Friday, August 16, 2013

I'll Dye Another Day

I survived my first retina lasering session. I know, I know. I sound extreme. Why wouldn't I survive it? Well, I wasn't so much concerned about the laser as I was about the dye test they had to administer beforehand.

At the appointment during which I was told of my retinopathy, my doc explained that he would have to insert a needle into my hand to administer sodium fluorescein, a fluorescent dye that helps light up the blood vessels in my eyes to faciliate picture-taking so he could have a good road map for zapping those unwanted vessels on my retina.

As is standard protocol for consenting a patient for a procedure like this, he listed off the possible side effects of the dye. In residency, I consented patients for procedures and surgeries all the time. No big deal. Let's get on with it: Nausea (pfft, that's nothing), vomiting (meh), hives (itchy, but I can deal), and anaphyctic shock (hmmm, not so fun), and about 1 in 250,000 result in death (um, WHAT!?).

But I was so overwhelmed and emotional from hearing that my eye was trying to invade itself with wayward blood vessels that I just sort of thought I heard him wrong.

When I got home, I talked to my husband about it. I thought 1 in 250,000 sounded kind of high. He thought it did, too. But why would they do it so commonly if the risk was that high? I convinced myself that I misunderstood him. Wanting the truth, we both used our doctor-tools to look up doctor-papers and come to doctor-conclusions. I wasn't able to find that exact stat, but I did find papers that detailed a few patient deaths. I fixated on one that occurred because the patient had no access to life-saving epinephrine (to stop the anaphylactic shock). I felt better! Surely, the office had epinephrine.

But then doubt crept it, mostly because I work in hospitals and clinics. I know that supplies aren't guaranteed. Things expires. Things go missing. I wanted to call the office to ensure they had epinephrine, but I stopped myself because I didn't want to be "that patient". You know, the crazy one.

Fast forward a few days later, and the issue is still haunting me. So when the office called to confirm my appointment, I hesitated for a brief second and them meekly asked if I could ask a question. "Of COURSE we have epi, the staff assured me." Cue sigh of relief.

So I go the next day, petrified of the unknown but determined all at the same time. The tech who would administer the dye asked if the doctor had listed the possible side effects. With a smile, I said yes. Then (I don't know why I said this) I continued with, "But he said 1 in 250,000 resulted in death. I heard that wrong, didn't I?"

She looked at me and simply said, "Oh no, that is correct."

My heart rate rising a bit, I pushed it, "Oh, but only those without access to epi die, right? I mean, they go into anaphylactic shock and then die because they don't have epi, right?"

And she says, very matter of factly, "Well yes, they go into anaphylactic shock. But 1 in 250,000 die regardless of the use of epi."

I think I turned white. She took note and quickly tried to comfort me, "But don't worry! I've been doing this a long time and that has never happened! It will not happen to you!"

Cardinal rule #1 of medicine: Never speak in absolutes. Doctors tend to be superstitious folk. In residency, if someone told you "Oh don't worry, you'll have a quiet overnight shift!" it pretty much guaranteed you would have the worst, most disastrous night of patient care you have ever experienced and would ever experience in you entire career.

So her well-meaning words of comfort only served to send me into panic overdrive. I was going to die.

I was sent into the waiting room so my eyes could work on dilating. Waves of sadness and fear washed over me. Of all the ways to die, I wasn't really keen on it being that day, in that office. I thought about backing out of the test, but knew I was being unreasonable. Nevertheless, I wanted to tell my parents and husband I loved them...you know, just in case. These were the thoughts flitting around my scattered brain. If I called them, I would (probably) unnecessarily freak them out. So I sent heartfelt text messages. That made me feel better for a minute, and then I lost it all over again.

Trying to muster all of my powers to self-soothe, I figured a comparison might work best. There are far more common ways to die, I thought! Things I do every day, like driving! I happily googled, "chance of dying in a car accident." I am the most morbid person I know.

BUT, it completely worked. I found this great New York Times article and felt comforted by the fact that I have a 1 in 84 lifetime risk of dying in a car accident. I get in cars all the time regardless of this horrific fact! And I also learned that I have a 1 in 79,746 lifetime risk of dying by lightning. I spent over 20 years of my life in Florida, which is lightning central!

Smiling like a loon, I found comfort in my macabre fact search. They called me back, inserted the needle, pushed the flurescein, and I forced myself to take a deep breath.

I'm still breathing.

7 comments:

  1. Great post. I would have reacted the exact same way.

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  2. I'm glad you did the research. Often we tend to gloss over that stuff and defer to the doctor to tell us if it's the right thing to do, but we don't need to do that. I'm also glad you didn't die. Obviously.

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  3. I would be more freaked by the lasers! The laser that are zapping my eyeballs! Ack!

    Nice post ... Thanks

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  4. You aren't alone, I'd be freaking too. I don't know that I'd have thought to look up other stats on dying though. That was a not so bad idea.

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  5. Love seeing your view of this. My husband has had countless lasers and surgeries on his eyes with retinopathy. great blog!!

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  6. being killed by lightning is that common?! bring on the hand-eye dye.

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  7. Nice post! Glad you are still breathing :)

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