I’m in a relationship … 5 of 5

Its a relationship which makes the difference.

[Continued from 4 of 5]

Epilogue

I met Dr. Sandra Yong again in the early hours of January 23rd, 2018 by which date my eyesight had improved enough for me to drive to her clinic in Vancouver, without using my old prescription glasses.

“Good,” she said, drawing out the word for emphasis. “The wounds have healed and while there are some scars left on your right eye, they won’t interfere with your vision. I’m going to send you back to Dr. Dubois for future visits, OK?”

“I’d much rather return to Dr. Richard Caldwell for those. He’s been my regular ophthalmologist hitherto. I met Dr. Dubois because of the emergency last month.”

“That sounds right to me. Do give this slip to my assistant as you go and she’ll arrange that for you.”

“There’s one thing also; is there any indication of the pathogens’ serogroup on my record?”

“Let me see … no, it simply notes that it was neisseria meningitidis.”

“I’m curious about its source.”

“In that case, remember to ask Dr. Cadwell about it. He can access the lab record, for additional information.”

“You have a good morning.”

“You too.”

I’d learnt from my niece that serogroup B of this pathogen is not uncommon in North America. About one in ten persons carry the pathogen in their nasal and throat cavities, without manifest symptoms. My niece should know, since for many years, she’d made a career of getting people across the globe pricked and poked to immunize them against various pathogens. Serogroup A wreaked havoc through deadly epidemics at regular intervals, in the so-called Meningitis Belt; the Sahel of Sub-Sahara, until it was reined in by effective immunization drives between 2010 and 2015. Serogroups C, W-135, X, Y, etc. appear to be less concentrated regionally. The pathogenic serogroups are spread through contact with respiratory secretions; such as through coughing, sneezing and kissing, rather than through casual contact, or air dispersal. As a result, its not as contagious as say, the flu virus.

In any case, here is peace, peace at last; thank God this insanity is over. Hostilities have indeed ceased and I’ve returned to where I stood on December 8th, prior to the Pearl Habour-like strike on my eyes. I should visit my optometrist soon, to learn if and what corrective lenses I’ll need, following the surgery four months ago.

So, What Relationship?

The alliance of healthcare service providers sustained by the province of British Columbia’s Medical Service Plan (MSP) offered the urgent and comprehensive response I needed, when neisseria meningitidis threatened my eyes with grievous damage and my body with worse. Its members acted with dispatch and in a manner which made economic sense to me. Other healthcare professionals may second guess the steps taken, after reading this narrative and that too makes sense to me, because techniques and technologies improve incrementally through such reviews. And yes, I love to be annoying too. More specifically, I love to visit the neighbourhood pharmacy just when I’m about to run out of long-term medication and ask sweetly that they fax a request to my family doctor, for renewal of my prescription. Its such a convenience that I’ve no intentions of mending my ways anytime soon.

This brief, if unlikely war over my eyes gave me renewed appreciation of the value of British Columbia’s single payer healthcare system. I’m in a relationship with other partners in the MSP. They include the Ministry of Health, a hierarchy of Health Authorities across BC, Colleges, Boards and Commissions which regulate and oversee healthcare delivery practices, vendors of healthcare goods and services, other patients and Health Insurance BC. If a subscriber is assessed as capable of affording it, based on his preceding year’s tax returns, he pays a regular premium to Health Insurance BC, to pool his risk of healthcare costs with all other subscribers. Therefore, he doesn’t shoulder the full cost of the care he receives when he needs it. We cover each other’s back, by that means. Premiums have been reduced by 50% for all, this year. Besides that, the threshold of income which qualify subscribers to pay full, or reduced premiums have been adjusted favourably, to offer financial relief to more subscribers.

All of this makes economic sense to me, not to talk of the moral imperative for universal access to healthcare. While a resident of BC is healthy, he remains an asset in full bloom, in the pool of talent which the Province can look to, to address any challenges it faces. Why throw part of that talent pool away by excluding it from BC’s healthcare system? The rich in any society don’t have a corner on the best ideas for addressing the challenges which confront them, or all of humanity. Sometimes the best ideas have humble origins.

  • The much acclaimed Apple II computer emerged from Steve Wozniak’s garage and translated the personal computer in the workplace, home and school from concept to reality; a reality we now take for granted. Steve Wozniak didn’t have much to his name, when he developed the remarkable circuitry of the Apple II.
  • The unscholarly Wright brothers blessed humanity with the first aeroplane, from their mechanics’ workshop and on a shoestring budget. Flying to a distant, or remote city seems the natural thing to do today.

