Wednesday, January 31, 2007

Adventures in Dilating

When I stepped into the waiting room, I knew it was going to be an adventure. There looked to be only half a dozen available seats in the large oval room. There were chairs lining the Pepto colored walls and two rows of chairs in the middle of the oval back to back. Sort of the “Mushpot” area in the middle of the room.

I walked up to the counter and signed in. The lady behind the counter with way too much eye make up on shot me a glance, almost as if I was annoying her. I just entered the last bit of info, 4:22 check in time, and found a seat.

Ah, a seat right by the door with a buffer seat between me and the stranger near by. This is prime real estate in a crowded waiting room. I sit down, fold my arms, and wait to be tortured.

“George Simons?” says Eye Make-up Girl (ugh, it’s Simmons. Two M’s people!)

So I go up to the counter pay my co-payment and turn around to see that a mom and her kid walked in and took my seat. Great. The only spots available were in the middle of the room. GREAT!

So there I sit. Right in the middle of the room. If I look up, I am either staring at the backside of a patient at the counter OR I am face to face with EMG. “Please call me next. The drops are not as bad as this.” I whisper under my breath.

While I am sitting there I hear EMG answering phone calls and making appointments for people later in the week and some next week. I remember back to when I called EMG and asked for an appointment.

**in sitcom fashion the scene becomes blurry and I go back in time for a moment***

“We have an appointment available on the 29th of January. Would that work?” EMG says.

“January? But it is November. You have nothing available until next year?”

“That’s it.”

“… okay I will take it.”

“George Simons?” (ugh)

**Flashback sequence has ended**

I spring up and dash to the meet the Ophthalmologist at the door. I remembered her from last year. Then the next chapter of the nightmare begins.

“So how is your blood sugar? Are you stable?”

“Well, it is better then before. I mean, it is a constant struggle.”

“I understand.” She said. “So, what we are going to do is put some drops in your eyes to dilate them so I can look inside and see if the diabetes has affected your eyes.”

“Right,” I said “just like last year.”

“Well, you will have to have this test every year until you are off medication or considered a ‘non-diabetic.”

Did she really just say that? Anyway, I make a mental note to mention that here and I continue on.

She puts 2 drops in each eye and then starts typing in some stuff into her computer. Wow, it is not so bad. Maybe they got new drops. Molasses free drops or something. That was not nearly as bad as I remember.

Then she says, “Oh I need to put one more drop in.”

She must have found them. But these drops were “extra spicy” because the stung like hell!

I sat there trying to blink while she continued to type info into the computer.

“The last time you were here I see that we showed you the video about how Diabetes affects the eyes. I am going to show you a video about LASIK surgery. We offer that here in our office and I am sure you are curious about it since you wear glasses.” She double clicks. “I’ll be back when you are dilated.”

I am thankful because I did not have to go into the waiting room BUT she is putting a video on her computer screen for me to watch when I CANNOT SEE!!!

Seconds into this video and I am completely grossed out. I cannot see it but hearing the host describe the cutting and folding of the eye totally freaked me out! The best part was at the very end of the movie I hear, “most people are good candidates for LASIK except for some pregnant woman and diabetics.” Nice.

She comes back in and does the exam. I do know where you can purchase lights that harbor the intensity of 1000 suns but apparently ophthalmologists know. Oh my goodness, I swear that cannot be good for your eyes.

She said that she saw several spots where the blood vessels are bleeding but that is to be expected. It is nothing to be alarmed about (I am alarmed anyway). She said that there is one that is close to the center of my retina and that she would like me back in 6 months to have it looked at. She goes on to say that if this particular spot was more to the side she would not even worry about it.

I am worried anyway. Should I be? OC please tell me what I should do. I am nervous. Can I trust this person after the other things she did? I hate not feeling confident with my health care.

So that was it. I come back in 6 months for another adventure. Looks like Karma got me for saying it was the worst day of the year. Now I get two.

Jinxes suck.


Minnesota Nice said...

