La vie est corte, mas et es large

After reading my past few posts I’ve noticed I had become a bit cynical. Worst yet, very down on myself. I think it’s easy to spend time focusing on your faults and all that isn’t in your life. I recently went out with (fingers crossed) soon to be very good friends. After a few drinks and a great chat I realized I am young. Sometimes I forget that being a doctor is actually something to be pretty proud of. I work hard and it isn’t easy.

Yesterday I had a patient, a young 20-something, in for a routine exam. She lost her glasses a few months ago and as a moderate myope (pretty nearsighted) she really needed a new pair. All new patients get a full exam meaning including dilation. I love my job because not only is it faced paced, but it is full eyecare. It isn’t a corporate sell out job. I dilate as many people as need it. Optos ( a new photographing machine that can take a picture of most of the retina) is not a replacement for dilation. You can see a lot with a photo, but it does not beat a doctors eyes. Anyways, I refract and find her prescription, drop her and send her to pick out some new specs. So 20-something? actually she is my age… picks out her specs and heads back to my chair to check out the back of the eye. Every doctor has their own routine and I usually start with a 90D view of basically the optic nerve and macula. I generally have the patient look around a bit too and then head for the BIO. For the laymens who read – its that really funny hat with a light that makes us look like coal miners. It, along with a lens, condenses light so we get a 3D view of the retina’s periphery. After 90 I was already thinking “F@#$@K”. I take another look around, take off my miners cap and get comfortable in my chair. I ask again if she has ever had a dilated eye exam – no. Does anyone in her family have any eye problems? Any trouble with nighttime vision? I send her for an optos just so I have something to show her to explain. See this? It’s a normal retina. Here is a picture of your retina. Notice the black spiny area in this donut around the midperiphery? We generally refer to these as bony spicules. Now I haven’t done all of the testing needed to confirm this diagnosis, but it appears that you might have an eye disease called Retinitis Pigmentosa. If in fact this is RP, she will steadily lose her peripheral vision and although she may remain 20/20 will have a field of maybe 10 degrees. Take your hands make them into fists and place them over your eyes as you look through your curled fingers – that’s what she could end up with. My stomach turns and I hold in the tears. I cant say this is what she has for sure, but it’s the most likely cause of the way her retina looks. She is my age and by 40-50yrs she will be with a white cane, having trouble navigating. This is not to say her life is over – many people do wonderfully with a little low vision aid and training.

I am in my mid/late twenties and ya know, life isn’t so bad. I may not have a boyfriend or a super busy social life, but I am happy. I am meeting new people and hope to really solidify some friendships Ive already made here. I think of the trip to Cappadocia, Turkey I want to take with my sister… and the dive trip to Honduras with my friend Katie… I think of camping and skiing in NH and surfing right here in RI… I think it was a wake up call to do things while you can. Live life to the fullest. More importantly, be happy for the things you have and not so sullen by what you don’t. The grass can be greener on your own side of the lawn.

I like sunsets, puppies and long walks on the beach....

I have barely started this blog and already am running out of material. In order to create material, I need to meet men. So, reluctantly I joined Match. A friend from Optom school is getting married in 2 weeks to a man she met on match. They really are perfect for each other and that gave me hope. Another friend in the field is also happily dating a guy that she is head over heels for. So, why not? I have nothing to lose, since my dignity went out the door years ago.
I wrote a simple bio, added a few of my better pics…. And submit! Its been two weeks and so far I have only gotten 10 emails and a handful of winks. I would love to not stereotype or group the men who are interested in me into a category… but it is safe to say this is the standard: Mid thirtys, balding, income of 25-50 grand, body type: a little more to love…. I’m not superficial… well, Im somewhat open just a little judgy… My last few blogs have been about how clearly I was discarded by the last boy because I am not pretty or thin enough. I get it. I know where I stand. But really? This is all I can get?
I am growing increasingly discouraged… 200+ and bald? It would be one thing if this was pure muscle and for aerodynamics. Haha no, I couldn’t handle a pro-athlete. But that would be fun. Wouldn’t it be great if political correctness and even just plain old manners could be thrown out the window. My profile would most likely read:
Just moved into town. I am dying of boredom and have started quilting in my free time and live with the constant fear of cats and dying alone. My biological clock isn’t ticking, but I would prefer to have children before the likelihood of birth defects exceeds 50% aka before I am 35… I really do enjoy anything outdoors. I like to exercise and went for a 10 mile walk just to take up time. I scuba dive, horseback ride, and ski. I really like to travel. Which means, I would appreciate it if you had the means to do these sort of things. I spent the last 9 years working my ass off and now I make a pretty decent living. So, Id be happy if you did too. I’m horribly self-conscious and have weight issues… but I’m also superficial enough to ask no overly fatty’s please. You don’t have to be a model, but I would appreciate not being embarrassed to introduce you to my friends.
Haha I just read this and it makes me sound horrible. Real me is so judgemental! I had a patient the other day. I walked into the room and right off the bat got a very odd look. He turned to me and said, ‘ you are not what I expected to walk through the door’ From the tone, I don’t think this was a compliment. And to be honest, its true. I think Im a pretty fun person to hang out with (well, Im all I have to hang out with at the moment). My face doesn’t break any mirrors… but lets face it, beggars cant be chosers. Maybe I’ll just have to reply back to one of these emails someday soon…

