I just had my ophtha consult and the exam result was interpreted as me having a mild glaucoma. It is not curable so the doctor told me that we need to monitor it. He kept the exam results.
According to stlukeseye.com:

Glaucoma is a disease caused by increased intraocular pressure (IOP) resulting either from a malformation or malfunction of the eye’s drainage structures. Left untreated, an elevated IOP causes irreversible damage the optic nerve and retinal fibers resulting in a progressive, permanent loss of vision. However, early detection and treatment can slow, or even halt the progression of the disease

I asked me if lack of sleep affected the exam, he said it can have.
My IOP was normal.
I also raised my observation that ever since I had my eye checked by a glaring light last week, my left eye’s vision became webby. He just shrugged off the idea telling me that the blurred vision effect will only last for a day. He did not do further assessment.
I also got my pair of glasses as the error in refraction of my right eye has increased.
I was planning to go for thoric contact lenses maybe next month. I seriously need to wear them because I could hardly read with my bare eyes.
The doctor asked me to see him after six months.
I will see him maybe next week. I will just get my exam result and I will have an optha consul with another doctor.
I do not feel good vibes with that doctor and with the hospital.
I would rather travel far than to have a substandard healthcare service.

Yesterday morning, I had a rheumatologic consult at St. Luke’s.

I am pretty impressed with the spa-like set up of the clinic and the consultant is the only one holding clinic there.  Usually, there are about 3-4 consultants occupying an OPD room.

When I’ve made my appointment last week, I was informed that I was fifth on the list and I should come by 11:30 a.m. so I came. Only to find out that the doctor was still seeing the first patient.

While waiting for my turn, I was interviewed by a fellow (read: a resident).

When the fourth patient has been called, the doctor went out and patted me on the back apologizing for the long wait. Pretty unusual for a consultant. How can you get upset especially when you look at his pleasant face?

I was finally seen at past 1:00 p.m.

The resident started to present my case.  I felt I was on Grey’s Anatomy playing as the patient being presented by the interns to the attending.

It was kind of interesting. On a side note, I have always wanted to be a doctor ever since I started watching Grey’s.

I was there for a consult about my joint pains so I did not bring my lab work up and the biopsy results. Too bad, the consultant asked for it. He even corrected the resident in jotting down a diagnosis telling her that you always suspect a diagnosis and it is important to check first the lab work up results.

Pretty impressive!

He asked me to being the results ASAP and just slip them into the clinic’s door and he will just contact me for anything.

The consultant was so courteous that he kept apologizing whenever he needs to talk to someone on the phone. Another praise-worthy act.

During the interview, the consultant asked me who I am seeing for a nephro consult and I do not know if it was just me but I noticed that he and the resident exchanged awkward looks when I told them who is my nephrologist.

He asked me if I was given the option to take cyclophosphamide instead of the immunosuppressant I said yes and I declined to go under chemo because I was also presented with its dangers. After learning that I have been on immunosuppressant for 4 months already he informed me that the dosage that I am taking is not the maximum yet and it can be increased upto 3000 mg per day. This I think my nephro did not discuss to me actually, he did not discussed anything to me.

Since I do not have the lab results with me then, the consultant informed me that on the interim, they need to focus on cough and the fever that I have had for this might be signs of infection and the infection might be the one that causes my throbbing joints. A good point actually because when you are feverish, you tend to manifest body aches.

He then prescribed Zithromax which is one of the most potent antibacterial. He kept on reminding me to take it in full stomach to avoid upset. He also informed me that I could temporarily stop taking the immunosuppressant while on antibiotics,

Then the physical exam part came.  This procedure was never done by my nephrologist. The two doctors perform four components of physical exam: inspection, percussion, palpation and auscultation. They both confirmed that my lung fields are clear but then the consultant has ordered a chest x-ray work up to rule out bronchitis.

I feel comfortable with the doctor. I hope that this first impression would last because I really need a doctor who really cares and who will practice not just no maleficence but more importantly benevolence.

On Monday, I shall be having my chest x-ray and dropping by his clinic to hand over the lab work up results.

Yet again.  Seriously.

I got my lab  result and although the creatinine-protein ratio has improved  to 2.84 (which is still high, should be less than 1), I am still on edematous state.

My cholesterol level spiked at 400+ since I stopped taking in Crestor.

I took the liberty of getting urinalysis as I noticed that my urine is getting reddish plus  the fact that I have had fever in the past couple of days.  The tst revealed that I indeed have hematuria or blood in the urine and lots of bacteria too.

The doctor simply asked me how long  have  I been on therapy, I said about four months.  He just scribbled the same prescription as last month adding Crestor 10 mg (the previous dose before it was raised to 20 mg) to the list of medications.  I asked what he will do about the hematuria, he said that it’s a sign that I am on exacerbation and that I just need to take a rest.

He recommended a bed rest for the next 2 to 3 days.  Which I have requested by the way.

I don’t know but every time I come into his clinic, my mind always gets lost that I always forget to ask important things.  Is it because I could sense  that he’s always in a hurry? Or is it just me? I have been told by my friend, and as a nurse I should know, that it is my right to ask since I am paying for the consult.

