After block IV

March 31, 2011

Hey, so I said I’d catch up after exams were over, but the week’s been busy.

Blocks went ok on Monday.  Because of the curve (smallest yet) my best grade (before the curve) so far in physio is technically my lowest, but I was pleasantly surprised that my grades in physio keep going up.  I’m passing–not everyone in our class can say that so I should be grateful, right?

Biochem was another disappointment.  Again, it was assoc. biochem gal’s questions that screwed me over.  I’d read the first sentence or two of the question stem and think “oh this is so easy, I know this disorder” but then the answers wouldn’t be that easy at all–they’d ask about enzymes or pathways involved, so basically if you didn’t know every step of every pathway and every enzyme, you were screwed.  I still passed, but it was well below my standards and not even close to representative of the amount of time I put into biochem last block (especially last weekend–I had 12 pages of last minute test notes for biochem alone!) .  Main biochem gal was REALLY upset about our grades–apparently we usually have a significantly higher average than her previous semesters’ did on blocks but we were quite low on this block.  She blames us studying for physio because so many people are failing or close to failing.  She might be right, but I think assoc. biochem gal’s tricky questions had something to do with it.  When we did the test review, she had a ppt to go along with her questions to show you where the answers were within her slides from that block, and all the questions I had missed were from FINE PRINT in diagrams where she said we only had to know certain (other) parts of the diagram.  I didn’t feel so bad after that.  Anyway, the profs were so bewildered by the low average that they actually gave us a 4 pt. curve!  I was shocked–that was DOUBLE the curve we got in physio.

Genetics is consistently my only decent class.  We have the genetics final (!!!) coming up this Monday along with block V exam for biochem (integration of nutrition) so I have to balance my time this weekend between studying a semester’s worth of genetics and the nitty gritty of the major cycles of nutrition from biochem.  Ugh.  Then after that, the epi final is next Thursday (!!!) and it’s on the material from when our epi prof came to lecture waaaay back in February!  I don’t think anyone’s looked at the material since then.  Too much other stuff to do.

Plane tickets are booked and ready to go.  I’m trying out American Airlines going through Miami this time, instead of going direct with US Airways from Kitts to Charlotte.  The tickets were cheaper but everyone says the Miami airport is a headache.

I’ve been posting more on valuemd.com lately because all of the newbies are asking questions about MUA and I came to the realization that most of the lists up there were from 2003 (8 years old) back when the main new Med building wasn’t even open.  A lot of the stuff there isn’t needed anymore.  Med 1’s are starting to ask about how to study for shelf exams–pray?  Haha.  We don’t have nearly the luxurious schedule we had last semester with almost a week between histo and anat–biochem’s Monday after next, then Physio’s Tuesday.  Bleh.  Must get studying.

Advertisements

Bad Day

March 26, 2011

I yelled at the physio prof yesterday in class.  He tried to spring Acid/Base and how to tell the difference between metabolic and respiratory on us, on THE LAST DAY OF CLASS before the block.  He just wants us to memorize.  It’s not going to work.  It’s too much info, too late.  Plus only half the class was there anyway.  These block grades will be bad.  And then…do you know what his retort was?

“I can’t be responsible if questions on this material shows up on your test.”

YOU WRITE THE TEST?!!

Studying.  More after block.

Frustration

March 22, 2011

Friends in other semesters often want to know why I seem so irritated when they stop to greet me during the day at school—here’s a glimpse into today’s frustrations. (I really am a nice, pleasant person outside of school…)

Physiology

Because shelf exams have started that are occupying the testing center (and consequently, the daytime internet access at school between classes), our week 3 block quiz for physio was moved from its norm, Monday morning at 8:30 to today, at 7:50. That means that I had to arrive on campus at 7:30 for my 9:00 class. Annoyed, but what else can you do? The quiz is for bonus points on our upcoming block exam and god knows I need every point I can get, so show up at 7:30 I did. I’d been up since 3:00 this morning studying for that stupid quiz (which was just on the first 4 lectures of the block—all renal) and went in to the quiz and ended up only getting 4 out of 10 points—my lowest score on a quiz so far. So I’m starting to question why I bothered, when I go back upstairs to begin class (we’ve been starting early since last week because our primary lecturer can’t keep to a schedule and we’re chronically behind), and there is a note written neatly on the board: Class starts at 9. The current time was 8:05. So wait, I got to school an hour and a half early for a quiz that meant almost nothing, and now my prof. has decided to piss away an extra 55 minutes that I could have NOT sacrificed sleep for this morning? (Deep breath.)

