Wednesday, January 25, 2012


I have cataracts. Have I mentioned that? I also have astigmatism and some major near sightedness, which means that basically, my eyesight blows.

I was updating my contacts prescription as well as getting new glasses today, and the doctor was explaining all of the various things wrong with my eyes. I asked him if my cataracts are related to my PKD. He shrugged and said that such a thing has been postured, but never proven. He also said that my particular type of cataracts, something called "posterior subcapsular cataract" (PSC) is not necessarily congenital, and can be related to kidney problems, but is more often caused by steroid use.

Now, before you ask, no, I'm NOT actually a professional baseball player looking to beef up my home run average. I was briefly on an inhaler for asthma my early years in college after a freak asthma attack during an outdoor basketball game. I used my inhaler sparingly, mostly when I exercised outside (and since I lived in Boston for so long, you can imagine how often THAT happened). I had the most trouble whenever I went back West, where I am allergic to pretty much anything that grows out there. Also, the winter inversion in Salt Lake City, where my family is from, doesn't help much either, as evidenced by an attack I had there once at the top of a ski slope.

(And, for the record, husbands who have LEFT you on top of said ski slope are not very helpful either, especially at the bottom of said ski slope. Neither is saying, over and over, "Just come down! You're fine!")

I gave the doctor a shortened version of this history, basically saying, "Yeah, I had an inhaler for a few years, but hardly ever used it." He shrugged again and suggested that it might not matter how often I used it, if I had PKD at the time (which I did), my body could have just processed the steroids differently, because people with compromised kidney function could react differently to various drugs.


We talked a little bit longer, about how I still struggle with my eyesight, and how even though living a lifetime with myopia has given me some cool compensatory strategies, I am not crazy about how my contacts are correcting my sight. I'd like to see better. He said, "Frankly, with your issues, I'm surprised you see as well as you do."

He went on to tell me that not only are my cataracts sort of uncommon, but that MY cataracts, specifically, are atypical of PSC. They're not placed where the typical PSC would be. He said that he can't really tell me how my eyesight will progress, either for better or for worse, because usually, these kinds of cataracts get bigger with time, and mine are not only in the wrong place, they haven't progressed at all since the last time I saw him. Which happened to be 4 years ago, because I may have gotten a little behind in my yearly eye exams.

So he said something along the lines of, "Your issues are just very atypical", which I pretty sure is doctor speak for "Lady, you are messed. up."

And WHO KNEW my mess could even impress an eye doctor? Nephrologists and ER docs, pshaw, no sweat. But an eye doctor? That's brand new territory, folks.

So I asked him about surgical options, and he shrugged AGAIN. I don't mean to imply that this doctor had no answers, it's just to illustrate that "shrug" seems to be the medical default in my case. We talked about Lasik, and cataract surgery and all that. I have to decide if Lasik is worth me undergoing to knife (laser?) twice in my life for my eyes, in case I need cataract surgery in the future, or if I'm just willing to shell out a coupla hundred bucks a year for the next little while for contacts and glasses that kinda sorta basically fix my eyesight except driving at night when I'm tired and there are all kinds of glares on the road to mess a be-cataracted sister up.

And my insurance didn't cover a nickel of this whole thing. Thanks a lot, Obama.

(I actually don't have any idea how Obamacare affects my insurance, it just feels good to blame somebody.)

1 comment:

Rob Monroe said...

HA! Love the last line!

Don't you just love stumping/pestering a doctor? I was my GP's first "real" diagnosis, having just started the day before in the practice. He practically DANCED in the office. I was a little concerned, he was a little peppy. Turned out we made good friends after that.

Good luck with the eyes. I have not thought about mine in a while, might be time for a check up.