Sunday, December 16, 2012

My LASIK Experience Part 2

The Disclaimer

    Warning this post contains plain talk about medical stuff.  If you're the sort that get's a little green at medical talk, well you probably want to skip past "The Technicals" and "The Procedure"

 The Technicals

   First off, though I call it LASIK, I technically had INTRALASIK surgery.  The difference being that with traditional LASIK they use a metal blade to cut a flap in your corneal epithelium (the top layer of your cornea) and with IntraLASIK they use a laser to to the cutting.  The idea is that by using a laser they are able to more precisely gauge the depth of the cut to precisely cut just deep enough into your eye to only get the fast healing corneal epithelium and not nick the corneal stroma (the slower healing, middle layer of the cornea).  The end result being happier eyes that heal faster (Of course, I have nothing to compare it to, so I'll have to take their word on this one).

 The Lead-in

     I didn't mention it previously, but I had to wear glasses for at least 5 days prior to the initial exam and leading up to the surgery.  Normally, that would be no problem, but some time ago my glasses lost a spring in one of its arms, so I spent the week with it constantly having to be repositioned and sitting lopped sided on my face.
     The day before the actual procedure, they have you blast your eyes with some steroids (Prednisone) and an antibiotic (zymax) along with some general gentle scrubbing of the eyelids to get them as healthy as possible for the actual procedure.
     Once I arrived at the Dr. Tylock's office I signed in and had a short wait in the lobby before being brought back to an exam room where they took my glasses, gave me a Valium, and had me watch a video on what to do post-op in terms of eye drops (your eyes will practically being swimming for a week with all the medicine and tear drops they have you putting in them!).  The nurse came back and explained it all again after the video and made a joke about me probably not remembering this conversation.  I guess most people are fairly loopy at this point from the Valium; I was not.
     In fact, through the whole thing I was *extremely* alert.  I was told wonderful stories by my friends and family who had this procedure done that you'll be off in la la land just doing whatever you're told to do.  For most people, this is very true.  For me, and my grandma Ruby, I think we went from a 10 on the anxiety scale down to a 9.5, maybe even a 9.
     Thankfully, the hardest, and most painful, part of the procedure was the almost 2 hour wait time from this point until I actually went into surgery!  As an ADHD guy it was literally a painfully boring experience.  You're lead into a room where you can hear the sound of the lasers, so that when it's you're turn you're not freaked out (as someone who was completely alert, I can confidently say I didn't even notice the sound lasers during the procedure, I had other things occupying my attention), and told to sit there with your eyes closed.  No TV with the news on, no radio, just waiting.
     I tried to strike up a conversation with the people around me "Anyone up for a game of eye spy?" I would ask, and there would be dead silence.  "So what are y'all in here for?" I would say; more dead silence.  I finally caught a guy before the Valium knocked him out and found out that he was a welder, I started to tell him that one of my father-in-laws used to be a welder, but he was out by then.
     It should be noted that my wait times were slightly inflated as they were running behind schedule, but since most people nap through the whole thing, it's not that big an issue!

The Procedure

     When it was finally my time, I was brought into a very cold room and given a nice blanket.  They did one more cleaning of my eyes with what I assume was a saline solution or some iodine (I remember being asked at one point if I was allergic to it, so surely it must have been used at *some* point, but it might have been in the exam stage), and it was my turn under the laser.
      While most places, I'm told, have two separate chairs, one for the cutting of the flap to expose the corneal stroma so they can shape it with the laser, and one for the actual shaping with the laser.  Dr. Tylock had a single bed which rotated you to the two different devices.
     Now remember I was fully alert at this point.  They gave me some numbing drops for my eyes, and then used a spring device to hold my eye open and, I suspect, to keep my eye from moving.  Then came the unnerving part.  Though I couldn't feel anything but pressure, they placed something over my eye at this point that was largely uncomfortable.  Yes, that's right the worse part of the actual procedure was only "largely uncomfortable." I rank routine dentist visits as worse than "largely uncomfortable"!
     At this point I'm sure my corneal epithelium was cut, but I didn't feel it, and I was largely focused on this uncomfortable pressure caused by whatever they placed over my eye so I didn't notice any sounds, but 20 seconds of this tops and they were done with my right eye and another 20 seconds and they were done with my left.
     Then the bed rotated me over to the cool laser (the one that would shape my eye) and used another spring to keep my eye open.  At this point they used a little tool to gentle fold back the flap they had just made in my corneal epithelium and everything went blurry.  I thought I knew what blurry was being as near sighted as I am, but this was a whole new level of blurry.  Everything literally lost shape and definition.  Mind you none of this was painful, but it was certainly fascinating.  After this they turned on the laser for 15 seconds and you smelled something burning.
    At the dentists office, when they pull that drill out and shove it on your teeth and you smell something burning you go "wow, that's my tooth they're doing their best to set on fire" and you're right.  When you smell something burning at LASIK, don't panic!  It's not your eye, you're only smelling ozone created by the laser.
    Dr. Tylock then cleaned off the flap to make sure he wasn't slapping any nasty bacteria on my eye, gently laid the flap down, repeated the procedure on my other eye and that was it!