I try and make the best of a bad situation and work on my notes with my iPod full-blast, draining out my neighbors loudly remarking how pissed off they are about the quiz and their apparent bad scores. Just as I start to feel productive, the situation gets worse. Prof finally comes in at 9:10 to start class (those who know me know exactly how much I love tardiness). First thing’s first, he comments on our quiz. He wants to know why so many of us missed a particular question. I should elaborate that the reason my neighbors (and myself) were so angry about the quiz was that we all felt like we were familiar enough with the material covered in class that we were ready to do any variety of the calculations associated with kidneys, but then there were no calculations on the quiz—it was all miniscule, STUPID fine-print material that was not at all what was emphasized or even taught in class. He’s asking about one of the few questions that did have something to do with the calculations we discussed, but the problem didn’t involve making any calculations at all. He gave us the pressures associated with the nephron and calculating filtration rate, yet the question wasn’t asking for just the numbers associated with the calculation; the answers were trickily worded so that instead of calculating GFR, the question only wanted the net pressure of filtration. It was one of the few questions I got right, but it was because I flagged the question and came back to it and read it very carefully. I agree it was a cheap shot. You can know everything about calculating the net pressure and the GFR and still get the question wrong because of a technicality–because you went one step too far in the calculations. We were upset with the same professor because he pulled the same crap on the last exam, asking trick questions that were very easy to get wrong even if you were very familiar with the concept they were testing. Anyway, we try to explain our confusion and he gets offended. He tries to insult us, implying that we’re stupid for missing the question, and we almost explode at him. We started the class off on a very bad foot.

He drones on about acid/base balance in the kidneys, covering only a portion of the lecture he was scheduled to finish today, and then before he leaves, he comments on our schedule. He wanted to let us know that we would be starting GI tomorrow. Excuse me? We’ve just spent 2.5 intensive weeks on the kidneys and now you just want to throw in GI in the remaining 3 days left of the block?! “Oh it is easy.” I don’t care if it’s easy—this is a joke! What a HORRIBLE IDEA. I ask aloud if we are going to receive a review for renal. No response. So we’re learning new material the last school day before the test, with no review of the previous 2.5 weeks’ material. Hah. These scores ought to be real high.

Car=fail

March 16, 2011

Ugh, island cars.

So I bought a blue jeep back at the end of November last year because I needed some ground clearance to get to my current apartment.  Jeeps are a commodity here because the roads suck so bad.  So I couldn’t really be picky about my jeep–it’s a nice 4 door jeep, but it has some cosmetic flaws.  I knew when I got it the tires had issues, but I got Don, my mechanic, to replace them for me during break.  “Replace” on this island means put less-worn used tires on.  He mentioned that while switching out the tires, that the left rear wheel was a couple inches smaller than the rest but that he’d switch it out later.

3 Months later, yesterday, that tire blew.  I was driving to school this morning, got out onto the main road and all I could hear was flop flop flop.  I pulled off to the side, got out, and saw that the tire was completely dead.  I pulled to the side, called Don, then started walking.

P.S. Even though my apartment may have its ups and downs, I’m never dissing it again–being able to walk to school and not miss classes even with a flat tire nullifies most of the bad things.   (Although really what saved me was my handy habit of leaving for school 45-60 minutes early).  Still, I was able to get a ride to school with a couple of other students who live right by me in the bend of the Southern half of Brick Kiln–that wouldn’t have happened had I moved into the place out in Gingerland behind the Best Buy–I’m pretty sure I’d have been screwed.

