Thursday, March 17, 2016

EYES THAT HAVE HAD IT




The issues I watch concerning my eyes:

1.  Strong near-sightedness, which can mean the shape of the eyeball inclines towards retina detachment.  

2.  Early eye-glasses — age ten.  Some years of bad eyesight before this was discovered at school, which has meant my eye/hand coordination is zilch.

3.  Major difference between the sight in one eye compared to the other.  (R. eye is the strong one.)  This means that in childhood I did exercises for amblyopia, which is the weak eye shutting down, “lazy eye”.  It’s in the brain, not the eye.

4.  Ocular migraines from much eye use, esp. now with computers, but most troublesome before I had access to them.  I was seeing patterns and had swollen eyes.  I couldn’t access care in Saskatchewan, where I was, because their socialized system depends on gatekeepers that I couldn’t get past.  So I returned to Montana where Dr. Andrew Jordan at the Great Falls Clinic made the diagnosis of ocular migraine which is caused by swelling of the blood vessels.  He also discovered my eyes had small holes in the retina (maybe from stretching by swelling) and sealed them with laser “surgery.”  Dr. Jordan left.

Harry Potter glasses from Zenni Optical.

5.  I’m told that because my mother had high blood pressure and was treated for glaucoma, I probably have inherited both.  Indeed, I have.  I also inherited a slightly askew insertion of the optic nerve at the back of the eyeball, which is also a precursor for glaucoma.  My intra-eye pressures are just beginning to be more than twenty.  They have been in the high teens in previous years.  I have no glare or rainbows or restrictions on peripheral vision.  

My mother did not have cataract surgery or macular degeneration. (She died at age 89.  Her eye doc in Portland, named Dr. Laird, a dignified Scotsman, said that if she would do what he told her, he would keep her reading to the end.)  I have only the early beginnings of cataracts.  


6.  Dr. Padilla at the GF Clinic added two other conditions at this examination.  One was “dry eye syndrome”, which my mother had, and which is probably aggravated by computer use since it decreases blinking. 

The other one was psoriasis.  I’ve had a scabby patch on my right cheek for years, but didn't know it could creep into eyes.  Dr. P. recommended a consultation with the dermatologist.   I use OTC ointments but not very often.  I forget.  I’ll be more motivated, but I can’t afford the co-pay for another doctor visit for a while.  I don’t think people who administer hospitals realize that even a low co-pay can be prohibitive.

Also the last GF Clinic dermatologist I met with was so weird that I bolted.  He’s gone.

7.  I teeter on the threshold of diabetes with readings that tend to be around 120, lowest in late afternoon when it can go a little below 100, and highest after meals, reaching maybe 170.  If I go for a short brisk walk, I can knock the figure back by ten or twenty points.  I’m told that organ damage usually starts after 140.  

My metformin intake has been doubled officially, but I often forget the evening pill.  I’m daunted by the medical profession’s failure to achieve a unified understanding of Metabolic Syndrome, which is clearly what I have, along with many other folks.  Foods are recommended, then discounted.  Fat is in at the moment, carbs are out, coffee and chocolate go in and out.  Diets are recommended, then attacked.  Even Weight Watchers is under fire.


I’m successful at restricting food to almost no sugar or sweet foods, but can crave starchy carbs: bread, crackers, etc.  I don’t have “gluten obsession.”  I don’t eat in meals but in small amounts through the day.  Protein is often legumes but almost always includes a quarter pound of meat at supper.  My biggest shortfall is exercise.  My core strength is almost entirely lacking.  My best intention would be starting an exercise regime specifically for that.

8.  I asked the assistant to prompt the doctor to look for toxoplasmosis, but she didn’t.  I think she didn’t know what it was.  I have a household with free-range cats.  One of them can’t manage the cat flap to outdoors, so I must have a litter box in the house.


These issues need to be addressed by a doctor, not a recent high school grad with a check list and no formal training.  The people who used to be assistants, taking notes so the doctor’s hands will be free to manage eyes, have now BECOME the doctor, administering drops and framing the presenting information.  Doctors who are not keyboard-friendly are crippled by this.

Because so many of the assistants are young women and medical institutions have become so much more casual, the atmosphere is more like a school cafeteria than a clinic.  No more jackets to formalize staff.  On the day of my appointment there was a class of observers in attendance and the place was like a chicken house with a case of distraction.  Lots of high pitched conversation, giggling and shrieks.  Invasion by Barbie dolls.

http://www.zennioptical.com/glasses/women/Full-Rim-Plastic/Sunglasses-for-Her?Prescription-Single-Vision&title=Sunglasses%20for%20Her|0  $19.95
Lolita, they're YOU!!

I remember Dr. Jordan’s office, the same institution but a peaceful refuge for creating trust.   The focus has changed to promoting eyeglasses and cataract surgery, money-makers.    I’m told the clinic is expanding to dispensing glasses. But consider Chinese direct marketing.  A person is silly to buy glasses costing hundreds of dollars when $10 frames are easy to get online through websites like Zenni Optical.  Also, I read that there is a new strategy for cataract surgery that will put people like the departed Dr. Boes out of his niche.

The young assistant was upset by my grumpy attitude.  (My sewer was stopped up, can’t be excavated for repairs for a while yet, so no shower.  I forgot about daylight savings when I made an 8AM appointment so that I had to get up at the equivalent of 4AM, left at the bogus 6AM and drove in the dark which I don’t like to do, though I still can.)  She coped by fetching Thaddeus, who has been Dr. Padilla’s assistant.  I’m fond of both these low-key cheerful men and feel safe with them.  I thought that’s who I was coming to for help with scary stuff like blindness.

The vertiginous balcony hall of the Optical Center.

It is poor marketing to eliminate what makes doctors and patients happy.  Why all the economies?  Is it paying for the architecture or for lawsuits?

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