Jane Russell - Ain't There Anyone Here For Love?

As I walked the 9 miles of ocean drive today I thought about the time when the weather will turn and I will definitely need to join a gym... I like doing things, but mostly outdoors... however my love life might depend on appearing to be athletic.... this is pretty much what I think of gyms :) enjoy!

Koonu "When life gives you lemons, just say 'Fuck the lemons,' and bail"

So… I was watching Forgetting Sarah Marshall and thinking how I moved to a beach town and keep running into the last person to bruise my heart a bit. No, its not Hawaii unfortunately. No one seems to be as nice or free to give me liquor. But that shouldn’t stop me.
I remember when I first saw this movie in the theaters. I went with a friend at the time that happened to be a guy. I had a crush on him in Optom school, but ended up spending my third year sleeping with his roommate instead. The roomate quickly turned into a crush and then turned again into my first and most beneficial heartbreak. I don’t look back upon that year with any animosity anymore. It is what it is. I needed that heartache. I had dated guys before and things didn’t work out. I usually just walked away and didn’t really feel anything. This was the potato chip, crying couch boy. We all need that I guess to know we do have the capability to love. Anyways, after all was said and done I used to hang out with Jake a bunch as a friend. We went to the movies a lot and he tried to get in my pantalones a bunch of times, but I didn’t feel that way. So we went to this movie and of course I loved it. Who doesn’t love Jason Segall?
A few months later, while studying for finals Jake showed up with a CD. It had a bunch of letters on it and was a home-made burned CD. I put it in the computer at school and Cake’s Love You Madly started playing. I was shocked. I felt horrible and wonderful and so confused. Was this a confession? Who gives CDs in the first place? I listened on… and then I realized haaha This was the soundtrack from Forgetting Sarah Marshall and not a boys way to tell me he liked me. I was a bit sad and also happy. I giggled a bit about this one….
I doubt that some hot receptionist or town information guide (I don’t know what the equivalent is) will want to hang out with me. I don’t think my neighbors will bring me extra rum nips with pineapple juice… and unfortunately Ive already jumped off a 15 foot cliff right here in Newport with the last boy… So, again, not sure where to go… But Im hoping for the best. This is the bright side….

sometimes its hard to breath, even above water...

Scuba diving, like optometry, is yet another random/quirky love of mine. When my sister went into her junior year of HS she decided to ditch the idea of becoming a "burger king giver outer" and aspired to attend college to become a nautical archeologist. My father only saw this as a minor step up. Being the practical man that he is, he insisted she take scuba diving lessons to first make sure she could handle this possible future job. He decided to join her and they spent the next two years taking trips and leaving my mother and I at home. Naturally as my sister was about to graduate and move far away (NH - the university has the best nautical archeology program in the states), my father realized he needed a new buddy (you always dive with a "buddy" as a safety precaution). He basically forced me into lessons, which I was not happy about. Although, I took them with a good friend and the best part about diving is its a good thing to pee your pants. In this case its a wetsuit, and in the chilly water, your own urine is quite warm! Lauren had me giggling in my booties every week so I blame her for my lack of hypothermia.

Anyways, diving requires a lot of learning. You can spend hours, if not days, reading about how you can die underwater and what NOT to do to get yourself into that predicament. But in the end, they overall process is quite easy... You put a hose in your mouth filled with air, jump in, and as Nemo's friends would say 'swim down!'. There is a ton of stuff to see down there most times. I prefer the warmer weather of the florida keys or some island in the carribean... Ive been to: the bahamas, turks and caicos, cayman islands, puerto rico, dom rep... I cant rememeber everywhere, but mostly fun trips.