So, back to the car stuff, I’m not just being melodramatic with the title.  That was today.  Yesterday, I went to get in my car at 4:45 to go to school for my 5:00 Student Surgical Association meeting and then go to the gym, when my car wouldn’t start.  I just knew my timing belt had finally crapped out.  I called Don, who came by and gave me a jump–it was my battery.  Whew.  Still, I missed the SSA meeting.  But there again, I look on the positive side and thank my stars that it wasn’t a block morning or at least it wasn’t a school morning.  Oh, and I wasn’t in the middle of town somewhere, and I had access to my phone.  Yea, it could have been a lot worse.

But 2 semi-major car-related issues is two days?  Give me a break.  I am trying to study here.

So far I’ve been celebrating the weekend by doing laundry and working on a group project.  We had no group projects last semester, though we have one for epidemiology and one for genetics this time.  Ugh, I don’t like presenting in front of a group, but I feel like I know all these people well enough that getting overly nervous shouldn’t be a concern for my subconscious.  Besides, it’s been 7 years since I had a formal group presentation–I should have had enough time to rest and recoup.  For epi, we get to be in a group of 8 (significantly less pressure) and we could choose any infectious disease we wanted.  We picked the black plague.  For genetics, we have to be in a group of 4-6.  I’m just with 3 other people in that class, but we’re presenting an article on cancer after Chernobyl–moderately interesting.  I am, however, moderately concerned about  being grilled by biochem gal, tho.

It’s been a new frame of mind for me this weekend–I’ve been working like a dog all week to make sure that I’m caught up on lectures, sometimes before I come home, so I didn’t really have that much work to do this weekend.  What does one do, relax?  I’m still within 2 weeks of finishing my antibiotic, so no sun–>no beach, but I did have a blast last night playing a new game online.

Well, I’m due at another group meeting at noon in a few minutes, so I should go.  Have a nice rest-of-the-weekend, ya’ll.

 

TGIF

March 11, 2011

Doesn’t feel like Friday but it is.

Please enjoy: http://www.youtube.com/watch?v=CsGYh8AacgY

Robbed

March 8, 2011

No, I wasn’t literally robbed, but I feel robbed by the block 3 biochem exam.  And I’ve been in a bad mood ever since the review this morning.

So, per usual, I  studied hours upon hours this weekend (once the eye drama subsided).  As I mentioned before, my friend and I finished genetics at the hospital, then started in on physio.  We came back to the house and got the first 5 biochem lectures done.  Then Saturday we spend the entire day doing biochem–finishing the other 10 lectures.  We started out Sunday morning doing a couple of biochem reviews, and in grand total, calculated that we spent somewhere between 15-17 hours studying biochem.  And you want to know what I made on the exam?  A C.  A boring, mediocre C.  WTF?!  I studied 15+ hours for a C?!!?!

Tricky questions.  We went through the review of the test today and for example, she (associate biochem gal–who had the whole block to herself this time) would put buzz words in the stem, and then have a completely different answer choice.  I’d give a specific example, but the pathways are sooooo complicated to explain.  The point is, we have 3 major tests in one day, and you choose to measure our knowledge with stupid minuscule painstaking questions that suck the energy and life right out of us, as students, and we still have another test to go right after this one.  Can you be a little more inconsiderate?  ::takes a minute to calm down::

The questions were unclear–there were at least 2 or 3 we argued over during the review, but oh no, they don’t curve in that class, so I’m stuck with my stupid C.  And now pulled down to a B in the class.  So angry.  I know the material, yet because of stupid technicalities I’m made to look like an idiot moron on paper.  Thank God we get main biochem gal back for at least part of this block.

Otherwise I did pretty well in block.  I thought I’d do better in physio than I did, but it’s still a steady improvement overall in that class.  Who knows, I might actually get a passing grade BEFORE the curve by the end of the semester.  I’m getting closer.  And genetics…beasted that again.  Just goes to show you what a difference can be made when you have fair questions.

