Limited Access to Health in Rural Areas

I was diagnosed with dry age-related macular degeneration (AMD) a few months after having cataract surgery at the age of 65. I began seeing a retinal specialist two years ago when I starting noticing vision loss in the right eye. My AMD had advanced to the intermediate stage and now requires visits to the retinal specialist every six months.

I soon realized how living in a rural setting limits my access to healthcare and makes it difficult to make lifestyle changes easily.

Limited access to healthcare

Last week I made the two-hour trip to the nearest facility that treats macular degeneration. By the time I arrived home that evening, I was exhausted. The rural community I live in has no public transit options. Each visit requires me to arrange for a driver, which is an added stress. My husband has his own issues with vision loss due to scarring from surgery to close a macular hole and cannot drive in city traffic.

I am fortunate to have a choice of four retinal specialists at the facility I go to. They can perform routine tests such as the OCT. Should I require any type of procedure beyond an injection, I would have to travel five hours one way for treatment.

Living in a remote area means that if I have an emergency such as retinal tear I may not be able to access care in time to prevent loss of vision. Many in our macular degeneration community do not have that choice when they live in a rural setting as I do. This can result in poor outcomes.

Healthy diets and food deserts

Having lived with macular degeneration for six years, I am aware of the benefits of eating a healthy diet including:

• Leafy green vegetables
• Fresh fruit
• Nuts
• Whole grains
• Fish
• Olive oil or canola in the place of butter

I live in a rural setting classified as a food desert. The nearest supermarket is 32 miles one way. I do most of my shopping at a small market 15 miles away and owned by the Choctaw Indian Tribe. I am thankful they opened it, but it doesn't have all foods I need to support good eye health.

I cannot purchase fresh fish and the only frozen options are breaded. The selection of fruits and vegetables on any given day is scarce with few choices.

Exercise

It is important for general health as well as macular degeneration to get regular moderate exercise daily. The nearest walking trail is 15 miles from home. Living in a rural community, the beauty of nature surrounds me but it is hard to get exercise outdoors. 

My country road is narrow with no sidewalks. Taking a walk requires constant vigilance not to be run over by speeding vehicles. With no zoning laws, dogs roam free, sometimes in packs. When I hear they have killed livestock, I am scared to walk alone. Unless my husband walks with me I walk boring laps around my yard.

I love my country life

I have learned so much from the macular degeneration community about resilience that helps me adapt. Though life in the country can be challenging, I still am blessed to wake every morning to the beauty of the mountains and clean air. I have to work a little harder to do the things necessary for my health, but I love my country life.