ryan Taban is a practicing Ophthalmology doctor in Garden Grove, CA.



20170627-TU: Day-05: Examination 2 (Confirmation and Treatment Plan)
Again, we were examined by Doctor Taban who made a tentative diagnosis of a detached retina. We were referred to Doctor Rol a retina specialist.  Doctor Rol scheduled us for next day outpatient surgery at his Huntington Beach Office.  Note his being available for the exam and the surgery adds up to some “Luck”.


FYI - Dr. Michael Roh, MD - Long Beach, CA - Ophthalmologist - Vitals

Find an Ophthalmologist › CA › Long Beach Ophthalmologists


20170702-SUN: Rating: 4.6 - 5 Votes by patients. 9 reviews
Dr. Michael Roh, MD - Garden Grove, CA – Ophthalmology - Healthgrades

20170702-SUN: Rating: 5.0 - ‎4 Votes
Order to Operate


20170628-W: Day-06 - Day Of Surgery (DOS)
The Presenting Problem
 
Right Eye on Left is Relatively Normal

 
Retina Imaging Room - Day of Surgery


Assigned treatment position [SEE EYE PATCH PHOTO]
Keep The Arrow Up As Much as Possible

Your Friend The Gas Bubble (GB)

The Inserted Gas Bubble Reshapes Itself
 
 



Trying Different Things to Keep up With Prescribed Treatments





20170628-W: Day-06 - Surgical Report (For Doctor Rol)
Wow I didn’t expect to benefit from writing a surgical report.  I will keep it brief by pointing out the highlights.  I was required to have a family or friend drive me home.  My friend Mel Shanks picked me up.  Some odd five or more eye drops were used to prepare me.  Both eyes were imaged to show the retina, macula and I think fovea.  [SEE IMAGE BELOW].  For the procedure I was moved to the special room with the special chair.  I am not complete sure what the procedure is called yet I think it is called a Vitrectomy.



 
Healthy Eye (LF) Damaged Eye (RT)

“Vitrectomy is surgery to remove some or all of the vitreous humor from the eye. Anterior vitrectomy entails removing small portions of the vitreous humor from the front structures of the eye—often because these are tangled in an intraocular lens or other structures.”  “A vitrectomy, sometimes called vitreous surgery, refers to the removal of the vitreous gel from the eye. This procedure is performed in a hospital operating room, using an operating microscope. There are several retinal disorders for which vitrectomy surgery may be the appropriate treatment.”

FYI: 20170704-TU: Find of the Day
“The vision is usually quite blurry in the days and weeks following retina surgery, so expect gradual recovery of vision. If you have a gas bubble in the eye, we typically examine the eye every two to three weeks until the bubble is gone, to ensure that the retina stays attached as the bubble dissolves.”

20170628-W: Day-06 - Surgical Report (Continued)





The 1-2-3 Repair
Doctor Rol described his technique as a 1-2-3 (not to be confused with Lotus spreadsheet software of the 1980s).  I don’t have time to create a pain curve.  Probe 1 starts bad and gets terrible.  It is hard to tell about Probe 2 because Probe 1 is so terrible.  Like, I had to compensate with short fast breaths.  Probe 3 seems insignificant because it is a relief over Probes 1 & 2.


Prognosis - Generalized
He said good job in his words.  Re-attachment is rather high.  “However, the visual outcome is not always predictable.”  The role of “modern therapy” is pending.


Treatment Assignment - Prescriptions
After completing the surgery Doctor Rol ran his ideal treatment prescription by us.  The initial treatment assignment was to hold therapeutic position for one half hour sessions totaling as many as I could even with missing sleep.  I told him going sleepless was not wise because I may panic and thus complicate my recovery.  Doctor conceded and said I could sleep.  I had to alter delivery of the posture(s) because it would fatigue me too much.  While trying our best for five or so day we through our balance off and accumulated muscular-skeletal pain.  One of the foundations for our health is excellent sleep.


