Through each of the hardships that have chipped away at her health over the years, Joanna Colon-Espino has forged ahead by dint of her stubborn optimism.
It’s why a new wheelchair sits unused, the armrests still in plastic wrapping, inside the living room of her West Park home. Doctors prescribed the wheelchair after amputating the fourth toe from her right foot in December.
Days after the amputation, she was ambling around the living room, her right foot wrapped in a black walking cast.
“I don’t want to use it,” Colon-Espino, 55, said of the wheelchair. “I can’t see myself in it.”
Though the amputation has slowed her ability to walk, Colon-Espino is still able to care for herself and her family, which includes her husband, Fernando, a construction laborer, and two children, Justin, 15, and Amanda, 27. A third child, Colon-Espino’s son, Angel Allende, 32, is stationed in Jacksonville and serving in the U.S. Navy.
According to a 2013 study published in the medical journal, Clinical Microbiology and Infection, an increasing number of endophthalmitis cases are occurring after intravitreal injections to the eyes.
A native of the Bronx in New York City, Colon-Espino and her family moved to South Florida in 2011. She receives Social Security disability benefits, and she’s covered by Medicare.
On a recent weekday, Colon-Espino was preparing a chicken dinner and explaining that she would use a walker instead of the wheelchair when she takes a city bus to Miami Gardens for kidney dialysis the following day. She goes for dialysis three times a week, and each treatment typically lasts 3 1/2 hours, she said.
Colon-Espino was diagnosed with adult onset diabetes about 15 years ago, and she has lived with hypertension most of her life. She said her kidneys began failing about two years ago, and she believes her chronic medical conditions also contributed to the amputation of her toe, which was blistered, and the removal of her left eye in August.
The eye’s retina had an inflammation, she said, and at first an ophthalmologist treated the condition with drops and injections of Avastin, which is sometimes used to treat eye disorders associated with diabetic retinopathy.
The condition worsened, and Colon-Espino lost vision in the eye. It became swollen, she said, and the injections were not helping.
“I couldn’t stand the pain,” she said.
I couldn’t stand the pain.
Joanna Colon-Espino, 55, of West Park
Eventually, the ophthalmologist referred Colon-Espino to Thomas Johnson, an oculoplastic surgeon with the University of Miami Health System, or UHealth.
“She came to me after her eye was already blind and painful,” Johnson said. “She had developed endophthalmitis” — an infection inside and throughout the eyeball.
Though Johnson had not been providing regular care for Colon-Espino, he said her eye condition likely was related to her diabetes. “Diabetics are more susceptible to infections,” he said.
Johnson said doctors tried to save Colon-Espino’s eye. “She was reluctant to have the eye removed,” he said, “so we treated her medically with drops. It got to the point where it was too painful and uncomfortable.”
Surgery to remove her eye took place in August, Johnson said.
“A lot of times a blind, painful eye, they get to be so uncomfortable that patients can’t take it any more,” Johnson said. “The eye looks inflamed and it doesn’t look right. Blind eyes turn inward or outward because they don’t have that fusion with the other eye.
“They look bad and they’re painful,” he said.
$3,000 Cost to Colon-Espino for prosthetic eye
Colon-Espino said she had the surgery expecting that her Medicare HMO would fully cover the prosthetic eye, which is painted by hand and akin to a work of art.
When she went to the ocularist to begin the process of fabricating and fitting the prosthetic, though, Colon-Espino said she learned that it would cost her about $3,000.
That’s more than Colon-Espino can afford. Her holiday wish is for a prosthetic eye so she no longer has to cover one lens of her eyeglasses with tape.
She said the eye socket has healed, and no longer causes her pain, for which she is grateful. Finding the silver lining in every black cloud, she said, is a characteristic that has served her well.
“My attitude is you have to move forward,” she said, “because life goes on and it’s not going to wait for you.”
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