The eye thing is good for now, I don’t want to jinx it.  I’ve been taking my Augmentin like a good little patient.  Fasting for 2 hours before the dose and 1 hour after.  Not taking it with carbonated beverages or fruit juices.  Eye hasn’t even thought of swelling again.  Vision is still about the same.  Decided that since the swelling was no longer an issue that I probably didn’t need to go back to the ER to see the doctor again.  The plan is still to just take the flight home in April, get the appointments knocked out then and try to figure out what happened.  Parents are convinced I’ve had a “stroke” in that eye.  WTF?  I’ve agreed to have my clotting times checked when I get home, however I think that’s very unlikely that they’ll be out-of-whack.  I’m a child, I shouldn’t have to worry about blood clots or any kind of emboli that would cause anoxic events.  Why would a stroke cause exclusively vision problems, and then swelling two weeks later which consequently responds to antibiotics?  Makes no sense.  More than anything, I would have liked to have seen my CBC with diff.  when the probable infection was going on to see if my WBCs were elevated, specifically if my PMNs or Eosinophils were elevated, indicating bacteria or parasite.  Oh well.

Caught up ppt from last block in genetics that biochem gal decided not to put on block III exam, praise the Lord!  Now on to first ppt. of renal for physio and first ppt. of protein metabolism for biochem.  Joy.

Leave it to me to sit up writing a post about how my eye is improving and that I’ll get to go home later and things will be better, only to wake up to things that aren’t better at all.

Friday morning I woke up and my eye felt funny.  I groggily looked in the mirror and noticed that it was swollen.  I could still open my eye, but the part above my lid was definitely swollen.  And it was my left eye, my bad eye.  I was freaking out.  I took my shower and tried to calm down and think about what to do.  I let my parents sleep until 6:00 their time before Skyping them with the bad news.  They suggested going to the Emergency Room.  We compromised that I’d go to the review classes from 9:00-1:00, THEN go to the Emergency Room.

Class was uneventful, except that a good friend of mine volunteered to go to the ER with me.  (I will be eternally grateful.)  We packed up and headed to the hospital with our school things in tow.  A man met us outside as we walked to the emergency room door, asked us if we were here to see a doctor and we said no, that we had no appointment but were here for the emergency room.  Apparently the “emergency” room in Nevis is for someone who is dying.  Everyone else is directed into the “outpatient” entrance.  He directed me to the correct entrance and I checked in, just like before at the ophthalmologist, and because the waiting room was full, my friend and I went outside to study without disturbing others (or having to sit on the hospital floor).

We studied genetics for a good hour, then went inside to check and see if the 4 people who were in front of me on the list had been called.  3 people had been called and there were more signed up below me and a couple of them had already been called–I thought perhaps their acuity was more severe.  So my friend and I then found a place inside in the waiting room.  We finished studying genetics, then started studying physiology.  We noticed that slowly the waiting room thinned out.  People kept coming in but the amount of people in the waiting room still dwindled further.  We could have sworn that we saw seemingly healthy people who had come in after us, walking out the door.

2.5 hours after we had arrived, I checked again with the receptionist only to find out that there was still, remarkably, 1 more person on the list in front of me.  We saw a Guyanese family come in and 20 minutes later, were taken back to see the doctor.  We got very frustrated at this point.  We turned our chairs around and angrily stared at the receptionist.  3 hours hit.  We were fuming.  At 3:15 I went up to the desk, told them I’d been there for 3:15 and couldn’t wait much longer (I was going to walk out at 3:30).  The receptionist offered to let us go across the road to see a different doctor.  I said that I wanted to see the doctor I’d been waiting over 3 hours to see.  She told me the doctor was starting an admission (of a man that had just arrived 3 HOURS AFTER ME) and I told her to go ask the doctor how long the admission would be.  Her response, was to let me back to see the doctor.  Hmmm.  Interesting.

My friend and I went back to the clinical area to realize that it was quite small.  There were 3 or 4 small bays with curtains and stretchers.  We were directed to a lady in scrubs sitting at a desk.  No introduction.  Thought she was a secretary.  She asked me why I was there–I said simply, my eye.  She looked at it and I explained further that I woke up and it was swollen, then shockingly, she started rattling off medical terminology.  Not only was she not a secretary, she wasn’t a nurse either.  She was the doctor!  She invited me into a bay and announced that I probably had a bug bite.  I told her I didn’t think so and she unceremoniously (and without gloves) had me close my eye while she looked and felt for a bite mark.  When there wasn’t one there, I told her my whole spiel about flashes, optometrist, ophthalmologist, go-see-an-internalist, get-a-CT-scan.  She informed me that there is a CT scanner at the hospital, but that it is old.  She said that she thought the flashes and the random swelling of ONLY the same affected eye wasn’t related (?!), that I had a simple case of blepharitis (infected eye lid).