20170629-TH: Day-07: Follow Up Exam – Delegate to “Luck”
On this day Doctor Rol stated that now it is up to “Luck”.  We define “Luck” as success or failure apparently brought by chance rather than through one's own actions.  This actually gives us a break from having to be perfect.  And so enters the spiritual nature of healing.  On this day we strive to find faith or a complete trust or confidence in someone or something.  We trust that Doctor Rol did the best that he could.  Our confidence in ourselves waxes and wanes.  We got to carry the encounter paperwork from the exam room to the clerical area.  We noticed that the paperwork indicates: Outcome Very Good.  The visual acuity for my left eye was stated orally yet we did not catch it.  We have conviction in the face of despair.


20170629-TH: Thing Greater Than Us = Positive ENERGY
20170629-TH: Day-07 – Follow Up Appointment



Assessment – Performance Challenges - Legend

AcroCode
Meaning
DOS
Date Of Surgery
FUA
Follow-Up Appointment
FUE
Follow-Up Examination
HO
Held Over
PSPB
Psychosocialphysical Balance
BND-QOL
Quality Of Life (Brand New Day Version)
-



Performance Notes
We would like to focus more on what is going right as compared to our troubles.  The day of our follow up we saw the best with our left eye.  This may be due to the fact that the Gas Bubble (GB) was smaller.  We are hoping that the Gas Bubble covers healthy receptors.







20170629-TH: Day-07
Assessment – Performance Challenges

-
Performance
20170628
W
DOS
20170629
TH
FUE
20170701
SAT
20170702
SUN
20170705
W
HO
Days Out
6
7
9
10
13
-
Driving
Bus and Ride
Pass
Finish a Report
Not Done
Not Done
Inspiration
Faith
Self
Rol – now “luck”
Faith
Replaced with Faith
130pm
Lost Hope
Mini Laptop Screen
Accept
Pass
Pass
See Smartphone
Accept
Pass
Pass
Short Drive
à
à
Bank
Increase
Fears
Vision at Distance
Eye Covered
Pass
With Good Eye
Treatments
Surgery
Tried for Maximum
More than 7
Modified
Focus on Regaining
PSPB
Gas Bubble Status
Creation
Regrouping
Growing
Persists
Walking
About
Can Take Bus
To
To and Home (Dilated)
Confidence W/ Driving
No
No
Improved
Impaired by Discomfort
DriveAbility
à
à
à
Pending
Quality Of Life
(BND-QOL)
à
à
à
Updated in
Appendix
Sadness (PHQ-9)
à
à
à
Updated in Appendix
Living Well Evaluation (MSG-LWE)
à
à
à
Pending

Performance Challenge Chartered: 20170629-TH: QOL and PHQ-9 Assessment Results Shared in Appendix Section.
 
Clearer Image of our doctor and friend Doctor Rol
 
20170629-TH: Day-07: Resources - Patient Portal Communication
When we got home we received a note via email about our patient portal utility for this service provider. We will only address the first part (the referral) at this time below.


Subject: Office Visit Summary from: Michael Roh, MD

To: ktork46

Date:‎ Thursday‎, ‎June‎ ‎29‎, ‎2017‎ ‎11‎:‎45‎:‎21‎ ‎AM
Dear Keith,

Thank you for choosing our practice for your health care needs.

In order to better serve you we will be sending information about your care to a secure internet portal that only you can access.

If this is your first time accessing the portal:
The portal has already received your email address, so now you just need to setup your password and the answer to your secret question. We will be sending you a summary of key elements about your visit as well as educational opportunities for you to learn and be an active participant in your ongoing care.
This link will take you to the portal:


Sincerely, Michael L. Roh, M.D.

Orange County Ophthalmology
12665 Garden Grove Blvd Suite 401
Garden Grove, CA 92843

(714)534-8373 - Fax (714)534-8759




20170630-F: Day-08 - Progress Notes

Progress Note Format – First Applied Day-13 (W)


20170630-F: Problems
1.cataract. Diagnosed: 07/18/2016. Status: Active.

2.Presence of intraocular lens. Diagnosed: 10/10/2016. Status: Active.

