Sunday, June 10, 2012

LASIK: Was it worth it?

Was it worth it?

My sister asked me this question last night, a little over 24 hours post LASIK surgery.  The answer is a resounding Yes, but my experience was quite different than what I was prepared for and I wanted to write down everything before I start to forget all the emotions and physical responses I had before, during, and after surgery.  This is a very very very long post, and it's more for posterity than it is for anyone's personal enjoyment.  It isn't my "brief account," but rather my FULL account.  If you want to just skip to where I start talking about the actual surgical experience because that's what interests you gore-aholics, feel free.  If you're thinking about LASIK and the pros/cons, you might read the whole journey I made, as I include my reasons for opting to have the surgery despite my intense fear of losing my vision.  Also, as a generalized disclaimer, this is MY personal experience and I fully acknowledge that all surgeries, but specifically this one, vary greatly from person to person.  I also realize that there are many other laser eye centers and they might do things differently than Mann Eye Institute does.

I have thought about the possibility of LASIK most of my adult life.  It never seemed like something I would be able to afford, or be brave enough to undergo, so it was a very remote thought.  In the last few years, however, it seemed that more and more people I knew were opting for the surgery and claiming both amazing results and 100% satisfaction.  Most said it changed their lives and was one of the best decisions they had ever made.  I still had my doubts.

But then I started thinking... there are lots of little things I would enjoy so much more if I wasn't worried about my contacts.  I love to travel, but eye care is just one more hassle when you travel.  Every single time I go on a trip, near or far, I pack an extra pair of conacts.  Early in my contact-wearing days, I had more than one ruined vacation due to a torn or lost contact.  Without them I was entirely, well... lost.  Glasses were never my cup of tea.  I think I wore them for a year, before trying contacts and immediately loving the freedom.  Sure, it was a funky feeling at first, having something in your eye, but the benefits far outweighed any irritation.  I haven't really been able to enjoy swimming every summer, since I started wearing contacts, since there's the constant worry you're going to lose one or get splashed and it will just fall out, and obviously you can never open your eyes under water.  Bye, bye contacts!  Then there are the higher impact activities I've thought about trying - like sky-diving or surfing or mud runs, etc - that just have never seemed convenient with something in my eyes.  And all the practical problems that exist, too, like what if there were ever an intruder at night and I had to quickly get out of bed and run for my life or escape a burning house?  I'd be doing it blindly.

Then I did the math.  In 14 years of wearing contacts, my parents and I spent around $4,000 on yearly eye exams, prescription contacts, contact solution, etc.  And that's not including medication and doctor fees for several eye infections that could possibly be from contaminating my eyes with contacts.  $4,000!  That's roughly $285 a year.  LASIK at the price I was offered by Mann Eye Institute would cost me $3995 with 24 months no interest financing and monthly payment that rivaled our car payment.  In addition, I usually put aside several thousand every year towards my IRA retirement fund, and I had the revelation that maybe THIS year I should put that money towards something I would use not 35-40 years down the road, but today, tomorrow, and every day for the rest of my life.  In late April, I ran across a GROUPON savings for $1200 off the surgery.  It was the final kick in the butt I needed.  I booked my free consultation a few days later.

I chose the Mann Eye Institute & Laser Center for a variety of reasons.  Yes, it was GROUPON deal that spurred the fast action, but I also knew their name and they are one of the most experienced and technologically up-to-date laser eye centers in the country, and certainly the best in Texas.  These guys are the doctors that perform LASIK on our country's fighter pilots, professional baseball pitchers, and NASA employees, to name a few.  I figured if they were good enough for NASA, I could probably tolerate them.  They have the most advanced, newest lasers available.  My consultation was a basic eye exam, I spoke with a Mann Eye Consultant for 10 minutes about the procedure and risks, and as I was deemed a likely candidate we scheduled an appointment for a few weeks out.  Tim's final question for the consultant was "What are the main reasons people choose not to have this procedure?"  The guy said, "Fear or Money."  And I said, "But you make it so affordable."  And he said, "Then you're afraid."  I readily agreed.

