If, for example, you had a retinal detachment in the middle of your eye, a positioning of face down would put the gas bubble against the back of your eye, conveniently pushing the rear part of the retina back into position. In contrast, a face up sleeping position would put the gas bubble pushing against your cornea, offering little assistance for a retinal detachment, because the retina is at the back and not at the front of your eye.
Positioning, however, is not quite how we live in our usual lives. There is very little of life where you face downward for multiple hours of the day, for example. This has many implications on the rest of your body, as I will try to discuss.
- Face down position, upright: I had to do this for a couple of days. What I originally did was curve my back and slouch forward to do this position. This made my back and shoulders ache in pain. Instead I kept my shoulders as straight as possible but cranked my neck down in a more severe angle, relieving my shoulders of pain, though the pain in my neck continued.
- Face down, sleeping: I had a part of a massage chair that had a hole in the middle for your face. This was convenient for sleep, but I found that through gravity my back and spine compressed my rib cage and prevented me from breathing easily. I thought that I could get used to this position, but alas, I could not get to sleep. This made me sleep deprived, probably slowing down my recovery. I also found that if I put my head into the hole, resting it on my forehead and chin, my chin would ache. The jaw can go back and forward and is not used to having constant pressure on it. An incline bench set to 45 degrees, with my head pointed downward offered some relief, but not enough to get a good sleep.
- Lying flat on your side, arm beside your body, head angled up 30 degrees: This offered the most comfort sleeping, allowing me to get a couple of hours shut eye, but I would wake up with a numb arm and shoulder joint pain. After 4 nights this shoulder pain was felt all day, even when standing. I later learned that putting a pillow under your rib cage would allow a small “tunnel” for your arm, thus relieving some of the pressure. Despite the pillow, after 3 nights I could not rid myself of shoulder pain. This pain continued even after I could sleep in any position I wanted.
- Lying flat on your side, arm beside your body, head angled up 30 degrees, version 2: Instead of lying down, I tried aligning my body straight to my head, but tilting the body 30 degrees, thus retaining the intended head position angle. I used an angled bench at 30 degrees, lying on my side for this. This helped with keeping the neck and body aligned and in a neutral position, offering some relief. I used a yoga block as a spacer to keep by head in line with the outside surface of my shoulder. This worked quite well for short naps and as an alternative position.
- While the patient is doing all this positioning, their bodies are in a non-activity state. Muscles are not being worked. This lack of activity near 24 hours a day probably promotes healing of the retina, but at the expense of the rest of the body. I can feel the degradation of my muscles, the muddling of my brain and increased sad mood as the days of positioning go on.
- Using your computer and smartphone less: I found that less use of digital devices reduced headaches and made me feel a bit better. It is a reminder to reconsider the number of hours spent online. Devices are useful tools for a specific purpose, but should not be relied upon for general entertainment, as they are addictive.
- There is benefit in not doing anything: Learn to relax and be content with yourself. When I had a headache and also had tired eyes, I could not use electronic devices. Sitting quietly and relaxing felt like an effort, but it should not be this way. These are things I need to improve.
While the gas bubble is an ingenious tool for the surgeon, it does come at a big cost to the patient. It is not the surgery that is difficult, but the recovery and specifically the length of time for positioning. I don’t know if there is any alternative, but the discomfort from positioning for 24 hours a day is quite painful.