Ok, hon - I'm just gonna put down some random thoughts here. First, calm down. After all, she didn't immediately rush you into the laser room. And, you don't have to go back for six months.
Is this woman a retinal specialist? If so, I guess I'd be more likely to trust her than a general opthalmologist. If not, can you self-refer (under your insurance) to someone who is?
And, how about asking your endo if this woman has a good reputation for dealing with retinopathy.
I hate it when they act so casual - saying "that's to be expected", as if it were nothng more than a broken fingernail.
And the lasik video - give me a break.
George, remember that retinopathy can be successfully treated.
Still, I'm sorry you are going through this.

Shannon said...

I don't think I could add or say anything better than MN did.

I really resent that she didn't take care to determine that you were Type 1 diabetic and that she said the bleeding was to be expected like it's no big deal.

Kelsey said...

Yeah, she didn't sound very competent... I'd look into finding someone who specializes, or just has a better grasp of diabetes in general!

Sorry for your pain... the part I hate most about the eye doctor is that machine that puffs air into your eye! I can't stand it!

George said...

MN - Thank you for making me feel better. Her attitude was bizarre.

Shannon - Me too and even if a T2 gets off of meds, aren't still diabetics? What is a non-diabetic? ugh!

Kelsey - That is probably the only cool thing. they do not have the "wind tunnel in your eye" machine. They have a little round blue donut looking thing that actually presses again your eye. Not even as bad but kind of freaky when you think about it!

floreksa said...

“Well, you will have to have this test every year until you are off medication or considered a ‘non-diabetic.”

I would've had to stop right there and either fall to the floor laughing or ask that moron if she's the one who's been hiding a cure for all these years.

Sorry I don't know much about bleeds, but I'd be finding a new Dr. While I HATE, eye exams, my Dr at the very least explains EVERYTHING to me and can read the chart fast enough to remember that I'm a T1.

as a side note, my word verification is qrrlap. Sounds like a bad name...I dub your Opth a "qrrlap!"

Chrissie in Belgium said...

K's advice was perfect. I believe wholeheartedly in getting a second opinion from another doctor. That way at least you will feel more confident that you are getting the best treatment possible. Remember your opthamologist did not book you immediately for a laser treatment. So calm down, but get a second opinion! Also remember that both K and I have had laser and vitrectomy operations. Here we are talking to you, and we are doing just fine. You will get through this too.

type1emt said...

if it were me, I'd go somewhere else and get a 2nd opinion. She's not the one going through it. If they say the same thing-you'll know that Doc Optho is not as uncaring as she sounds.You deserve the best care and 6 months is way too long to be checking up on something when you have a problem.It would drive me nuts too. I would strongly recommend going somewhere else.

Erica said...

That's terrible of her to be so casual and completely disrepectful with both the video and the assumption about your diabetes. I agree with everyone else, if it were me, I'd probably go see a different opthamologist for both a second opinion and in hopes of finding someone who treated me with the respect I (and you of course!) deserve.

Kerri. said...

SuperG - First, find a doctor who deals with you with more compassion. You deserve better than mutterings about "non-diabetic." If you aren't confident with your eye doctor, find someone else and have the exam done again. Sucks to be dilated, but it could make you feel more secure about the level of care that you're receiving.

Secondly, I understand what you mean about "They said not to be alarmed but I'm alarmed anyway." I felt that this past September when I had the Fisher Price "My First Hemorrhage" moment. Whether it's "expected" or "understandable" or whatever, it still throws us into a panic as to what we can do to protect ourselves from further damage.

And thirdly, SuperG, you are protecting yourself. You've stopped smoking. You're making huge strides towards gaining better control of your diabetes. You are having these eye exams and doing what you can to take the very best care of yourself. I'm proud as hell of what you've accomplished and I know you can keep your own personal Eye Squirrels from bringing you down.

Keep acorns on your bedside table. Maybe they'll abandon you if they see something tastier. :)

Thinking of you.

Lyrehca said...

Chiming in here with everyone else--it doesn't sound like your clinic specializes in diabetic eyes, or in retinopathy, which is what you're worried about here. I'd definitely go get a second opinion from a doc who understands the intricacies of the diabetic eye.