Last Wednesday I had to stop wearing my contacts in anticipation of the surgery.  Contacts change the shape of your cornea, and in order to be able to properly map the surface of your eye, you have to leave them out for a certain period of time to let your cornea reshape.  You can read about the agony of living in glasses in my post Eyes That See.  After a week with no contacts I went in for my pre-op appointment.  This was more testing, more in-depth mapping of my eye, and a consultation with Dr. Cessac who wasn't the surgeon, but who would officially approve my candidacy for the surgery.  The night before this pre-op exam, I sat down to look back over the paper work, and as requested read through the consent form.  I hadn't yet done this and became incredibly anxious about the procedure after reading all the potential side effects and complications.  Sure, they have to list every exceedingly rare possibility as a release of liability, but it was unnerving to have had none of that mentioned before... by anyone, patient or doctor.  They just skim over it as if it isn't even a concern.  I suppose they are confident enough in their expertise it really isn't a concern, to them.  

After the technician ran the tests I was ushered into the exam room to consult with Dr. Cessac.  At this point I was becoming very emotional.  I hated myself for it, but my fear was surfacing.  I looked at Tim and said "I'm about to lose it."  The technician hadn't been particularly gentle, or exceedingly personable, and coupled with my anxiety I was starting to doubt my decision.  I felt sort of commanded through one exercise or another, poked and prodded, and if you're sensitive about people putting things in your eye, near your eye, etc... well this would be an uncomfortable experience.  When Dr. Cessac arrived, I was really ready to fall apart.  She was warm and friendly, and very kind.  Kindness always makes me cry when I'm already emotional and anxious about something.  It's like how you can hold up just fine under pressure and then your MOM walks in and you lose it.  I was realizing I was way more scared about this procedure than I had let myself believe in the weeks leading up to it.  She cheerfully told me my numbers looked great and that I was cleared for surgery.  She examined my eyes and then asked if I had any questions.  I did, but instead the inevitable happened: I started crying.  I felt like a big fat baby.  I apologized and explained I was just really nervous and fearful, and then Tim lovingly took over and asked a few questions so I could pull myself together.

They see this every day.  Every day they tell someone it's no big deal.  But you don't realize "it's no big deal" until you just experience it, because you don't know exactly what to expect.  Sort of like a rite of passage: every one nods knowingly at you, but they're on the other side, and already have completed the trials and overcome the obstacles.  It doesn't matter how many times they tell you what will happen, you still haven't actually been through it so you're going to be anxious until you do.  I was sort of tired of feeling dismissed, but again - they do this every day so they know the benefits far outweigh any risks.  Through all of this I sort of always knew I would just do it anyway, but I think I wanted a bit more hand-holding from the whole Mann Eye team than I felt I received.  On my way out, the front desk team made up for everything I felt was lacking on the medical end that day.  They are gems: super comforting, accommodating, and genuinely want you to leave with a happy feeling.  I left feeling so much better thanks to David at the front desk who told me he'd had LASIK last year and reassured me I was right to be nervous and scared, but I would really be glad I did it in the end.  I left with that as my mantra for the evening.

Surprisingly, the rest of that day and evening I didn't feel too nervous.  I know I had at least several people praying for me consistently throughout the last couple of days, and I so appreciate all of them and I feel like this contributed to the peace I did feel.  I should take this moment to mention, if it isn't already perfectly obvious, that I am absolutely terrified of losing my eyesight.  Having surgery on your eyes is the worst possible thing, in my opinion, especially when you have to be awake to see and feel it.  So I know that there was a strength that I drew from all those prayers that helped me take all the steps that led me to going through with the surgery.

That morning I felt good.  I was anxious, and my stomach was a little wobbly, but I ate some breakfast and was then just ready to go and "get it over with."  Fortunately, they don't ever make you wait around too long.  That is one thing I will say for them: Mann Eye is very efficiently managed.  They do all their LASIK pre-op appointments on Thursdays, all their surgeries on Fridays (and do up to 50 eyes in that one day), and all their day after check ups on Saturdays.  I'm sure it's arranged for those who want to recover over the weekend and be back at work by Monday.  Every staff member obviously knows their part backwards, forwards, and upside down.  Even with the minor complaints I had, I always felt like I was in extremely competent hands with plenty of experience behind them.  

