Friday, May 27, 2005

Aging boomers (and I guess I'm one of them)

I've gotten to the point that going to the doctor, any doctor, is something I hate to do. I never liked it, but now I simply detest it. After all, the best that can happen is that things have stayed the same. But the reality is that, as time goes by, it becomes more and more likely that the news will be bad.

Those of you who are of a certain age know what I'm talking about. Slowly, more and more of your friends are taking pills--high blood pressure, cholesterol. A hearing aid blooms here and there, blushing pale pink in a (usually masculine) ear.

You want to postpone the test, the check-up, the mammogram, the prostate exam, the colonoscopy, and sometimes you do. But sooner or later the postponement goes on too long, and fear takes over, and so you go.

All this is a lead-in to say that yesterday I had an eye exam. I don't even wear glasses, except for night driving and the theater, or reading glasses for those intimate low-light restaurants. Oh, yes, and computer glasses for blogging. But in normal life I don't need them, and I can even read books without them.

So yesterday it was a surprise to me when the technician looked into my eyes, prior to the opthamologist's grand entrance, and said, "I'm going to have the doctor come in now to take a look before we dilate you." And then he went into some arcane discussion of the angle of my iris and the fluid and the shape of my eye and something something something. When I asked whatever was he talking about, he tried to find a diagram of the eye to show me. I didn't want to see a diagram of the eye, I said, I wanted to know what it all meant--did I have some eye disease? Oh no, no, he said, just something that might make it dangerous to dilate my pupils. And then he left me alone to ponder that thought.

Next there was quite a bit more fussing with my eyes by several people, including the doctor. Measuring, putting numbing drops in, measuring again, being told to stare at little targets. Their conclusion was that yes, indeed, I have some relatively rare malformation of the eye that is congenital but gets worse with age (doesn't everything?).

What does it all mean? Well, although it's highly unlikely to happen soon, as the thing progresses, I would be at risk for sudden blindness if my eyes dilate quickly or forcefully, blocking off some sort of fluid canals and causing a clogged-drain effect in which the eye fluid pressure builds up alarmingly and speedily.

Huh? Not exactly what I expected to hear. That's what he meant by "dangerous;" the eyedrops used to dilate eyes for the eye examination can cause an attack, requiring immediate emergency surgery to preserve the eyesight. Modern medicine being the relatively wonderful thing it is, however, there is a simple (they say; I hope!) laser surgery that puts a little hole in the iris and prevents any possible buildup.

The doctor then said he thought it would be okay now to dilate my eyes to examine them.

Now, one word I really don't like to hear a doctor say is "I think" (actually, that's two). So I inquired about this "think" thing, and he said if I was apprehensive (if?), I could just have the laser surgery soon, and postpone the drops for afterwards.

I made an appointment for laser surgery in three weeks. And then decided to write this little post to tell all of you that it's not a bad idea to keep up with your regular eye exams. A cautionary tale.

12 Comments:

At 12:32 PM, May 27, 2005, Blogger Goesh said...

I enjoy the comedy of the pill commercials on TV where we see smiling happy people who have instantly fixed a problem by taking a pill, then we hear a litany of potential side effects. Trading heartburn for liver problems and constipation sounds like a winner to me. Now it appears as if some of the guys who can't get it up could be going blind using viagra. An orgasm for blindness, another good trade-off in the realm of modern medical cures wouldn't you say?

 
At 2:05 PM, May 27, 2005, Blogger Bookworm said...

One of the good things about being blind as a bat from the git-go, is that I've pretty much stabilized now. Aside from the ever present risk of retinal detachment, things are the same.

I've been warned, though, that I'll be getting farsighted as I move ever closer to my 50s. "Oh, great," I said. "That will offset my nearsightedness, right?" Well, no. It means that I will simultaneously be farsighted and nearsighted, something almost mystical, if it weren't so irritating!

 
At 2:44 PM, May 27, 2005, Blogger chuck said...

An orgasm for blindness...

There is something vaguely familiar about this particular side effect...

 
At 3:37 PM, May 27, 2005, Anonymous Ray Zacek said...