Second, you should definitely write a note (or have spoken up at the time, which I would have done) about the Lasik video not being for diabetics, since you are one.

And third, yes, I much prefer the blue-circle glaucoma test than the puff of air test. Ask if you can have that done the next time you go in. If your eyes are numbed and you don't think much about what the circle is doing, it's usually tolerable.

And fourth, like MN said, (and I guess Chrissie too), I've had laser in both eyes within the past year (but not a vitrectomy) and while it's unpleasant, it prevents future vision loss. And frankly, I was type 1 for decades before this popped up. Laser is typically done once your eyes move from "non-proliferative" to "proliferative" retinopathy, which means they can stay "non-proliferative" or not-likely-to-cause-vision-loss for a long time, or ever, if your control is good.

Scott K. Johnson said...

I bet your endo can offer some references or recommendations to good specialists.

Definitely worth a second opinion.

Even if you decide not to, as others have said - it was not something that demanded immediate attention.

You have to feel confident about the specialist. It's your eyes bro!

And I'd also like to express how proud I am for all that you've done to take care of yourself this past year. Huge strides.

Nicole P said...

George -

I can't really add to much here.

I agree with Kerri - look for a doctor with whom you feel comfortable. Also - feel proud of what you've already accomplished - and keep moving. Those squirrels have a tough time chasing us if we just keep moving.

So, Mr. Simon (her her), although I know this is hard and scary, you also know that we're all behind you.


Scott K. Johnson said...

Oh yeah - I also believe that tightening down your control, after a period of being out of control, can have a slight negative impact on your eyes before they start getting better.

It's like "system shock" or something...

Don't trust me on that though - ask around. I might be unintentionally full of crap...

Michko said...

I second Scott's comment about having eye issues after being in super duper control. I've read about some pregnant women who get tighter control and then "suddenly" get floaters or something of the like. Again, I might be full of it, but I'm relaying what others have told me.

Kevin said...

Hey G,

Like everyone else has said: Get someone who specializes in retinopathy. (is there an echo in here?).

I too have had laser treatment in both eyes this past year and like Lyrehca said, it's no fun, but ultimately a preventative step.

At my 6 month check-up post-laser treatments, there were 3 new microanurisms in the macula (the center of the retina) in my left eye. But the doc (who I trust very much) told me basically the same thing: try not to worry about, come back in 6 months, and we'll see if there's any change. He also said that if these microanurisms burst, I could see some distortion in my vision and I should come in before my 6 month check up. He also indicated that even though they're in the center of my vision, if they got bad, they too could be treated with a much more precise laser treatment.

I'm just unloading on you here, sorry about that.

No doubt, it's freakin' scary, but try to relax (easier said than done, I completely realize).

Anonymous said...

SG - it's Kathy - Google is not letting me comment - maybe they figure I've already put in my two cent's worth.
Anyway, great comments here. I sure wish I had the OC when I was going through my R. experience.
Anyway, re what Scott said - I have read many times over that a change to good control can temporarily worsen retinopathy. Actually, I think that's what may have happened to me. Ask your endo.

Sara said...

Short story - find a new eye doctor that one was crap.

Long story - check out my blog as I just went to the eye doctor too and heard some interesting stuff about diabetes and eyes. Not sure if it is true or not but worth considering. Basically she said that most eye bleeds are never even seen and occur, cause no problems, and heal between eye appointments with no one knowing the difference.

caramaena said...

I won't bother echoing what the others have said about second opinions, but I agree.

I never knew that lasik wasn't recommended for diabetics though. I had lasik surgery not too long after being diagnosed. In fact it was the diagnosis that made me actually go get it done.

Just to let you know that it might have sounded freaky but it's not really that bad. Quick and you don't really feel a thing. The most uncomfortable thing for me was the speculum holding my eyelids open for the very short time it took (you really really want to blink!) but I'm so glad I had it done.

Theresa said...


Have you ever heard of the Jules Stein Eye Institute at UCLA? If Whittier is not too far from UCLA, you might want to check the place out. They do have a website if you do a search. Good luck.