Had a 25 yr patient come in for her 6 mo diabetic retinal exam. Shes a AA who is overweight and several years past 75 but mentally sharp.
During exam she asked if i could give her something for headaches, right side, hurt to chew, temple to ear. I started questioning her about it and come to find out she had gone to the ER for the same kind of headache, but worse, about 10-11 days ago.
Well, what did they find. She couldnt remember but they gave her some pills and an injection and she got well, for several days but she said they made an appt for her with a neurologist. The ER doc said he would only give her enough pills in the rx for 1 week.
So, callec pharmacy. Sure enough, they were Prednisone. I asked her if the doc at the ER said anything about Temporal Arteritis. Bingo. She remembered that name. So, she had probably been given an injection of methylprednisolone.
Next question was when she ran out of the pills. Last week. When is the appt with the neurologist? 12 more days. Unreal.
How can they give meds for one week when the neuro check is 4 wks later. She would probably be dead or at least blind by then.
I called the neruos office and talked to his RN. Its 4:00 PM.
Good news. Send her to the ER and he will see her there in 2 hours.
PTL. Only by the grace of God was she scheduled for a diabetic exam today.
Temporal headaches in the elderly are often a semi-emergency. The vascular inflammation can back down to join other arteries and then progress up to the optic nerve or brain.
Doc,
I may give you lots of guff on our favorite subject, but I have not doubt you are a fine Eye Doc.
Good Job helping this lady. You work a difficult location for a difficult demographic.
