Eye Laserz: The LASIK Experience

[ETA 3 December 2019: I needed a correction on my LASIK on my right eye, and just underwent additional surgery on 27 November 2019. I'm in the process of healing, but if you are interested in what corrections to corrective eye surgery is like, see part II.

Oh wow. I don't even know how I'm going to be able to describe the experience of eye surgery, but here I go.

THE ASSESSMENT
Firstly, I had a free assessment to see if I was a good candidate for LASIK. This was back in May. Basically, they do all the normal eye tests--see how far down the chart you can see, take an assessment of your vision ("1, or 2? ...1, or 2, or 3?", check for glaucoma, make you look at the doctor's ear while they shine a bright light into your eyes, take photos of your eye, and finally, measure the thickness of your corneas and scan the eye three times to map the "topography" of your cornea. That last step is key to the surgery, as it provides a personalized map of how your eye is shaped and where the defects are that are causing impairment to your vision.

You are likely a candidate if:
1. your corneas are thick enough to handle a little trimming and reshaping (mine were 600 um (micrometers or microns), which is apparently quite thick--they need to be >450 um or so I think?),
2. your vision is stable and isn't TOO bad (less than 6 diopters off--I was at about -3 and -4 with a lot of astigmatism).
3. Your eyes and optical nerves are otherwise healthy.

They talk you through the surgery, options for different lasers, and tell you what they recommend. For me, they recommended the Femto-LASIK which uses a really sensitive laser that can track your eye movements and respond within a ..femtosecond? I just looked that up and it is 1 quadrillionth of a second--that is a 1 with 15 zeros behind it, so...uh...very fast?  1/1,000,000,000,000,000 of a second. DAYUM! This means no surgical blades are used at all, which I was a big fan of.

I signed some paperwork stating I understood the risks and surgery and went on my merry way, thinking, even if I don't do this, at least I got a free eye check up out of it!

TIMELINE
They wanted to schedule me in within a few weeks but I still wasn't 100% sure yet and I also needed to pick a time when I wasn't under major work deadlines and when I could make the 1 day, 1 week, and 1 month check ups. I also didn't want to be in surgery on my actual 40th birthday or related celebrations, so that delayed things a few weeks, too. We settled for end of July via email, and set my 1 day and 1 week check ups.

Meanwhile, I wasn't sure I would be able to do much screen time and work while recovering (my work requires detailed, precision microscope work as well as a ton of computer time), so decided to use some of the 60+ days of medical leave I'd accumulated over the past 10 years. I took off the day of the surgery (Friday) through the next Friday, unsure when I'd be able to stare at a computer for 8 hours a day or down a microscope again (note: today, the day after the surgery, I am REALLY GLAD I arranged for this ahead of time!).


BEFORE THE SURGERY
The few days prior to the surgery, they ask that you do not wear contacts or eye make up. (Easy for me, I do neither except on special occasions!)

I scheduled my Uber ride there. I also downloaded an audiobook and a few podcasts to listen to while I wasn't able to see/had to have my eyes closed.

The night before the surgery I couldn't sleep and was pretty nervous. I just told myself that I could do it and that in 24 hours I'd have perfect vision!

THE DAY OF
Here is where it gets really detailed. But I figure, if you've come this far, this is the bit you want to know about!

On the day of my surgery, my appointment started at 9:50 am. I arrived at the clinic at 9:30 am because my Uber was early and because I was nervous I'd be late.

I sat down and immediately they brought me back to finalize the paperwork and pay $5900. I got $200 off because I was referred by a friend.

I sat down again, they brought me peppermint tea which made me have coughing fits (?) and I read a terrible magazine that suggested all sorts of holistic new age-y non-scientific medicine cover to cover, for want of doing anything else. I start on a magazine the person before me just left--it is more interesting but still is about how the Queen of Spain is feuding with her mother in law, the former Queen of Spain. (Why would a doctor's office have these?!)

I use the restroom. They bring me water. They are super nice to me, and very attentive.

