It’s Not Cuckoo Bananas, But It’s Not Good Either

It has been a busy week, so I haven’t had a chance, until now, to post an update on last Fridays appointment with Dr. Garg, the retina specialist.  Unlike two weeks ago when I went to the glaucoma doc, this appointment was lacking most of the nonsense.  By the end of the appointment, I wasn’t any closer to an answer than I was since late April.

The appointment started with the typical questions from a tech about how my vision was doing, if I was experiencing any pain or discomfort, etc.  Then it was time to read the chart with my left eye.  The E was not a problem.  The next line, C and D, I could see, but if I didn’t remember it I might have said G instead of C.  The next line, which I now know is DHN, I couldn’t see.  With the pinholes, I was able to make out the H.

She moved on to my right eye.  Good news there, I can still tell if a light is off or on if it is a foot or less away from my eye…  Yippee.  She then put, or should I say shot, drops into both eyes.  God only knows how many, but it was sure more than one of each.  One is to numb the eye to get IOP (pressure) readings, while the other was to dilate my eye.  While she was doing this, she left the chart on, so I continued to try to read it.  She then used a hand-held device to get the IOP (Dr. Ayres calls this device a glorified random number generator.)  IOP was nine in the left and mid to upper 20s in the right.  The previous week at my glaucoma appointment, it was eight in the left and 13 in the right using the standard device (the one that you put your chin in, press your head against the bar, and look at the blue light.)

She waited a minute or two and then tried to get another number on the right eye.  Meanwhile, I’m still trying to read the 20/100 line on the chart.  She then said I was cheating by continuing to attempt to read the line.  Eliz didn’t like what she said and asked how I was cheating if I was just trying to read the chart.  While the lady answered Eliz, I had my hand in front of my eye, trying to simulate the pinholes while still trying to read the line.  Hey, if you don’t want me to keep trying, shut the effing thing off!  As we got up to move to the next exam room, I glanced behind the chair where the chart is bounced off of a mirror and saw that the line was DHN.  Now maybe that was cheating.  How would that help me though?  It’s not like I could get a drivers license for reading the 20/100 line.

In the next room, Dr. Garg came in and asked some questions and then had a look.  He then told me that the only thing left to try were injections in the eye.  Before we try that though, he wanted to get another OCT scan to make sure the risk/reward was worth the attempt (actually, attempts, as it would take several injections over the course of a few months for it to work.)

Tom gave me the OCT scan a few minutes later, then we headed to another exam room.  After a minute or two, Dr. Garg came in and had a look at the scan.  He said that it wouldn’t be worth trying the injections as there was only a 15% chance of them helping me see better.  At that point, I said, “Okay, so there isn’t really anything you can do for me?”  “That’s right,” he replied.  He told me I could come back in five months (why?,) or sooner if I was having any other problems.  He did tell me to make sure that I see him, Dr. Ayres, Dr. Pro, or Dr. Ruffini frequently to get IOP readings.  Seems like ‘roids that I take 2x per day in the left eye could cause the pressure to rise.  Maybe it’s time to see Dr. House, Dr. Riviera, or Oscar Goldman…

So while my vision is not cuckoo bananas (a technical term Dr. Garg used at my last appointment in June,) it’s not good either.  So what do I do now?  Some days, my vision is better than others.  Today, for example, it sucked big time (I suppose that is a technical term I picked up somewhere along the way.)  Maybe I’ll see a little better tomorrow.  I’m not holding my breathe (but would if it would help…)

Share

Why Do I Bother?

Had a 9.00am appointment yesterday (Friday, 9 July) with my glaucoma doctor at Wills Eye Institute in Philadelphia.  We usually schedule appointments that early for the cornea and retina doc’s in Bala, since Jane’s school is on the way and we can drop her off, so I guess we were in that frame of mind when we made the appointment (because Jane has been on summer break for a month…)  I’m not sure why I even needed this appointment since I was just there in May.

We left the house at 8.15am and traffic was surprisingly light.  Even the road work on the Girard Point Bridge didn’t slow us down.  Things were going great until we were about 25 yards from the parking garage at Wills Eye.  A minivan was at the entrance and the driver seemed like she didn’t want to go in.  Once she noticed us, she proceeded slowly.  She got her parking ticket out of the machine and continued very slowly up into the garage.  We always like to park on the top floor, which is the seventh, because it is the only floor that you don’t have to go to the ground floor, get off the elevator, and then get on a different elevator.  On seven, you walk right into the hospital and grab an elevator to either nine (low vision,) ten (cornea,) or eleven (glaucoma.)