My treatment options were a) antibiotic tablets or b) antibiotic injection.  I told her I’d take what ever would be most effective.  I had exams and didn’t have time to worry about eye swelling.  Surprised by my no-nonsense attitude, she offered both.  I accepted.  3 minutes later I had a fresh puncture wound on my left hip, a prescription for Augmentin, and I was headed out the door with orders to come back and see her on Tuesday evening for a CT scan and follow-up if my eye didn’t get better.  The visit (IM Gentamycin included) cost $40 EC.  What a bargain!  ER visits at home cost something crazy like $600 just to walk in the door–not to mention treatment, seeing a doctor, medicines, etc.  It was almost worth sacrificing 3.5 hours of my study time of a block weekend.

We rode into town to one of only 2 pharmacies on the island (conveniently right beside each other).  My prescription of 14 doses of Augmentin (1 week’s supply) was ~$60 EC.  We drove home, grabbed dinner to-go at Flavours, then headed back to continue studying.  We studied 5 hours that night–all biochem.  We got the first 5 lectures knocked out then agreed to sleep and start again after a much-deserved sleep-in, at 11:00 the following day.

I woke up this morning, blinked, and had an “oh $**t” moment.  I hopped up quickly and ran to the mirror.  My eye was swollen shut.  So much for the effectiveness of the Gentamycin and 1 dose of Augmentin taken so far.  I panicked.  Not good.  My mom must have read my mind, she rang in on Skype at almost the same time.  I gave her the bad news.  She was worried too, but suggested putting cucumber or tea bags on my eye to reduce the swelling.  I was skeptical.  But still, noticing that I looked like Quasimoto in the mirror, decided to give it a try.  I ran a regular Lipton tea bag under the faucet to loosen up the leaves, pulled a buff over my head, then slapped the tea bag against my puffy eye and slid the buff down over it to hold it in place with a bit of pressure.

Embarrassed at the state of dishevelment of my place (I was not expecting long-term visitors yesterday), I tidied up a bit, did some old dishes, and then decided I should probably try and get some laundry done today–so I put in a load.  Then my guest arrived.  We started out with biochem and ended up taking 3 hours to complete the first lecture.  It was soooo complicated and there was a LOT of information missing that we had to fill in the gaps for.  Half-way through I removed my buff and noticed that I could open my eye again.  HURRAH!  I had had enough of the teabag and the buff for a while, so grateful that I could see out of both eyes again, even though the left was still pretty swollen, I took a breather from the tea bag and buff for a while.  When we finished the first, crazy long lecture, the significant bit of swelling that remained at the inner corner of my eye was really starting to bother me so I prepared another tea bag and put it on my eye with the buff over it to hold it in place again.  I hung up my clothes to dry, started a new load of clothes in the washer and we moved on.  The rest of the lectures went much more quickly.

A couple lectures later, I excitedly removed my buff and teabag to notice that my eye looked almost completely normal.  There was still just a touch of swelling and redness, but overall, it looked NOTHING like it did this morning.  Oh happy day.  I took down my dry clothes and hung up the second load of wet clothes out on the clotheslines.  I went ahead and started drinking liter 1 of my Jillian Michaels fitness water for the day and the studying continued, buff and teabag free.  We took a break for dinner at 4:00.  I noticed that my eye had gone down even more to the point that it looked completely normal, except for the red hue that made me look like I was wearing red eye shadow on the left side.  So happy, so excited, so relieved.  I made a homemade 4-cheese/pepperoni pizza and a Parmesan BBQ chicken pizza in the toaster oven while we snacked on salted cantaloupe for an appetizer.

After dinner we put our noses to the grindstone and worked hard to finish up the last few lectures.  We ended up finishing right at 11:30.  As of now my eye is still normal with no more tea bags since this morning, 2 liters of Jilian Michaels fitness water (which contains Dandelion tea, a natural diuretic) down.  We’ve decided to continue studying tomorrow at 9:30, so I suppose at 8:30, we’ll see if my eye is dramatically swollen again, or if perhaps the antibiotics are doing their job.  Otherwise, you know where I’ll be Tuesday evening.

