welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Wednesday, May 4, 2016

the treatment

THE TREATMENT
did you ever see the movie
road trip
then if you did you understand why i didnt complain
about the phone system and not being able to talk
to a human being very long

now i usually see dr w at this place
she has been my ophthalmologist for 15 years
in fact ive seen her several times this year for my
iritis thats inflammation of the iris
the eye turns red it hurts a lot you get headaches
its relieved with tapering doses of steroid eye drops

i went years without a flareup and now have had several
since the first of the year

luckily for this injury i had just finished tapering off
my steroid drops two days earlier
which helped some fighting the inflammation from this
eye injury

now i saw a new person
she seemed to take her job seriously
it was hard to get her to smile

she described the injury
the thorn went into the limbus
now i knew what that meant
the area where the cornea meets the white part of the eye
it went into that front chamber
nicked the iris as it went in
causing some bleeding at the puncture site
then dripping some blood like off a knife
that is used to stab someone
down into the bottom front of that anterior chamber

your biggest problem will be
she said
inflammation getting worse in that eye
infection from germs carried on that thorn that just got
injected into the eye
well she didnt mention the other thing
pain

so she gave me
atropine to dilate the eye
makes you look like a hoot owl in one eye
for a long time
thats just one drop
she said use a drop each night
i thought man im gonna look like a hoot owl
hope i dont hoot in my sleep
or start hunting for rodents

then she said restart those steroid drops every hour
i thought when am i going to sleep
i see 6-8 hours of not using them each day
i think she read my mind
ok just use them while awake

then heres some antibiotic drops
to fight the infection
when i went to the pharmacy they said
you know your insurance doesnt cover this
i dont care i thought this eye hurts i just want to go home
so i paid the man
dang thats a small bottle
i calculated that each drop cost about $5
i burned 5 bucks when my first drop hit the floor
so i just used that drop to rub in to our floor
to at least use it for something

come back tomorrow she said
i thought dr w i want to see her then

when i went to the pharmacy
sorry we dont have those atropine drops
you need to call other pharmacies to find some
we will transfer your prescription

i thought
mam thats your job to do that
my eye hurts i want to go home

so i said
what about your stores pharmacy just down the road
oh yea she said
she called they had it
just do your job mam is all i could think

i got the hoot owl drops and instantly put them in
they helped ease the discomfort some on the way home
by now a heart beat had started up in that right eye
by midnight i reached for my left over pain meds from
my oral surgery to get some pain relief

i was also told to not read
to sleep in a chair
to not bend over
to sit up right
to basically do bed rest

that worked ok on day one
but it was a real struggle the rest of the week

so the next day
my wife she went with me
i didnt feel like driving
i got to see dr w
she said
i need to talk to a corneal specialist and a retina specialist
she was gone a long time
made me worry a little

she returned
infection and inflammation are your two biggest worries
i thought and being a hoot owl and pain should be added

so she wrote me prescriptions for all these medications
two antibiotics that had to be compounded by a compound pharmacy
there arent many of those left
walgreens cvs heb etc dont do that no more
what that meant was
it was going to be a while before those got ready
so
just a block away from the pharmacy was one of central texas
well known taco places
ive never been so we went there and waited
ok i ate two tacos and was full and was happy
then
your prescriptions are ready she said when i answered

so the two compounded meds
vancomycin
we called it vanco terrible when i was a resident since it always
seem to wipe out the patients kidneys when it was used
the other was
tobramycin
when given iv can damage the kidneys make your ears ring
and damage you hearing permanently
of course
all of that was going through my head when the pharmacist
was doing her thing telling me how to use it

but
she forgot to tell me
that
when you put those drops in your eye
especially the vanco terrible ones
that it would feel like 3 fingers were poked into your eye
or like someone poured rubbing alcohol in there
you would drop to your knees crying

use each drop every hour
she didnt say while awake but i did

wait a minute that means i use a drop every 30 minutes
plus the steroid drop every two house plus the atropine twice a day
plus natural tears before using the drops to lubricate the eye
thanks goodness i was told to stop the antibiotic drops that
were made of gold
wonder if i could sell those on craigs list

plus now i had to use an antibiotic cream at night
what a messy one that was

you do the math
i was doing drops every 30 minutes at least sometimes every 15 minutes
how in the heck was i going to keep up with all that
but
i did

i went to see dr w every day for a week
my eye got better each day
once my eye pressure went too high
but once the steroids kicked in that went back to normal
after the first day i didnt really have any pain

there was one day i just felt bad
slept all day
felt like i had the flu
but felt better the next day