Anyway, after a couple of floors, this lady has a parade of cars behind her.  She sees an open spot and tries to park.  She pulls in at the wrong angle and sees she will hit the car on her left.  Backs up, but doesn’t change her turn at all.  Tries to pull in exactly the same way, then backs up again because she sees she still doesn’t have clearance on her left.  Horns start honking.  People start yelling.  She then just stops.  Seriously.  I ask, “Who’s driving that car, Stevie Wonder?”  She is in the middle of the driveway, blocking us and everyone behind us.  More honking.  More yelling.  Eliz did neither.  She pulls away from the space to give us and everyone else room to get past her.  At this point, I’m regretting coming to this appointment.  We get to seven and head inside.

We sign-in on the eleventh floor and have a seat.  Eliz starts to read out the letters for the word scramble in the newspaper.  My mind is not in shape for figuring these out (I was up until 2.30am researching colognes, perfumes, and other hair and skin care products that can be drop shipped to our customers — watch for them soon on ForYourSalon.com.)  After a couple of minutes we get called to the desk to confirm my info and to pay the copay.  As the receptionist is running our credit card (we always pay by credit card at doctors’ appointments because we’ve been burned in the past by having to prove we paid,) she is distracted from another receptionist talking on her mobile phone.  She realizes as she’s handing Eliz the slip to sign that she charged us $25, not the correct amount of $20.  “Oh, I’m sorry, I’ve charged you $25.  You don’t mind if we just put the extra $5 on your account, do you?  It really is a pain to void it,” she says.  Eliz says okay and signs the slip.  We head back to the waiting area.  I’m more annoyed now.  I’m not sure if it was just the receptionist I was annoyed with or me for not saying anything about it.  Eliz and I discuss what just happened and then Eliz starts back on the sudoku.  I close my eyes and wait to be called back.

After some time, we get called and head to a room.  The tech takes us to a room we’ve never been in and begins to ask how things are going.  I tell her the same old story.  She then asks about my meds.  I begin to tell her about the eye drops I’m on, while she is reading the meds that were written in my chart from the last appointment.  She interrupts me before I get one med out of my mouth.  She says, “Are you still on Predforte?”   I answer no and again begin to tell her what I’m on.  She interrupts again asks about another steroid, similar to Predforte (but not the one I’m on.)  Again, I say no and say I’m on Durezol, but pronounce it Durzol.  She then says, “Do you mean…” and says something with about something that begins with a “D,” but is about six syllables longer than Dur ez ol.  Eliz and I say no.  This goes on for another couple of minutes and we move on to the next eye drop.  Since it is the newest one, I had ripped the top of the box off and brought it with since I couldn’t see to read the name.  I then have to explain to her several times how it is applied (though it is an eye drop, the cornea doc told me to put it on my finger — it is very thick — and, with my eye closed, rub it along the seam where my lids meet.)  She wasn’t getting it…  The last eye drop was an easy one.  She writes it down and has a look at my eyes.

She asks me to cover my left eye while she shines a light into my right.  She asks if I can see it, which I can.  She moves the light back a foot or two and asks again.  This time I can’t see it.  Okay, now onto the left eye and the eye chart.  I was happy that it was a different chart, one I haven’t memorized.  “Do you see that,” she asks while showing the big E.  I tell her yes, it is the E.  The next line was a C and a D, which I also am able to read.  I can’t really see the next line, so she hands me the pinholes.  Still no luck.  She says okay and takes the pinholes from me and writes somethings in my chart.  While she’s doing this, I continue to try to see the 20/100 line.  One of the letters in the middle looks like an H or an N.  I ask if that is true and she says, “Yes, it’s an H.  I’ll give you a plus one.”  Hooray.  We then have to go back to the waiting room until there is a room the doctor can see us in.  I’m happy to get away from that know-it-all tech.