My mom met us at the office, as she was going to drive me home and stay with me so Tim could go to work.  As soon as we checked in, they went over post-op dos/don'ts, and gave me the instructions for applying my eye drops.  Then I was taken back for my prep where they double checked my prescription again with a vision test, and then cleaned my eyelids with iodine, gave me a hairnet, and offered me two Valium and some ibuprofen.  I was more than ready for the Valium.  Then finally I got to meet my surgeon.  Dr. Lisa McIntire was, like Dr. Cessac, kind and friendly and very confident.  She again assured me that my numbers were great and she felt confident that I would have great results from this procedure.  She asked if I had any other questions, etc.  I restated that I was very nervous, and she assured me this was perfectly normal and she would walk me through everything during the surgery.

They left me alone for about 10 minutes to let the Valium begin to take affect.  I started thinking that maybe I wasn't going to get to see my mom or Tim again before the surgery, and I got a little teary, but just as my emotions were mounting my friend David at the front desk (provider of the mantra day before) thankfully led them into my room, saying he didn't want me to be alone.  Bless him!  So I got to chat for another 10 or so minutes, which really helped keep me distracted.  When the assistant came to get me for surgery it suddenly became all about business, and I felt very rushed and sort of like I was on an assembly line.  As I was going in, another post-op patient was coming out.  I was pretty blind, as I had handed over my glasses earlier, and the assistant guided me to the "table" and helped me lie down.  I was immediately under blazing bright lights.  So bright I couldn't even open my eyes, and even with them closed my eyes were watering.  They covered me with a blanket since I said I was cold, and I think she could also tell I was very tense, so they offered me a big stuffed dog to hold.  I said, "Yes, I would very much like a dog, please."  And I remember thinking how silly that sounded.  It was rather unnerving to have several people talking to me, but not be able to see them.  I finally asked, "Who am I talking to?" The woman told me her name was Carol and that I had met her yesterday with Dr. Cessac.  I said, "Oh, yes.  Well, I'm the one that cried."  Don't ask why that was how I wanted her to identify me... I was trying not to pee my pants and I was squeezing that dog as hard as I could.  I remember asking if I was going to have to look at the bright lights, and Carol said yes.  She had to peel open my eye lid to get more numbing drops in, and then I clamped them back down, and she said I could keep my eyes closed until Dr. McIntire came in.

To be perfectly honest, trying to fully account for the next few minutes is making me queasy.  The process was such that they insert an eye speculum to keep your eye open.  Then they lower a suction vacuum onto your eye.  Once that clamps down your vision goes grey, the incision is made, and you can hear them counting up "50 percent, 75 percent, 100."  The suction is what leaves red bruising spots on your eyeball.  The right eye seemed to go very smoothly.  It was uncomfortable and I was trying not to cry, but there didn't seem to be any complications and the incision was painful, but very quick.  Then they release the suction, flip back the flap that was created (you sort of know this is happening but can't really feel it), and you stare at a green light while the actual vision correction is made.  That creates a burning odor, rather like the smell of burning hair, while the laser corrects your eyesight.  I had read about this part on the internet, and I'm really glad I knew about it because no one in the operating room prepared me for it and it would have been completely unnerving if I hadn't known that it was normal.  This is a perfect example of how I wish someone had been verbally coaching me through the surgery.  One of the attendants did keep patting me and saying it would be over soon and then I could go home and take a nap, but that wasn't exactly comforting.  

After the correction was made, I COULD feel the doctor place the flap back and smooth it down by painting my cornea repeatedly with something sort of gluey.  It didn't hurt, but I was entirely aware that was happening.  They flood your eyes with drops, drops, and more drops, and then remove the speculum and immediately place a dark eye patch over your eye.  I closed my eye right away.  Then they moved on to the left eye and this was where I started to lose whatever nerve I had left.  I was already in pain in my right eye and my body was anticipating the pain that was about to come.  They had difficulty getting me to keep my eye open, getting the suction to attach and lining my eye up with the laser.  I just remember Dr. McIntire saying over and over, "Try to look straight up at the light, Laurel.  Look at the light.  Tilt your chin back.  Keep your chin back."  And the attendants were all patting me, telling me not to squeeze (makes your eye bulge), raise my eyebrows, we're almost done, etc.  The incision on my left eye was far more painful, and I even said something out loud.  I can't remember what it was: "Oh Wow" or "Oh my gosh" or something.  It was funny because I remember thinking "don't say a bad word."  But I sort of wish I had.  I'm thinking now that they didn't really have any idea how painful it was for me.  