Well, he asked me if I am experiencing pyuria (difficulty urinating). I said no, except that  I feel my urine is quite acidic that I need to wash after I urinated. He also asked if I have had fever, I said I had for two days but it went away immediately after taking paracetamol. He did not say anything.

My fear is that, I am close to finishing my treatment but I do not see any signs of light at the end of the tunnel.  Does this mean that I have to submit myself to chemo therapy in two months?

I am really scared.

God please help  me.

This week is the opening of classes for public schools ad the weather is really crazy.

There’s intermittent hard rain and strong wind and today was no exception.

After six sessions  of physical rehab, I  was bound for a follow up check up with my doctor. To make sure that I will not be wasting my time, I phoned  her clinic before 1 p.m. and  was able too confirm that she will be holding her clinic today  in the midst of  the rowdy weather.

I was fifth on the list.

Since I know that she will not show up on time, I decided to  swing by the Lung Center to claim myy Bsic Skills Training (BST) shirts.

My BST training at LCP will start on June 15 an I am really anxious.

I arrived at St. Luke’s around 2:30 p.m.  and I went straight to rehab  department to  get my  progress report.  I reached the doctor’s clinic before 3 p.m. and the doctor was still checking on patient number three!

So I had my turn after 20  minutes and the doctor asked why I was wearing a mask. So I told her that I am on immunosuppressant and I am seeing a nephrologist.

She asked me why I did not tell her about it during my first check up. I told her that I was so tired waiting for  her and she seemed to be in a hurry then that it slipped my  mind.

She was concerned about me taking the pain killer (Myonal) as it is nephrotoxic (would harm my  kidneys). I told her I did not take it.

After some physical exam, she told me that the spasm is so minimal but I have to continue with my rehab  and she ordered for another six sessions.

As I have mentioned, the weather was crazy and as I went out of the doctor’s clinic, the sky was dark so I decided to go home straight.

Darn, I forgot to swing by the rehab dept to  request for a rehab sked on Saturday!

I phoned St.  Luke’s and I was told that I need to go there personally for the sked unless I want to have the six sessions with  my former PT.

I want another therapist. So I will just drop by tomorrow.

What I like about my doctor is that he almost always come on time.

I arrived at St. Luke’s around 9:30.

I handed out my lab results to the secretary and did not ask if he was already there.  I sat in the hall.  A few minutes had past and the secretary called me  into the doctor’s office.

While I was glad that I did not have to wait long for my doctor to see me, I was not quite pleased with the lab result or the way the consultation has went .  Although the protein creatinine ratio has improved, it is still high plus by cholesterol level is at 291.

I am already on medication for three months and no dramatic changes or signs of improvement I can see.

I just feel stupid not to ask my doctor the things that have been bugging  me.

I know it is my right to know my chances of getting well or if I will ever be getting well.  I just can sense that he is not willing to or capable of  answering my questions.

There is something in me that tells me he has not handled the same case as mine before.

I have to pop the questions to him next time.

Oh btw, he has increased my dose of Crestor to 20 mg.

I need to get to work.

As approved by the ER doctor, I went to my third session of physical rehab this morning at St. Luke’s (I think I need to rent a space there because I am a frequent visitor already)

The session is scheduled at 7:00 a.m. and Brye, my therapist has arrived on time. I just noticed that there is someone also waiting for him. So I asked him if he’ll be having 2 patients at a time. He said yes. Then I told him what happened to me this morning and I informed him that I needed his undivided attention. He said that the therapy of the other patient will just be quick and will not take much of his time.

Thing is, it is unfair to anyone who is paying premium and not getting a premium service.  His response did not make me feel any better.

Anyhow, he informed me that we will go on with the therapy but he will not  put pressure on my back when he gives the ultrasound and the massage but he focused on the part of my back where I felt the tingling sensation.  The gadget that gives a small amount of current was also taped on the affected part of my  body. Funny thing is, the sensation the gadget sends to my body is the same as the one I am feeling in my back.

As the therapist was giving me a massage, he told me that the muscle on my shoulders are swelling because of the nodes that I have. I thought they were just muscles.  It turned out that they were swollen muscles that give me back pain. Brye  told me that my bad posture aggravates it and he instructed me to straighten not just my back but also my head and my neck.

As he said, it is painful at first but it will really help me come off the back pain.

So what is the  best way to keep my body straight? Lie flat in bed and snooze away!

Right now, the tingling sensation is hardly noticeable and I am looking forward to my fourth therapy tomorrow.

Just when I thought I could pull through the entire graveyard shift this week, I was wrong.

While everyone on the floor was busy feasting on the Katrina Halili-Hayden Kho sex video, I was busy composing my  email to my supervisor. Suddenly, I felt dizzy and the things around me started to swirl.

Before that, I felt the there’s a tingling sensation just below my nape and there’s a numbness that radiates through the back of my head. This is a normal thing and I am getting the physical rehab for it but the sensation and the numbness was a little intense but generally ignorable.

Then I heard my friend calling upon me asking me if I were okay. I remembered I responded a couple of times telling her that I was okay then it went black.