The Aftermath

     I had really bad near sighted vision (-5.75 in both eyes, it's worse than many of the people I know, but not the absolute worst I've ever heard of), so from the very moment I stood up I had a marked improvement.  As in I could see.  Not 20/20 level or anything but close.  It was absolutely amazing.  At this point Dr. Tylock took the time to make sure the flap was lying down the way it should, and answered any questions I had for him.  Then it was another 30 minutes of waiting with my eyes shut to make sure everything was healing nicely and I was released to Amy's care.
     Now I have to do those tear substitute drops you buy at the store every 20 minutes for the next week and every couple of hours after to keep everything healing like it's supposed to, plus I have to do the Prednisone every 2 hours for the next 6 days (and 2 a day for the next 6 days after that), plus the Zymax 3 times a day for 4 days.  So like I said earlier, you're eyes feel like they're swimming in water for a long time.
    But it's so worth it.  I wake up in the middle of the night and look out through these funny little goggles I have to wear when I sleep for the first few days (they don't want you rubbing you're eyes in your sleep and messing with that flap), and I can see everything in the room (I have very good night vision).  No more do I see non existent shapes or fumble for my glasses.
    Of course, I have to go to the DMV in the morning and get my Driver's license changed to reflect the fact that I no longer need corrective lenses or else they'll give me a ticket, but that's a small price to pay for vision which the day after the surgery was hovering just shy of 20/15, and will get better as the swelling goes down (and my eyes stop being water logged with all these tears I have to drop in them!)
    So long story short, Lasik is extremely worthwhile, and Dr. Tylock is definitely someone I will recommend to family and friends!


As a side note, I went to the DMV this morning and was a little disappointing that they  had me read such an easy line for my eye test.  I had to resist the urge to say "come on, couldn't we try something a little more challenging?"
Share/Bookmark

Thursday, December 13, 2012

My LASIK Experience Part 1

Making the Choice

      I have been thinking about doing Lasik for many years now.  Ever since I was in the third grade I've needed corrective lenses.  Well actually, when I was in the third grade I thought glasses were the coolest thing ever and lied on my eye exam so I would get them (I did feel guilty about that later and confessed, but I fear the damage was already done and while I would have eventually needed glasses anyways, I had hastened the time table!). 
    Since then, my eye sight has been getting progressively worse, but I didn't mind too much.  I had to use glasses or contacts to see no matter what, so it didn't matter if my eye sight was negative 2.75 or negative 5.75 (which is where it's at now).  What I do care about is I tend to wake up in the middle of the night feeling slightly confused and not being able to see tends to freak me out in these instances.  For a long time I wore night and day contacts and that was blissful!  30 days of uninterrupted vision.  Unfortunately, a couple years ago I went to a doctor by a place of previous employment who was lack luster.  They were trying to market themselves at rich trendy people (which is a double strikeout for me), while providing sub quality merchandise.  It was a miserable year for my eyes as the contacts just never seemed to fit quite right.
    Thus, for the past 2 to 3 years I have been unable to wear my night and day contacts.  This year, I finally decided that it was time to get serious about checking out Lasik.  My eye sight was stable and I had the choice of either shelling out for contacts year after year, or make an upfront investment for hopefully 20ish years of not needing glasses (well after 15ish years I'll have to start getting reading glasses I'm sure, but such is the fate of age).
    It was time to bust out google.

