So there I was, minding my own business in Manhattan, hanging out with eight girlfriends, all of us in or near the Golden Years and all of us on vacation. After a long day, three of us decided to have a late Italian dinner. We walked into a dark restaurant, got seated and whoa! what was that?
I saw a lightning bolt on the right side of my right eye. It flashed on and off. And then another. And another. I hadn’t seen such a light show since I’d done psychedelics in my college years.
The only reason I knew it could mean trouble was that just two days before, another of the women on this fabulous trip to NYC had been describing her bout with a detached retina. My symptoms sounded suspiciously like the ones she’d described. If not looked at quickly, I could lose my sight. I tried not to panic.
At home, we have a good internist who is what’s now called a “concierge” doctor. I’d watched her quarterback serious illnesses for close friends over 30 years, even before she became a concierge physician–and was impressed. We pay a monthly fee for 24/7 access to her via cellphone, text and email. This includes as many office visits as we want, our annual physical and regular inoculations. I understand that we are lucky and privileged to be able to have this level of service, especially in our Golden Years, when shit seems to happen a lot. It has served us well so far, especially since our doctor is well connected among world-class Stanford Hospital specialists.
But she was 3,000 miles away.
Back at my hotel room on Google, I found the New York Eye and Ear Infirmary, which specialized in eye problems. In the morning, I’d be heading there, while my friends roamed the city having fun. I didn’t want to go alone, so I asked (who else but) BFF to come with me. I texted my doctor what was going on and she responded “Good plan.” I did not ask her for a referral, although in retrospect, I should have. I didn’t call either of my Calif. girlfriends who had lived in NYC for decades, although in retrospect, I should have. Wasn’t thinking clearly. I mean, who could think clearly with a light show going on in their eye?
The pre-Victorian Infirmary building sat massively on a corner near Union Square. BFF and I headed straight for Urgent Care. Ahead of us were at least 100 people who looked like they didn’t have insurance, much less a private physician. No one looked like they’d ever had a private physician, much less a concierge doctor.
“I think I have a detached retina,” I told the intake clerk.
We were immediately fast-tracked through the intake process and within an hour, I was seeing the opthamologist in Urgent Care. Or rather, what was probably a third-year resident. After taking my history, numbing, then dilating my eyes, she proceeded to shine bright lights in each eye, examine them through a headpiece scope, and poke at them with what looked and felt like a medieval torture device. I tried not to look at it, because when the doctor picked it up, BFF looked aghast. In all, the resident put me through 45 minutes of lights, poking and prodding. It seemed to go on forever,though, and it wasn’t particularly comfortable. She finished, and pushed her chair toward her desk and the chart.
“I see some hemorrhaging and I think you need to be seen by the retina specialists,” she told me. She escorted us up the elevator to Opthamology. About 75 patients sat waiting. They looked poor, sick and used to waiting.
We sat down — we had every reason to believe we’d be fast-tracked again. How wrong we were.
We sat. And we sat. And sat. On my way to the rest room I found the OTHER waiting room, with 30 more waiting patients.
In all, we sat for almost five hours before being seen by….another resident. She was painfully slow with the exact same intrusive exam I’d had downstairs. She used the same instrument. I tried not to look at it, but could barely see it without my glasses, anyway. The Infirmary was founded in 1820 and from what I could see, the instrument looked like it had been in use at that time. Museum-worthy. Wooden handle and what looked to me like a four-pronged foot. Ancient. BFF gasped in horror and laid her hand on my arm as the resident poked it in my eye. Sanitation did not seem to be a priority, either, she whispered to me.
It turned out that this was a first year resident, which explained her ploddingly slow, hesitant and tentative exam. And then, she pulled out a clipboard and a blank drawing of an eye. Clipping the drawing to the board, she laid it on my chest as I reclined slightly in a chair. The metal clip rubbed dangerously close to my throat.
“Please don’t give me a tracheotomy with that clipboard,” I told her. She moved it further down my chest.
Pulling out a zippered bag of colored pencils, she began drawing what she saw. Slowly. And then, coloring it in, choosing her colors carefully. On the clipboard. That sat on my chest. Even without my glasses I could see the look of horror on BFF’s face.
Seriously? I thought. I doubted this would be happening at Stanford.
Oh, you doubt me? You don’t think they draw with colored pencils? Here’s the drawing.
It’s called a fundus drawing and is considered a lost art in medicine. Which is to say there are many more modern ways to capture an image of the retina. Like with cameras. CT scans. You know. Stuff that modern doctors use today.
“I see hemorrhaging, and the head retinologist is going to come do this exam again,” she told me.
Yes. The exact same exam. For the third time. She saw the look of distress that crossed my face.
“Oh, he’s much quicker,” she told me. “He’s the god of retinas nationally.”
The god of retinas wasn’t quicker. That’s because he kept telling the young resident to repeat portions of the exam that she hadn’t gotten right. I was participating in the making of a new opthamologist. Now, I am all for doctor training, but not on MY eyes. Finally, he came back in to repeat the exam. He was only marginally faster.
When the GOR (god of reintas) heard I was visiting from California, he told me that he’d dated Dianne Feinstein when she was 20. She is now 80. Draw your own conclusions about the god of retinas.
As he examined me, I could smell on his hands the pastrami he’d had for lunch. No, sanitation was not a priority here at the Eye Infirmary. When he finished, he told me that I had a small hole in my retina and that I could fly home the next day as planned, as long as I was treated ASAP. He wrapped his cape around him and flew off into the night. Ok, not really, but that’s how it felt.