Finally, they bring me to the pre-op room. I sit in an easy chair and they put up the feet on the comfy recliner. A nurse talks to me about anything last minute, what to basically expect, and gives me a pouch with a ton of meds (mostly eye drops). She puts cloth booties over my shoes and gives me a cloth hair covering/showercap like thing for over my head/hair. I tell her I'm nervous and scared and she tries to reassure me. She talks me through which eye drops I need to take over the next 24 hours, the painkillers (500 mg acetaminophen), the sleeping pills (5 mg diazepam). Basically, I am to go home after the in office recovery and check up, take a painkiller and sleeping pill, and nap. I can keep taking the pills to sleep that night. When I wake up, I am to take off my eye shields and start on my two drop regimen for the week. I'll get the rest of the instructions at my 1 day appointment.

She gives me liquid acetaminophen in a cup because my throat is still super-sore from my peppermint tea coughing fit and I can't swallow the 2 capsules (weird). I think I am too nervous and my throat is too dry. This is the first pain killer they give you. I ask if I can take Advil (my preferred painkiller) after my surgery instead of the acetaminophen capsules, and she says yes, as long as I take it with food.

The nurse then puts two sets of eye drops in my eyes. I'm not sure what they do exactly, but I think they are the start of my regimen? They must clean my eyes and get rid of bacteria or something. One of them stings a little but honestly, if you have ever worn contacts, it's not any worse than that can sometimes be. She gets some alcohol on a gauze and wipes my forehead, nose, eyes and upper cheeks area to cleanse them and says not to touch my face no matter what. I'm now sterilized and ready for surgery.

The nurse leaves. I wait. Another nurse comes in and gives me her number to call if there are problems later. She leaves. I wait. I notice that it is around 10:30 or so? I text my flatmates to let them know I'd be wandering around our house with eye patches for the next day (I wouldn't want to run into someone looking like that late at night!). I text my family to let them know I'd be off the grid and basically unable to see my phone well for the next few days. I wait.

My eyebrow itches because the alcohol is evaporating off and making things kind of tingle. I resist (if I can get my eyes lazer'd, I can certainly resist an itch!!

Around 10:50, the doctor comes in and says a few final words about the steps. He has a surgical cap on and this is when I freak out and start asking questions about what happens if I really freak out in the middle. He reassures me, but I can tell this is like routine shiz for him and he doesn't think I should be worried. I freak out inside but try to keep it together. I get jealous of my friend who came to this same clinic and was given Valium before his surgery. (note: WHY WASN'T I OFFERED VALIUM?!). The doc tells me I am to be a 'surprised zombie' during the initial stages.

Around 11 am, IT IS TIME.

I am brought into the surgery room. there is a flat bed in the middle of two machines, and a computer alongside the left wall. I lay down on the bed and they put a cushion under my knees and cover me with a blanket, which I hold on to very tightly.

They start immediately. The bed is a swivel one, and can be moved between the two laser machines. First I am swiveled to the left machine and my right eye gets some drops to numb it and my left gets a patch over it. I am told to focus on a bright white light above me and try to see a diamond shape. I barely make it out, but eventually do. As soon as I do, more eye drops happen and the doc gets out a retractor thing that keeps you from blinking. This is what I was worried about, but it's really no big deal at all because my eye was numb. He places the retractor thing over my right eye and sort of...cranks it open? to his desired width to reveal my eye socket. That sounds horrible, but ...it somehow wasn't. There was a little pressure on my eye lids, which weren't numb, but honestly it was fine. I know the next step is crucial--I am about to get a flap lasered into my cornea. (Oh God) I focus on the green light above me as I was told to do, focusing really hard on it. The machine talks and says "Ready." and then "Suction On." Honestly, that bit is crazy, because the machine has moved down until it is over top of my eyeball and apparently 'suctioning' it! I feel absolutely nothing, though. I stare at the green light until I have to be a surprised zombie and look THROUGH the green light (the doc tells me when to do this). This is harder than it sounds. I do my best to relax my eyes as told. Things go a bit blurry. The doctor tells me it's perfect and I try to relax. I am holding on to the edge of the blanket like a vice.

Then it is time for my left eye. My right gets the retractor thing taken out of it, and a patch over it. I think they tell me to keep it closed? I get the numbing drops and the retractor immediately over my left eye, which I feel a bit more because the drops haven't taken full effect yet. It still doesn't hurt--it is just a little pressure really. This all happens in like 30 seconds.

