The purpose of the Guidelines for Psychological Practice with Transgender and Gender Nonconforming People (hereafter Guidelines) is to assist psychologists in the provision of culturally competent, developmentally appropriate, and trans‐affirmative psychological practice with TGNC people. Trans‐affirmative practice is the provision of care that is respectful, aware, and supportive of the identities and life experiences of TGNC people.
Monday, August 31, 2015
Monday, August 24, 2015
Open Minded Health discusses self-injury. In all likelihood, you know someone who does this.
Monday, August 17, 2015
in·ter·reg·numˌin(t)ərˈreɡnəm/. noun. A period when normal government is suspended, especially between successive reigns or regimes. An interval or pause, as in, "the interregnum between the discovery of radioactivity and its detailed understanding."
After cataract surgery on my first eye, I entered a bizarre period in which that eye had excellent vision at intermediate distances (computer screen, conversation) and the other was a total blur. I’m very near-sighted (as in -15 diopters), so there was no possibility of fusing images. So the world looks blurry and sharp at the same time, and I have to use parallax (shifting my head) for any kind of depth perception. Needless to say, I do not feel safe driving. Or pouring water from a pitcher, unless I can brace the lip of the pitcher against the glass – we found this out in a somewhat spectacular fashion.
One solution might have been to wear a contact lens in the nonsurgical eye, and I had worn hard or RGP (rigid gas permeable) lenses for over 50 years. But a couple of years ago my eyes, which had become drier over the decades, flatly refused to put up with contact lenses. I tried all sorts of lubricating drops, but was never able to wear my lenses more than a few (2-4) hours a day. If I did any work on the computer, that time dropped to an hour (people blink less often while staring at a computer monitor, hence increase in scratchy, red eyes). Finally, earlier this year, I lost one of my lenses. This has happened maybe half a dozen times over the years. I looked everywhere (if you wear contacts or are close to someone who does, you know the crawling-around-on-the-floor routine) and eventually concluded that after I had cleaned them the night before, the lens had stuck to my finger instead of sliding off into the soaking solution. Since then, I had washed my hands and tidied up the counter area. So, no hope. I’d been wrestling with spectacles ever since.
My next idea, which friends have tried, was to pop a lens out of my spectacles, so that my nonsurgical eye sees through the remaining lens. Great idea, right? And it worked – so long as I covered one eye, didn’t matter which. When I tried to fuse the equally-clear images, however, my brain went nuts. It turned out the images were of sufficiently different sizes, too disparate for my brain to turn them into one. This might not have been the case with a person less near-sighted than I am. So, rather than putting a patch over one eye – toss a coin as to which one – I’ve been wandering around in this visually bizarre state.
Wednesday, August 12, 2015
Monday, August 10, 2015
The surgery took place in a surgical center associated with a hospital, and clearly it was cataract surgery morning. Nonetheless, I appreciated the care everyone took with me. The nurses were great -- but I think nurses are great, anyway. It takes me a long, long time to feel clear-headed after Verced, usually used as a sedative, so the anesthesiologist and I came up with a different plan. I'm old enough to remember the days when you got what they gave you no matter what you said. How wonderful to be listened to!
Once I was hooked up to an IV and my eye was dilated, it was time to begin. The first step was a femtosecond laser to break up the cataract and make an incision for its removal, at the same time correcting my astigmatism. This was not only painless, but an amazing light show. Gorgeous colors, flashing lights, snowflake mandala patterns...and the laser makes funny noises as if it's singing to itself.
Phase two was the removal of my lens and implantation of the artificial corrective lens. After talking with my surgeon (and my financial advisers!) I opted for accommodative lenses, which should give me great distance and intermediate (computer, piano, social) correction. I'll still need reading glasses, which is okay.
This is the phase that disturbs most folks. They envision (excuse the pun!) pointy metal instruments coming at their eyes. I saw nothing but lights! The lights were not as entertaining as those produced by the laser, but they were quite benign. Before I knew it, my doc was saying it was over and was placing a clear, perforated plastic shield over my eye.
I spent a little while in recovery, not so much from the surgery as the anesthetic, and then my husband drove me home. The surgical center folks were adamant (a) that I not drive; (b) that I have someone at home in case of need. "Need" amounted to eating a light lunch and sleeping most of the afternoon. The next day I had a follow-up exam with the surgeon, who was very pleased by how everything is healing, and was allowed to take off the shield except for sleeping. Oh joy, I get even more eye drops four times a day!
I had thought that I'd be able to pop a lens out of my spectacles to correct the nonsurgical eye, but alas that didn't work. So I toddle around with one still-dilated eye that can see intermediate distances just fine -- far distance will come as everything settles and my eye muscles learn how to flex the lens -- and one utterly myopic eye. Needless to say, I can hardly wait for the 2 weeks to fly past so I can get my second eye done!
It is amazing to open my eyes in the morning and have (one of them) see clearly. Also, the brilliance of the colors astonishes me. I had no idea how much my cataracts "grayed out" colors. I feel like Dorothy, stepping from black and white Kansas into Technicolor Oz.
*My doctor's protocol; yours may have a different one.
Eye image licensed under Creative Commons.
Tuesday, August 4, 2015
As part of my preparation for cataract surgery, I’ve begun talking with my eyes. Or rather, talking to them. I say, “Eyes, something exciting and perhaps a bit perplexing is going to happen to you. But don’t worry, it’s like a hip replacement. It’ll help you see even better than before. I’m going to make sure you are safe (antibiotic eyedrops) and comfortable (steroid and anti-inflammatory drops). And we will have such fun seeing bright colors and sharp detail for many years to come.”
They don’t have a lot to say in response. But…
A week or so ago, I started dreaming about the surgery. It was the usual showing up without clothes or without having attended class or without having memorized your lines. In this case, I arrived at the surgery center, having forgotten I was supposed to fast. There was much hoo-ha and calculation of what I had eaten how long ago.
This last weekend, I drove our van down to LA to help my older daughter move in with us. The drive down was in daylight and the only visual problem I had was seeing the street signs while looking for hotel and then her apartment. But (for various reasons, you know the drill) we did not get started back until 7 pm. I am normally an early-to-bed person and ended up consuming as much caffeine as I usually do in a year, I’m sure. I was painfully aware of how stressful and difficult night driving has gotten to be. Almost all the freeway driving was in darkness. I have never appreciated trucks so much – all those lights made them easy to discern, much more so than the lane markers. Daughter and I took turns leading as we caravaned along, too.
I could imagine my poor eyes saying, “We’re trying, mom! This is the best we can do!”
“I can’t ask for more, eyes. I’m going to get you some help real soon now.”
So now I am taking my pre-op eyedrops four times a day. Fortunately, I’ve been using lubricating drops for so long, I’m used to putting drops in my eyes. After surgery, I’ll add two more. I have to wait two minutes in between each medication so it doesn’t wash out the one before. Other surgeons may have different protocols. I’m observing this one meticulously. I’ll be taking these for a while, because I’ll still be on some of them when it will be time to start full doses prior to the second surgery.
I am considering dubbing this season The Summer Of The Eye Drops.