Tuesday, July 29, 2014

Hind Sight

     "Then the law is a ass," wrote Charles Dickens.  I might add, "Medicine is a ass."  I went for a follow-up visit to the specialist who had advised that my status as glaucoma suspect had in his opinion progressed to glaucoma, though of the low or normal tension variety.  I wasn't convinced but agreed, finally, to the SLT, after doing research which indicated it was pretty much risk-free if not always helpful.  So I asked the esteemed doctor a few questions, which seemed reasonable to me, but the answers were either  non-existent or off-base enough as to be meaningless.  He asked, as does his office mate, "What's new?"   Well, what do you want to know? In regard to what? would be my question.  But I mention a few symptoms and he says I should tell them to Dr. S.  I do know the difference between the cornea and the retina, but can't always sort out which symptom goes with what part.  He hunches over the computer and says that the eye pressure is lower than before, but not as low as he would like. My eyes, as usual, fall to his feet; I notice he is wearing a black  leather ankle brace, and wonder if he is in much pain.  The tech had previously told me my eye pressure was 12 and his "target" pressure was 11. I know that eye pressure means nothing in itself.  High can be OK and low can be not OK.  Eye pressure measurements just happen to be a "best test" in assessing the health of the optic nerve.  I ask if all today's testing and pictures show if the optic nerve shows any more damage, but he doesn't respond.   Since I'd had  laser for retinal tear (in other eye) since I'd last seen him, I asked about the effect of physical therapy as possibly being detrimental, since the eye has had 2 tears already.  He said to avoid any exercise that could possibly raise pressure and contribute to another tear, like lifting something heavy for 3 hours or more.  He added to likewise avoid the type of yoga where the head is lowered for several hours.  The ass.  How helpful is that.  Maybe his research paper on oral sex among orangutans was well received by his peers, but he could have spent his time studying human eyes. 
    I mention that my vision is blurry in the mornings.  He believes it to be from the so-called "secondary cataract" and says that is a simple fix with a laser.  I say I think it may be from Fuchs' Dystrophy, but he says that blurriness is not a usual symptom.  All of the renowned ophthalmologists and about 5,000 members of the Corneal Dystrophy Foundation would strongly disagree, and I know he is wrong.  I say nothing, but start to lose trust in  his decisions. He obviously doesn't keep up with latest ophthalmic developments because I'd just read an article on Fuchs' in his waiting room.  If it's true that when all you have is a hammer, everything looks like a nail, then it must be true that when all you have is a laser, everything looks like it needs lasering.

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