Just a Routine Eye Exam
I went to the optometrist before work today to get a new prescription for my
glasses, since it's beginning to get difficult to read fine print far away
again. It's been one or two years since my last prescription, so this isn't all
that unexpected.
My eyes have deteriorated just a bit — I seem to always go in for new
prescriptions when my eyes have gotten -0.25
diopters worse. So now my
right eye is -5.50 and my left is -5.75. My left eye also seems to be developing
a slight
astigmatism,
which I hadn't known about before.
Glaucoma Testing Fun
Then it was time for the beloved
glaucoma test. By which I
mean, I hate the test where they blow a puff of air at your eyes.
Always makes me nervous in anticipation, then I jump back when it happens.
Sometimes we have to repeat the test in the same eye because I blink and
jump back before they get the reading they needed.
I asked the doctor (assistant doctor?), Mauricio, if he was going to do the
air-puff version of the glaucoma test, and he smiled and said no, they have
another type of test for glaucoma that doesn't involve the puff of air. It
involves eye drops instead — which I'm also not so thrilled about, but I'm
just squeamish and overly protective of my eyes in general. (This is why I don't
wear contacts; I can't even touch my eyes.)
So after a couple of tries, he gets the drops in my eyes. The drops stain my
eyes (yellow, judging by the color of the drops themselves) and numb them.
He brings one of the machine gizmos up to my face and says he needs to get very
close to my eyes, hence the numbing agent. I ask Mauricio if "very close" means
a chance of actually touching my eyes, to which he says yes. I sorta freak out
calmly, by which I mean I hyperventilate and squeeze my knees with my hands
while holding very, very still so as to reduce the risk of him bumping into my
eyes and minimizing the time needed for the test.
It was over soon — maybe one minute, two? — and he sat back down at
the computer to type up the results. He was busy saying something about the
pressure in my eyes looking good when suddenly I noticed a headache coming on.
Within a few seconds it grew much worse, so I closed my eyes and leaned back in
the exam chair. I mentioned, "Um, I have a really bad headache all of a sudden."
And Not-So-Fun Adverse Reactions
The next thing I remember is waking up feeling very confused. My arms felt very
heavy, like I'd had way too much to drink. My left hand was clutching the
kleenex I'd used to dab the excess eye drops from my eyes, and it wasn't really
feeling like unclenching. Someone was holding my right hand (in retrospect, I
believe they were actually taking my pulse). I opened my eyes and looked around
at the three doctors in the room with me.
The primary doctor,
Dr. Kelly,
said that this wasn't an unheard-of reaction (although not common, either, or
they wouldn't still be using those eye drops!) to the
fluorescein (the dye)
and/or
proparacaine (the
anesthetic) in the eye drops. For most people, he said, they felt back to normal
within 10–15 minutes. Very occasionally, people's nausea would lead to
them throw up, so he showed me where the trash can was but told me not to
worry about it too much. The woman doctor gave me a cup of water, which helped
my very dry mouth and made me a little more alert. They helped me get out of my
fleece zip-up, since I'd broken out in a cold sweat. I asked someone to fish my
cell phone out of the fleece pocket and call Gaurav (my manager) to let him know
I wouldn't be in on time. Some talking went on — I don't remember clearly
— and then they turned down the lights for me and let me rest in peace.
(I heard Dr. Kelly out in the hall talking to Mauricio, who sounded
understandably upset and concerned. [CYA? Heh.] He had apparently not known
about this possible side effect. Dr. Kelly said something about not needing
to give it to younger adults; my memory is, uh, a bit hazy and they were talking
out in the hallway, but my impression was that he was saying younger people were
more likely to have this reaction? I'm not sure... Anyhow.)
After the promised recovery time of 10–15 minutes had come and gone,
the doctors asked how I was feeling. About the same level of abysmal, I told
them. (Me: "Ugh, meh." Doctor: "What?" Me: "Um, not any
better.") Soon, the nausea got the better of me and I threw up in the
previously-pointed-out trash can. I felt a little better, but not much, so I
climbed back in the exam chair and rested some more. When Dr. Kelly came in
to check on me and I told him I'd thrown up, he said something along the lines
of "Oh, geez," like I was reacting unusually badly, even for having this unusual
bad reaction in the first place. He said that would be the low point of my
feeling bad, and that I should feel better soon. He checked my pulse again, was
satisfied, and let me rest some more.
