Protective eyewear for soldering

please feel free to copy and paste and forward. I am a semi retired neurologist with good neuroopthalmology training and a secondary subspeciality. I have had the honor of being elected a fellow in my specialty society and subspecialty society and am board certified.

When selecting a physcian to be your primary care doctor, make sure that they are board certified and also belong to their specialty medical society. For family pracitice it’s the American Academy of Family Medicine… board certification is usually not a problem because virtually all medical staffs require board certification, and for those new physicians who have just entered practice, board eligibilty, which expires within three years… they have three years to pass the board exams. Current practice also requires every ten years, recertification… Despite the rigourous board exams, there are still good and bad docs…passing the boards weeds out those who are dangerous only… going by reputation online is not useful as doctors are rated by personality and not by qualifications… the ideal is to have a qualified doctors with whom you can communicate with freely and get your questions met…That is not a problem for me because I know what to ask and am persistent in getting my issues met… it’s far more difficult for a lay person who doesn’t know the fine details of their medical condition… nbeing able to communicate with your primary care physician is of utmost importance… If you aren’t satisfied, change physicians until you find one that you can get along with and who you know is qualified…

…In that regard, online symptom self diagnosis and online self (mis)educated people, can be a pain for physicians, as they have to spend time correcting inaccurate or false information… Much of what is online does not pertain to your case unless you have been given a specific diagnosis…social media is the worse source of bad information… stick to Mayo Clinic, Cleveland Clinic, and academic medical center websites (Harvard medical school, Stanford, etc.) that give simplied information to patients that are still in general informatiive and accurate…I can go deeper into research papers on medical condtitions but only a trained physician is capable of understanding the molecular biology, genetics and other very difficult information presented. But even that is difficult and slow reading for me…

One final comment is that every physician is bogged down and have their hands tied by insurance and Medicare (CMS) rules… what they can and can’t do for you is restricted by Medicare rules and regulations that also apply to private insurance… It’s an undending source for frustration for all medical practioners. Electronic medical record demands take time away from direct face to face contact… the doctor is furiously entering check box information in the computer with his back turned to you but that doesn’t mean he or her is not listening and hearing you… the electronic medical record is also a medicare/CMS requirement and has intruded totally in doctor/patient relationships… My long career spans from the time we had paper records to the modern system…bureaucratic restrictions and roadblocks to good patient care have been steadily mounting…doctors and nurses do everything to comply with Medicare"CMS regulations, leaving little time to devote to patients… failure to compy with Medicare/CMS regs risk draconian punitive fines and other strong actions. Health care plans and managed care for Medicare patients that are farmed out to insurance companies, further restrict access, cut corners and try to save money by delaying ro denying care… The savings aren’t returned to Medicare and pocketed by insurance companies who make a lot of profit from it… Humana, United Health, Centene, Cigna, Aetna make godd profits and are publiclaly traded companies on the New York Stock Exhange… thier revenues are in the 100 BIllion dollar range…Thier consistent high profits make them investment porfloi core holdings… but it all comes at the expense of patient care and Medicare spending…

Eye health and musculosketel health are indispensible for those in our craft of jewerly making… Health in these areas have to be maintained. Growing older blunts our visual acuity and leads to serious problems… musculoskeletal probems prevent us from bench sitting. Some of it can be avoided by good ergonomics from the start, and the use of microsocpes for vision as we grow older.

I’m sorry for being so prolix, but this topic is important and for a general audience… it especially applies to older jewerlers…
without health, wealth is meaningless… wihout health, quality of life suffers… eat healthy, move more, stress less, love more… 4 simple rules to live by for good health…

best of wishes to all and to all a long and healthy life. Steve H, MD FAAN FACNS

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PS: pardon the typos… I noticed them after posting… still no big deal to understand… thanks

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I was an optician (dispense glasses) and para optometric for eleven years in Washington state. Here optometrists can prescribe medications and dilate people’s eyes. The doctors I worked for were exceptional diagnosticians and did post op care for their cataract patients. Not every state allows an optometrist to practice at this level. Not every optometrist practices to the full extent of their license. It’s good to make inquiries and to get referrals from happy customers. I agree that optometrists definitely give a better refraction than an opthalmologist. During my years in optometry I did plenty of visual field studies, ultra sounds, and took retinal photos. Our doctors managed the care of hundreds of glaucoma patients. When our patients required more extensive care we always referred to specialists. Patients who saw specialists always had better outcomes than ones who opted to go to general opthalmologists who do a little bit of everything.