The same thing happens with my left eye but this time my eye accidentally moves to follow the laser when I am supposed to be a surprised zombie and look THROUGH the light. I start to freak out, thinking I just ruined my vision. I concentrate really hard on looking through the light and relaxing, and soon it is over and the doctor is saying I did extremely well. My eyes are blurry and my body is still physiologically reacting to possibly effing up my eyesight in my left eye and I really freak the F*#% out at that point, start sweating, go red, and start breathing deeply to try to calm myself. As they swivel the bed to the right-hand machine, I say, I just need a second, do the deep breaths with the nurses coaching me, and as soon as I feel like I have a handle on myself, I say, OK. Let's do this, get it done. The doc says, Great, but we are going to do things right, not fast. (That is what I meant! but I don't say this because that is over explaining and seemed wrong to do with two flaps in my corneas, I just wanted them to start again.)

THIS IS WHERE IT GETS REALLY REALLY WEIRD.

The lasered flaps in the corneas was really pretty easy, considering. It is the most crucial part to stay still, apparently, but I found it to be the easiest to sort of narrate in my head about what was happening to me, and to recite instructions to myself to keep myself calm.

For the next bit, I...can't exactly describe what happened or why because I don't think I actually know what was happening to me. I'll just say what I saw.

First, my left eye got the bandage covering and they put stickers over my top and bottom eyelids to keep me from blinking. My right eye was then retracted again. It was flooded with solution and I could see that the doctor, behind me, had tools in his left and right hands--tiny, tiny tools. I think those touched the surface of my eye to peel back the flap that the last laser had made, but I am not 100% sure--because I didn't feel it at ALL. Normally something coming at my eye would make me shudder and cringe and move away, but...I didn't? And I'm not sure why? Maybe because things were a bit blurry? And I couldn't see them well and definitely couldn't feel them?

I dunno. At that point, I think I was told to look up at the laser again, which was a scattered ball of green light. I stared at it for like 15 - 20 seconds as it worked maybe? And smelled...something like I've never smelled before. It was odd with a tinge of ew. Just a little tinge of ew, though--not horrible, just a hint of something strong. If it had been stronger it would have been disgusting, I just know it, but it wasn't. Just strange and not at all identifiable. This was my eye flesh burning. (Sorry)

It didn't hurt. I felt nothing. In the middle of the cornea reshaping, just as the laser started to coalesce into a discrete point of light, they flooded my eye again and I couldn't even see the light. They did that a few times even after the reshaping was done. At the end, the green light was pretty solid and not a scattered ball of light anymore.

AND THEN.

You know those first-person point of view cameras shows sometimes have? And it is supposed to show the person walking around, blinking, interacting with their environment? And you watch this and see what is happening but don't feel any of it, because it is all a video and behind a camera lens?

That is what this bit is like.

The doc then declared everything well done and (I think) took some sort of brush and wiped down my eye and used the tiny tools to replace the cornea flap (I am not sure in what order this was done). There was a lot of brushing and solution rinsing and suction happening for a minute or two. At one point one of the tools was sort of...pushing down around the edges of my vision, obviously, making sure that the flap was in the correct place. Again, I felt nothing and wasn't at all cringing or "instinctively" moving away from the thing coming towards my eye. It was exactly like I was watching one of those first-person camera shows, albeit a really weird one. The brush kept moving over my eye, solution applied, and it was actually kind of calming after a while. All I had to do was lay there and watch.

They then applied a bandage with tape to my right eye and moved on to my left. This one was harder because my right eye was blinking and flinching when the solution hit my left eye, and I felt my eyelids react strongly.

Still, no pain.

This time I knew what was coming with the brushes and tools and I became a true observer and scientist, trying to figure out what was happening, and just marveling that all of it was even possible. It was pretty fascinating, and I was glad the doctor was so skilled.

The bandage was put over my left eye, the blanket removed, and I was swiveled to the center again, with assurances from the dr that everything had gone really really well. Two of the nice nurses helped me off of the operating theatre floor and into a dark room to rest with my eyes closed.

The whole thing took less than 15 minutes, tops. The worst bits, pain wise, were when they took off the eyelid stickers after my procedure under the right hand machine. Which is to say, not painful at all, not really. Not as bad as pulling off a band aid, even.

I felt nothing, all was great. I just rested. The nurse had moved my personal belongings into the room--that was super nice of her.

All that was left to do was rest, really.

I was there maybe 20 min? I patted myself on the back and congratulated myself for getting through it, and completely alone!