 

So I really don’t have time to post, but I shall.  Naturally all the excitement happens the week before block.

I gave you a brief intro about what happened with the eye below.  The prequel is that my glasses broke…I dunno, a couple weeks into the semester and I finally got the replacements the week before block II exams.  I noticed, though, that whether I had the glasses on or not, I would see a flashing out of the corner of my left eye every now and then.  The best I can describe it as is when a mirror or a watch face catches the light and casts a reflection on the wall, randomly.  I’d turn my head to look for the source of the flashes and there would be nothing there.  I thought I was overstressed and ignored it.  Studied hard for block II, did fine, then was at dinner with friends at Pizza Beach, went to pay and noticed that I was having trouble recognizing the EC dollars in my wallet–$10 looked like $20–it was like my eyes were “playing tricks on me.”  Pizza Beach has weird lighting, so I thought it was just that.  Being the studious girl I am, I went home to pre-read and prepare to start block III the next day and noticed that I was still having the same odd phenomenon.  I closed one eye at a time and realized, quickly, that my right eye was completely normal but the vision out of my left eye was really off.  Things were dim and I couldn’t focus on anything because there were big splotches or flashes that were obscuring my field of vision.  It’s like when someone takes a photo of you with flash and then you can’t see for a minute or so because the flash leaves a temporary imprint on your retina that obscures your field of vision.  Except mine were many of those spots, scattered all throughout my vision.

Anyway, I decided I was completely exhausted and that was nature’s way of telling me that it was time to go to bed, now.  I went to bed, woke up and it wasn’t better.  I thought, well I only got 5 or 6 hours of sleep, maybe I’m not caught up yet.  I went to class, had trouble seeing the board (the right eye compensated, but when I had to look to the left, it was difficult to read), and came right home and went to bed, to catch up on sleep.   Woke up and it was the same.  Crap.  Not wanting to believe that something was wrong, I waited–I thought maybe I’ve eaten something bad, or I’m still recovering from the stress of blocks.  I decided to give it three days.  Three days later, I was still having problems seeing out of that eye.  I typed the vague symptoms I was experiencing into google and eventually came up with a diagnosis that would explain everything–the spontaneity, lack of trauma, reduced field of vision, “flashes,” everything.  Posterior vitreous detachment.  As I mentioned below, half of the optometrists/ophthalmologists recommend laser surgery to “super glue” the vitreous humor back where it should be with the retina, whereas the other half take a more liberal approach and let it heal naturally in the coming weeks or even months.  The only serious consequence if if the vitreous humor continues to pull away from the retina and causes a retinal tear or even worse, a retinal detachment.  That can cause loss of vision in that eye if proper intervention is not received.

So I checked the sad piece of paper that the school had given us during orientation with the list of available doctors and noticed there were 2 optometrists–both on St. Kitts, but one with a second office on Nevis.  I called the number, got no answer, and decided to check the St. Kitts/Nevis yellow pages online just to make sure the school didn’t miss anyone.  I came across a Nevis Optical Eye Clinic (catchy name…not redundant at all) that was in town and made an appointment for the soonest date that I could–the following Tuesday.  I email all my profs, divulge my symptoms and they all agree that I should go get checked out and of course, that it’s ok to miss their classes for a medical reason.

