Recently, I had my first experience with Jamaican healthcare and I’m alive to tell the tale! Healthcare has been something that was concerning to me but I have been pleasantly surprised with the care that both Allie and I have received. The nurses at the embassy explained to us that the education and training are very good, doctors and nurses are knowledgeable and capable, but often the facilities and equipment are lacking.
Some foreign service info for you – Each embassy has a health unit. Here in Kingston, our health unit is staffed by two wonderful nurses. They have been a great help and comfort to me since we arrived. Allie has had her vaccinations done there and I have had some shots of my own. Anything that requires a doctor, the nurses will give recommendations and help you maneuver through the health care system. If there is any medical issue or treatment needed where they feel like the local care is not sufficient then you will be sent to the US for treatment. This is called a MedEvac (medical evacuation).
Sunday, Sept. 13 – I noticed my eye getting a little bit pink. It didn’t hurt, itch, or burn. It wasn’t dry, no symptoms, just a bit pink.
Thursday, Sept 17 – I went to a luncheon for a women’s group that sponsors scholarships for children here in Jamaica. (That deserves a post all it’s own) I had noticed the pink in my eye again, but still, it didn’t hurt. I guess the fact that I put on mascara was reason enough for me to take a silly-looking selfie.
That night it started to hurt. I thought it was strange because it wasn’t dry, it never itched or burned, there was never anything oozing from it. It was a pain like when you get kicked in the shin but in my eye. Like a really achy pain in one specific spot. Scott emailed the nurses and they made an appointment for me at a general practitioners office for Friday morning.
Friday, Sept 18 – I had my appointment with the doctor. I was a tiny bit nervous simply because I didn’t know what to expect and the office was in an area of town I’d never been to. At the appointment, they had me take a pregnancy test, I explained I was there for my pink eye, they replied it’s standard practice for every appointment. Spoiler: I’m not pregnant. I explained my symptoms, the doctor looked at my eye, took a swab to have the lab check for bacteria, prescribed me some antibiotics, and sent me on my way. At this point I wasn’t sure what it was. I wasn’t feeling like it was an infection but I knew there wasn’t anything in my eye, there had been no trauma to the eye, so I wasn’t sure what else it could be.
I was given my own swab sample to deliver to a lab! I thought that was so funny for some reason. I went to the lab to drop off my swab. The “lab” was about the size of a handicap bathroom stall and on the desk there was an old computer. Remember those ones that are like a foot deep? And the screen on the monitor was pretty small? The ones where hours were spent playing Oregon Trail and Mah Jong Tiles? Yeah, it was one of those. Like the nurse had told me, equipment isn’t quite up to date! I delivered my sample to the lab tech there, then made my way to a pharmacy.
I started my antibiotic eye drop but nothing really happened or improved for several days. I would still get really intense pain off and on. But still, no dryness, no itching, no oozing, no crusty.
Scott started giving me homemade, makeshift eye patches with medical tape and gauze. I’m not sure the world can handle my level of beauty in these photos but we will give it a try!
It was really strange to me that the pain and sensitivity would fluctuate so much. At this point I was more and more sure that it wasn’t an infection.
Monday, Sept 21 – Sunday was a painful night and when I woke up on Monday my vision had become cloudy. This scared me a little because I know that vision is not something to mess with. At this point, after I had been using the antibiotic and my vision started to cloud, I was sure something else was going on. I let the nurses know my concern but decided to wait until the test results on my eye swab were done to rule out an infection.
Throughout the day, I could tell that my vision was becoming cloudier and cloudier. I was pretty concerned at this point. I didn’t want anything permanent to happen to my vision. Luckily, my ophthalmologist back in Utah agreed to consult with me via FaceTime (okay, okay, he’s my uncle). After chatting with my uncle, whose name is also Scott, he agreed that it wasn’t an infection and that I needed to have an eye exam by an ophthalmologist. His concern was if I didn’t start getting treatment, the pressure in my eye could go up, up, up, until my vision was damaged. He explained that his suspicion was that I had a case of iritis but couldn’t be sure without an exam.
When I was done chatting with Scott (uncle Scott) I sent a quick e-mail to the nurses just explaining everything, that I didn’t want to wait for the swab, and could they help me find an ophthalmologist.
Tuesday, Sept 22 – Scott went to work and apparently also sent an email that was “not as friendly” (his words!) as mine was saying I needed to get to an eye doctor ASAP. I got a call from the nurse saying they had contacted an ophthalmologist who agreed to see me as an emergency patient and had also been in contact with the MedEvac doctor so everything was ready to send me to Miami if we felt that was necessary. I was like whoa, slow down, I just need an eye exam! Because I was unable to see and therefore unable to drive, the embassy nurse picked me up and took me to my appointment. We went to the ophthalmologist, Dr. Brown, who diagnosed me with iritis, just as Scott (uncle Scott) had suspected. She kept saying it was good I came when I did because it was getting close to being a severe case.
Iritis is an inflammation of iris, the colored part of your eye. It can happen spontaneously or, if it happens chronically, is associated with several different autoimmune diseases. Inflammatory cells are found in the anterior chamber of the eye. And that’s why it hurts, people!
Associated with the iritis, I also had some synechiae, iris attachments to the lens. Unfortunately, I didn’t get any pictures, but because of the synechiae my pupil was all sorts of weird shapes for a day or two.
At this point, the nurse gave me a the choice of going to Miami for a second opinion. Since Dr. Brown had explained everything exactly as my uncle Scott had I felt that was really unnecessary. I’m sure they would say the exact same thing in Miami and figuring out arrangements for Allie, traveling, being away, etc, definitely wasn’t worth it to me.
I was put on an hourly drop to treat the inflammation as well as a drop to keep my eye dilated to break the points of attachment. After about six doses of the hourly drop I could already tell a difference! If this ever happens to me again I am definitely NOT waiting so long to see the doc.
Thursday, Sept 24 – follow up with Dr. Brown
Tuesday, Sept 29 – follow up with Dr. Brown. I was given permission to drive! Hooray!
Tuesday, Oct 6 – follow up with Dr. Brown. As much as I like Dr. Brown, I really wish I didn’t have to see her so often! Everything is improving and my eye is looking better everyday. My drops have been set back to every 2 hours instead of hourly. I’m still on the dilating drop so I not only look crazy but my vision is still blurred. It’s definitely more clear than it was 2 weeks ago but certainly not clear. I will never take great vision, glasses, or contacts for granted!
I have another follow up with Dr. Brown on Thursday, Oct 15 and we are hopeful that I can discontinue the dilating drop, which would be so awesome. I will probably be on the other drop for a total of 6 weeks because it has to be tapered down slowly. We are going to Panama for week beginning the 17th so I really hope I can stop the dilating drop!
I’m very grateful to the embassy nurses for being with me every step of the way and giving me rides when I was unable to drive. And I’m hoping with all of the hope in my hoping heart that this is a spontaneous episode and not a chronic condition.
OH OH OH and how could I forget… the lab results came back and there was no bacteria in my eye.
And finally, I can’t do a post without some pictures of the favorite Ficklin, so here ya go!
Allie will now sit up on her own, has mastered the little army crawl, and is still toothless!