Once the incision was made, the rest was not so bad.  And it is sort of blurry in my memory because I was just really trying to keep it together, and then I was suddenly being told to sit up and swing my feet off the bed.  I had these clear sort of goggles over my eyes, but I could already tell that I could see far better than I had when I was ushered into the operating room.  I sat down and Dr. Cessac did a quick check of my eyes with the microscope.  She said everything looked great.  I was totally trembling and trying very hard not to sob.  I said, "Can you tell me why my left eye was so much more painful?"  And she said, "Oh, your left eye hurts right now?"  And I felt really sort of irritated at this, heightened by my disorientation.  UM, OF COURSE IT HURTS, YOU JUST BURNED IT WITH A LASER (is what I was thinking).  But instead I said, "Well, in the surgery it was much more painful than my right eye, but yes it does hurt right now."  And she said, "Let me put some more numbing drops in.  Sometimes they have to apply more pressure to one eye than to the other."  I mumbled okay, and she helped me out the door.

As I walked out, there was Tim taking my picture.  "Don't take my picture!" I barked at him.  There was a group of people standing there all ready to watch their family member go next.  It was very weird and felt very uncomfortable to walk out into a group of people you don't know, having just had a (for me traumatic) surgical procedure.  I really wish it was not organized like this.  I realize not everyone has the same experience I had, but it is still a disorienting process and seems like they could wait a matter of seconds for one group to move one before bringing the other family members over.  

My mom could tell, I think immediately, that something was wrong.  I just said "That was very painful" as she put her arm around me, and started crying.  I started walking as fast as I could towards the exit, as it was clear that there would be no post-op conversation with the surgeon or anyone really - which was another impersonal part of the procedure, but I assume they just want to get you home and asleep as quickly as possible.  Tim had to buy my drops at the desk on the way out, but I couldn't just stand around, I was embarrassed I was crying so much, so I kept heading toward the elevator and my mom came with me.  Tim told me later that the front desk staff were very concerned about me because they could tell how upset I was.

I could see well enough to give my mom directions to our house, get out of the car and go straight to bed.  I tried my very best to do exactly what they told me and just go to sleep.  The pain was too intense and I was still steadily crying, partially from the pain but also from my anxiety that something was very wrong because there was so much more pain than anyone had warned me about.  Finally I called my mom in and asked her to just sit with me.  I was keeping my eyes closed because they were very swollen and it was painful to open them, so it was scary to be in pain, be alone, and be totally blind.  We finally decided to call the office, because I was not able to sleep and I couldn't stop crying.  She promptly got through to someone who told her I was actually drying my eyes out by crying so much and this was increasing my discomfort.  They advised doing a round of the antibiotic and steroid drops, and then following with some artificial tears to insure that my eyes were staying hydrated.  This was agonizing as I had to pry open my eyes to put the drops in and frustrating because I couldn't really tell if I was getting drops actually IN my eye.  But it did seem to help and I also started to calm down.  They gave my mom a direct number to call back in a half hour if I wasn't feeling better.  I got back in bed and THANK GOD, slowly drifted off to sleep.  I could tell my mom sat with me until she knew I was relaxing and dozing off.  I had to keep the clear shields on all day the first day, and I'll continue to sleep in them at night for a week, to ensure I don't unconsciously rub my eyes while the cornea flap is healing.

I was only able to sleep an hour, and when I woke up there was still discomfort, a sensation that I had a torn contact lens or dirt in my eyes.  My eyelids were really puffy, too, from the speculum holding my lids open, and I had the big red bruising spots they warned me about from the suction.  We did another round of drops, and then I rested the rest of the afternoon with my eyes closed, getting up for dinner and a few other things, but trying my very best to just keep my eyes closed.  Mid-afternoon I received a call from Dr. McIntire, personally checking up on me.  By the time I was getting ready for bed, I only had mild discomfort, like from an eye infection, and other than a romantic haze (like Soap Opera lighting), my vision was nearly as good as what I could see with contacts in!