If for their potential alone, everyone in the talent pool deserves to live, not just the rich, the famous, the privileged.

The sudden assault on my eyes in the wee hours of December 9th terrified me initially, as an unexpected encounter with the unfamiliar tends to with most persons. By morning though, I’d settled into my educated attitude of, “Yeah, so …,” which my son says he found puzzling. I chose that attitude over every other, because of a relationship:

  1. Jesus of Nazareth affirmed some two thousand years ago that I’m of such value to His and my Father in heaven, that He even numbers the strands of hair on my head. Put another way, every detail of my life is of interest to God. Nothing has happened since that affirmation which undermines my faith in it. On the contrary, much has happened to strengthen my faith; such as the details of His death and ressurrection (which was predicted before His time) and the testimony of His contemporaries;
  2. Since I’m of such worth to my Creator, the Sovereign of the universe, when I pray as I did on December 3rd for better eyesight, He hears and invests in the outcome of my prayer. Sometimes it gets worse before it gets better, when He intervenes in our lives. Jesus put it pithily when He said, “… unless a grain of wheat falls into the ground and dies, it remains alone; but if it dies, it produces much grain.” (John 12:24; NKJV);
  3. God’s calculation of when and how to intervene in my life must be infinitely more complicated than I can comprehend, since He knows every possible outcome before the event. Mind you, He created and moderates the time, space and matter of the universe to fulfill purposes which are far weightier than my immediate fixation.

Therefore I’ve no need to be anxious about the urgency of the immediate. He intervenes on my behalf for the best possible outcome, in the most opportune moment. Now, some dismiss such reflections as pie in the sky thinking, or belief in fairy tales, without bothering to examine the historical evidence* of the authority of Jesus of Nazareth to pronounce on these matters. Some speculate that the universe is infact, self perpetuating and doesn’t have a creator.

center-universe

What evidence you pay attention to is yours to choose. Nevertheless, here’s the end of the matter. Consider the vastness of the universe; I’ll assume you’re well informed enough about its size. Compare that expanse with the size of the earth, just to gain some comprehension of the enormity of eternity, when compared with our lifespans on earth. If I happen to be wrong about Jesus of Nazareth, I will have:

  • spent my organic lifespan for more than me, myself and I;
  • laboured to reign in my urgings and appetites, rather than be ruled by them and
  • laboured to manage my personal relationships in response to what Jesus taught and did for me, as my expression of appreciation towards someone I adore.

I can live and die with that error, without regret. If you happen to be wrong about Him, do you have a contingency for living with your error throughout the endlessness of eternity? ©


*   The first five books of the New Testament.

I’m in a relationship … 4 of 5

Ceasation of hostilities and reconstruction

[Continued from 3 of 5]

Tactical Nuclear Weapons Replace WMD

“Hello, I’m Dr. Sandra Yong. How are you today?”

“Certainly better than I was over the weekend. This eye infection started in the early hours of Saturday morning. The pain I was experiencing has subsided, thankfully. The profuse tearing up has too and while I can now see your facial features, my vision is still blurred in both eyes, which wasn’t the case prior to the infection. My eyes have become hypersensitive to light too.”

“OK, let’s see what they look like through the microscope,” she said and then after the examination, “Well, here’s the good news; while you do have some lesions on your right eye cornea, there are none on your left eye. I’ll prescribe some eye drops to help you combat the infection and to stop further development of the lesions, lest they become perforations.”

“And the bad news?”

“There’s a lesion sitting right smack in your right eye’s line of vision, where it can cause the most damage. Its going to take weeks to heal, I’m afraid and even then, you may need a cornea transplant in that eye. Not every one does in a situation like this though, but I won’t be able to tell until your eyes have healed completely. Either way, we will make progress from where things stand now, alright?”

“Mmm hmm.” Well, just what on God’s earth happened?

“What medications are you using for your eyes at the moment?”

“None. I used to apply a drop of Symbrinza to my left eye twice a day prior to the infection. It was prescribed to help me regulate the pressure in that eye after I’d had surgery to ameliorate the exfoliation syndrome in it, but I stopped using Symbrinza after Saturday morning, because it aggravated the pain.”

“I see. I doubt that it’ll cause you any more pain, so you can start using it again. Here,” she said, pushing the completed prescription form into my hand, “You need to purchase and apply these three drops immediately. They include a broadspectrum antibiotic which is compounded by a particular pharmacy in the next block, so you’re better off going to them first. I’ll have you booked to see me again on Friday, the fifteenth, so I can assess how well you’re responding to the drops. Will that work for you?”