Something I've noticed as I've grown middle-aged: youth is indestructible; at 25, you feel quite solid and confident, and the world is a terrible place, run by fools, and it is falling to pieces; at 50, the world is quite solid, even if still run by fools, but you're falling to pieces.

 
At 4:46 PM, May 27, 2005, Blogger John Moreschi said...

It may not be politically correct, but I will send a prayer your way.

 
At 4:56 PM, May 27, 2005, Blogger Pancho said...

The world of medical reality does tend to catch up with one at our certain age. After a life of healthy living I started having upper back pains several days before this last Christmas. They would come and go, but the day before Christmas Eve I started to get short of breath also. Thank God for a wife who ordered me to medical care [real men don't go to the emergency room]. I went in and had it checked out, thinking I would be home a few hours later.

The outcome was an EKG, then an angiogram....then very shortly thereafter a triple by-pass. Age and heredity had it's way with me.

 
At 8:44 PM, May 27, 2005, Blogger Dr. Sanity said...

Now you have me worried. I have my annual exam in 2 weeks. I've already put it off twice since the beginning of the year.

Sigh...I hate getting old, too.

The surgery isn't too bad. I had surgery on my eye to tighten up some muscles a few years ago and the recovery is pretty quick.

 
At 8:55 PM, May 27, 2005, Blogger Kerry said...

"I think" the one word/two words you would not want the doctor to say prior to decisions are "I feel". That modern malady afflicts too many of the citizenry.

 
At 10:57 PM, May 27, 2005, Anonymous Anonymous said...

The laser op is simple and painless from what I have heard. I think that it is a bit funny that one naked monkey can shoot (direct or whatever) a laser into another naked monkey's eye and correct problem with the first monkey's eyesight. We have come a long way from digging around ant hills with sticks. Good for us:)

 
At 10:35 AM, June 01, 2005, Anonymous Steve, MD said...

Wait a minute. Your doctor has to do a procedure(laser) to make it safer for the doctor to do another procedure(dilate your eyes)? Sounds like they're worried about acute angle glaucoma (I'm not an ophthalmologist).
You should ask what the risk of dilation without laser is vs the risk of the laser. If the former is 1/10,000 and the latter 1/1,000 maybe you should skip the laser. Or what's the risk of skipping the dilation altogether-probably would be my choice.
That's why the doctor said, I think. Things are black and white only to the color blind, and do you want a color blind ophthalmologist.

 
At 2:45 PM, June 03, 2005, Blogger LibraryGryffon said...

Standard disclaimer: I am not a physician or other medical professional; I am a medical librarian though, and spend a lot of time poking about in the literature.

I looked up acute angle glaucoma and found this article:

http://www.emedicine.com/EMERG/topic752.htm

It does indeed sound like they are worried about an acute closed angle glaucoma, and it states:

"Once the acute attack has been broken, the definitive therapy for narrow-angle glaucoma is surgical. A peripheral iridotomy, surgical or by laser therapy, is performed. The hole provides an alternative pathway for aqueous humor to reach the anterior chamber and relieves the relative pupillary block. Because the contralateral eye has the same anatomy, predisposing it to an acute attack of closed-angle glaucoma, a prophylactic iridotomy in that eye also is performed."

I didn't find anything on the glaucoma society sites, medlineplus, or similar which suggested that there was much risk from a laser iridotomy, the primary concern seemed to be that there is a small (5%) chance of it closing up and requiring a second procedure at a later date. Do ask your doctor, but it does sound like the risks from the angle closure are much greater than the surgery. I found things such as darkened movie theaters listed as risks for an attack of acute angle glaucoma.


I too am blind as a bat, so bad that even if I was willing to let someone shave my cornears (which I am not) I'm not eligible. We're waiting till the implantable lenses have a year or two in this country and then I'll try that if I can dig up the funds. By then, the FDA may even allow the lenses which can fully correct my vision. Even if they don't, it would be enough of a correction that I would be able to find my glasses if I'm not wearing them. Your 4th grader does tend to make fun of you when when you have to get her in to find the glasses which you knocked off the nightstand.

 
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