This past year, I managed to escape residency for three trips to the keys. Its so easy to get to and there is enough to see to keep me occupied. The first two trips were with a boy I thought I was dating. After all, who in their right mind goes away on a trip with a person of the opposite sex, just as friends. The trip was tons of fun and only inspired me to get my advanced certification. This flaky guy was off and on and although I really liked him, I tried to just go MIA during the holidays so he would get the hint this was clearly not working. Needless to say we booked another trip in February. After a lot of talk, I knew he didnt want to be in a relationship, but I went anyway. This was partially in a last ditch effort to satiate my heart (big mistake) but more importantly to take time off of the hell of residency. I was crying approximatly three days a week after work at this point. I was ready for it to all be over, but I still had four months to get through. Why not get out of the snow and into a bikini?! Of course we embarked on this adventure in February... the weekend of the 13th and 14th. Not only was this Valentines, but his birthday. I was nice, I got him a little something (for being old only). The diving was horrible. My toes and lips were blue and I was shaking. I only stayed under the water long enough because above water was colder. The trip was a bit of a bust but a trip to Shell World and a Lobster/candlelight dinner wasnt too bad. Are you as confused as I am by now? Valentines morning, I woke up early and ran out to get coffee and muffins and a candle to make it like a mini bday cake... I go back to the hotel to find a box of chocolates and a tiny bear dressed in scuba gear. I have never recieved anything on valentines day, let alone from someone I liked who I thought did not feel the same way. If any of you have watched Sex and the City you know my exact feeling if you can picture Miranda seeing the "I love you" cookie cake. Clearly I couldnt shove a box of choclates into my mouth without him seeing, but I thanked him and felt uneasy the rest of the day.

In the end, many months later on a trip up to Newport (where he lives, about 2 blocks away from me right now - fantastic!) to interview for my now job... I drank a pitcher of margeritas and told him how I really felt about the whole situation. It obviously did not go well and the next day will go down in history for the worst hangover anyone has ever had, despite it not including tigers, strippers, or mike tyson. I moved up two months later and the texts and emails started and I kindly asked for them to stop. He left it with "I wish we were only every just friends" Which clearly means you are fun to hang out with, but I find you unattractive.

Yesterday I get a text, after about a month, of a picture of his new regulator (air supplier mouthpiece thingy) Ironic, since I was supposed to be diving that day and the weather threw too much surge to go out. I woke up this morning headed to the dive shop and picked up some tanks. As I was turning out of the driveway there he comes prancing with a box of dunkin donuts in his right hand and a girl in the left.She might have been an extra on the set of Gossip girl by her looks and apparent age, but Im not going to judge. Im sure she is a perfectly nice girl that actually laughs at his jokes and doesnt question his girlish fear of spiders.

I headed out to Ft. Wetherill, a small cove on the tip of Jamestown. It took approximately 20 minutes to pull 6mm thick neoprine over my not size 2 body. It was there I thought I should come home and blog about this all. I know its not that funny, and Im rambing a lot, but I just wanted to write to get it all out. Diving is like life. You scrape your knuckles and curse the sky trying to wedge your fat rolls into a thick wetsuit. You spend another 20 minutes adding more weights (to get you under the water - like I didnt have enough of my own) and tanks and BCs... you walk ten minutes with 100lbs on your back and wonder why you do this all in the first place. But that is what life is, sometimes you bear the weight weather its in equipment or emotion. But then, you slip into the water, let all the air out of your lungs and sink below. You cant hear a thing, but a dull hum of ocean life. I can scream at the top of my lungs and no one will hear me. Its amazing. I have a framed picture in my living room by an artist Brian Andreas its of an odd looking character and it says "i always like the time before dawn because there is no one around to remind me of who im supposed to be" ... its like that. And, if I could get to 100 feet, the compression of the wetsuit might at least get me to a size 4. But, my hair will always be curly and gangly. I will always just kill the damn spiders myself.

I step out of the water after an hour of swimming around. Peel off that wetsuit and head home. Its been a good day, none-the-less. I spent a year wondering what I could do to be good enough. I dont believe its anything other than plastic surgery can fix. I dont really know where to go from here... other than submerge myself in the ocean to forget all my problems. I know I dont want to spend another year being reminded of what I am not. So fingers crossed for new dive buddies!