I’m not dissing opthometrists… as I said, I use them myself. however what is true in Washington state is not true in everystate of the Union…A dilated exam with direct opthalmoscopy given the right skill set can’t be substituted for an indirect…I have a congenital retinal pucker also on the far periperiphery of one eye that can’t be seen without depressing the globe but it was found years ago by an astute academic othalmologist and remains a risk point for a retinal detatchment… I have had to have cryosurgery for a retinal flap tear… a consequence of being an aging high myope with an additonal astigmatic axis deviation…surgery is beyond he scope of practice of an OD… however, Medicare won’t cover routine eye exams and refractions. Few if any opthalmologists at all will accept VSP eye insurance… I routinely use both OD’s and MD/DO eye docs for my annual eye exam… Medicare will cover my MD/DO eye doc expenses having had eye surgery once before… my VSP insurance is a bargain since the cost of lenses far exceeeds my premiums…my OD is a participant and has always done a far better job at refractrions. I like him very well and am completely satisfied with his services… My othamologist retired and his replacement is as nowhere near as thorough as he was… leaving visual field exams, refractions, etc. to technicians, the latter who only did confrontation finger count fields, which is nearly a useless screening… an Amlser grid, even with it’s profound limitations is still better than finger count VF’s… My OD does a far better job than they do…but I still don’t care much in particular for tangent screen visual fields…having had neuroopthalmology training in Goldmann perimetry.(completely impractical except for academic purposes due to time constraints)… Farmworth Munsell color sorting testing for protan, deutan, and tritan color visual loss but confirmatory of optic nerve problems with a Tritan loss…eg. B12 and toibacco/alohol amyblyopia ( again highly cost/time ineffective!!!) and pharmacologic pupillary testing for localization of Horner’s syndrome and Adie’s tonic pupil (yet another cost/time ineffective procedure), I do know more than the average general neurologist does about neuroopthalmology… (my retired opthalmologist did pseudo Goldmann screening using red and white light isopter spot checking)…Being a clinical neurophysiologist, I am well versed in ENG and VEP interpretation (both techniques being highly dependend on the technician’s skill to get adequate results!) …What I AM pointing out that I personally have found the best of both scopes of practice… and use both to my advantagfe for the bet eye care I can get locally. All of this is contingent on my medical training… That degree of sophistication is not within the reach of the average layman… and that being said, there are bad MD eye docs as well as good ones (one here was terrible at overdiagnosing optic nerve head druzen as papilledema)…just as there are good ODs and not so good…I can’t put in a position of dispensing medical advise either liability-wise nor ethically… just pointing out what different eye docs can and can’t do for their patients… it’s up to the individual to find a competent eye doc, either OD or MD/DO… navigating health care system bureaucracies and insurance restrictions is a complete frustration for everyone including myself…

Agreed, they both have their place. The doctors I worked for were very skilled and worked to the upper limits of their practice/licensure. We are very fortunate to have them given that we live on an island and only have two general practice opthalmologists on island.

having anyone is better than no one… unless that anyone is a bad one… bad docs can do worse than no doc… you are indeed lucky to have skilled people in an isolated setting… Being on a island is the situation where I came frorm originally… even in Hawaii, people still have to be transported to Honolulu to get speciality care. The Lahaina fire whose aftermath is still in the news. created so many badly burned victims that the burn care unit in Honolulu, where they had to be transported, was nearly overwhelmed… even the State’s main medical center where there are many specialists, there are still some people who have to be transported to academic medical centers in California to get the requisite care…enough said, no more from me on the topic, I’m getting too far off base and apologize for that.

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