“You bet it will.”

“Good, if you give this slip to my assistant, she’ll appoint a time for you to come back on the fifteenth. See you then.”

“Do I need to continue on the intravenous therapy started by the Burnaby Hospital’s ER?”

“No, absolutely not.”

A Decoy

My son and I walked over to the pharmacy Dr. Yong had directed us to and after purchasing the prescribed drops, drove to the ER at Burnaby Hospital. I presented my Care Card to the receptionist on arrival there and started to explain that I’d just seen the ophthalmologist and her opinion was that I wouldn’t need additional intravenous therapy, but I was interrupted by a young doctor standing nearby.

“What’s your name again?” She asked.

I introduced myself and related Dr. Yong’s opinion to her, knowing as I did, that her colleague Dr. Morton had indicated the previous day that the therapy sessions would be repeated for up to five days, depending on the opinion of the ophthlamologist.

“Do come in, so we don’t have to discuss this matter out here.” She led us to an isolation chamber, offered me the seat there and said, “I’ll be back shortly.”

After quite a few minutes had passed, Dr. Morton joined us in the chamber, all suited up to attend to a patient in quarantine, which I found odd, since my son was standing in the same chamber without any protection, but whatsoever.

“Hi, you’re somewhat early today,” he said.

“I know,” I responded. “We drove here after seeing Dr. Dubois this morning and, by his referral, Dr. Sandra Yong, who’s a cornea specialist. She prescribed three different eye drops for me, including two antibiotics. She says I don’t need to continue the intravenous therapy.”

“Really? Do you have a followup appointment with her?”

“Indeed, I do. I’m due to see her again at a quarter to twelve on Friday the fifteenth.”

“Oh? Well in that case, I’ll have to remove the peripheral line on your arm,” which is exactly what he proceeded to do after pulling off his face mask. “When did you say you’re due to see Dr. Yong again?”

“About noon on Friday.”

“Well, there’s no point detaining you any further then. You have a good one,” he said, as he walked us out of the isolation chamber.

“And you,” I replied.

“Are you letting them go this soon?” the young female colleague asked him, as we made our exit from ER.

“They know what they’re doing,” Dr. Morton replied.

There’s a book-long young medic, I thought. It appeared to me, by her inflexible adherence to the rule book, that she may be a newbie to a vocation she’d chosen, but may lack the flair for. On the other hand, I just may have succumbed to a bit of uninformed conceit, as I sometimes do.

De-escalation

My eyesight had improved significantly by Friday and I could feel little pain in the eyes, though they remained hypersensitive to light. We arrived in the block where Dr. Yong’s clinic is somewhat early, on my request. As a result, we had time to scout for a cheaper street parking slot. It was worth our while. I directed my son to a lane where parking slots cost five Dollars an hour; a bargain which felt good to gain at the cost of the walk past two blocks.

Dr. Yong thought I was responding satisfactorily to the medications she’d prescribed, when she examined my eyes in the microscope. “Let me see you again next week, OK? Do give this slip to my assistant and she’ll let you know the date and time for your next visit. Enjoy your weekend.”

“And you.”

Our next visit was during the morning of December 19th, by which time my eyesight had improved some more and our anxiety over the vicious neisseria meningitidis had subsided. In large part, the war against the pathogen was over, with just a few holdouts left to be mopped up. To our surprise, Dr. Yong’s clinic was virtually empty when we arrived. It turned out that in preparation for the Christmas break, they’d retained only the most urgent cases on their calendar for that week. She again examined my eyes under the microscope after dilating the pupils, as they always do prior to such scrutinies.

“Your eyes are looking much better now. The lesion in the bull’s eye of your right cornea is healing. Now, as I mentioned earlier, some people experience a complete regeneration of tissue after such damage, but that isn’t always the case. If you do experience full regeneration, there’ll be no need for further intervention from us. Otherwise, you may need a cornea transplant. So, I’m going to have my assistant set up an appointment for you to see Dr. Morrison early next year, for a possible cornea transplant. In the mean time, the progress you’ve made so far means we can begin to tapper off your use of the medications.

