The Royal Heffernans

Quite possibly the best family ever

Saturday, January 11, 2014

Kevin's LASIK


I finally got Teresa’s approval and shelled out the buck$$$ and got LASIK done for both my eyes.  Here’s my story…

Prior to LASIK:
I had to fill three prescriptions and buy a bunch of preservative-free eye drops.  The three prescriptions are for a eye steroid to fight infection, another steroid to reduce inflammation, and Xanax for the day of surgery.  Other than that, there really was nothing that I had to do before surgery, except fill out a bunch of forms.

Day of LASIK:
My appointment was at 1:20, and I would be at the LASIK center (TLC Lasik in Dublin, OH).  I took the entire day off and got a few things done around the house.  I picked up Teresa from work around 1:30, and we went for a lunch together (sans children), which was nice.  I had no anxiety, but Teresa assumed I would never see again, so it was nice for calming her nerves.  I arrived at the center at 1PM (I like to be early), checked in, filled out some more forms, and found out that the Xanax was optional, and only if I wanted to take it.  I didn’t want to take it, so I didn’t (waste of a prescription). 

I got taken back to prep for surgery around 1:20.  Prep involved a quick eye check by the LASIK doctor (Dr. Boyle), a bunch of info about what to expect, a bunch of eye drops for numbing my eyes and preventing infection (something like 5 different drops in each eye over a period of 10 minutes), and then just hanging out.  I got taken back into the actual LASIK room probably around 1:50.

NOTE:  if squeamish, you will want to skip the next paragraph
The LASIK room smells and sounds like a data center (e.g., climate controlled, computer fans, slight smell of electric current passing through silicon).  The LASIK (picture below) has a bed that you lay out and your head swivels under two machines.  The first is a laser that cuts open your cornea to create a “flap” on the top of the cornea that can be folded back.  This is actually the most painful part, because a device applies pressure to your eyes to hold it in place for the laser.  This is the only time during the surgery where my vision was lost for any period of time, and this was mostly because of the pressure on my eye.  Before anything was done, I had devices put in my eye so that the lids couldn’t close.  They did each eye independently and taped shut the opposite eye when the other was having the flap created.  Once both eyes had their “flaps” created, I was swiveled under the other side of the machine.  This was the LASIK laser, which simply reshaped the remainder of the cornea under the flap to refocus the light passing through.  It lasted about 30 second for each eye.  After the reshaping was done, Dr. Doyle used a tear-like solution and a very gentle brush to wash my cornea’s and remove any debris the laser had created when ablating my corneas.  This was the weird part, because I could see her doing this but couldn’t feel it.  It didn’t hurt at all, but it tickled when she touched any part of my eye not numbed by the drops (e.g., eye lashes, eye lids).  Finally, Dr. Doyle folded back my “flaps”, which, much like contacts, stuck to my eyes by suction.  No sutures are necessary to secure the flaps; however, rubbing the eyes and any contact with the eyes is strictly forbidden for a week, because touching the eyes and move the “flaps” and cause them to fold open or move.  The “flaps” won’t move on their own, and heal shut within 24-72 hours, and will completely heal back in something like 1-4 weeks.

 Here's the process in a pictorial format:

 This is the LASIK machine that I was under

Immediately after LASIK
My vision was fixed, kind of.  I could see as soon as I got up, but everything was foggy.  Think of looking through a really dirty windshield in your car.  Yeah, you can see, but any light has a halo-effect to it, and the details are all a little vague.  This is because tears and moisture got under the “flaps” and need to be absorbed.  Once they are this effect goes away.  Also, while my vision was much improved, at first I knew that I didn’t have 20/20 vision.  In fact, my right eye could see much better than my left.  I was kind of pissed.  However, the numbing drops were wearing off, and I didn’t want to have my eyes open anymore. 

