One patient, many eye doctors

I'd been complaining to my optomestrist that my eyes felt gritty and uncomfortable and that, moreover, my botton eyelashes were falling off, and he prescribed drops for dry eyes.

Then I went to my Boston dermatologist, who said that the red rims around my eyes meant I had rosacea, and she prescribed the antibiotic doxycycline. She also said that someone with my history should really be seeing an opthamologist for extra TLC, so when I returned home, I paid a visit to an opthamologist I had seen in the past.

He took one look and said that yes, I had dry eyes, but I also had a relatively common irritation called blepharitis. He prescribed an antibiotic ointment and said I could also dissolve baby shampoo in water and wipe my eyes with a cotton ball.
On the way out, I filled out the paperwork for my files to be transferred from the optometrist's office.

Meanwhile, the dermatologist had done a biopsy on an flaky area under my eye. It was close to my tearduct, and she said that if it came back positive, which she expected it would, I would need to have the rest removed by an opthalmic surgeon, a new specialist to add to my list.

Last year I had similar flaking on a spot on my forehead, and it turned out to be a squamous cell cancer in situ, meaning on the skin. (I never knew that flaking was a sign of skin cancer. This was not your normal kind of dry skin flaking, but bigger pieces of skin.)

The dermatologist was able to get rid of it by giving me a cream that turned the spot really angry and unsightly before it did actually vanish. But I couldn't apply a cream so close to my eye, hence the need for the surgical removal, scheduled for today in Boston.

It was just on the skin like the other one, and it would be under local anesthesia, so I didn't expect it to be a big deal. But Joe was concerned that I might need some help, so he took the day off and drove me.

When we got there, the doctor took a brief look and said I would need so see a different doctor who would perform Mohs surgery, a procedure in which one thin layer is removed at a time and examined to see if the margins are clear until it is certain that there are no signs of cancer.

But, but, but, I said, I thought you were going to just scoop it out now. (Not very scientifc terminology, but when I called my dermatologist later, she said that she had indeed e-mailed this surgeon twice and had thought it was clear that the point of my visit was to have it removed.)

No, the surgeon said, I needed to have the Mohs and then go back to her for the repair.

Now this was seeming a little more complicated to me than one little scooping out session.

At my last visit to Dana-Farber, Dr. Alyea had wondered if some of these problems with my eyes (not the dermatology part) might include some involvement with GVHD. The local opthamologist had thought no, but Dr. Alyea wants me to see a specialist in Boston, so I have tacked that visit onto my next check-up.

While I was at the opthamologist's today, I got the idea that maybe I could at least cancel the appointment with the other specialist and ask the one today if she could check for GVHD.

She said that no, she only does eyelids.

Talk about specializing.

Turns out that she does a lot of cosmetic surgery, so I got another bright idea. Maybe this was the chance to have the eyelid lift I've wanted for a long time. That way Joe wouldn't have taken the day off for nothing.

I have actually raised the eyelid lift question in the past and was told by one particular friend, when I pulled up the skin on my eyelids and asked how I looked, that I looked like a deer in the headlights.

So that's not going to be in the cards, but I have enough eye stuff to keep me busy.

I will come back to Boston to see one opthamologist to check for GVHD, one for the surgery and one to have the hole caulked, and noboday died, but it definitely is frustrating.