That was a morbid ending to a would be humoros blog... so Ill end on this... I had it wrong. Peeling a label off a catus is nothing... compare to knocking that cactus over and trying to replant it! Thank goodness for neoprin scuba gloves!

Is that the truth or are you talking trash? are you MVP like Steve Nash?

Don’t worry, your girls have the “good kind” of eyeturn, I explain to their mother. As I’ve written before, I have a small problem explaining eye problems without an air of rainbows and unicorns. I always try to find that silver lining. After all, they had small angle alternating exotropia. Both eyes turn out slightly but they can switch back and forth, like Steve Nash. Therefore both eyes get used at some point and they won’t develop amblyopia. Amblyopia happens when either an eye turn is permanent or one eye has a strong prescription – that eye isn’t really used, so the brain kinda just shuts it off. So Steve and the twins have two viable eyes and since they are slightly out, technically a better peripheral vision.
Peripheral vision is pretty important. It’s probably the reason for Homo sapiens trumping the Neanderthals… or something like that. It allows us to know what’s going on around us without looking directly at it. Like, so we don’t get eaten by sharks or scorpions.
In relationships, peripheral vision would be pretty handy. More commonly the exact opposite thing happens. We decide we really like someone, start working out more… wear tighter jeans and push up bras….. And the most important accessory? Harness winkers! You know those leather patches, otherwise known as blinders, which horses wear in order for them to focus only on the race path straight ahead. For every time he doesn’t call or changes your plans you keep your head straight, eyes on the prize and make an excuse. I guess it just makes life easier. I’ve made a lot of mistakes, well I’ve let a lot of mistakes happen in the hopes they’d work out anyway… but I think I’ll take that harness off for now … and keep my eyes out for sharks… and canadians

the thorns in our sides....

There are certain things in life that pose, without malice, a certain amount of awkwardness and difficulty. One of these I encountered this morning and it entailed pealing the purchase sticker off a small potted cactus. Why Lowes needed to put such a large and very sticky sticker on said cactus, I am not sure. I believe a smaller UPC code would have been quite handy on the bottom of the pot, where I could have left it indefinitely. Martha Stewart explained to me last month that succulents are the new hot ticket item. Naturally, I went out right away to purchase. Heaven forbid someone walk into my apartment and not see a perfectly quaint Oreocereus trolli. More importantly, it is pretty unlikely that I will kill this “plant” and thus I have a friend to come home to.
Another one of those uncomfortable and almost tiresome life tasks is meeting people. I was more than excited to move to a beach town. I love it here and have more than enough fun riding my bike and jogging at the beach. However, this is the first time I’ve moved to a place where I actually have no friends. It’s not like when you go to college or when I went to optometry school and you are given a set pool of people and you actually get to pick and chose who you want to hang out with. I’m here, alone, living in a 1 bdr apartment. Above me is a 40 yr old woman with cats. She is actually quite nice, however a constant reminder that this is a potential course in life in which I do not want to take. I cannot even begin to explain how much I loathe cats and would much rather peel cactus labels for life than end up old and alone surrounded by felines. So how does one make friends? It’s been suggested numerous times that I go to a bar by myself. I think this is about as good of an idea as investing in a litter box.
I am happy about my move and really love my job; although it poses many difficulties itself. Just the other day I had a elderly woman explain that her eyes were empa~nadas. I couldn’t for the life of me understand how it would be a problem for her eyes to be small warm cheese filled dough pockets. My stomach rumbled and I paged one of the girls in to translate. That tilde sure makes a difference, as she was saying her eyesight was blurry… this did not, however, help the fact that it was noon and clearly I was starving. The next patient came in complaining of lingering images. When she looked at an object and then looked away that object remained superimposed in front of whatever new she was looking at. As she explained this to me, in English – thank g*d, the lovely image of Dr C popped into my own head. He vaguely resembles ‘Doc’ the bushy eyebrowed old man from Fraggle Rock. When he stepped into the classroom that first day of Visual Perception, I was instantly in love. He not only is the kindest, nicest man ever to live, he was also a pretty good teacher and thus I knew I had me a case of palinopsia. That’s about all I knew and as soon as I dropped her (dilation) I went to the nearest computer to google it. Fantastic, Wiki tells me ‘attributed to a number of conditions affecting the brain including, but not limited to, medications], seizure disorders, tumors, occipital lobe or visual pathway lesions], subcortical hemorrhage], and dural arteriovenous malformations. Her eye exam was normal as I expected. Now the hard part: how do you explain to someone who already has extreme anxiety ( a side effect of palinopsia, as most people think they are going crazy), that she may or may not have some serious business going on in her cranium. I am young, but I am fairly professional in the exam room (well, on occasion). Most of my newly diagnosed glaucoma patients believe they just won the lottery as rainbows fly out my ass when I explain they probably only need a drop or two to prevent them from going blind. The difficulty in being a doctor is explaining things that are scary without making a patient crap their pants or leave not really knowing the severity of their condition. This was a sticky situation. Worse yet, trying to convince a person (with which docs in general are against their religion/way of life) that doesn’t have insurance that she needs to be seen by a neurologist and have an MRI/CT scan. I did my best, and fingers are crossed but Im not even sure she will show up for the follow up with me. I clearly can do nothing, but bring people back almost just to ask them if they have done what I have said. When I was at the VA I made about 20 phone calls a week making sure my patients went to retina evals or were taking their meds properly. I got a text from my former boss last week letting me know a patient came back complaining about the drops I ordered for him. Betoptic a beta blocker which I only ordered through the VA since its cheap, but the Rx came from his Glaucoma specialist MD. Apparently this gentleman had been feeding the drops to his cat and now poor fluffy is no longer with us. I generally felt really bad about this (really, hehe ok well maybe), but take zero responsibility for his cats death. I cannot be held accountable for stupidity, I only saved you some money dude. But, in general, compliance is tough.
So I left work with a bit of a knot and not an empanada in my stomach- hoping for the best. I came home to my cactus and the pitter patter of cat paws upstairs. And, against my better judgment, I let a colleague set me up with someone. I haven’t met him, although accidently facebook friended him. He is clearly not into me, yet I’ll keep attempting to make this work because frankly, I don’t need a guy so much as someone to hang out with. My cactus doesn’t answer when I talk to it. I have maybe a chartreuse thumb. I’m not horrible, I have a pretty decent herb garden growing on my porch. However, when I went home last weekend and checked on the pumpkins I planted in the spring, I came across a 2 ft zucchini. Clearly this would’ve been the time to mark a plant with a giant, difficult to remove barcode.