I was told to go home and nap for four hours, because I would experience “discomfort” and maybe some “burning” in my eyes and the nap would help promote healing.  To say that I was grumpy was an understatement.  Teresa, bless her heart, drove me home, after a detour to pick up the kids from Daycare.  Here’s what I was dealing with during that 45 minutes:

-         Discomfort – Imagine wearing contacts (or not) and getting something in your eye.  Something big.  In both your eyes.  At the same time.  And not being able to rub your eye, remove your contacts, or do anything about it.  It was so damned annoying!
-         Burning – Here’s an idea, take normal tap water, mix it with some soap, and put that in your eye.  The burning sensation was kind of like that.
-         Nausea – I didn’t want to open my eyes, because it felt better to close them.  However, riding in a car that was wobbling and moving was making me somewhat nauseous.  Then I open my eyes, and my vision is totally different than what I’ve ever experienced, which makes me nauseous.  Needless to say, I made it home just in time. 

I got home at 3PM, put on the sweet goggles they give you so you don’t touch your eyes inadvertently when you sleep, and went to the guest room to lay down.  I prayed to fall asleep and finally did.  I woke up around 5:30, with my eyes only slight less “discomforted” and “burning”.  Teresa came up and asked if I wanted dinner, to which I very un-patiently responded I didn’t (did I mention she was awesome?), and decided to roll over and stay in bed until 6:30.  At some point, Dr Doyle called my cell phone to check on me, and actually left her cell phone number to call in case of problems (what a swell doctor!).  I fell asleep again, and when I woke up at 6:52 two things dawned on me:  1)  I could see the alarm clock from four feet away! and 2) the discomfort and burning were gone.  Yeah, there was still some discomfort, but whereas before I wanted to gouge my eyes out, now I just wanted to put in some drops and wash it away.  Also, all traces of nausea were gone (thank God).

 I have no idea who the girl is, but she's wearing the LASIK goggles.  Picture courtesy of the "Internet"

Night of LASIK
You’re not supposed to read books or strain your eyes, but TV is OK.  I sat with the kiddos and Teresa, all of which were very happy that “Daddy the grouchy bear” was gone.  We watched some TV and I applied my three sets of drops (steroids, anti-inflammatory, and tears), and then did tears as often as possible.  My vision was still foggy, but I could see pretty well.  I still noticed that my right eye was better then my left, but as long as the burning and discomfort were gone, I was ok with it.  I went to bed around 10PM, put on my sweet goggles, and slept pretty well.

The morning after LASIK
I woke up to Sam and Ryan coming down the stairs and into out room, looked easily over at Teresa’s alarm clock (did I mention that’s really cool?!), and got out of bed at 6:47am.  I had a follow-up appointment at 9:10am that we’d all be going to.  My vision that morning was much better, less foggy, though there still was some “halo-effect” happening.  But I could see very well, and while my eyes were dry, I used all my drops to get them going.  Nearly all of the discomfort was gone, and no burning remained at all.  Most of the discomfort was because I could feel my eyes were dry.  The tear-drops helped that, and I used them frequently. 

I got to my doctor appointment, sat in front of the reading charts, and for the first time ever, without corrective lenses, I saw the chart.  I read the bottom lines of the charts with each eye and together, getting a “that’s really excellent” for my eye doctor.  She didn’t tell me what my vision was at the time, saying that it would continue to progress and likely at that point would only get better or at worse stay the same.  She did mention that I have a couple of spots, one in each eye, that are very dry.  I am to continue using all the drops I have at the regular times, and they should clear up on their own.  If they don’t clear up by themselves, it is possible I may need to have another procedure to address those spots because they could affect my vision long-term.  I have a follow-up on Thursday to take a further look.

Personal thoughts:
First, my eyes are dry and I use drops a lot.  I used to hate putting drops in my eyes and was horrible at it.  Literally, 24 hours after this procedure and I’m a pro, putting drops in my eyes whenever I need to and not really batting an eye about it (literally and figuratively).  My current thoughts are that I should have done this sooner, and I’m very happy I did it.  My vision looks to be on its way to getting to 20/20, so I’m wicked excited about that.  I don’t know how to describe the pleasure of being able to see without wearing contacts or glasses – those of you who don’t have to deal with that are lucky as hell.  Those of you who do have to deal with those, I recommend the LASIK. 

