Snowbirds

“Me alegro decirle que la presión del ojo es estable-“

“¡Qué rico!”

“Sí, la combinación de colirios está funcionando para Usted. Entonces, vamos a continuar con estas gotas. Recuerda, la botella con el tapón amarillo es dos veces al día en los dos ojos, y la botella con el tapón marrón es también dos veces al día.”

“Sí y voy a necesitar ‘refills’. Bastante para 6 meses.”

“Bueno, voy a verle otra vez para cita en tres meses para comprobar la presión..”

“No, no puedo. En un mes, más o menos, voy a irme a mi país, para ver mi familia y pasar el invierno allí. No me vuelvo hasta que abril o mayo del año que viene.”

“Oh, sí, olvidé que viaja Usted cada invierno afuera del país. Bueno, recuerda Usted que glaucoma es una enfermedad crónica, y tenemos que vigilar la presión con atención.”

“Sí – tengo oftalmólogo allí, un especialista quien puede examinarme.”

“Está bien. Entonces, voy a darle este papel, donde escribo la presión de los ojos de esta visita. Por favor, cuando esté en la oficina de su médico,  déle a él está información. Pregúntele a él comprobar la presión y pregúntele mandarme el resultado. Él puede utilizar este número de FAX.”

“¿Cuándo hago la cita para ver a mi otro médico?”

“Debe verle tres meses de ahora.”

“Está bien, entonces, le llamo a Usted cuando me vuelvo para una cita aquí.”

Let it be said: I am a member of the Cornell Lab of Ornithology. I love birds. I don’t think enough people pay attention to them, or realize how much beauty, in sound and appearance, they add to the world. I enjoy backyard bird watching, as well as learning about new and different species from around the world. Which is precisely why, when I was working with a patient of mine one day and introduced to a new kind of bird, my curiosity was piqued.

I had just finished my examination and was trying to schedule a follow up appointment for one of my patients. He told me he wouldn’t be available in three months to see me, as, he and his wife are “snowbirds”. Snowbirds? After seeing the look of confusion on my face, he proceeded to explain that he and his wife don’t like spending the cold winter season at their home in the northeast. They prefer to fly (figuratively speaking- he liked to drive) down to Florida to spend November through March in their condo in the Keys. “But we come up once or twice to spend the holidays with the kids.”

And there it was, a new type of migratory species. And with this migratory pattern, brought new challenges to their eye care. Some of these patients have chronic eye diseases, like glaucoma, or dry eye, or iritis, ad infinitum, and they need consistent monitoring. So for these people, I had to set up a new system of care. This involved sharing their eye care with another ophthalmologist in their new winter habitat.  For these patients, at their very last visit with me before departure, I make sure to put together a short summary letter of their eye condition over the last few months. I send them on their journey with this information, and tell them when they should schedule their follow-up with their other doctor upon arrival to their wintering grounds. I always ask that the doctor they visit do me the same courtesy on their return. And I have and continue to successfully manage many patients this way.

Many of the Spanish-speaking patients in my office experience a similar migration, if somewhat farther. They return to their home countries come winter, to Peru or Ecuador or Bolivia – to a variety of South and Central American countries. I write a summary of their care, including their most recent visit with me, their visual acuity, eye pressure and general ophthalmologic status.  A separate challenge is worrying about their medication supply. Most of the time there is an equivalent eye drop (to what they are using from U.S. pharmacies) available in their home country. In situations where this is not the case, I will give them a supply of samples to cover their stay while out of the country. I make sure to reiterate that they need to arrange the appropriate follow-up with their other doctor. And of course, once their trip comes to an end, I look forward to continuing their care on their return.

“Bueno, nos vemos entonces, tenga un buen viaje.”

“Gracias-.”

“Y no olvide – lláme la oficina cuando vuelva. Quiero comprobar la salud del ojo en su retorno.”

“Claro que sí. Mucho gusto-“

"Dottie & Casper", Barn Owls. Courtesy: The Cornell Lab