Cataract surgery Attempt Failed

Well, I had a bad day yesterday. It was time for eye #1. I had also found out the other eye was virtually un correctable. but they still want to do it later. I had a bad high BP issue yesterday so they wouldn’t do the surgery. I had fallen and smashed my head and neck in October, so I was not feeling tip top anyway, but my BP had been just fine. It went up the day I fell, and was at the ER but once home it was ok. I read that spinal/cervical neck issues can also cause some BP problems. I’m seeing a doctor for all that late this month. He said that doctor was not sufficient for anything.
This clinic was frantic. They first told me to take no insulin for 12 hours, and I explained that ummm then I would be in the ER not eye surgery. I had a hard time getting my BG down, but apparently I was stressed. So, the anesthesiologist explained he could not do the procedure. Fine, I get it. I promised to verify my BP meds were working ok. But he made me sign a paper that only a Primary care doctor could evaluate my BP. My CDE, CNP has regulated my thyroid meds and BP for years. She’s got it figured out. He said she was unqualified. He would not accept anything from her.
So we have a Primary Care shortage here. My husband just lost three doctors in a row, waited months for a new one who told him since he has cancer, she wont see him (he was already there in front of her). She referred him to a different place, with a now five month wait. The local university health system has a one year wait. I reminded him of this and he wasn’t very nice to me. Insisting no other doctor but a primary will do, and I need signed documents from such a person or I am not allowed back in the surgery center. He also said no primary care doctor will turn down a diabetic and he thinks they are the only people a diabetic can trust with BP.
I intend to follow up with my CDE, and will be seeing the spine dr as planned. But now I’m thinking, maybe I need to try a clinic where they do anesthesia free cataract surgery. They do a tranquilizer and whatever. I got an appointment and it’s on my plan.
I don’t know how my plan will look at yesterday’s failed mess.

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I am sorry to hear what you have gone through. I can just tell you my husband just got cataract surgery about 6 months ago and they didn’t knock him out. We go to an eye center and one of the doctors there does the surgery at the hospital. But they just give you a calming drug and then paralyze and drug the eye while you are awake. An anesthesiologist was there to monitor everything. It took about 30-45 minutes. He didn’t even have to get clearance from anyone, just a visit to the same eye doctor before as a precheck. He’s not diabetic per se as he’s a controlled is/was type 2. For me when I had laser surgery on my eye (easy stuff) all he wanted to know beforehand was what my A1c was for healing purposes. My Dad when he had his cataract surgery years ago, they didn’t knock him out either.

This happed to me. Years ago about 14, I was scheduled for an test for endometrial cancer. The pre-op folks said take half the insulin meds the night before. I did so and none the day of the procedure. Get prepped to go in the surgery and the anesthesiologist canceled the surgery. I was very upset. Glucose too high. Had the scaping with no anesthesia in referring surgeons office. It was not bad. I do not know if I would re commend it. Currently I would go in at 150 BG, not stopping meds, and then disconnect pump and I would not go up or down much during the procedure.

I take olmesarten for bp. Take 25 a day, Had pretty resistant blood pressure.
Tis seems to work for me.’ Good wishes

It’s unfortunate that you live in an area with so little choice of body repair mechanics. I call most doctors repair mechanics because they couldn’t make a human body. They literally don’t understand how one works except at a superfical level. Like car mechanics , doctors aren’t uniformly competent. Unlike car mechanics, doctors are members of a guild that protects them from consumers.

It’s more unfortunate that you had no way before you needed a doctor to learn that the ones you need in your area aren’t competent in general medicine, let alone diabetes care. But you aren’t alone. Most people wait until they have a problem before meeting with a doctor, don’t find out what tne doctir is capable of until too late.

It’s not their fault that doctors don’t actually understand much, and what they “know” is mostly anecdotal information in the form of warnings from others who didn’t really understand what they witnessed. The “first do no harm” credo, taken literally, is to do nothing. It takes a special kind of bravery (ignorance or arrogance) to attempt anything when you don’t really understand how something works.

But ignorant medicine seems to have gotten worse with corporate medicine and siloed specialties. There they follow guidelines from committies and don’t directly talk to each other about individual patients under their mutual care - unless there’s an inquest.

Some of this can be excused because of the small number of doctors in the US. In 2016 for 320 million citizens, there were total 950,000 doctors (336:1) , 202,000 of them PCPs (1584:1), 45,000 opthalmologists (6670:1). For the 34 million PWD there were 8000 endocrinologists (4250:1 ).

To address this shortage there are now new regulated, licensed medical practitiioners. Every Certified Nurse Practitioner nurse in the US is licensed to diagnose, prescribe and regulate chronic conditions like blood pressure. Making you sign a form saying that only a PCP can assess your BP is illegal. I wouldn’t allow an anesthesiologist who did this participate in my care, but I would report them to the facility adminstrator.

I agree. I’m trying to visit other surgeons in my plan while my CDE CNP works on my thyroid dose and BP meds. With a severe shortage here, they ought to be smart enough to know that having a CNP who is already your prescribing person, has a greater chance of correcting things promptly.