Thursday, January 26, 2012


Ever since I moved here I have been dying to go to Sergio's. The restaurant is in Murphysboro just off of Rt. 13. It is a cute yellow building with lots of string lights - seriously adorable.

Since we were dining with a SI Daily Deal and needed to spend $25 we really enjoyed ourselves. We started with drinks - I had a little margarita -- they also offer a 44 oz one!! Brandon had Modelo.
Chips and salsa were complimentary. We ordered also ordered queso. For the entree, I ordered the taco salad with fajita steak.
All the toppings were under the lettuce (guac included!). Brandon had the steak fajitas.They came out a sizzlin! We ate a lot!
But that didn't stop us from ordering dessert.
Deep Fried Cheesecake
Best decision of the night. It came with 2 pieces of cheesecake wrapped in tortilla and fried with a ball of "fried" (cornflake crusted) ice cream and tons of strawerries! Wow. Only $4.

Very friendly service and cute atmosphere. The restaurant had pictures up of people celebrating their birthday. Coincidentally, it was someone's birthday that night. The employees came out and sang in Spanish. $1 beers on Monday, Tuesday and Wednesdays. Go there!

Friday, January 20, 2012

What I Do at Work part 2

There are 2 things that make the patient believe that the technician does all the work (and to that I tell them I deserve a raise). The first is the manifest refraction I described in the last post - "which is better 1 or 2?" The second is when I check the pressure in the eyes with a tonometer.
Not me, but you get the idea (source)
To do this I give the patient a drop of flucaine in each eye. It is a bright yellow numbing drop. Ironically, the drops sting when they first go in. I then hold the patient's lids open and  place the tip of the Perkins tonometer on the cornea. When I look through my tool, I am looking for a green line that I will align and use to obtain the measurement.
My View (source)
Can you see the faint green semicircles? Now imagine if the patient is sensitive and is squeezing their eyes shut. To get a good view, one must get up close and personal. Short fingernails and good breath are a must. When I have to give this test to prisoners, I get scared. Usually the patient is unaware that the instrument is touching the eye. Pressures between 10 and 20 are normal. Savvy patients, usually those with glaucoma will be very curious as to knowing their measurement. This method of measurement has replaced the need for the "puff of air" test in our office.

After checking pressure, I will instill the dilating drops. We use two types phenelyephrine 2.5% and tropicamide 1%. Because we usually instill these after the numbing drops, no pain is felt. This is different than when I worked in pediatrics and we just had to tell the kids that it would feel like soap is in their eyes. The dilating drops are important so that the doctor will be able to look into the back of the eye where the nerves and blood vessels are. To look inside, he will need to shine a light in. The dilation drops keeps the muscles of the eye from contracting and gives the doctor a more complete view. The drops can last anywhere from 4 to 24 hours depending on the individual. This will make it especially hard to read and the sunlight will seem very bright. We encourage our patients to bring a driver with them, however, if you've had them before and are comfortable driving then it may not be a problem.

In my next post I'll discuss testing like visual fields, OCTS and pachymetry.

Thursday, January 19, 2012

What I Do At Work part 1

Have you had an eye exam recently? Then maybe some of this will ring a bell. I wanted to explain a bit more about what I do all day.

I call the patient back (sometimes seriously embarrassing myself with mispronouncing names). Some common techniques to deal with this are to
- make eye contact and ask "are you ready? come with me"
- call the patient by just their first name, or Mr. or Mrs. (last name) based on which is easier to pronounce

When I bring the patient back to the room I introduce myself as the technician. I still feel awkward calling myself a technician. I feel like I should be repairing a car or computer or something...
My job is to find out why the patients are here and get some basic measurements. To get a chief complaint I will always ask about blurry vision, pain, flashes, floaters and double vision and whether or not you use any eye drops. General medical history is also important - medications, chronic conditions, etc... This is when you get to find out how talkative the patient is. As they talk I fill out this worksheet:
And don't worry, electronic medical records are coming this year. I'm excited!

As a healthcare professional I deal with people all day long. As an introvert, this is a very tiring thing! But, the patients always keep things interesting and the majority are friendly. I am always amazed when I find myself telling my life story to random strangers - some people just know how to ask the right questions! 

I use a lot of equipment when I do my initial patient work-up. The first thing I will hand the patient is the occulder.
Me, back in the Doc Plot days (source)

Every time we will start by checking your vision, Believe it or not people will complain that we have to do this. I'm sorry but even if you were just here yesterday we HAVE to make sure you can see, you're at the eye doctor!! I turn on the projector and have the patient read lines off the Snellen eye chart. When they can't got any further I have them use the pinholes which can sometimes help (like squinting). Up close, we use a Jaeger reading card:
For patients who see an MD, I manifest refract the patient. That's when you look through the phoropter and I ask "which is better, one or two?" Patients get so nervous about making the right choice! In this post, an optometrist gives advice for refracting. I like his advice to call certain lines of letters "teeny tiny" or "for bonus points." This really works well for kids. Speaking of kids and babies, this video explains how pediatric eye exams are done (surprisingly entertaining).