I had Don, the H-Bus driver, take me to town on Tuesday (because I had no clue where I was going, much less where I would park since this place was in the middle of town somewhere) and eventually ended up at this place in the Soloman building.  The doctor was a British guy with blondish-whitish shoulder-length hair who did a routine eye exam (except no pupil dilating) and declared that my prescription was correct, I had no glaucoma, and I definitely had something wrong with my left eye.  He wrote a note to the ophthalmologist that comes to Nevis to the eye clinic at the hospital every Wednesday, and told me to go see him the next day.  Bewildered and slightly alarmed that I had to go to the hospital (::repeating to myself:: it’s not because it’s that serious, it’s because this is where the eye clinic is located), I quietly paid the $75 EC fee for the visit, went outside and called Don and told him I needed to make an appointment at the hospital.  Don, thinking I’d be longer, had taken some fares to another part of the island and wouldn’t be back for some time.  So I walked from town up Government Rd. to the hospital.  I was a sweaty mess by the time I got there, but even with my bum eye, it was easy to locate the sign on the building adjacent to the outpatient clinic, marked EYE CLINIC.  I went inside, looked at the receptionist desk and saw no one–no patients in the waiting room and no receptionist.  Just then, a voice on my right side asked how she could help me.  An older lady in business attire was sitting hunched over a file cabinet in the back of the waiting room.  I could only assume she was the receptionist.  I told her that I’d just been to visit an eye doctor in town who referred me to the ophthalmologist, and that I’d like to make an appointment.  She told me to be there before 10:00 the next day.  Surprised at this leniency, I quickly asked when the clinic would open (so that I would have the most time to assure I’d be seen that day) and she told me 8:00.  I waited for 40 minutes for Don, sitting outside the EYE CLINIC building, sitting on a bench, apparently looking nervous and weathered because each of the nurse passers-by asked me if I was ok and if they could help me.  (Their nurses still wear all white and even the hats too!)  I replied simply that I was waiting on my ride and they smiled and continued on, looking less concerned.  Don came, picked me up, and I made it back in time for biochemistry.

I talked to my parents–told them what the optometrist said and read them his referral letter.  Dad volunteered to give my ophthalmologist at home a call.  I emailed my profs–quickly updated them and told them where I would be the next morning.  I apologized again for missing/potentially missing their classes again, but hoped that they would understand.

The next morning, I woke up bright and early, packed my bookbag for school and headed out in my own car for the easily-navigable-to hospital.  I made it there with 10 minutes to spare and sat down on the bench next to a middle-aged white guy who looked like he was on vacation.  We waited until 8:15, at which time the receptionist walked outside holding a cell phone and announced that the doctor had just called, said he was sick and would not be in.  I asked her when he would be back and she said next Wednesday.  Crestfallenly and secretly hoping that nothing would go wrong with my vision before then, I hopped in the car and sped back to school, hoping to make it to physio on time.  Made it.

During the next week (1.5-2 weeks after my symptoms started), I noticed my vision was getting better.  The flashes were less prominent and I could very easily see the board in class now without the flashes obscuring too much, even with my right eye closed.  Still, even now though, things on that side are a couple shades darker than they should be.  Dad ended up talking to my ophthalmologist at home and he agreed with me, that my description of symptoms sounded like a PVD.  He wanted me to come home so that he could repair it, but also said that if there was a trained ophthalmologist on the island, that they could fix it too–it was a 5-minute procedure to “super glue” the vitreous humor back in place and prevent a retinal tear.  Relieved, I went on with block III learning and catch-up.  I emailed all my profs Tuesday morning to let them know I’d be trying for an ophthalmologist appointment again this past Wednesday and not to miss me if I wasn’t in class.

Wednesday, repeat of previous Wednesday except this time, the doctor showed up.  He was a thin man of medium height with a European flair to him.  We all sat on the bench together, outside, waiting for the receptionist to come open up, then we walked in together.  The order of appointments are determined by the order in which you enter the building and sign in.  Because I was the last to arrive before the clinic opened, I was therefore the one on the bench outside furthest from the door, and therefore the last to receive an appointment.  I waited in the waiting room until 8:40 when I was called back into the single, lonely exam room.  In broken English with a very heavy Italian accent, he started grunting commands of a basic eye exam.  After completing the same basic eye exam as the optometrist did (sans glaucoma test–thank Goodness–uncomfortable), he asked me about the flashes.  I answered his questions, and he decided that I needed drops in my eyes.  He applied them, then told me to wait in the waiting room with my eyes closed.  30 minutes and several patients later, he came out into the waiting room, checked my pupils to see if they were dilated yet, and told me I’d be next to be seen after the next patient.