3.Retinal detachment with single break, left eye.

Diagnosed: 06/29/2017. Status: Active.

4.Age-related nuclear cataract, right eye. Diagnosed: 06/29/2017. Status: Active.

20170630-F: Day-08 Progress Notes – First Full Day of Treatment – In Need

The client is in need of a utility to share concerns and get peer-to-peer (P2P - Survivors) support


20170630-F: FAQs

Is my insurance going cover this without any co-pays?
Could turnaround between inception and retinal failure have been an issue?
Scheduling: We would like to get you in ASAP what is good for you?
When did Brand New Day (BND) our insurance approve of it and how?


20170701-SAT: Day-09 - Progress Notes
The prescribed side to sleep on is the right side which keeps the eye in treatment up.  Client may have flipped to the wrong side during the night.  The proper prescribed posture for the waking hours is causing back and neck pain.  A lot of treating this issue appears out of the patient’s control.  He cannot even come close to achieving perfection.  Patient needed inspiration in the morning.  Client drove in light traffic to the bank.  The patient passed a short driving test as it was uneventful.  Passed work on laptop test.  We plan to use bus on next checkup – Thursday July 6, 2017.


20170701-SAT: Day-09 – Summarize Supporters With Our Treatment

List of Supporters On-Board – Major Supporters

-
Supporter
Note
-
1-Mel Shanks
Lived experience eye condition
Key ride home from surgery
Christine Fein
Exhaustive Pre-operative pep talk
Dave Fein
Passed message along
Gerard Grenier
Maintains dialogue
Gloria Shanks
Random eye exams
Joyce Maxine Brown
Talk Therapy
Lanaii Kline
Neutral Enforcement
Sharon Litzau
Lived experience successful surgery
-
Detractors
-
Rochester Cannon
Interferes with rest and sleep
Mike Calentino
Has worse eye condition
Kevin Torkelson
Disinterested
Joan Zhorne
Unavailable
-

Table Last Updated: 20170705-W:


20170702-SUN: Day-10 - Progress Notes
We slept nine (9) hours.  We woke up with muscle soreness.  We still continue to be disenchanted.  Vision in the left eye hasn’t got much better than the day after surgery.  Because of low spirits we have decided to get some things done by working for one hour between postural treatments.  We have been worrying about finances.  We began to examine our Quality Of Life (QOL).  We selected a few written assessments to work with: Quality Of Life, Personal Health Questionnaire (9 Item), Living Well, and DriveAbility.  How is it that today at 130pm we gave up Hope for fully functional vision?  Anxiety control is high on our priority list.


20170702-SUN: Day-10 - PM Observation - Scale Variation (Vanishing Point)
 
Left - Injured Eye Sees Objects as Narrower and Stretched
 
20170702-SUN: Day-10 Assignment of a Thing Greater Than Us = TIME
 
20170703-M: Day-11 - Progress Notes

GB = Gas Bubble - B = Blurry - F = Floaters

We suffered a poor night’s sleep due to muscle soreness that kept getting worse while trying to keep the recommended postures all day and all night.  Client started the day by debriefing to his landlady Gloria S.  At 915am client received call from insurance carrier (Brand New Day @ 657-400-1900) approving his upcoming follow up office visit this Thursday the 6th of June.  Query of the day “blind people hotline” & “blind people hotline pdf”.  1000 AM: Client apprehensive about car driving performance challenge.  Client passed driving challenge and noted that 40 MPH was his limit.  Left eye sends brain excessive alarm signals that result in fear.


