Friday, August 28, 2009

Dear Medical Students, Please Don't Skip The Class On Running Your Office Efficiently

Avery had an appointment for a check-up with her eye doctor yesterday. We've been seeing him since she was 18 months old so we knew to expect it to last 2 hours. Not because it actually takes 2 hours for the check-up, of course. The planning and scheduling at this place is so incredibly inefficient that no matter what time you have an appointment, it will take 2 hours.

At least they are consistent with their frustratingly ridiculous non-adherence to appointment times.

(But! But! They have a TV in the waiting room! And it plays Sponge Bob Square Pants over and over! And what about the plastic house they have in there to play with?! THIS SHOULD MAKE THOSE 2 HOURS YOU ARE WAITING TOTALLY FLY BY.) (Some people are just impossible to please.)

We signed in when we got there and settled in for a long wait. Avery was playing in the house and Matt and I were checking out the sparse magazine selection. Then after about 15 minutes I thought I was tripping on acid when I heard the nurse open the door and call our name. HOLY CRAP! We have never been seen that fast. It was like we had won the lottery, except instead of a butt-load of money we get some time back in our day. Life was good.

Back in the exam room the nurse ran Avery through a 3 year old version of the eye chart.

And even though she has never seen a phone that looks like that, Avery nails it. Every. Single. One. Over and over again.

So then the real test begins. The nurse covers her "bad" eye first and shows her the pictures again. This time they get progressively smaller and smaller. She got almost all of them right and I was feeling good about her progress.

After going through the same pictures about 23 times the nurse covers her "good" eye and asks her to look again and tell her what she sees. At first Avery plays along but she quickly starts looking around the room, playing with the buttons on her chair and being coy with her answers. She failed that section of the exam miserably.

I wondered, though, if she was unable to see the images or if she was just bored with answering the same questions repeatedly.

After that, the nurse gave Avery 3 eye drops in each eye to dilate her pupils so that they could do more tests. She told us to go back to the waiting room and they would call us back in 30 minutes. Perfect. Just enough time to read a magazine.

After 30 minutes we were on pins and needles because it was our turn next! And when the nurse opened the door to the waiting room I automatically grabbed my purse and started to stand up. Except she called for "Skye," not Avery. Damn.

....then 45 minutes passed.....then one hour....and finally after 1 hour and 10 minutes in the waiting room from hell we were called back to the exam room.

The nurse put Avery's face in a machine and took some measurements of her eyes. Then she led us into a room and after 2 minutes asked us to come back out and do the test again. Apparently the doctor didn't get a good reading the first time.

Then after about 5 minutes in the exam room the doctor comes in mumbling about how terrible the nurse is and that she can't do her job. Which, let me just tell you for any readers that might be doctors, it doesn't instill the most confidence in your practice when this is the way you walk into an exam with a patient.

He continued to look down at Avery's chart and talk but we weren't sure if he was talking to himself or if he was talking to us. If he was talking to us we had no idea what the hell he was saying. Something about just doing it himself....I don't know. He didn't look at us at all during the entire time he was in the room with us. NOT. ONCE.

Next he put some heavy metal glasses on Avery and covers her "good" eye with a patch so she has to use her bad eye and shows her the same damn pictures she saw before. And again, Avery acts coy and doesn't answer a single one of them right. And I can't tell if she is just messing with us or if she can't see at all.

[Let me pause here and say that you are probably thinking that I am delusional because clearly she can't see out of that eye if she didn't answer things right in 2 different tests. And you might normally be right about my mental state but in this case I just feel in my gut that she just isn't cooperating. I certainly don't think that she has perfect vision, obviously, but I also don't believe she is blind in that eye. There is an obvious positive difference in her eyes over the last 18 months.]

So then the doctor, clearly frustrated, starts spouting off that he can't be sure that the results of the test are right because her dilation isn't very good and says we'll just need to come back. AND I AM REALLY CONFUSED because we have just spent 2 hours in his office and he is saying we have to come back? So I ask, as if I am pulling teeth, if he thinks her eyes could be getting worse. He said he didn't want to worry me with the 12 bad things that could be happening and would rather wait and see at another visit.