After a short wait, we head to a different exam room.  The tech this time is William, who is 43057895743759385473% better than the first tech, puts some drops in my eyes and Dr. Pro walks in.  He greets us and asks me a few questions.  The first couple of answers where fairly short, like, “yeah, it is about the same as the last time I was here.”  He then asks me another question, but after I say about five words, he begins talking to William.  I stop talking.  He says go on.  I start again and he starts talking to William again.  He says continue, but after a few words, his mobile goes off and he checks it to see that it is a doctor that he needs info from (Eliz later told me that he had an emergency surgery scheduled at 10.30am, so it probably had to do with that.)  He hands the phone to William to get the info and asks me to put my head in the machine so he can have a look.  Let’s face it, I really didn’t have anything good to say, and even if I did, I don’t think he was really interested.  He has a look and then takes the IOP of each eye (13 in the right, 8 in the left.)  William has finished on the phone and Dr. Pro starts giving him the info of what he saw in my eyes (besides the blank stare back.)

Dr. Pro then tells me things on the glaucoma side look good.  He says he believes the vision issues I’m having aren’t glaucoma related and it is best for Dr. Ayres (cornea) and Dr. Garg (retina) to figure out was the issue is.  News flash, no one seems to know why my vision came around for those ten days in April after the surgery and then went bye-bye.  Not me, my doctors, or even that voodoo woman named Phyllis.  We shake hands and head to a different reception desk to checkout.

We get to the desk and the receptionist is finishing up with a woman.  When she is done, she says to us, “I’ll be right with you, I’ve just have to send a fax to a doctor.”  Her tone made me believe she meant: You’re done, you’re not as important as a doctor, so just wait a few minutes.  After about five minutes, she starts to help us, but notices the lady before us is still there.  The receptionist asks her if she had a question.  The lady says she was just waiting for an appointment card for her next visit.  The receptionist apologized for not giving her one and writes one out for her.  Now it is our turn.  She reads the form Eliz handed her and says, “You’ll have to call back on Monday.  The doctor wants you to have a Fields test and I can’t schedule that now.”  So, we wasted our time standing there waiting.

Let’s recap:  We wasted nearly three hours (an hour and a half at Wills, plus travel time to and from) on this appointment and wasted over $43 (the $20 copay, the $5 credit we’ll supposedly get for next time, and over $18 for parking — that is with validation, otherwise it would have been $22.)  I told Jake the night before it was going to be a waste of time.  I only wish I could use these Nostradamus powers to select the correct Powerball numbers.

Share

Visual Fields Test

My appointment with my glaucoma specialist went well, except for the fact that I was back to the 20/200 line and even that wasn’t as crisp as a my second PostOp appointment on 27 April (I also believe it was slightly worse than my unscheduled appointment with Dr. Ayres this past Friday.)  I’m glad everything looks great, but that isn’t helping me see better.  As per Dr. Pro’s (and Dr. Ayres’) recommendation, I’ve scheduled an appointment with Dr. Garg, the retina specialist I saw earlier this year.  I have a feeling I know how that appointment will go too.  Everything will look fine, but my vision will still suck.  Call me Nostradamus.  I’ll let you know how things go on 18 or 19 May.

Central Vision Visual Fields Test at Wills Eye

Central Vision Visual Fields Test at Wills Eye

One of the problem I’ve noticed is that I seem to have more blind spots, especially in my central vision.  When Eliz and I were working with Jane at softball, I noticed I had trouble following the ball when Eliz would flip the ball to me from three to five feet unless I looked to my right.  I’m not sure what the above test indicates, but since I don’t think I’ve ever had this particular visual fields test I don’t think there is anything to compare it to.

Visual Fields Test Machine in the Glaucoma Dept. at Wills Eye

Visual Fields Test Machine in the Glaucoma Dept. at Wills Eye

After my appointment at Wills Eye, Eliz and I walked up Walnut Street and stopped into the Associated Services for the Blind and Visually Impaired.  I had contacted them just before we moved Salon Supplies + Interiors and ForYourSalon.com out of that disaster of a building (which has been condemned, by the way.)  Between the move and setup of the business and waiting to see how things went with the surgery, I didn’t follow up.  Looking back, that seems dumb.  As it stands now, I don’t think things will improve dramatically, if at all.  You may say I’m a pessimist, but I disagree.  I would call myself a realist.  Sure, I can hope and wish, but I’ve been doing that since I was a small child.  Maybe I learn something and gain some confidence.

Share