Then I go on and check your pupils, by shining a light in your eyes and watching to make sure they are round and react equally. By shining my light from the side, I can check angles. Closed angles create shadows and that is part of a check for glaucoma. Then I will have you follow my light to check motility of the eyes. Your eyes should be able to move in all the directions. Finally we do a peripheral vision test. I have the patient cover one eye and look at my nose. Without looking at my fingers, I ask the patient to tell me how many fingers I am holding up in each of the 4 quadrants. 
For older patients we check for cataracts by performing a test called the BAT (brightness acuity test) using a "big flashlight." I perform the glare test by having the patient look through the light and read the letters on the wall. If a patient has cataracts and they are advanced enough, the light shining in their eyes will cause a glare that decreases their acuity. For more information about cataracts, check out this site.
To be continued....

Wednesday, January 18, 2012

Southern Illinois Bride

The River Radio Ever After Bridal Show was this past Sunday. Yes, I attended a bridal expo just one week after getting engaged. Brandon asked if I wanted to go, so I said yes. I mean, what better time to go than now, with no pressure - an really no ideas of what I wanted. I invited Nancy, and Knute tagged along to keep Brandon company.

The event was held at The Pavillion in Marion. We got there right at noon when the doors opened. There were already about 30-40 people infront of us in line! Upon check-in, I registered as a "bride" and got a bright green "bride" sticker to wear - fun! I also got a Bingo card with all the vendors names on it. At each booth I had to get a signature then enter my card in a raffle for $1,000. I guess I didn't win. The card actually made it easier to get a signature and run away from talkative vendors. Most of the vendors were putting on a hard sell. "Do you have a date?" was the most popular question I was asked. My favorite booth was the jeweler who cleaned my ring:
We also loved the party bus. They had one of their limos that we could look at and it was seriously decked out (stripper pole included)! I also confirmed my desire for a photobooth at the wedding. Larry's had the best cakes:
I don't think I want people eating my face, but cute idea:
 By far, the most unique cake display was this one:
Woodland chic... not my style at all! But I love the birds and the dark blue icing. Unfortunately, we didn't have time to stay for the wedding dress runway show. But, I got a lot of catalogs with dresses to start looking over. Ooh and a lot of goodies, cupcakes, pens, magnets, chapstick, coupons, etc. Obviously, there were only local Southern Illinois vendors. Probably, not getting married out here but it was still fun to look. I think we all had a great time!

Tuesday, January 17, 2012

Quote of the Day

"How did you end up with a River Rat from Murphysboro?"

- a patient asked me

Good question.

Monday, January 16, 2012

The Rest of Florida

It was required that we hit the beach, if only just to walk in the sand for 15 minutes. I mean look at the pretty blue water!
We stayed at Joey's in Seffner, which was next to Brandon, Florida. I would not let Brandon miss this photo-op. He promised to name a town after me someday :)
Brandon in Brandon, FL
We found the perfect souvenirs at CVS. All those magnets say "Brandon."And no trip would be complete without some good eats. Joey's girlfriend Mara is the GM at Captain Just's Crab House. Hush puppies and honey dipping sauce, yes:
She also had us try Oysters Rockefeller:
Oysters smothered in cheese, spinach and bacon - why have I not had this sooner?! We also met up with our friend Nate, who took us to Burger 21.

I ordered the shroom burger, fries and a strawberry milkshake. The burger was delicious and the bun was perfect. The fun part was the ketchup station. The most unique flavor was toasted marshmallow. Not a fan!

Sunday, January 15, 2012

Marathon & The Proposal

The reason we came down to Florida in the first place was so that Brandon could run his first marathon. On Saturday we drove from Tampa, where we were staying at a Joey's house, to Orlando. Our first stop was Disney, to check-in for the marathon. We were greeted by sweet retired people ushering us into the correct buildings. One was dancing and singing dy-no-mite and another read Brandon's shirt and gave him a high five! Sign me up to retire in Florida. After packet pick-up we visited the runner's expo:
The expo had some neat things but was crowded. We picked up a 26.2 sticker for the car and a baby one for the scrapbook. Then, we left in search of a hotel. We found a great deal on a "blind" hotel with Hotwire. Our goal was to stay at the cheapest hotel in the "Disney Main Gate" region. For $30/night we stayed at the Ramada Maingate. It was just an exit away from the park. This was great for me because I had to drop Brandon off at 3:30am. I promptly headed back to the hotel and back to bed. The race officially began at 5:30am but Brandon crossed the starting line around 6am. I got text messages updating me on his splits for the 5 mi, 10mi, 13.1 mi and 20 mi marks.   