Then he asks if we have ever given her eye drops. After we said no he went right into the terrible side effects that most kids have. Matt and I look at each other because we must have both experienced some kind of wrinkle in time since we missed the part where he tells us that he is going to prescribe some drops that will cause her eyes to dilate for a full week so that we can come back in and get an accurate look. BECAUSE HE DID NOT SAY THAT AT ALL. I stopped him during his description of how some kids end up "climbing the walls" with these drops because they are somewhat painful (awesome) and ask him if he is telling us that we are supposed to now give her drops.

I guess in outer space people have half conversations out loud and half telepathically and it all works out but HERE ON EARTH you actually have to verbalize the entire conversation for the other people to have any idea what you are talking about. And that is where we found ourselves yesterday.

And then he left the room.

Matt and I both looked at each other and said, "Did that just happen?"

And when I thought it couldn't get more frustrating, I went to make her next appointment.

I tell the lady with the fancy computer that we are supposed to come back in 4 days and the girls at the front desk inform me that the doctor only works on Thursdays.

Awesome. Something he failed to mention. It was probably something he expected us to pick up from his thoughts. Damn broken mind reading powers.

So now the next time we can see him is September 10th. And in the meantime, we have to worry about whether her eyes have gotten much worse in the last 6 months or if it was a faulty test. I asked the nurse if using the drops would give us some definite answers since we had just spent (surprise!) 2 hours there for nothing and she said, "oh yes! We won't have to worry about the dilation wearing off next time because those drops are very powerful."

It was at that point that I had to contain all of my hostility because IF THEY HAD CALLED US BACK TO BE EXAMINED AFTER 30 MINUTES (when her damn eyes were probably perfectly dilated) WE WOULD NOT HAVE TO PUT AVERY THROUGH THESE AWFUL DROPS AND WE WOULD NOT HAVE TO SPEND ANOTHER 2 HOURS IN THAT OFFICE.

I can't remember the last time I was that mad. This is my child's sight we are talking about and if something is wrong, we need to fix it now. And that means that you need to get your shit together and keep a decent schedule. Period.

When I called the only other pediatric opthamologist in Austin today to get a second opinion (I mean, how can we trust anything from that cluster of an experience), the receptionist was incredibly snippy with me. To the point where I had to ask her if I should call back at a better time to schedule an appointment. She had no idea why I would ask that.

I guess rude and abrasive are the new black. I have never been fashion forward so I must have missed the start of that trend.

1 comment:

Dana said...

There has to be some board you can complain to about this. He should not put his nurse down in front of you. He should talk to you and say hi, and look you in the eye and explain things fully to you. It also sounds like he should work more than one day a week to accommodate all of his patients. Sheesh..
It is difficult, but try to keep looking for another eye dr. until you find someone you like, even if you have to travel to the next city. I wish I could send you to my eye dr., Dr. Green, he was in Belleville and I don't know if he's still practicing, but he is amazing. He performed all 3 of my eye surgeries and convinced my insurance to cover it even though they were technically "cosmetic" surgeries. I don't know if they make 'em like him anymore. Sounds like there's definitely a shortage. I have a friend who travels to San Francisco to see her eye specialists, so broaden your search if you have to. It will be worth it to find someone who is competent and makes you feel like you're in good hands.
It sounds like Avery might have something similar to what I have. In my "bad" eye, I can see objects, colors, light, and movement. I can walk through the house without tripping on anything, but I can't read a single letter, cook, drive a car or do anything that requires any detail and I'm "legally blind" in that eye. I would fail the 3 yr old eye chart w/ my bad eye, but my my brain adapted and processes my vision in a way that suppresses the bad image so I'm not dizzy or seeing double vision because my brain only processes the good image from my good eye (Cortex Suppression). Hopefully Avery's condition can be remedied before it is too late for her, but even with one bad eye, if she was born with this condition, she'll adapt and she'll be ok and she'll go on to lead a normal life. That's not to say that you shouldn't fight to make sure it is corrected as much as possible! Hang in there Amy! Avery is lucky to have such a good mom!