The more results I see, the more I feel better about the whole process and the more my anxiety about complications subsides.  My followup Saturday morning went great.  They had goody bags with coffee mugs saying "I love my LASIK a Latte," and samples of biscotti and gourmet coffee  for us as we walked in the door.  They also served donuts and coffee for all the  that had LASIK patients from the day before for their followups.  I met with Dr. McIntire and she had no real explanation for the pain I experienced, except that every person is different and every once in a while the procedure is more painful for some than for others.  She apologized for my pain and discomfort, but assured me that everything went smoothly and perfectly from a surgical perspective.  She also told me during my exam that through the microscope she could hardly tell I'd had surgery done, so I was healing very rapidly and could only expect things to get better!  I was reading much of the 20/20 line with each individual eye on the vision test, and with both eyes together I am definitely seeing 20/20. Yay!  I hope this only sharpens as my swelling and bruising subsides.

One thing I will say about this center is that you can tell they really care about their patients and they want you to be happy.  Even though there were some things I felt they could have been more thorough about, they are all genuine, kind people and were clearly upset that I felt so traumatized.  And never, at any time, did I feel like I wasn't in the best of surgical hands, so to speak.  I really appreciate personal touches like the front desk giving me a sample of the very expensive steroid eye drops, to save me some money when they discovered I did not have insurance, and getting sent home with my surgeon's personal cell phone number, and both of the Dr. Mann's (father and son) cell and home numbers, in case of emergency.  I don't even have the cell phone of my general practitioner -- much less my eye surgeon?!  Of course, I appreciated the Saturday morning free DONUTS, too!  I am eager to go back for my one week followup to see if my vision has improved past 20/20.

If you've read this and you are considering LASIK, you now probably have mixed feelings.  I want to reiterate that my experience was likely heightened because so many people told me it was barely uncomfortable, and I happened to find it more painful than that.  My expectation did not equal my experience.  In turn, that caused me to be even more anxious that something was wrong or had gone wrong in my surgery.  I was also very scared of the whole procedure, before and during, and I'm sure that intensified the pain for me.  But as I immediately saw results, and I'm learning how quickly your eye heals itself, I can see how even if patients experience pain or discomfort, they quickly forget it because it seems like such a small amount of pain in such a short amount of time versus what you end up with in the long run.  Most things that are rewarding require a bit of effort, and sometimes a little bit of pain.  I certainly wouldn't want to go through this again, and I'm hopeful I don't have to have anything "tweaked" to keep my vision 20/20, but I am overall satisfied and glad that I did go through with the surgery.

So, was it worth it?  Waking up yesterday morning, the day after, was a special moment.  I've heard people describe opening their eyes the next morning and how surreal it is that you can see almost perfectly.  I woke up, but didn't immediately open my eyes.  I just lay there thinking about how relieved I was the worst was over, and how proud I was of myself that I had gone through with it despite my absolute fear.  I sent up a little thank you that God had gotten me through such a terrifying (for me) experience, that he had blessed me with so many friends and family members who were praying for me to be at peace about the procedure, and that my recovery was already going so well.

And then I opened my eyes and could see.

Wednesday, June 6, 2012

Eyes That See

Since last Wednesday I have been wearing glasses.  This is a requirement for anyone undergoing LASIK eye surgery who also wears contacts.  The week before your surgery you must go without your contacts.  I know that the Vision Professionals have you do this because contacts can affect the shape of your eye, but I am now convinced that they also do it to ensure you are completely and 100% dying to have the surgery.  Contacts were relatively convenient.  Glasses.... suck.  Any doubt I had has quickly been replaced by the wish to never have to wear anything other than sunglasses ever again.  Well, at least until my mid-forties.