20170703-M: Day-11
Inspiration of the Day
“In recent years I came close to realising this fear. I’ve had four eye operations and my vision was badly affected for a while. I am one of the lucky ones: my sight is almost back to normal. My mother however needed help with the most basic tasks. Old age can be a period of great fulfillment but without the right care and support it can be depressing, leaving blind and partially sighted people anxious and lacking in independence”

20170703-M: Day-11 > TGTU = LAW1 & Orange County Ophthalmology Medical Group (OCOMG)



20170703-M: Day-11
FYI - [PDF] – Research Toll-Free Hotlines & Website Links

https://www.dfmc-florida.org/public/docs/Highway1.pdf


20170703-M: Day-11
Some 25 Numbers - Need to Talk and Process
For Blindness/ Visual Impairment there were some odd twenty-five (25) phone numbers.  Based upon the descriptions none seem worth the effort at the moment.  We have a need to talk about it with a survivor.  Mel Shanks is helpful because he suffers a problematic eye issue yet he is not the survivor we would like to talk to.





20170704-TU: Day-12 – Baseline Productivity

Productivity Challenge Table (First Half 2017)

-
Deliverable
##
July 2017
20170705
-
Posts
AnimaCules
1
2 Updates
The Torkel Sagas
8
1
Clozapine
2
BND
2
1
-
Pages per Post
40
Pages per Word Document
10 or More
Documents (Total)
600
Documents (Excel)
75
Documents (Word)
400
Documents (PDF)
120
Images Managed
2500
-

Last Update: July 5, 2017 – Approximate Snapshot of Clients Productivity for First Half 2017



20170704-TU: Day-12 - Faith Sharing


Torkel Prose by Keith Torkelson Powered by AVEY – The Torkel Sagas
Link to Newest Batch (Date Chartered July 4, 2017)

We are going to share this version in the following blogs and posts

http://the-torkel-saga-2059.blogspot.com/2017/07/torkel-prose-by-keith-torkelson-powered.html


20170704-TU: Day-12 - Purpose
We prepared this version to enter in the Orange County California Mental Health Services Act (MHSA) annual calendar contest.  We used to be in the distribution of deadlines and such.  Yesterday we called the proctor for this year’s calendar.  The 2017 proctor is the MHSA Wellness Center Central.  We were told we missed this years writing deadline.

AnimaCules (Legacy)

Keith Torkelson - Prose



20170704-TU: Views = 198: Chartered 9/18/12


20170704-TU: Day-12
Brand New Day – Eye Specialist Report


Day-12 of Retinal Detachment Crisis
We are building faith for a substantial recovery.  We cross applied this writing for the process of surrendering to a Thing Greater Than Us (TGTU).  For all that appreciate our Whisper story please think good thoughts about us.


20170705-W: Appendices (Metadata)

Quality Of Life > Assess_QOL_Cluster_17070201_Results V2017
Personal Health Questionnaire (9 Item) > Assess_BND_PHQ-9_17060201_Results



 
This one is either a "Selfie" or he let a client take a photo of him

Appendix Addressing Assessment
 
Quality Of Life
Assessment Results for Keith Torkelson, M.Sci.

Date
% Normalized
(Items Scored)
Comment
20150623
71 (15)
Prep for Helper #4 – Jeff Gibbs
20151219
62 (15)
2015 – Yearly Average - Retro
62 (15)
2015 – Yearly Average - Calculated
67 (15)
20160309
66 (15)
Baseline
Submitted with new service plan
20160612-SUN
70 (15)
201706-1st Half Retro
79 (15)
Before retina issue
20170627-TU
Date of diagnosis
20170702-SUN-Real Time
52 (15)

High Resolution Longitudinal Process Measures for Quality of Life (QOL-15)

Personal Health Questionnaire (9 Item)
Assessment Results for Keith Torkelson, M.Sci

Date of Assessment
For Period
Raw
Percent
Depressed
Comment
20170602
1989R
2.2
8
20130831
2012R
12
44
20130912
2013RT
12
44
2013 Pre-physical
2013SS
6
22
20140623
2014RT
10
37
20140103
2014SS
11
41
20160114
2015FWY
9
33
20170602
2017RT
2.5
9
20170702-SU
2017RT
8.0
30
Detached Retina

Last Update: 20170703-M: Context Retina Repair
 
End of Report
Updates and Progress Notes will be shared separately
The Up End


1 comment:

  1. Thanks for posting about Eye and Cataract Surgery. it's a good thing to inform other people about it

    ReplyDelete