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SARAH'S SCRIBBLINGS

March 17, 1999
9:00 p.m.

bad experience at the eye doctor

I went to see the eye doctors today. I went to the cornea specialist first. I got a good report there. He was actually very straightforward with me, which I liked. I'm not really any better, but I'm not any worse. He doesn't feel like I'm rejecting the cornea, although he's not entirely happy with how it looks. Well, I can live with that. He made some med changes. We discussed options for removing stitches in June unless it becomes necessary earlier. That part of the day went very well.

Then I went to the retina specialist. I didn't expect any problems there. Those visits usually go with no trouble at all. But because Dr. Trese is so well respected, his office is extremely busy, and his staff is often a bit less than gentle. It's just the way they are, and I know this. It's nothing personal. They're very stressed out. Usually I can deal with that. They also have kind of loud voices--probably from having to project over the whole waiting room. It's not a small one.

I get in there, and I have to sit forever and wait. Normal. Then the desk lady starts yelling, "Do you have a referral?" What is she talking about? I'm a routine patient. I've been coming there for five months now quite regularly. Why would I need a referral? Duh!

Then she says my follow-up is over after 90 days. That means this is my last authorized visit. Well, nobody ever told me. Nobody ever explained to me how this worked. I'm on Medicaid. All I understand is that if the doctor takes Medicaid, I'm supposed to be able to go there. That's what the Medicaid people tell me. I'm not on an HMO plan, thank God! But I have to go get another stupid referral just to keep seeing the doctor who still wants to see me for post-surgery checks. But even when I asked questions, nobody could explain this to me. They knew the follow-up period was 90 days. They should have told me that when I had the surgery. Shouldn't they? Shouldn't it be a matter of course, part of informing me about how this whole procedure works? Isn't it reasonable to think that I should know about the standard length of the recovery period, frequency of visits, problems with insurance that could arise, etc?

Then I got into the doctor's office. It was not a good day. I have nystagmus, which is where the eyes move involuntarily. It makes exams very difficult because I actually only have minimal control when the doctor asks me to look a certain direction. It was just a very bad day in this area. The light was really bright because I've had all these improvements. He's telling me to look down, and I'm trying to visualize myself holding a stuffed animal that I can look at. It set off memories of being examined after surgery when I was eight.

I was still doing ok, but then he decided to try another approach. He had me lean back in the chair instead of putting my face on that chin rest thing. I just flipped out. I had to really fight not to ask him if I was doing bad. My chair was still sitting up, but I was flashing back to when I was little. I couldn't look down then, and exams usually lasted a very long time because of this. They would lay the chair back with my feet up in the air so that I couldn't fight them as easily.

Well, the exam was fine this time. He got his look and said I looked ok. But I guess between being angry and frustrated about the referral thing and the flashback, I was just completely drained. I was trying to get my fuming out by talking to Dad. I was saying that it's stupid to have to get a referral for continued care. I don't want to go and see this local doctor again just for that purpose. I'm not going to be negligent about taking care of this eye, but I don't need to be going to the doctor again for another six weeks, and I don't want to go before then unless it's a dire emergency! Dad asked when I had to come back, and I told him."You're obsessing," he said. Rationally, I assume he meant that I had plenty of time to work this out. Duh. He's missing the point. I had to stop myself from saying, "Oh, in other words, shut up, right?"

I just don't know how to deal with this vulnerable feeling or what I'm supposed to do when it's not ok for me to be upset.

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