Around 9:30, Joey and the gang picked me up at the hotel and we had Cracker Barrel for breakfast. Now that was a good way to start the morning. Although, I did feel a little guilty not getting to cheer Brandon on.
Brandon was taking his race really seriously, and didn't bring a cell phone with him. This made me nervous! When we made it to the finish line we were trying to estimate his time of arrival. I was so worried I was going to miss him! And so were my friends because they knew Brandon wanted to propose at the finish line.
That's a picture of Brandon crossing the finish line. See those fences, that was the best view we could get. As Brandon made his way to the family reunion area, he realized that the proposal wasn't going to happen. As he requested, I gave him a big sweaty hug anyway. 
He said the race was just as tough as he imagined it would be but was still up for a day at the park. What a trooper! So we headed to the Magic Kingdom and rode some rides. The ring was in Joey's pocket the whole time, yikes!
After Thunder Mountain, Brandon decided we should walk over to the castle and take a video. At the time this did not sound fishy, lol! We video taped Brandon at the finish line earlier. Brandon's plan was to walk through the castle and propose inside (the same path he ran earlier), however, a tent was blocking the path. Amber (our Disney expert friend) suggested that we walk around to the front. I remember babbling on about this and that. Then we arrived and Brandon said, "I ran 26.2 miles today, but I'd run a million more with you. Will you marry me?" Down on one knee and everything. Swoon! 
There are 25 small diamonds in the ring adding up to one karat and it is plated in white gold. I love it! But, my finger is still getting used to it - it hurts! lol. I'm taking it to get sized tomorrow, so it will be gone for 1-2 weeks. Have one more look:

Friday, January 13, 2012

Atlanta, GA

Well before all the engagement excitement, I was blissfully unaware of what was yet to come. On our drive down to Florida we passed through Atlanta and I had to stop. Ever since I read The Hot Zone and learned of the CDC, I have wanted to visit. Atlanta also has an awesome medical school and used to have a restaurant called Mitra, fate I tell you! Anyway, our stops were none of these places but just as fun.

First up was the Atlanta Cyclorama. As John A. Logan fanatics this was a must see! The Cyclorama is a 40 ft x 350 ft oil painting depicting scenes from the Battle of Atlanta. (Yes my Civil War museum journey continues!) The painting was commissioned by Logan for use as a campaign poster - go big or go home! Unfortunately, he died 3 days before it was completed. It toured the country as a circus sideshow and by chance it ended up in the hands of a wealthy Atlantan. To view the painting you need to purchase a ticket. A tour guide takes you to a theater where a movie about the Civil War is played to guide you through the progression of the war to Atlanta. Then you go to the painting where you sit in the center of the room on a revolving platform. Lights and narration guides you through the painting as you spin slowly around the entire painting. It was awesome!

We weren't allowed to take pictures but you can see some highlights on the website. At the bottom of the painting is a diorama that brings the painting's scenes right to your feet. The coolest figurine is of Clark Gable who requested that he be put in the diorama as a dying soldier. An adorable child in the audience asked, "What injuries did Mr. Gable have?" Our tour guide was great.
Me 'n Johnny
Our next and final stop was the World of Coke. As you would imagine, it's a museum about Coke. We love Coke but the movie and exhibits were all fluff! (Disclaimer: I'm a museum snob)
They have a functioning bottling line, the smallest and slowest in the country - ok, that's cute. But the exhibit on the "secret recipe" was sooo lame. It had great production value (I felt like I was at the Spy Museum) but no FACTS. I guess it's because the Coke recipe is a mystery... locked in this vault:
Brandon and I doubt that anything special is in there. But the alarm did sound when people taking pictures got too close. What do you think?

By far the best part about the experience is the tasting room. Unlimited tastings of Coke products from around the world. Beverly, an Italian bitter soda was our least favorite. Bebo, which tasted like pina colada, was one of the best.
Cherry Coke
Classic Coke
Little did we know we got a free bottle of Coke on our way out! We also went through the gift shop and picked up an ornament for our Christmas tree and a magnet for the fridge.

Wednesday, January 4, 2012

Christmas Vacation part 2

The day after Christmas, Mom and I decided to head on down I-95 to Richmond. She was dying to visit the Museum of the Confederacy after reading an interesting book about Jefferson Davis. When we pulled into the city, I realized that I had seen the museum before... when I was a visitor at the VCU Medical Center.
Turns out the The White House of the Confederacy (not literally) is surrounded by a hospital campus. Nevertheless, we walked around the 3 floors of the museum and then took a tour of the house. One of the most memorable pieces in the museum was a painting of Davis by an intriguing artist named Julio. Mom's favorite piece in the house was Davis' desk where Lincoln may have sat. Our tour guide danced around the subject and would not confirm that fact. Mom had the final revenge by reaching over and touching it. Our tour guide was a total nerd history major!
On Tuesday, we had another adventure at Oatlands Historic House & Gardens. I treated Mom and Jeila to tea time as part of their Christmas present. The tea was held in the carriage house. It was a pretty building with a lot of tables - kinda like a church lady convention. But that was just the atmosphere we wanted, lol!
Giftshop lady photobomb!
Now, I know why she took that photo over again... We were served their signature calendula tea which was black tea with marigolds. Our hostess kept visiting our table and filling our teacups. We also munched on a tower of treats:   

Then it was time to tour the mansion! Sorry, no photos allowed. Definitely a place worth visiting. Unfortunately, we couldn't walk around the gardens too much because it was raining. (We did try!)