Monday, February 25, 2008

Dispense As Written

the saga continues...remember I wrote last June about my eyes going all red and diagnosed with iritis? How the first doctor misdiagnosed me?

The second doctor did know what iritis is. I was initially diagosed and he sent me home with a prescription for steroid drops and dilating drops. I went weekly for exams. I kept asking how long am I going to be on steriod drops? The first answer, "1-2 weeks." The second answer, "2-3 weeks." The third answer, "4-6 weeks." The fourth answer, "8-10 weeks." The fifth answer? I don't know because I didn't like the fourth answer and his bedside manner was not the greatest.

I called my HMO and asked for an expert with iritis. Best I got was a retina specialist. I start seeing him. He knows what iritis is. The doctor gave me a new prescription for steroid drops, dilating drops (that don't take 3 weeks to wear off) and an anti-inflammatory drop. The first visit was also the same day I developed a bells palsy. The treatment for the bells palsy was an oral course of prednisone and my eye symptoms diminished (steroids in the bloodstream).

I have the baby and finally get back in the see the retinal specialist and he tells me the kind of iritis I have is actually called pars planitis and all the steriod drops can actually cause more damage than cure me (cataracts and glaucoma). I need to wean off of the drops. He wrote down the name of the type of iritis on an Rx pad and sent me home to go look it up on the internet. (He didn't want to explain it.)

Fast forward to last Thursday, I have an appointment with DH's optholmogist. I didn't want to bother the retinal specialist for a new eye glasses prescription (one of my lenses is cracking) and I am not comfortable just seeing the kookey-big-haired Sam's optomitrist with all these eye issues going on. And I am lazy-the doc's office is less than a mile from the house. It is time for the top 3 children to be checked also so I make 4 appointments with #1's and mine first.

We have our turn with the assistants, get dilated, yada yada yada and finally the doc comes in. He introduces himself, remembers DH mentioning my problems and start the appointment. He askes how many flare-ups I have had. I reply 4 or 5 and that morning I could tell I was going to start another episode (my eyes get sore and very light sensitive). He is surprised and asks me about the tests that have been done to determine underlying causes (auto immune, lupus, RA). I have had none of them (the other doctors weren't looking for an underlying cause). He then informs me that because I have had so many flare ups I am now considered chronic acute and that I should be seeing a rheumetoid specialist for a work up because this isn't going away.

He asks about my medications and I tell him and mention the prednisolone which was filled by the pharmacy (the first doc prescribed PredForte, the second doc prednisolone). He is shocked and asks me if all this time I have been using a generic medication? I say yes. Aren't they the same? No! They aren't. The particle size on the generic is larger than the name brands and therefore the medication isn't absorbed into the eye. The last eight months have been spent putting this medication in my eyes that isn't being completely absorbed. I have been extremely blessed that I do not have a large amount of vision loss. Extremely blessed.

I came out of his office with a name brand steroid drop given to me and instructions to put them in every waking hour and to wake in the middle of the night to put them in every 3 hours and take motrin in massive amounts (because it is an anti-inflammatory).

Can you read my frustration? The other doctors just said we aren't ever going to find the cause of this iritis. You are just going to have to deal with it, take this medicine and then don't bother to check the little box at the bottom of the Rx pad so that the medication could actually do what it is supposed to!!

Next time you end up with a prescription make sure to check with the doctor if it needs to be the name brand. And if it does make sure that little box that says dispense as written is checked.

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