I started feeling cold, so I draped my fleece over me and dozed off. The
headache never really got any better, my limbs still felt heavy and difficult to
use, and then the nausea came back and I threw up a second time. About two hours
after the beginning of my eye drop reaction, I finally felt well enough to stand
up and wander into the hallway, looking for Dr. Kelly, Mauricio, or the
woman doctor (whose name I never caught).
I found Dr. Kelly and reported my status — still very crappy-feeling,
but wanting to go home and lay down in my own bed. I asked if anyone would be
able to give me a ride home, just two blocks down the street, since walking even
that distance didn't sound like much fun at the time. He went off to ask around.
But I'd forgotten that, insurance-ly speaking, the office couldn't let an
employee drive me home in their personal car. They offered me a taxi, but the
waiting for the taxi would take longer than just walking home, and it felt lame
to take a taxi for two blocks even if I was feeling that bad.
I declined the taxi and said I'd walk after all, which they okayed so long as I
wasn't feeling dizzy. Which I wasn't... But just walking from the exam room to
the reception desk brought on the headache much worse, so I slunk off to a back
room with a gurney, pillow, and thin blanket to rest some more. A while later, I
wasn't feeling any better, and was actually shivering. All I could think
about was getting back to my warm apartment and my own comfy bed. (My
apartment's gotten warm since the cold weather has set in, because the steam
pipes deliver warmth to the apartments above me even when my own heater is
turned off.)
I tracked down the woman doctor and told her I'd take her up on that taxi after
all. But when I went downstairs to meet the taxi, it wasn't there. I could
see my apartment building from where I was standing. My legs were
shaking and my head hurt. I just wanted to get home, dammit, so I gave up on the
taxi and walked the two blocks home. (I did call the optometrist office when I
got home, to let them know I hadn't disappeared on them.) I crawled into bed,
where I dozed off and on for the next many hours.
Researching the Reaction
While I was still at the doctor's office, Forrest called several times on my
cell phone to check up on me. He was also googling about what information I
had passed along to him. He was concerned that he couldn't find much online
about this supposedly "not unheard-of" reaction to the eye drops. At his
suggestion, I called my primary physician's office at Virginia Mason for a
second opinion. The nurse there taking patients' calls said that, so long as
my pulse was okay and the headache had abated in 24–48 hours, I should be
medically okay. Not at all a happy camper, but okay.
It wasn't until 12 hours after the eye drops that I could finally sit or stand
for more than a minute before the headache forced me to lay down again. (The
headache isn't responding to ibuprofen, but laying down makes it much more
manageable.) Once I could sit at the computer, I googled fluorescein and
proparacaine for myself. Like Forrest said, there wasn't much talk about such
bad reaction to eyes drops.
What I experienced (with all durations of symptoms being estimates):
- losing consciousness (lasted a few minutes? I'm not sure; I wasn't
quite there at the time ;))
- nausea (lasted 1-2 hours)
- vomiting (twice, about an hour into it)
- bad headache (lasted 14 hours and counting :()
- sweating (lasted 1 hour)
- chills and shivering (started 1 hour into it, lasted 1 hour)
- muscle rigidity (lasted 1-2 hours; like when I had too much
caffeine, back in high school)
- light sensitivity (lasted 1 hour)
- dry mouth (lasted 2 hours)
- tiredness (sleeping on and off for the past 12 hours; however, this
was partially to escape the nasty headache)
- paleness (lasted 2? hours; the doctors commented that I looked
pale)
On three different medical websites, I did find some mention of some of these
reactions.
WebMD
talks about the following "severe" rare side effects:
- low energy
- excessive sweating
- abnormal nervous system function affecting mental alertness
Medscape
warns about these rare adverse effects:
- CNS depression
- fatigue
- hyperhidrosis (aka excessive sweating)
- pallor
Drugs.com
(heh, original name) lists these adverse reactions also lists "CNS: stimulation
followed by depression" among the adverse reactions.
Decent overlap with my actual reactions, eh?
And Still Without New Glasses!
So yeah, that was what I did today instead of going in to work. :(
Thankfully, Gaurav is not a slave-driver; he was concerned about me and told me
to take the day off, or work from home if I felt better by mid-day.
Dr. Kelly said he was glad to hear I wasn't going to lose my job or
anything. (I hope he was just kidding around; it would suck to have a job where
you got fired for such things happening to you!)
And after all that, I still need to go back in and actually pick out my new
frames and get the prescription for new lenses filled. Ah well, such is life
sometimes. At least everything but the headache has cleared up.
And how was your
case of the Mondays? ;)
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