 Choosing a Doctor

    The first couple of places I contacted where places I had heard advertised on the radio.  People like Key-Whitman, Kleiman/Evangelista, and Boothe.  Key-Whitman was good, but they require you to come back every year for an eye exam that won't be covered by your vision insurance in order to keep their "lifetime warranty" on your eyes.  Kleiman/Evangelista were good, but too expensive (in the over 3K range), Boothe... well not many people had anything bad to say about the surgery itself, but everyone did say he was a bit of a jerk and when things did go wrong he would avoid you and send you to someone else.  He was very much in it for getting people in and out and gone.
    After a bit of google searching, I found two more options South Western Medical Center (which I ended up not contacting so can't provide any information on) and Dr. Tylock.  After a pleasant talk with one of their finance people, I decided to come in for a "free" exam.  Free in the Lasik industry, for the record, means $150.  They get away with calling it free because if you decide to get Lasik from them, then the cost of the exam is applied to the cost of the surgery. Of course, that means that if you don't want it from them then you're out $150.  It seems underhanded to me, but everyone I called had this exact same setup, so at least it was underhanded across the board!

The Exam

     The exam was a rather quick affair.  I came in and waited for a bit, was taken to a back waiting area and then in quick succession had some photos of my eyes taken, had an eye exam to confirm my prescription, had my pupils dilated, some bright lights to check out the insides of my now dilated eyes, another eye exam, my eyes number, and a cell sample taken from the surface of them.  Then I was charged for the exam, set up a time for the surgery, was given a pair of sunglasses and Amy drove me home.
     Funny story about them dilating my eyes.  The guy said, "Okay, we're going to put these drops in your eyes and they will burn a little" at which point he came in to put the drops in my eyes.  I stopped him and said "Wait, if they're going to burn, why are we putting them in my eyes?"
     He looked a little shocked at this, like "no one has ever asked me this before, they just let me do it".  What he actually said was "We need to dilate your eyes".  Now call me crazy, but that's not actually an explanation.  That is telling me what the burning drops do, but not telling me why we need to do them.  I could tell I was really messing with his flow though and let him do it.  For the record, my eyes burn worse when I get a bit of shampoo in them.  I also found out later, from another guy, that the reason for it was the dilated pupils let them see the inside of my eye better.
     Another one of these moments happened when a doctor said "Okay we're going to put these drops in your eye that will numb them".  Why on earth they would immediately start to move after saying these things without waiting for confirmation from the patient is beyond me.  I stopped this guy again and asked "Why are we numbing my eyes?  Are you going to be poking them?"  There was an uncomfortable silence that yelled "yes" Before he gave a noncommittal answer. 
     Later when he brought the poking stick out and moved towards me without so much as a how-do-you-do? I stopped  him again and said "what is this now?"  I tell you, questions really catch these guys off guard!  I finally did get a straight answer though.  The poky stick was actually a swab stick and it was to take a sample of the cells on the surface of my eye in much the same way as a doctor swabs your tonsils to check for tonsillitis. 

The Aftertaste

    All things said, the exam was a very pleasant experience.  Despite them being floored by me asking a question, they were extremely friendly, they were clearly paying attention to how I was feeling the whole time and it was obvious that had I been freaking out they would have taken the time to work with me rather than strapping down my wrists and moving this along.  At the end of it, we talked to a guy to schedule my Lasik (which is today in a couple hours!) and he was very nice.  There were no high pressure gimmicks, no pressure to get it done.  The most he did was when I was trying to decide if I could do this today, he said, "if you like, you can schedule it for today and then call us to cancel it if you change your mind".  To follow up on this they actually called me yesterday to confirm that today was going to work out and just to make sure we didn't need to change things.
     Having dealt with very push salesmen in the past (and even at some of the Lasik places I called), I was extremely impressed with their professionalism.  Rather than say I felt I was at a car lot, I felt like I was at a doctors office where he was saying "this is an optional procedure, we can schedule it if you want it, but it's ultimately up to you"

Hopefully in a couple days I can write how the surgery itself went and hopeful it will have been as pleasant as the exam.
Share/Bookmark