“Here’s how I want you to proceed for the next month. Continue using the antibiotic eye drops twice a day for the next week and then cease using them altogether. Use the steroid drops four times a day during the same period, then three times a day during the ensuing week. Reduce it further to twice a day in the third week, once a day in the fourth and cease using it altogether in the fifth week. Let me write it all out for you.” She wrote and handed me three slips for the routine she’d just described, for notifying her assistant of my next appointment in January 2018 and for the ensuing appointment with Dr. Morrison. “Merry Christmas to you both.”

There then; the UN’s Secretary General, acting on behalf of the Security Council, had issued the predictable statement calling for an immediate ceasation of hostilities, the return of all parties to pre-existing borders and the commencement of talks leading to the exchange of prisoners, the safe evacuation of wounded combatants and a lasting peace, with regard to the brief war over my eyes. Christmas would still be possible, howbeit I’d missed deadlines for the dispatch of greeting cards, etc because of the unseasonable outbreak of war.

I walked to the neighbourhood pharmacy that afternoon for two purposes. “I’d like to return these reading glasses which I purchased four days ago.”

“Ow, is there anything wrong with them?” the Sales Associate asked.

“Nothing whatsover, but my eyesight has been changing progressively, so I no longer find these suitable.”

After that transaction was completed, I stepped up to the prescriptions counter, presented my identifying Care Card and asked the assistant, “Could you send a fax to my family doctor to ask for a renewal of the prescription for my blood pressure medication? I’ve a day’s supply only at the moment and I can’t get an appointment to see him before December 22nd, which is, you know, three days away.”

“We will and we’ll give you a call as soon as we hear from him,” she replied.

“Thanks and Merry Christmas.”

It was cold but sunny that afternoon. I took off my sunglasses momentarily and looked up at the leaves of one of the trees which shade the walkway, as I made my way home. Thank God I can see the yellow leaves fluttering in the gentle afternoon breeze again. maxresdefault

Its a simple pleasure I treasure, because of an association and more. One of my cherished childhood memories is of warm afternoons spent outdoors, sitting under a tree as we listened to our first grade teacher read, or tell us stories about heroic figures. The fluttering leaves mean much more to me these days, because I also view them through the prism of just what it took to build a planet which supports organic life in this vast expanse we call the Universe; an expanse in which our solar system hardly qualifies as a speck of dust, let alone its planet which serves as our home. Yet this delicate, infinitesimal Earth presents us with such stunning glimpses of beauty and always, in the offhanded manner of a masterpiece.

[To be continued …]

I’m in a relationship … 1 of 5

No, not the kind evoked by the idiom, but no less intense, for that matter.

Last year was a notable one for many reasons, but I’ll recount a series of related experiences to illustrate the theme of this blog post. The names of persons included in my narrative are fictionalized, to respect their privacy.

Pearl Harbour Type

I was woken up in the early hours of December 9th by an excruciating pain in my left eye. The pain was hard enough to deal with at that time of the night, but my thoughts were even more disorienting. I’d had surgery in that eye 12 weeks earlier, to remove excess cataract scar tissue, in a bid to help me obviate the exfoliation syndrome. The condition caused periodic blurred vision, as loose pigment tissue floated into my line of sight. I’d been experiencing associated spikes in the eye’s internal pressure too, with attendant headaches which for many years, I’d attributed to migraine, tension headaches and any other demon I could name.

The surgery on September 15th had gone well, although it took longer than expected. The lens implant in the eye did become unstable, once the offending scar tissue had been removed, but that was not unexpected. Dr. Levesque had removed the wobbly implant and stitched a new one into place, while I totally ignored them and listened to my favorite music playlist, using the ear plugs attached to my phone. He’d been sufficiently satisfied with my post-surgery recovery and in response to my question during my last visit, had confirmed that it was indeed time to see my optometrist, for a review of my needs with regard to prescription glasses.

That was only two days ago and my appointment to see the optometrist was due in three days, on December 12th. So, what on earth had suddenly gone wrong in the eye which had hitherto recovered so satisfactorily from the surgery? Could it be that some of the stitches which hold the lens implant in place had snapped for whatever reason? Why was the eye tearing so profusely, all of a sudden? I was nothing short of terrified, in my ignorance, yet somehow, I drifted back to sleep after agonizing over my condition for a bit.