An hour after my first appointment started, I was back in the chair with a very bright light right next to my eye.  The doc took a good long time checking out each of my eyes, asking me to look all different directions, then sat down with a very serious and somewhat puzzled look on his face.  He asked me if I had any history of hypertension or diabetes.  I said no.  He asked me if I’d experienced any severe headaches or nausea.  Again, no.  Then he looked even more befuddled.  He told me my retinas were fine, but that the margins of my optic nerve on the left side were disappearing.  He elaborated that also, the veins leading to my optic disc on the left side were dilated.  He said that’s usually what happens with high blood pressure, but that if it was the causative factor, then it would have been present in both eyes.  He said for this to occur on only one side was very strange, and that there wasn’t anything he could treat from the standpoint of an ophthalmologist.  He referred me to an internal medicine physician, with a polite referral note, and suggested that I request that they order a CT scan or MRI.  I asked him if those radiological capabilities were present on Nevis and St. Kitts and he didn’t know.  I told him I’d have an opportunity to go back to the states in a month and asked if he thought it could wait until then.  He said no.  Starting to panic a bit, I decided I should go.  As I rose, he told me to come back and update him of what happened, I assured him, shallowly that I would, and walked outside to the receptionist desk.  She handed me a piece of paper and told me to go to the outpatient sign on the adjacent main hospital building to pay my $60 EC doctor’s visit fee.  I paid and drove home, not resisting the temptation to call my Dad in a panic.  I told him exactly what had happened and requested that he call my US ophthalmologist  ASAP to find out what to do.

I made it back to school with a bit of time to spare before the end of physiology, so I went to the library and looked up the preliminary diagnosis the doctor had written at the bottom of his referral note: early papilledema.  It wasn’t good.  All the sources online suggested CT scans or MRIs to rule out brain tumors.  My heart was racing.  I thought about the patients I’d seen in Hospice and how sad and empty they looked, when going to visit my grandpa.  I thought about what a waste it would be to die midway through med school.  I realized this train of thought was getting me no where good and I still had a day of classes to finish, so I packed up, logged off, and went up to the main building to wait for class to let out so I could go sit down and get ready for biochem.  I waited outside the classroom door and a classmate who had stepped out to the restroom beckoned me to come in with him, saying that it would be ok, that the prof wouldn’t mind.  Reluctantly, I walked in with him and took my seat amidst staring eyes.  A guy behind me immediately asked what the doctor had said.  I hissed “nothing,” and acted like I was deeply interested in the last words that the professor had to lecture.  Then he started attendance, no class missed, score.

I went to talk to biochem gal in her office over lunch about what to do and she strongly encouraged going home ASAP to get it checked out.  I have no absences, so that wouldn’t be an issue.  She quickly informed me that there were no CT scanners or MRIs on St. Kitts or Nevis, so I would have to go home to get checked out.

That night, I talked to my parents for a long time.  We discussed the pros and cons of going home for a week (I’d have to leave next Tuesday after blocks were over and come back the following Monday–for mandatory Epi presentations), priced flight options, tried to work out how I could possibly see an ophthalmologist, get a CT scan, and [probably] see a neurologist and possibly have to get an MRI done too–all in 3 week days.  It wasn’t possible.  I’m so close to finishing Med 2 that I don’t want to chance not getting back in time to finish the semester, and after the horror stories about people who have had to tangle with the Assistant Dean over attendance matters (the Med 5 who passed the comp but had to repeat a class due to 1 too many absences), I decided to chance it and wait until the end of the semester and just go home during break when I’d have 2 weeks to get all of this stuff done.  Dad cleared it with my doctor at home today–that it’s not unreasonable to wait 40 days to come get checked out–but I’m under strict orders that if my symptoms get worse in any way, I’m to come home right away with no questions asked.

So now I just have to try and not worry that I have a brain tumor, finish block III exams, breeze through block IV, ace my finals, take those loser block V exams AFTER finals, and then fly home.  I booked my flight today.  Dad booked my appointments today.  Everything’s lined up.  Now I’ve just got to sit tight and pray for status quo.

Block 3 Exams approach

March 2, 2011

And I have more eye drama I’m trying to work out with my parents and my ophthalmologist.  Will write when drama has calmed.

 

P.S. There is no CT scanner in the island federation of St. Kitts and Nevis.  Just FYI.