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What’s Your Emergency?

In honor of 9-11, I am going to digress on a topic of emergency medicine today.

As an ophthalmologist (or pretentious eye doctor depending on how you pronounce it) I occasionally get paged when I am on call.  Perhaps less so than an orthopedic surgeon, pediatrician, or cardiologist, but more so than your busy dermatologist or geneticist.

After business hours at night, on weekends and on holidays, our office is closed.  The answering machine at our office clearly states
that our office is now closed.  There is an option to leave a message.  Then, the recording tells our patients that if this is an emergency, to call the answering
service.

As an intern many years ago, I was introduced to the wonderful world of being on call.  I was awoken at 3 a.m. by a patient who asked if it would be okay to take an aspirin tablet that had fallen on the floor.  I.  Kid.  You.  Not.

How bad does your headache have to be to take this?

Does the five-second rule apply here?  Is there fuzzy stuff on the tablet, or does it look clean?  Can you rinse it off quickly and pop it in your mouth before it melts?  Might we just consider the possibility of throwing it away and taking another one that has not contacted the floor?

Labor Day weekend, I got a call at 7:30 am Sunday morning to refill a prescription.  The patient normally sees another doctor we were covering.  She didn’t know the name of the drop but thought it began with a P.  It had a green cap.  That actually was helpful, since it narrowed it down to pilocarpine, used for some forms of glaucoma.  But it comes in an array of strengths ranging from 1/8% up to 4%.  Of course she didn’t know which one she was on, but she knew she was going to run out before Tuesday.  And guess what, after several calls later, her pharmacy was closed anyway.  So much for sleeping in.

Seriously?  I take a baby aspirin daily ever since I had an episode of atrial fibrillation.  When I notice there are only about 7-10 tablets left in the bottle, I put it on the grocery list for my wife to pick up more.  She usually shops at least once a week, so I get my new bottle before the last tablet is gone.  Is that so hard?

Granted, you can’t see the drops in your medicine bottle, but you can generally tell, particularly if you have been using drops for years, when you are about to run out.  Plan ahead people.  Don’t let those pesky holidays creep up on you.  Buy a calendar.

Once, on Good Friday, a lady called complaining of itchy eyelids.  Now while that could sound like an emergency, most eye doctors will tell you it is not.  Uncomfortable perhaps, but not generally vision threatening.  This lady was the patient of another eye doctor as well.  Apparently, I am the only April Fool who takes call on holidays anymore.  Or I’m not smart enough to sign out to someone else.  Whatever.

So I ask her how long her eyes have been itching.

On or off.  For about a year.

This is an emergency????

Has she seen anyone else about it?

Oh yes.  She saw a dermatologist who prescribed a cream for her face that worked.

Did she call her dermatologist back?

His office is closed today.

Imagine that!

But he told her previously that she could use it on her eyelids as well, but she wasn’t sure she should.  The eye doctor I was covering for told her she could use it as well.  Apparently, she wasn’t convinced and needed a third opinion.  On Good Friday.  That has the weight of the Father, Son AND the Holy Spirit behind it as well.

Let me think about this one.  Hmmm.  The cream worked for the rash on your face.  Two doctors, including an eye specialist told you to use it on your eyelids.  Your eyelids are itching?  It’s Good Friday.  .  . I got nothing.  I don’t know what to tell you (although I know what I’d like to say) but maybe, just maybe, you should try the medication.  It’s a shot in the dark here, but if your eyes are bothering you enough to call a professional on a holiday, then I’d go for it.

I don’t want to sound insensitive.  It’s not that I don’t care about your itchy, watery eyes that have been bothering you for months.  Just don’t call me on a holiday or on a Saturday afternoon when Penn State is playing football.

I’m sure every job has its moments.  I imagine that most grocers have received phone calls at three in the morning asking whether or not it is okay to drink
milk that is one day over its expiration date.  Don’t you wonder about that?  It’s only one day.  But you don’t want to get sick.  It smells okay, but you just can’t
be sure, can you?  Better call and find out right now!  Oh, and I just noticed I’m running a little low on toilet paper . . . could you send some out in the morning?  Thanks!

Today is 9-11.  What’s your emergency?

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