When I did wake up again, it was to the urgent call for attention through pain, but of a different sort this time. I felt a burning sensation in both eyes, accompanied by a profusion of tears and an exaggerated sensitivity to the daylight seeping through the closed venetian blinds. Now the fight was on and it was a Pearl Harbour sort of engagement, not the tame Israel – Philistine type which was settled by David and Goliath, no. I could hardly make out the details of any objects I’d look at in the well lit bathroom, after struggling to open my tear sealed eyes enough to stumble there. My vision in both eyes were that blurred and my eyelids looked, well somewhat puffy. I did manage to redial Dr. Levesque’s surgery when I returned to the bedroom though, thanks to the saved history of recent calls which is standard on mobile phones. While the surgery was open that Saturday, its gatekeeper wouldn’t let me speak to the designated assistant on this occassion. The interactive voice response system of the modern office left me on hold long enough for me to drop the phone and recline again on my pillows in despair. Should I, should I, should I … I took some Tylenol pills in the hope they’d numb the pain, but by the next day, I was sufficiently distressed to ask that my son drive me to a nearby walk-in clinic for whatever assistance they could offer me and my wife was distraught enough to accompany us and make certain I didn’t miss a step in my faltering walk. I went with sunglasses to shield my now hypersensitive eyes and dragged a box of tissues along to keep the generous flow of tears from adding more drama.

The young doctor assigned to my case took a look at both eyes through a portable contraption, while I tried to give her a run on the history of my left eye. The narrative started forty years ago and ended with the third successful surgery, now thirteen weeks past. Of course, I mentioned the post surgery eye drops I was using and included some description of the beginning of my current distress.

“I’ll be right back,” she said and when she did return after a while, “I’m going to refer you to the Emergency Room of the Burnaby Hospital for immediate assistance. Just describe your current symptoms to them and they’ll know how to proceed.” Right, no stories in ER; not even the boring one about my surgeries. They’re serious out there.

Emergency Room

The drive to Burnaby Hospital was frustrating to me, perhaps because I could only tell it involved multiple left and right turns, by the swerves of my body in the car, yet it seemed unending. When it did come to an end eventually, I shuffled into the hospital on my wife’s arm and with my son in tow. “Yes, we just received notice of your referral,” the receptionist said after I presented my Care Card; the identification which both entitles me to insured health services in the province of British Columbia and offers service providers a single gateway to my health records. “Follow the directional signs to my right and you’ll come presently to ER.”

ER was at the end of a maze; at least that’s what I thought, but the directional signs did bring us first time visitors to it and I was relieved to be deposited onto a comfortable chair with a high back rest, in the midst of curtains and a bustle of nurses, at least one doctor and a number of patients. Some of the latter didn’t sound patient at all really, so I asked my son, “You think I’m better off going back home, for all these sounds I’m hearing?” He chuckled.

“Hi, I’m Dr. Vladileu Khorenian. I’ll be attending to you today. Let’s see now,” he said to me, “What the hell happened to you? When and how did this start?”

“I woke up in the early hours of the morning yesterday with an excruciating pain in my left eye. I took two tablets of Tylenol then and later drifted back to sleep. When I woke up in the late morning though, both eyes were sealed with drying tears, I felt a burning sensation in them and noticed the puffiness you now see. In the course of the morning, I applied the Symbrinza eye drops prescribed for me after surgery on the left eye thirteen weeks ago, but my eyes hurt so much more after that that I haven’t repeated the dosage since yesterday.”

“Why did you need surgery?”

“I’d been experiencing a frequent buildup of pressure in the eye and blurred vision from time to time. The ophthalmologists thought it was caused by excess scar tissue from a cataract removal operation forty years ago. The surgeon removed the offending tissue and inserted a new lens implant, because the old one became unstable, once the scar tissue had been removed.”

“OK. Was the pain you felt on Saturday morning sharp, or dull?”

“Good grief. It was a terrible pain, for sure. Ok, let’s try this for specifics. It started as a sharp pain in my left eye, but by the time I woke up in the late morning, it had become a burning sensation in both eyes; which is how it feels like now.”

“Do you have any allergies?”

“To penicillin, yes.”

“Well, for now, I’m going to give you a pain killer and take a swab of the puss in your eye; just for the records, together with a blood sample, oK?”

“Sounds good.” While he was gone, a nurse turned up and asked to insert a thermometer in my mouth.

“Its my eyes which hurt you know, not my mouth.”

“I know, but my job right now is to insert this thermometer beneath your tongue and record your body temperature. So, I need you to stop using your tongue for the moment and just open your mouth … good, now don’t you bite on that thing.”

“Hmm, thirty-seven degrees.”

“So can I go home?”

“No, we’re just warming up here. I need to draw a sample of your blood from your forearm. Which of your arms shall I use?”

“Draw it from the left arm; that’s the less critical one.”

[To be continued …]