I think I dozed off for a while and when I opened my eyes, the guards were already there with wheel chair.  I was brought to St. Luke’s Medical Center by my good old friend Kaye.

I told them there;s no need for such because I ahve come back to my senses again but they were worried they insisted. They said I was shaking and my eyes were rolling.

In the ER, they have ran ECG and FBS and they were all normal. I was asked to stay for half an hour then I was discharged.

The doctor told me that the syncope (dizziness) might have been triggered by the back pain and it’s okay to continue the rehab and to take pain killer.

The rehab, I continued this morning but the pain killer I skipped. I have so many medications already and I am so concerned about my liver and kidney functions.

I called the clinic this afternoon to request for rehab request forms for my three remaining sessions and the company nurse and the doctor advised me to take a sick leave and rest.

So I am here. Tyring to rest.

Will hospital gowns get a new look?

This topic I chanced upon Fox and Friends is appropriate for my experience this morning.

I was at St. Luke’s Medical Center this morning for my physical therapy/rehab for the MPS that I have been complaining for the past three months.

I was asked to change into hospital gown and for a 106  pounder, I feel like a hanger in it.  Even if I tied the gown at the back,  its continually drops from the shoulders.

Seriously, I have been to Cardinal Santos Medical Center and National Kidney and Transplant Institute (NKTI), and one of my greatest discomfort is fitting into their gowns.

I wish they could think of making small, medium and large sizes.

First of all, I am having severe leg cramps, yet again. It is my second day on Burinex and Aldactone. My doctor instructed me to pop these pills whenever edema sets in my feet.

As I had to evenly space out my medications, I decided to take them in around lunch time right after my dental check up. These diuretics are expected to kick in from 15 minutes to 2 hours so I need to be near a comfort room to go.

I have been to St. Luke’s and Lung Center of the Philippines and fortunately, their comfort rooms really offer comfort. I also had to use Chow King’s rest room which is clean too on my way to LCP.

I got the result of my 2D echo and the finding s are mostly normal except for:

- Minimal pleural effusion

- Mild mitral and tricuspid regurgitation

I’m a nurse but I don’t know that exactly they mean but from the sound of it, they are on the lighter side. Well, I don’t want to second guess, I will be having a cardio consult with our in house cardiologist.

I also went to see a doctor who specializes in physical medicine and rehabilitation. Gosh, I have to check what these doctors are called.

Anyhow, I arrived around 1 p.m. and I am already 10^th on the list. I have waited for almost an hour and when there was no sign of the doctor’s arrival, I told the secretary that I will just be back.

This is why I hate doctors. They make you wait forever as if they are the only people in the world who are busy.

I need to go to LCP to complete my requirements for the nurse trainee program.

I arrived at LCP before 3 p.m. and went straight to the training office. I wore my mask on. It was the Lung Center of the Philippines, which means every possible lung disease are existing there and afloat. Good thing, wearing masks there is highly encouraged.

After reviewing my requirements, the administrator gave me an order to get chest x-ray and PPD (Purified Protein Derivative) test. These are the tests required to all the trainee applicants. Although I had my chest x-ray last March, the result would no longer be reliable according to her. SO I obliged. Anyway, I also want to know if my lungs are still healthy. I could have the test performed in our office lab but I had to justify my request and I need to have the result interpreted by LCP’s radiologist which will also cost me some money.

The chest x-ray was available immediately. It’s like Polaroid! I was called by the receptionist and the first words that came out of my mouth: Are my lungs okay?

The receptionist replied that they are okay and the result will be sent to the training office. I felt relieved. I was scared that they might see some problems like pleural effusion – the thing that my nephrologist wants to rule out.

Then I headed for the PPD test. It is a skin test to check if you have been exposed to TB bacillus and do not ask me why it is called PPD. I was asked to be back on Friday for the reading and as I look on the test site, there has no signs of wheal formation. Maybe because I lost all the protein in my urine. Ha-ha. If you get 10mm or more of induration, you might be considered positive for exposure but it’s non-confirmatory.

I finished all the tests before 4 p.m. and I headed back to St. Luke’s. I arrived around 4:30 and went in to see the secretary. He told me that I have been called already and just wait to be called again after the patient then being seen by the doctor. Well, not bad. At least I had no time wasted.

I was called in after 15 minutes and related my back problem to the doctor. She ran some physical exams and the last thing she did was like sort of massaged my back really hard and I was in pain. She told me that there is muscle spasm on my back and it is called the MPS or Myofascial Pain Syndrome.

She ordered a 6 physical therapy sessions and ordered me to plot a sked at the rehab department. She also gave me some muscle relaxant. Another pill? Aaargh!

I chose to get the thrice a week session in the morning. I am planning to head there right after my graveyard shift so I could have longer and uninterrupted sleeps when I get home.

I hope that this MPS thing will go away after the complete session. I will be evaluated after 6^th session.

This is a very tiring day for me, although my plan was to hit the gym after running the errands, I begged off. I have done so much cardio running from one floor to another and from one place to another.

I need a cold shower to relieve my leg cramps.