cual es mejor? uno o dos?

When I mention that I am an optometrist most people either don't know what that is, or at least don't know how to react to the answer of what I do for a living. When you are a little kid it is stereotyped that you want to grow up to be a fireman or teacher... My sister at one point wanted to be a Burger King "giver-outer" aka the minimum wage job at a drive through. We are proud she made it a little further. Most kids dont say eye doctor. It was a little random how I got into it, but I honestly love my profession.

After Ive mentioned my job, of the people who know what it is I do, usually tell me they hate "the 1 or 2, which is better" Well, let me tell you... I HATE it more. Refraction is a big part of our profession. It is a part that seperates us from ophthalmology. Note to any who read - do not go to an ophthalmologist for glasses, they are eye surgeons. Everyone knows 20/20 is the end goal. That means you can see something at 20 feet that someone with "normal" vision sees at 20 feet. Lots of things can make this number difficult to attain. The larger the denomenator, the worse the vision. The leading cause of blindness in the world is cataracts. Now everyone and their mother comes into the office petrified to have cataracts. Well sorry folks, if you are over 60, you most likely have them! They are normal and natural aging process. And thanks to Charles Kelman, taking them out is a quick and easy process. Cataract surgery was actually described in the east by Sushruta in the 6th centry BC. But after this long tangent, let me wrap this together. If you are old you have cataracts, if you have cataracts your vision is less than 20/20, and after working a year at a VA I like having an end point of 20/30 and having that be ok.

Which is better? one or two? Cual es mejor? Uno o dos? You hate this portion of the exam? Well, I just asked for you to chose between one of two choices. The answer is one or it is two. The answer is not 'No', it is not 'none', it is not '3'. I cant help you, if you cant help yourself. Well, actually I can. I know what your prescription is, whether I do retinoscopy or cop out and use an autorefractor. Ive got an idea of what you would like to see, but Im being nice and asking you to fine tune it.

I have nothing funny or about boys today - sorry folks!