Friday, June 08, 2012

My optometrist says I can't lift heavy weights

Yesterday I had my biennial eye exam. I've been wearing glasses since gradeschool so this was a fairly routine procedure: first the technician sticks your face into a machine and tells you to keep your eye open for so long it would tear up even if you didn't know she was about to blow a puff of air into your eye (which you do know because she tells you it will). Then she shoves your face into another machine that takes a picture of the inside of your eye. Then she sits you in a chair where you cover one eye and asks you to read the same lines of characters over and over again, and you wrestle with the question of whether you can actually see the characters or you just remember them from the last eye exam two years ago and the six times in a row you just read it with various combinations of eye coverings. The doctor then takes over, asks you if you prefer #1 or #2 a lot while you look through a device that you hope nobody will photograph you at, tells you whether there has been any change in your prescription, and the rest is paperwork.

Of course, the doctor also asks you if there was anything you wanted to raise. Generally a formality, in my case, whatever type of doctor I'm visiting, I usually have a couple of things to mention. I'm sensitive. And obsessive. I notice things. And I have no clue whether this is simply something that "normal" people are expected to experience.

For example, two days prior I noticed some crazy floater action in my eyes. I was in a relatively dark room with windows looking out to the bright sunset, and as I shifted my eyes, it looked as though someone was twitching a snowglobe full of wet rice noodles in front of my eyes, the mass of noodles slowly following the direction of movement. I figured this was probably normal and just due to the odd angle of the sunlight traveling through my eye fluid.

I've had other issues with my eyes also. In addition to the counterproductive productivity side-effect of the antidepressant I've been on for the last year and a half is that it makes my eyes itchy. The itchiness makes me blink a lot and rub my eyes, which leads to more problems. It hasn't been to bad lately, which suggests that maybe just being aware of my eyes is what starts the cycle, and I've been too busy and distracted to be aware of them.

Between my G.P. and my optometrist, the best guess was that the itchiness was an allergic reaction to the antidepressants. So they put me on some prescription antihistamine eyedrops (which only work if you take them twice a day regularly because they're preventative). The allergy eye drops, however, made my eyes too dry, and I was advised to use some over-the-counter moisturizing eye drops.

To recap: the moisturizing drops are to counter the effects of the allergy eyedrops, which in turn counter the effects of the antidepressants, which in turn helps with my various aforementioned ambiguous psychological issues.

Given the ambiguity and interconnection of the problems, symptoms and treatments, none of which have a black-and-white diagnosis, I've taken to ascribing any issue with my eyes that comes up to: taking one of these drugs, forgetting to take one, stress, lack of sleep, sweat dripping into my eyes in the heat, rubbing my eyes after making contact with a furry animal, or some benign cause of another nature that could happen to anybody. Whatever the cause, I figure that any given symptoms I encounter would probably not happen if I were simply more diligent in with the eyedrop regimen. All to deal with mood issues.

With this in mind, I mentioned the floaters to the doctor anyway, and patiently went along for the ride as he made a more thorough inspection of my eyes, waiting for him to reassure me that it was nothing to be worried about. Such is how these things go when I bring this type of thing up at the end of a doctor visit.

"The good news," he said, "is that the reason you only noticed it two days ago is because the symptoms only started two days ago."

What do you mean good news? What's the bad news?

He showed me on the computer the photo of the inside of my eye (projected onto a 3D wireframe model of an eyeball no less!), and pointed to a blotch in an obscure corner of it (I assume he already planned to look into this but asked me if I had issues before launching into the investigation to avoid prompting me). Even without the image from the previous appointment as a comparison, it was obvious to the casual observer that this was not a normal thing. The other eye didn't have one.

I was informed that this blotch was where a section of my retina has detached from its supporting layers, causing a pocket where fluid had worked its way in behind the retina. Left unchecked, it could cause the rest of the retina to rip away from the back of my eye, causing potentially-irreversible blindness.

So the symptoms were not due to emotional detachment but retinal detachment. Go figure.

This type of issue, the doctor told me, needs to be addressed ASAP. As in, call the doctor the same day you see it, and get it checked within 48 hours and fixed within the week.

It was a spectacular coincidence that the symptoms had appeared just two days before my eye exam, because I probably wouldn't have done anything about it otherwise. It's entirely possible that the problem wouldn't get any worse if I didn't do anything, but treatment is pretty straightforward at this stage, and very intrusive if it gets a lot worse.

The fix involves going to a specialist to confirm the diagnosis and, assuming the specialist does so, getting lasers fired into your eye to burn off the fluid and/or reattach the retina.

So after my appointment Thursday, I get a call on Friday morning to come in to see the specialist Saturday afternoon. You know something's serious when you get an appointment with a specialist for a Saturday afternoon less than two days away.

In the meantime, I'm to contact my doctor immediately if one of a few symptoms occur, and I'm to avoid heavy lifting. Forty pounds was about the limit.

Damn, I thought. My left pannier is 15 pounds and my right pannier is 25 pounds. Exactly 40 pounds. I'm going to have to carry them back to my bike. And that's before I add tonight's groceries!

Seeing me doing this mental arithmetic, the doctor helpfully clarified that it's not like there would be a night-and-day difference between 39 lbs and 40. Somehow that helped.

At least, I thought, it won't be as bad as when I had to bike to the General Hospital--twice--for a series of asthma tests initiated by this visit to the doctor (all to confirm that, yes, I did in fact still have asthma like I told them), because those tests came with an extra hour or so of waiting before the test to allow me to cool down from the bike ride to the hospital, lest it skew the results.

"Actually..." said the doctor when I quipped about this to him. Actually what?

Because my eyes would be dilated, it wouldn't be a good idea to bike home, especially since we won't know the degree of treatment required until the specialist has a look.

Thankfully, when I whined about this on Twitter this morning, fellow cyclist Kate came to my rescue.

We'll see how it goes...

- RG>


jason said...

Good luck RG!

jason said...

Good luck RG! And sorry if this is a repeat comment.

RealGrouchy said...

All better! The doc also said the front of my eyes were very healthy.

Very strange experience to have someone hold a lens against your eye and shoot lasers into it.

While I didn't get lasers installed in my eyes, the procedure has preserved my ability to shoot a cutting glare at people who cross me.

Also, the eye exam that found this issue cost me $135. Luckily my benefits plan covers this once every two years, though I now have to get an exam every year.

By contrast, for the procedure to fix the tear in my retina, the only plastic card I needed was the one the hospital issued me. The Canadian taxpayer (of which I am one) paid for the repair to my eye. Had I not gotten the eye exam, much more damage could have happened before the problem was found. Fixing this, while it wouldn't cost me anything either, would have required much more expensive procedures, likely surgery.

This only goes to show the backwardness of Canadian healthcare. You don't have to pay to get a problem fixed, but you do have to pay for the checkup that finds the problem in the first place. In a digital world, good vision is critical to one's productivity in the workforce.

Ah well. If I had time I'd write a more thorough follow-up post.

The only other tidbit I wanted to add (aside from a thanks to Kate for the ride) was that the doctor's voice and personality reminded me of Homer Simpson's long lost brother, Herb.

- RG>

Finiola said...

I'm glad they caught this early, or else...yikes.
I'm at risk for retinal detachment too because I have a really strong prescription (pre-laser eye surgery that is), and was told by my eye doctor to get it checked immediately if I ever see floaters. Your post is a good reminder.

And I completely agree about the backward health care system. It's ridiculous that we have lost the focus on prevention.