there was only one scary moment
i bent over in the sink to wash my face
when i stood straight looking in the mirror
all that blood covered my pupil and i couldnt see
however
it gradually settled back down to the bottom of the chamber

now 1 week later
the blood has all resolved
i am still a hoot owl in that eye and will be that way for a week or two
until those atropine drops wear off
this makes my vision in that eye blurry
i have no pain
i have been released to full activities
i did get her to write a note saying i should do no housework

i even finished the job i started when i injured the eye
carefully very carefully lifting up that pot of agave
throwing it on my brush pile
along with all those cactus pads

so in summary

my eye should make a full recovery

medical offices should have a real person answer the phone
i wonder how much business they lose from folks just hanging up
in my case most would have just gone to the er
of course they wouldnt have done anything but sent you to
an ophthalmologist
costing you or your insurance an extra thousand bucks

meds cost too much

its too hard to get care sometimes
luckily having worked in the system for years i know how to maneuver
myself through the system
i have insurance thank goodness
even with this i still paid close to $500 for my meds
wonder what a poor uninsured or underinsured person would do

compliance in this case was important
i understood that
permanent blindness or worse loss of the eye was a possibility

folks just do your job

and lastly
always always use safety glasses and safety equipment

the organicgreen doctor

Tuesday, May 3, 2016

dethorned

DETHORNED
so there i stood looking in the mirror
a little blurry eyed on the right eye
with the hyphema in that eye
seeing also where the puncture occurred
there was some bleeding there
dripping down to the bottom of the eye
where i knew i wanted it to stay

what do i do now
i knew two things
if that hyphema gets worse i could be in trouble
in the future
if that thorn like a rose thorn carries some bad germs
they just got injected into my eye
staph pseudomonas fungus
all could lead to potential catastrophic events in that eye

sometimes i wish i didnt know as much as i do
about medicine
i might be better off

so here i am
30 miles away from health care
should i call my wife she at work
gotta get hold of the office
they have to walk down to her room
have her call me
then she would drive the 30 miles to home
then another 30 miles to medical care
that would take over an hour
i could already be treated and through by the time
all that time elapsed

so i went for option two
keep that right eye close and just drive one eyed to get care

now do i go to the er
having been an er doctor before
i knew they wouldnt do anything but call the ophthalmologist
who would want to see me in the office
so
i made the decision to go straight to the ophthalmologist

then i looked in the mirror
i looked like i had just did one of those mud runs
so i called the eye doctors office
put it on speaker
then jumped quickly in the shower
finished the shower i was squeaky clean now

now of course i got a recording
what happend to those human beings who use to answer the phones
in doctors office
it said
listen closely for our menu has changed
if you need an appointment push 1
if you have an emergency talk to us and we will help you
decide what to do
if you need a prescription push 2
if you are a doctor push 3
i almost did that the first time
push 3
but i didnt
i had pushed 1
mistake is what that was

so i went downstairs
found my keys
wondered outside to the car
listening to music on my iphone waiting for someone to answer
started driving
about 10 miles later
this person somewhere answered the phone
may i help you
i stuck a well i told her cactus since i thought
shes not going to know what a agave spine is
so i told her i stuck a cactus spine in my eye
but was able to remove it and needed to see my eye doctor
as she listened to my story
i think she sort of got squeamish
as she
suddenly said wait a second ill put you on hold
now im 15 miles out
then as she did that i heard that irritating sound
i just got disconnected

so
i redialed them again
ok so i wavered back and forth while i was one eyed driving
i know people thought
that guys either midday drunk
or he is texting
well i was one eyed texting which is worse

so dammit here came that message again
listen closely as our menu has changed
you can just imagine what word came out of my mouth
lets just say it wasnt words you would say in church
chose 1 to make an appointment
i didnt wait for her to tell me more
i punched 3
im a doctor right
well
then came this message
all or operators are busy please stay on the line for the next
available operator
well i thought
you must not have many of those

so
10 miles later i was still on hold
so
i hung up
started all over
redialed them
all our operators are busy
listen closely blah blah blah
i punched 1 this time
all our operators are busy please hold for the next available
i uttered those nonchurch words again and again
but i held on
all while driving erratically to the doctors office
then
lucky me
this operator not the same one
may i help you
yes
i stuck a agave no a cactus thorn in my eye
my eye is hanging out of my socket
its full of bloooooood
i can only see the floorboard with that eye
it keeps swinging around making me dizzy
well
i think that scared her a lot
she said wait let me put you on hold

ok i didnt really tell her that but i wanted to
i told her exactly what happened
but it scared her the same i think

