Wednesday, April 2, 2008

Diagnosis Part I

I was studying for my Critical Care Pharmacology test. I was working out drug problems and the paper the problems were written on looked faded, like the ink the paper was printed on was running low. I continued to work on the problems. Over the period of a few days, everything printed looked faded and I was beginning to notice other visual changes.

That Thursday I went to a nursing conference and almost fell asleep during the lecture. I have never done that in my life. I was exhausted, even though I had plenty of sleep that night. The following day was Friday. I went to work that morning and got report from the night nurse. I was still having trouble with my vision but I could still see. That was until around 7:30 am when I attempted to draw medication into an insulin syringe. I couldn't see the numbers on that small syringe. I immediately told my preceptor that there was something wrong with me I needed to call my eye doctor.

I gave my patients to my preceptor and made an emergency appointment with my opthamologist. I was very worried because I'm already legally blind in my left eye from a childhood accident. The doctor did a thorough exam of my right eye, including testing my color vision. I was perplexed by this at the time but have since learned the reason for this. He said everything looked fine with my eyes but told me to go to the ER for further testing. I could still drive, I only had trouble seeing writing and fine visual images. I went to the ER and signed in. The place was packed. I sat down and people were coughing, moaning and a little kid was crying.

I thought, "I feel just fine. I don't belong here." I walked up to the front desk and signed out. I told the nurse that I would see my regular doctor on Monday. That night my husband and I went to a potluck dinner thrown by one of his firefighter buddies. I drove home that night and I began having serious trouble seeing the road. I asked my husband to drive. I went to sleep that night hoping that I would feel better in the morning.

That morning my husband offered to stay home with me, but I told him that I felt fine and to go to work. Then, I walked into the bathroom and looked the mirror to see if I could see anything wrong with my eye. I had trouble seeing my pupil. I called my husband and told him I was going to the ER again. I was able to see enough to drive in the daylight, although I shouldn't have done that, in retrospect. I arrived in the ER, signed in and the nurse said that there were only three people ahead of me.

I was brought back almost immediately. The doctor asked me some questions, did a physical exam and ordered an MRI of the brain. After the MRI, I was lying on the stretcher in my little curtained room and I heard the doctor answer the phone. He said my name, then, "Oh, no."

I thought I had a tumor or something. I started to cry. He didn't immediately come into my room. I made myself calm down. After all I know some of the staff in the ER. A few of them recognized my name and dropped in to visit. I didn't want them to see me cry.

The doctor walked in and said, "Robin, I'm sorry to tell you this but it looks like you have optic neuritis, a symptom of multiple sclerosis. Do you know what that is?" Yes, I knew.

"A neurologist will be here in a few minutes to talk to you." Then I really started to cry. You see, I knew about multiple sclerosis. When I was in nursing school, I took care of a 25 year old girl with primary progressive MS, who was admitted after a suicide attempt. That is what I was thinking about before the neurologist arrived...

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