For someone like me whose glasses only serve as a substitute to prevent bumping into furniture when making my way from the bathroom to the bed at night, or to provide relief from irritated eyes when allergies or (God forbid) conjunctivitis comes to call, this was far more of a test than I had expected.  For almost a week now I have felt (dramatically) like an invalid.  I haven't worn makeup, fixed my hair, and honestly, I've hardly put on real clothing.  To be painfully honest, I've barely left the house.  This is somewhat easy to accomplish since I'm now (by choice) unemployed, and most of my work does not require me to go anywhere, but still very unusual for me.

The practical side of this complaint is that I'm not used to glasses.  They make me feel disoriented, sleepy, even at times sort of nauseous.  My perspective is affected, my night vision scarily worsened, and they aren't a pair meant for constant wear so they fall off my face continually.  In a very very very very very small way, this week I have had to face my handicap.  Oh, please don't think I'm comparing myself to an amputee or a hearing-impaired individual.  Never would I dare.  But the very few times I have purposefully tried to find my way around my own house without any type of corrective lenses was almost terrifying.  Trying to locate a "lost" iphone in my own house without vision assistance is certainly pointless.  What if there was a fire?  Or a strange man in my bed?  I wouldn't know the difference!  

Just kidding.

My contacts have amazingly over the years allowed me to sidestep a handicap that at another point in history would have been untreatable and possibly crippling.  Now LASIK will be giving me a permanent solution.  I'm trying to prepare myself for the surreal experience of waking up from a nap and being able to see clearly without having to go "put my eyes in."  I'm beginning to realize how excited I am, how many things I can do and enjoy now that I mightn't have before.

Can we all just revel in the wonder of science and medicine for a moment?
I am.
I am also a teeny bit scared.  
I will squeeze that damn teddy bear they give you until its stuffing shoots out.

Saturday, June 2, 2012

Birth Days

So many things have happened in the last few weeks.  Two weeks ago was my last day of working retail... hopefully forever.  Things always get good right at the end and people are always really sweet as you're leaving, so it was with a bit of trepidation that I left the store for good on May 16th.  On top of this second guessing, I had a restless night, knowing my very pregnant sister was going in the next day for an appointment about her high blood pressure, with the possibility of a necessary inducement.

I woke up, strangely unaided by an alarm, at 7:00am and texted my mom for an update.  Maggie was in labor and the contractions were already fairly close together.  I packed my bags and waited to be beckoned.  That baby sure had good timing.  First day of self-awarded unemployment and unlimited free time, here I come!  Her labor was about 8-9 hours, and since this isn't her blog but rather mine, I'll spare you the full birth story.  The bottom line is that this baby is even more of a miracle than most.  Between being posterior (face up instead of down), not wanting to come out, and an umbilical cord that could have detached at any time during labor or pregnancy, when I finally met Samson Zane, I was completely and utterly in awe.  And not just in awe of my first and only nephew, but of my sister's power, strength, and endurance through it all.  There he was... all 10 lbs 1.5 oz of him.  Hello, World!

I will readily admit that my heart changed about babies, birth, and motherhood.  Since I grew out of planning elaborate outings with my baby dolls, motherhood (aside from to my dog) has never been something I aspired to with any great thought or energy.  I'm still unsure that I would ever feel ready, or that I want to be a parent, but I'm not sure you ever are... ready.  And while I will love my Mr. Dog and his cuddles till the end of time, having a little sleeping baby on your chest is pretty super indeed.  For now I will just enjoy his snuffling sounds and the fact that he is the first baby that doesn't seem to cry endlessly when in my arms.  

I will be the Greatest. Aunt. Ever.

My personal new year was also sort of eclipsed by Sammiepie's arrival, as it rightfully should.  But I did begin my 27th year without much wailing or nashing of teeth.  And I received a label-maker from the Hubs.  Which, if you know me, will make perfect sense and you will be able to imagine the pure joy this gift gave me.  My sister made me a Funfetti cake (two years running!), by request, and we celebrated with drinks and a day by the pool.  I think she thought transposing the numbers on my cake would make me feel hopeful for the future.  I can't say that it worked.  But what did make me feel hopeful was the rendition of the "Happy Birthday" song I received from Tim and Nathan.  I'm hopeful I never have to hear it again.

I am really glad we only come out of our mother's vagina once.  We can celebrate that!  

Yes, I said vagina.