Here’s what you need to have for the procedure:
1)      Thick enough corneas that it can be done.  Your annual eye appointment will be able to tell you if you are a candidate
2)      The ability to stomach people mucking around with lasers in your eye.  The forms I signed basically said I was screwed if something went wrong.  All risks are explained up-front, so you do it at your own risk.
3)      Around $4-5K for the procedure.  Most places will take credit, so at least you get the points out of it.  I also maxed out my healthcare savings account to pay for it ($2,500 is my FSA maximum).  That saves you some cash out of pocket.
4)      Commitment to using drops for the next 3-12 months.  Steroid and anti-inflammatory drops are done after a wear, but the artificial tears get used for as long as you need, and they aren’t that cheap.
5)      Keep in mind that the condition that requires reading glasses (presbyopia) cannot be corrected by any LASIK procedures.  It’s hell to get old.
6)      Find a good place to have it done.  As long as I continue to get my annual eye appointments, I’ll have a warrantee for my LASIK procedure.  If my eyes degrade over time, I can potentially get my LASIK center to do another procedure to fix it.  There’s all kinds of caveats on this, but I plan to keep the warrantee anyways. 

In parting, a buddy of mine had a great idea too – he gets corrective lenses per his vision insurance every year (as most of us do).  Instead of contacts of glasses, he just uses the money towards a nice pair of sunglasses.  He purchases them through his eye doctor, but since he gets about $120 for corrective lenses, he gets a pretty sweet pair of Nike shades every year.  I plan on taking full advantage of this fact this week!


Teddy said...

My main questions:

1) What is your final visual acuity?
2) How long until you know this is "as good as it gets?"
3) How bout them halos? Do you still have night vision halos? Will they go away?

I would LOVE to do this, but 2 things hold me back:

1)They must guarantee 20/20
My vision is actually pretty decent. I can pass a DMV eye test, read a computer screen or book and in general go through a day without contacts. Anything short of 20/20 wouldn't help me.

2) The possibility of a complication.
Since my vision is my career, I cannot have a complication. I would be out of a job.

Since I'm pretty sure these cannot be guaranteed, I guess I'm stuck with contacts.

Kevin said...

Answers to your questions:

1/2) I don't know for sure yet. It's still adjusting, and can take anywhere from 3 days to 6 months to get to "as good as it gets". Right now, I'd say my vision is pretty damned close to 20/20, but I'll find out for sure at my appointments later this week.

3) I get Halos from the computer screen at work, from road signs reflecting lights, and pretty much any light source or reflection surface. They are annoying, but don't really affect my ability to see. Road signs are slightly more difficult to see, but it actually makes it easier to see colors (e.g., red lights, stop signed, orange construction barrels).

As for the surgery, nothing is guaranteed, and you will never be able to get them to a point where they will say there is zero chance of a complication. As close as you are to 20/20 (you can read and drive without corrective lenses), I don't even know if you'd be a candidate.

My recommendation would be to my twin brother, and also to my brother- and sisters-in-law who depend on contacts or glasses. You deal with four to twelve hours of pain and discomfort, a couple of months of using eye drops, and at the end of it you can see without contacts. That's why I signed up!

Colin and Liz said...

This sounds, how do I put it mildly, awful. If they cannot guarantee 20/20 vision for me, then I am out. I can't put in words how angry I would be if I went through all of this, and ended up STILL having to wear glasses and contacts, which by the way did happen to someone I used to work with who had LASIK. Also, it seems just too darn expensive. If insurance covered the costs I would consider it, but not until then. Also, Kevin, why did you turn down the XANAX. Rookie move!

Teddy said...

He didn't turn it down - he filled the prescription and elected not to take it. That means somebody's got some Xanax for sale!!!