The first year resident returned and told me that the Fellow would be coming in to re-examine me, as she was going to have to “write the case note.”
“NO,” I said. “NO. I’ve had this exam three times already.”
“She won’t be prodding, just looking,” I was told. I heaved a big sigh and let her at me. BFF kept her hand on my arm.
Did I mention that BFF was in the process of getting sinusitis, bronchitis and other itis problems? And she hung with me anyway? I love you, BFF. Thank you for not leaving me alone in that medieval torture chamber with a doctor who looked like he’d studied under Hippocrates.
Meanwhile, the other women on the trip were out having a rip-roaring, great time. So it was a big sacrifice.
I asked the resident to call my internist. In all innocence and without understanding the scenario in this chamber of horrors, my internist asked for some high tech stuff instead of a colored pencil drawing. This set the resident off on a 20 minute wild goose chase, delaying our departure. But finally, we were released.
I had been there seven and a half hours.
It was an unfortunate ending to a wonderful girls’ trip. But shortly after landing home at SFO, my doctor called with good news. She had gotten me a 10am appointment the following day to see the best retina surgeon in the world. He had operated on her retina, and the head of the department at Stanford who no longer operated had claimed this young doctor had the “best hands” he’d seen in 35 years of practice.
Our big fear was that I’d have to have a procedure that would require me to be face down for two weeks. We knew this was a big possibility. London would be out. So would reading, watching TV and normal life, for at least two weeks. “Don’t worry,” my internist said. “I had this two years ago and I”ll walk you through it.” I downloaded some audio books and left for my appointment, resigned to my fate.
Here’s what the facility looks like at Stanford:
When we entered, a lovely young greeter politely showed us the way to the desk and asked if we needed anything. I almost ordered a cappuccino, just to see if we’d get it.
At the desk, I filled out no paperwork because my internist was connected into the Stanford system and my information was available to this eye institute.
After a half hour wait in a pleasant waiting room, I was seen by the doctor. He did the same exam the others had done, only it took him less than 10 minutes. It was like a walk in the park, compared to the NY exams. I loved him already.
“As we age, the vitreous detaches and can sometimes pull the retina with it,” he told me. “You have a small hole in your retina. It’s on the bottom, so gravity is working for you. We can either do nothing and watch it, or we can close it up with the laser right now and not have to worry about it.” Ah. Another Golden Years condition.
I didn’t want to risk losing my eyesight, but I am a notoriously big baby about medical procedures. On the eye? We only have two and we need them. Just the idea of Lasik made me ill, so the idea that I would have laser eye surgery didn’t sit well.
“How painful is it?” I asked.
“Most people say there is no pain, about 20 percent say moderate pain and a tiny percentage say it’s terribly painful,” he said. “But you tolerated the exam very well and seem like a pretty cool customer. I think you’ll do fine with it.”
So did I, because a medium I know had emailed me the night before to say she’d “heard” that I would do very well with a procedure. She’d also done some long-distance healing. Sister-in-love’s sister had sent me Reiki. This doctor was very calming. All very integrative.
So, off we went to the laser room.
It was surprisingly casual. With all the equipment in the room, I figured I’d be seated in some contraption, or reclined and strapped in to keep my head still. After all, he was aiming a laser scalpel at my eye. No. He sat me in a rolling chair, asked me to lean my unrestrained head against a wall and set to work. Seriously. In its own way, it was as bizarre as my NY experience. Oh, did I mention he neglected to have me sign a consent or give me all the warnings? Such a mistake, especially when the patient is accompanied by her husband, who is a lawyer.
There are some flaws in even the best of medical systems.
Ten minutes later, I was done. Within five minutes, my eyesight was almost normal. No eye patch. I could drive, read, watch TV. No limit on travel to London in 10 days. Nothing but a follow up visit the next week. Best of all, no being face down for two weeks. Over the next few days, I seemed fine, except my vision in that eye just a bit fuzzy at first.
Oh, and how painful was it? Not terribly. It was a bit uncomfortable at times, but mostly from the surgeon pushing on my sinus area to get better traction to hold my eye open. A few times I felt the laser slightly and that didn’t feel good, but I focused on what my medium friend had told me. And then, it was over.
Here’s the public service info part of this post. I didn’t detach it this week. It actually happened months ago. First, I noticed a flash bulb effect last year, as if a flash had gone off and left a white spot on my eye. I called my internist, who told me it was probably an ocular migraine and to call her back if it didn’t go away or came back. I napped and when I woke up, it was gone.
Then, about two or three months ago, I noticed that my right contact lens felt foggy. A lot. It was as if it kept getting dirty faster than the left. I kept throwing them out and replacing them, much more often than usual. Maybe I needed a new prescription. I had even mentioned to a friend on my flight to NYC that I was looking for a new eye doctor.
And then, finally, the flashing bolt of light. You can see colors or other kinds of flashes, too. Mine was a lightning bolt.
It can be serious: a detached retina can take your sight, in some cases in less than 24 hours. If you experience any of these weird symptoms, see your eye doctor right away. Seriously right away. Because your case might be one of the serious ones and you could go blind. Better to be safe than sorry. This is something that can happen to anyone in their golden years.
As for me? Well, I’m doing great after laser surgery. My follow-up visit is tomorrow.
And as for those golden years, well, they can just kiss my ass.