I was then brought into a final room for initial examination. This bit I don't remember much about. I think the doctor took off my left eye patch and then looked at the flap placement in my eyes, put clear shields over each, shook my hand and said I did spectacularly, walked me to reception, and sent me home. Everything was blurry, like a smoky room, at this point. I definitely couldn't see my phone very well so hit what I thought were the right buttons, and had the receptionists confirm my Uber ride for me. I waited for Uber and the receptionist told me when the right car pulled up, and walked me to it. I called the Uber at noon, so everything was competely over by then.

I kept my eyes shut the whole ride home. At this point, the numbing had started to wear off and I was starting to feel an ache behind both of my eyes. It was only a 10 min ride home, but by the end, when the driver missed his turn and had to go a longer way, I was extremely ready to be in my bed and resting.

POST SURGERY, AT HOME
I got home and got into bed as soon as I could, about 12:30 pm. The shields covered my eyes so I wouldn't accidentally rub them during sleep. However, I couldn't sleep at all. The dull ache had turned into more of a roaring ache. I was sort of moaning to myself, "Why did I do this?!" and my right eye felt particularly scratchy and uncomfortable. I decided to take some Nyquil instead of taking pills (my throat was still bugging me & the main ingredient for the painkiller is the same/smaller dose). It worked a charm, and I slept until about 6 pm.

I slowly tried to open my eyes upon waking and it sort of felt like they were gritty and stuck, so I just took it slow. My right eye in particular kept pinging with sharp spikes of discomfort and that one was really hard to open fully. As soon as I stood up, my watery eyes shed all their liquid and it dripped below my eye shields. I wasn't allowed to reach in and wipe away tears, I had to wait until they dripped below the shields. This is all very normal.

I made dinner and took an advil, seeing what I could see. It was hard to keep my right eye open, because every time I blinked, I'd get a sharp sensation. However, I could see pretty well considering I had plastic eye shields on, and the pain wasn't excruciating. I could just close my eyes to alleviate it.

I decided to listen to my audiobook. I did that, and tried to read all the paper work they gave to me for instructions and to reassure myself my right eye wasn't dying. I couldn't read the print on the meds or the papers well--everything closer than arm's length is blurry to me--so I took photos of it all with my phone and enlarged the print until I could see it enough to read it.

The paperwork confirmed that my right eye wasn't dying, even though it was uncomfortable. I could see, and the pain wasn't bad enough to keep me from sleeping, which are the two things that don't happen when your flap gets displaced (!).  That is the main thing to worry about 24 hours after surgery.

I fell asleep again around 10 pm, exhausted from the poor nights' sleep the night before and the eventful, stressful day.

DAY 1, POST SURGERY
Day 1 started when I woke at 4 am. My left eye felt amazing. My right was still uncomfortable, though slightly less uncomfortable than the day before--I think.

I still had the eye shields on, so I thought that might be messing with my vision, so I decided I should take them off and start my drop regimen, as instructed. I have two drops I have to take for the next week: one 4x/day, and another 6x/day. Then I stop both and start a NEW drop 2x/day for 3 weeks. All the while I have to also use eye lubricating drops to help with the dry eyes that come with LASIK.

With the shields off, I should have marveled, but my right eye was still being annoying. I could see really well into the distance and my left eye feels a little bit tired, but perfect. Nothing annoying, nothing bothering me, not that dry in my left. I tried to read my book but everything was way too blurry. (I didn't expect to be able to read yet, I just wanted to check.). I lament my decision and wish I could get rid of whatever is wrong with my right eye and be able to read like before. Were glasses really so bad?!

I note my observations for my 1 day check up post surgery at 9 am. I go about my business, eat breakfast, download an app to help me keep track of when my eye drops need to be applied, etc. and then I Uber to my appointment. I'm seen almost immediately. They check my vision--better than 20/20 in both eyes at this point--and the guy awkwardly talks to me about my life (he was odd). I think the guy was expecting me to be excited about being able to see, but I'm worried so don't really feel like celebrating just yet.

