My patient today

I had a life-changing patient today.

She told me main purpose of her exam was to get glasses so that she could read and try to enjoy her life a little bit, because she wasn't planning on living longer than another four to five years. She had almost every problem known to man. When I picked her up, she was in a motorized wheel chair. She wasn't old (only 55), but she has suffered from seizures almost daily since she was two years old. This has severely impaired her walking ability.

She had breast cancer (with bilateral mastectomy -- she lifted her shirt and showed me the scars, which was shocking). She had colon cancer, and had almost all of her bowels removed, and uses a colostomy bag. She has lung cancer, from smoking every day. She has type 1 diabetes (the one you're born with). She has skin thinning, thrush in her mouth, yeast infections, incontinence, migraines, extremely low blood pressure, three heart attacks, a pace maker, 2 strokes, depression, and suicidal thoughts.

We had a long talk about suicide. That was interesting. Eventually, she said she doesn't want to take her life, but she is very ready to go. She is DNR, which means "do not resuscitate," so if she ever passes out or needs treatment or CPR or a blood transfusion or something, she doesn't want any help and she wants nature to take its course.

During the exam, I did her refraction and gave her prescription. I put the lenses in a trial frame her her to test out, and she was really happy with it. I mean, really happy. Like, almost in tears. She just wanted to read. But she had some other bad problems with her eyesight (like macular degeneration, and perhaps some retinitis pigmentosa), but we didn't want to dilate her or else she'd have a seizure in our chair. She told us we can try to just use the slit lamp to get a general overview of the health of her eyes, but we knew that she would need a dilated exam under general anesthesia.

Anyway, once we turned on the slit lamp and started looking at her upper eyelid, she immediately started having a seizures. Have you ever seen anyone have a seizure? They're pretty scary. Luckily, this one only lasted about 30 seconds, but it wasn't fun to watch. She started vomiting and crying and apologizing. Mostly she was just angry. Angry at herself and her body and her seizures. All she wanted was to be able to see, but we couldn't even look in to see what was wrong. She was crying and cursing and it was just very very sad. We gave her her prescription  so that she could use her glasses to read and watch TV, but then at checkout the metal detector alarm went off and and had another seizure.

This one was bad. She was foaming at the mouth with her eyes rolled to the back of her head, her body shaking all over the place. At one point she grabbed my jacket and pulled me on top of her wheel chair. She was squeezing my hand so tight. The EMTs arrived in about 15 minutes, and her seizure was still going on. I had never heard of a seizure lasting that long. She was still convulsing when they transferred her onto the gurney, and the sped away to the ER.

I heard come the clinic chief that she is currently unconscious. I hope she will get better, but then again, maybe this is her time to go. Maybe this is selfish to say, but I'm glad she didn't pass away when she was with me. We were all seriously thinking that it could happen.

So anyway, I think I might try to visit her in the hospital tomorrow. I don't think she'll remember me, because she also suffers from short term memory loss. But maybe she will. But I should get back to studying because I have a midterm tomorrow and I haven't read through all the material yet, but I just couldn't focus and I thought that maybe by writing it all down I can get it out of my head for tonight so that I can study.