so she put me on hold
click
those nonchurch words came out of my mouth again

i decided ill just show up at their front door
go in there
start wavering around like i have vertigo
scare the heck out of them
all while holding my right eye
bet i get quick service then

but
i didnt
i walked in holding my hand over my right eye
now a clean hand
i stuck a cactus thorn in my eye

have a seat well see you in just a minute
so they did

i will tell you the next day i brought in a thorn similar to
the one that jumped into my eye
as i took it out of my billfold and laid it on the counter
well
all i can say the first thing i thought was
they just acted like i placed a live rattling rattlesnake on
their counter
they all shrank back to the back of the office
leaving me alone with my thorn

tomorrow
my treatment
my thoughts on safety
my thoughts on just answer the nonchurch word phone

the organicgreen doctor

Monday, May 2, 2016

a thorny situation

A THORNY SITUATION
my life almost changed for the worst one week ago
today
this is a blog about a thorn the health care system
and
safety
now i have this big ole agave plant called the century plant
that when its time comes
when its time to leave this earth
it sends up this big beautiful stalk 20 ft in the air
then it dies
this stalk has been up in the air now for two years
still being enjoyed by birds and well us

it has sent out pups
little agave plants

one of the problems with these plants
well there are two
they keep producing pups like rabbits do babies
they also produce these long needle like thorns
which i keep clipped off for safety reasons
or
at christmas we cover them with christmas balls

so
last year i dug up a pup
put it in a small pot
so its growth would be stunted and would stay within
the bounds of the pot

then
came our grandbaby ms b
i started looking closely at my collection of cactus plants
deciding some had to go

so
i trimmed back one of my spineless cactus
planning to haul it off to my large brush pile
in my pasture that provides homes for birds and all
kind of varmints
so
after putting a load of cactus pads in the back of my
old black truck
i looked over at the baby pup agave in the pot
saw those big thorns
no i thought to myself
that needs to go
so
i picked it up and flung it onto the top of those cactuses

boy was that a life changing decision
as i flung it
how i still dont know
i felt this sting in my eye
saw this thing sticking out of my eye
unable to close my lid over it
it well it hurt like hell
it was all blurry in that right eye
i noticed the liquid dripping from my eye
well at least it wasnt red

upstairs to the bathroom i went
looked at the mirror
well it was all fogged over
as i was filthy and sweaty and real hot
but
as near as i could see there was this thorn
protruding out my eye
barely
as it had broken off at the surface of the eye
entering just at the edge of the cornea and iris
poking itself into the front of the eye
between
the iris the colored part of the eye and the cornea
filling that space with blood
dripping down from the entry point

i knew that bleeding was causing a hyphema
a collection of blood there that i had to be careful
and not bend over
as it would flow through the pupil into the back
of the eye
a permanent disaster that could be hard to fix
permanently affecting my vision

so it was important to keep the blood where it was
in the front down in the bottom of the front chamber

i also knew what infection in that eye could mean
the worst scenario wasnt a good one

no i did not have on my safety glasses that i wear when
i mow weedeat do carpentry work etc

it never crossed my mind
but let me tell you
it sure does now

now
so i knew to not bend over
but
i had to get that thing out of there
that thorn
so
where oh where would my wife she have put those
tweezers
quickly
i have been married to her a long time
so in this emergency i had to think quickly like her

she probably put it with her sewing needles and threads
and that instrument she rips out the seams with

so i not being able to see out of but one eye
i did run into the door well two of them
tripped over the bed
into her closet where all that stuff was
started opening drawers
there
it was stuck on this big magnet thing with all the needles

back to the bathroom more carefully on this trip
looked closely into the mirror
without my glasses
grabbed that small nub of the thorn

then i stopped
what would happen if i pulled that thing out
would all my eye juice just flow out of the hole

i couldnt close my lid though since it caught on that nub
hurting like well like hell
as it slid across

so i made the decision
it has to come out
so i reached up
grabbed it
it didnt come out
all i got was this stuff that was white
did i take part of my eye with that

so i tried several times
finally
i just grabbed real hard
my knuckles were white
pressed it in some to get a good grip
out it came

i quickly got real close to the mirror
wiping off the moisture fog
to see if my eye juice was running out

it wasnt

now
i said to myself
i will always always wear good eye protection from now on

now
what do i do now
like that kid in the movie i am home alone
i cant see worth a dam
i shouldnt be driving
heck im not sure i can make it down the stairs
will my eye ball leak fluid


tomorrow i will finish this blog about what happened
and
about my week
with this dethorned eye

the organicgreen doctor