I relay my concerns: 1. I can't see close up, anything closer than arm's length is blurry and 2. My right eye feels like it has an eyelash in it, permanently. It's uncomfortable and annoying, not painful, but I need it to go away to be able to live my life as before. The guy checks my eyes and says I have a capped gland in my right eye, which is a warning sign and something to be vigilant about because that is something that results and indicates dry eyes. The capped gland is a ball of oil which hasn't spread across my eye to lubricate it. I can't feel the capped gland, but dry eye is likely what is causing me to feel like there is something in my right eye.

The Dr comes in and checks my eyes, the flap, etc., and notes that when I've healed in a few weeks I will need to start doing some hot compresses and massage on my eyes to help with the capped gland/dry eye situation.

I am still experiencing swelling, so that is why my close up vision is bad--once it goes down my distance vision will decrease and my close up vision will increase. Also, apparently, they over correct for distance vision slightly because over the first 2 years the eye naturally relaxes (? gets worse?), so it'll all even out. I hope I will be able to read very soon.

OVERALL SUMMARY
I am not sure I am glad that I got the surgery yet. I think I would if my right eye weren't bothering me so much. My left eye feels amazing, and I can imagine that if both eyes felt like that, you'd be on top of the world--15 minutes and a nap and you can see! But that isn't the case for me yet. I can see, but in the process I acquired a condition more annoying than glasses. If that ever goes away (and it should within the next 3-6 months--crossed fingers), and if I regain the ability to read books easily/without blurriness, I will completely reassess this statement. Right now, though, at 1.5 days post-op, I am on the fence and not loving the glasses-free, contacts-free life. I kinda wish I'd not done it, to be quite honest. I hope this changes and I can say that it was the best thing I ever did, which is what everyone else told me immediately after their surgeries.

Life Update: UPDATE

Last month, I posted about things that were causing me stress:

1. my aunt had a severe heart attack and had to have triple bypass surgery this past week
2. one of my most supportive colleagues died suddenly
3. my sister is not doing well--she is having major delusions and hallucinations
4. my flatmates announced they are leaving in 2 weeks, after 3.5 years
5. both my job and PhD have MAJOR deadlines in the next 2-3 weeks
6. I've had a sinus or other kind of infection for 2+ weeks. I keep getting better and then doing too much and backsliding a little.
7. I can't seem to manage my sleep cycle. I am sleeping WAY too much (probably related to winter-time, being upset/stressed about the above, and my infection).
8. the only 2 NZ friends I ever hang out with anymore are away on vacation, so I don't have anyone to talk to here

Update on ALL THE THINGS!:

1. My aunt ended up back in the hospital after the catheter gave her a UTI. [THANKS, DIRTY HOSPITALS]. She is resting at home and recovering now, but things are very stressful re: money at their house because she was the main breadwinner for her, her husband, her two grown children, one of their spouses, and her 1 year old grandchild. I wish someone from her immediate family would pitch in a bit more (her husband mainly, who refuses to get a job, according to my dad?). My family is doing what they can, and I have offered to set up a food delivery but they haven't taken me up on it yet. I CANNOT imagine...
2. I cried in therapy about the death of my colleague. We worked out it was because he was just so kind and lovely and endlessly caring and giving to our community on every single level--someone I look up to and want to be like--and he died alone and young-ish, without fulfilling the (completely unself-serving) goals he had. I think it is SO UNFAIR that the most wonderful people on Earth don't get the lives and love and care they deserve while SOME PEOPLE are completely selfish, awful a-holes and get to be in charge of a whole country. Ahem. Also, I think I see a little of myself in my colleague (or at least I want to see myself in him) and I don't want to die that way, alone and without fulfilling what I have set out to do in the world. It still upsets me SO MUCH, that first reason. Why why why are horrible people so rewarded in our society? It infuriates me to no end.
3. My sis moved from an independent apartment place, back to a group home again. She keeps getting back together and breaking up with her 'fiance.' So, she isn't better, but she recognized that she needed more supervision than she was getting at her apartment, and made the switch. I am proud of her.
4. I found new, albeit temporary flatmates. They are two 22 year old girls, sharing a queen bed. Believe me, they were my last pick due to the age difference and the fact that they only plan to stay for 5 months (sigh). But the numbers just weren't on my side. After about 15 inquiries to my ad, I made 10 appointments to show my place. Just 3 showed up, and they were they ONLY 2-person application that I received. In order to afford my place, I really need to rent to TWO people and split the rent and utilities amongst three people. Luckily, things are fine with them. I barely see them and they pay rent and are reasonably tidy.

