The Eye Ultrasound (and other strange medical tests)

This morning I had a follow-up eye doctors appointment. I have been seeing a retina specialist for about two years to follow a cyst in my right eye. Initially the discovery of this eye cyst was very unnerving because they were unsure of it's origin or pathology.  However, it seems that somehow the cyst is in the perfect place, between all the important eye structures and my glaucoma tube shunt implant. And as long as it remains there, happily not bothering anyone, no one seems overly concerned anymore. As a result, every 6 months I visit this specialist and have two eye tests done, photographs of the inner parts of my eye and an eye ultrasound. When I first heard I needed an ultrasound, I thought "wait, how does examining my stomach tell you anything about my eye?" There are indeed a ton of different types of ultrasounds and ways to use ultrasounds. Physical and occupational therapist often use ultrasounds to provide deep heat to joints, muscles and tissues. An eye ultrasound is not a painful test but it continues to be one of the strangest sensations I experience. I am by no means uncomfortable with eye drops or touching my eyes. I have worn contact lenses since 5 years old, used eye drops since before then and have had four eye surgeries. However, this test is still very strange! First, they use numbing eye drops to make your eyes more comfortable. Then they use an ultrasound stylus with ultrasound gel on it and rub it all over your eyeball, taking pictures in certain spots. It feels as awkward as it sounds. There is cool gel being rubbed onto and all over your eyeball, your vision is blurry and sometimes you enjoy the pleasant experience of cool ultrasound gel running down your cheek. Fortunately, the test is over quickly and you can move on to more pleasant tests..

My second least favorite medical test is the visual field eye exam. As a result of my glaucoma I need this test every 6 months to make sure that my visual field (the amount you can see in the periphery when your eye is focused on a point centrally) is stable. For this test you close one eye and place your head inside a giant circular bubble. These bubbles remind me of the chairs Will Smith sits in during
Men In Black. Then they flash small bright dots in various directions inside this bubble and you click a pen every time you see a dot of light. Testing each eye can take up to 5 minutes but it often feels a lot longer. I once made the horrible mistake of scheduling one of these tests the day after St. Patrick's Day while I was in college. I had gone out the night before and was not feeling myself the next morning (read: extremely hungover). This may have been the worst possible test to take hungover as every flashing light made me feel nauseous, my eyes were tired and dry and I am sure I missed seeing many lights that day. I will never make that mistake again.

Climbing Mt. Everest

Yesterday I watched a TV show on Iraqi war amputees who were climbing the 7 highest mountain peaks to help them rehab emotionally and physically. Every step was a struggle but they eventually all made it. I often feel like I am climbing Mt. Everest and especially today every step felt like a struggle. 

I've been lucky to have some amazing doctors who treat me as a person and not a condition. Today though as I met with my glaucoma* doctor, I felt like he only saw my eye. As I began to inquire about my goals for a family in the future and the medication management required, his demeanor became grim. "Well...some people do great with improved glaucoma, and some people have a horrible, out of control eye disease" Fabulous, thanks for the boost of confidence. As a clinician myself, I often get asked questions about predicting the future. "Will my child grow out of Autism?" "Is he ever going to be able to pay attention in school?" And like my doctor, I can't predict the future for them and he can't predict my disease progression. However, how a clinician presents negative, uncertain or scary news makes such a huge difference in the patient's outlook and perhaps even their disease progression. One giant fall down the mountain...

Luckily, I do have an amazing ophthalmologist who agreed to see me the same day to check on my eye disease. She eased my fears and said my eyes were clear. She could sense my anxiety and stress about planning for a family in the future. We discussed how 50 percent of medicine is science and knowledge and the other 50 percent is relating to patients, appreciating their goals and easing their concerns. This is why this doctor rocks! I left my second appointment of the day in a much better place. Still terrified about what the future may hold, but optimistic. Climbing back up that mountain towards the peak...

And to further ease my stressful day, my amazing husband food shopped and cooked dinner so I could have a stress relieving bath. I do think with the support of my husband and family, I will be able to make it up that mountain, one step at a time, overcoming every storm and set-back in the way.

*Background Eye Information: My JRA caused Uveitis (inflammation of the uvea in the eye). It has been a constant struggle to control and the most effective treatment personally has been Prednisone eye drops, which unfortunately overtime can cause increased eye pressure leading to glaucoma. As a result I have had surgical interventions to control my glaucoma and am followed closely.