By the way, is this a fair split? Rent is $575 per week, they pay $350. I pay $225 per week. They have their own balcony, a private bathroom (toilet/sink), and a bigger room and closets and private storage space. I never know how to make things fair. This time I just set that price based on what I thought I could afford to pay, and what I thought was reasonable for my place/room.
5. I got through my deadlines, but some of it is on-going and my supervisor, OF COURSE, was a jerk to me on our trip overseas to collect data. OF COURSE. He blatantly told me, while I was doing a very sensitive, fragile procedure, that he didn't trust my judgment on anything having to do with my PhD. No reasons why. How is that comment helping anyone, ever? I pulled 4 all nighters to get all of my analyses done--without his help, by the way--and when we reached the airport, he didn't mention all the effort that I'd put in, just started talking about starting the next big project (nevermind that I'm in the middle of THREE projects ALREADY and delirious and hallucinating from lack of sleep at the time).
6. I still cough a tiny bit, but am mostly better. :)
7. I am still sleeping too much. I have one productive week where I work three or four 8 hour days in a week, then get tired from all that effort and basically am useless and sleep through the whole next week. I work from home that down week but do the bare minimum needed to keep my job moving and afloat (mainly answering emails and anything urgent). If I really need to, I take a sick day (I have 60+ days of sick leave accumulated over the last 10 years!). Then I feel guilty and make myself work three-to-four 8-hour super productive days again, and the cycle continues. I can't seem to regulate it, and feel terribly behind on all my work all the time.

This might be some depression expressing itself, maybe SAD, or some other mono or chronic fatigue thing happening. The thing is, because I am able to push myself when I need to (see 4 days no sleep in #5), and during my productive work weeks, and when I want to (like when a friend asks me to do something fun), even though I do have 'activity hangovers,' it makes me doubt it is chronic fatigue or some other auto immune or similar issue. Does the fact that I can push myself and get things done sometimes mean that I am just lazy/it's in my head? Or is this common to autoimmune diseases/viruses, and mean that I am just in the early stages of something, where it is still possible to pretend to live a normal life once in a while? I do wonder about myself. I've been in this limbo stage for a very long time, and it seems to be getting worse, this thing where I can't get out of bed no matter what. I'm not in physical pain, although I have normal 40-year old aches and cracks and soreness--I am just not able to make myself get up unless I have something urgent and un-cancelable on. I even had to postpone a meeting with my supervisors when I couldn't get out of bed recently...something I never allowed myself to do before. I blamed a migraine, but that wasn't the reason, it was being too tired. That is worrying, this progression, no matter what is the cause.
8. My friends are back but I've now gotten used to being alone and independent and I don't even want to see anyone. Definitely therapy time...

I Just Spent $5900 in One Go

Eek! I just put $5900 on my credit card!

I can't confirm, but that might be the most I've ever spent in one go. Even when I bought my second-hand cars and paid in cash, it was only $2750...  The other thing I've paid out that much for in one shot would be first-month's rent and security deposits, but those amounted to about $3K, max.

Then again, I planned on this purchase--and am sitting here, typing away, without glasses--because that $5900 went toward LASIK! Happy 40th birthday to me!

...I still can't believe that I went through with it. After about 20 years of freaking out about how I would never let anything like that near my eyes, then talking to my aunt and a few friends who'd gotten it done, then "just in case" saving up for it because I "couldn't think of another good medium-term savings goal," then going to the doctor's free assessment "just to see if I'm a candidate," I just went and got it done yesterday.

(!)

I think it was one of those things that I knew if I thought too much about and did too much research close to the surgery date, I wouldn't go through with it. (I did a ton back in the day already, and got completely scared off.) So I just pretended to myself it wasn't a big deal.

I even went to the surgery all by myself. I literally took an Uber there and back without any support people. I only told my Mom and my officemate I was getting it done (and only when she asked why I was taking the day off).

Doing it independently was part of some weird hang up I now have about going it alone in life after 40, I think. Something to work out in therapy for sure.

 In any case, that is enough screen time for now. It is time for yet another round of eye drops (they don't really tell you how full on the drop regimen is post-surgery beforehand...!). I'll put up posts depicting details about the surgery soon, I don't want to forget any of it so I can tell others what it is like, later!