Sunday, November 26, 2006

Didn't mean to take so long. I was out of town for a week and a half but I figured I'd get to posting part II anyways, but I didn't. Whoops.

Trip Report: Laser Eye Surgery, Part II.

All I know is the next thing I know, my eyes are being yanked open and there's half of a blurry, upside-down face looming above me.

"Hi, I'm Dr. Siems, I'm here to do the surgery." And without any hesitation, suddenly my eyeballs are clamped by what felt like industrial-strength vises.

And so it began.

Words were scarce. In fact, although there were probably some, I can't remember a single word exchanged between doctor and assistant. And aside from one exchange, the only words said to me were two commands, repeated over and over.

"Lean your head back."

"Look down, at the light"

Drugged up as I was, I was having trouble following those simple instructions. I'd tilt my head back and feel like I was holding it there doing a good job, but five seconds later I'd hear it again, "Lean your head back," and I'd realized that somehow my chin had slipped down again. I spent the next day talking to others who had the surgery, and it seemed as though that was a common problem among them, as well. Perhaps a brace of some kind is in order?

The procedure is pretty quick. Each eye only takes a few minutes. The eye is propped open. Then a flap is cut on the surface of the eye. Many doctors use an actual instrument, called a microkeratome, to cut this flap. The doctor I chose uses a laser to cut this flap, called IntraLase. After the flap is cut, it is moved back, so the laser can then be shot into the eye to reshape the cornea. After that, the flap is smoothed back down, and it's onto the next eye.

The entire procedure is supposed to be painless, although sometimes the eye being propped open can be somewhat uncomfortable. For me it definitely was. In fact, I just found a site that instead of using cute, harmless illustrations like most places, has actual pictures of the procedure being done. If I'd seen that site before having my eyes done, I might have lost my resolve.

So my right eye was propped open, and that was pretty uncomfortable. Then the flap was cut, and an instrument was used by the doctor to fold the flap back. Uncharacteristically, however, I could feel that as well! It wasn't overly painful, but I'm a squeamish guy with respects to that kind of stuff--that is stuff touching my eyeball. The eye-puff part of any eye exam is more than I can generally handle. It was quite a hurdle for me to even agree to having the surgery done. Actually feeling instruments on my eyeball had me trying to escape on the table.

Literally, I was trying to escape. I tried to clench my eyes, but they were propped open uncomfortably, and trying to fight the props made it hurt even worse. I kicked my legs, and would have sat up probably if I wasn't so drugged up (and who knows, perhaps I was restrained in some way, as well). I of course vocalized my discomfort using all the grunts in my arsenal.

Then came the laser. My eye was watering and uncomfortable at this point, and it was hard to keep my eye focused on the light. "Look down, at the light." And I did, but like keeping my head back, five seconds later, somehow my eye had lost it again. "Lean your head back. Now look down at the light." Okay, okay, okay, I'm trying.

The laser was red and round and dull except for when one looked right at it at which point it might as well have been the sun, or at least the sun viewed through somewhat tinted windows. I would look at it, and then it would slip away from my vision. Why did it keep doing that? "Look down, at the light!" Oh, right...

Finally that was done, and I got the distinct pleasure of feeling someone smooth the flap back down onto my eye, much like someone rubbing their hand on your arm, except it's on your eyeball. Yuck.

The clamps were removed and my eye mercifully shut closed, watering excessively. I had a fews seconds of relief, thinking it was over, but then my left eye was clamped open and it all happened again. This time it was more painful. Rather than merely feeling it somewhat at a distance, the cutting of the flap and the folding it back was now actually painful. Not extremely painful, but how much pain in one's eye does it take for one to be very, very uncomfortable and unhappy? I lurched around on the bed some more.

"Stop kicking."

"I can feel that!"

"No you can't."

"Yes, I can feel that!"

"You're squinting your eyes, that's what's causing it to hurt."

"I. Can. Fucking. Feel it."

"It's almost over."

It was red light time again, and my left eye was watering even worse than my right was. It was futile trying to focus on the light, as after two seconds, the light again slipped away to the edge of my vision. Being clamped open and unable to blink, my eye was on fire.

"There's only 10 seconds left, please just focus on the light."

No chance. Finally, they squirted stuff into my eye. Suddenly I was able to focus on the light, and when it came time to smooth down the flap, I could see that they were doing it, but I couldn't feel it. At all.

Then it was all done and the next thing I knew I was being led into the post-op room. My vision was blurry for the few times I tried having my eyes open, and it hurt some to have them open anyways, so I resolved to just keep my eyes closed.

Two of my friends were there. Apparently they'd arrived in time to watch the procedure through the glass. Their reaction was something like this:

"Wow. I'm never having that done."

My eyes were squeezed shut. I had on eye covers. Over that, I had on sunglasses. Over those, I put my hands. Yet when I was led out into the sunlight, it felt like my eyes were being pricked with needles. The pamphlet said, "there will be some sensitivity to light immediately following the procedure." No shit.

My friends drove me home, fed me and put me right to bed. It was over.


Needless to say, the next day I was not too happy. I was promised no pain, and yet there had been plenty of pain. I talked to my friends about it. They said after I had the numbing drops put in when I first entered the operating room, I was laying there for about 45 minutes. The nurse had told me, of course, that the drops would last about 30 minutes. Oops.

There was a 24-hour follow-up appointment. I went, and the waiting room was filled with people carefully moving about, all wearing the cheap sunglasses they give you for the "slight" light sensitivity. I talked to some other patients who had their eyes done the same day as me. One woman also felt pain. She had a slightly different procedure done, one that took two different lasers in different rooms. In the first room she had the same thing done I had but didn't feel anything. Then she was moved to a second room where she had to wait a while and when she was finally worked on, she was feeling pain.

I of course didn't see Dr. Siems, but other doctors in the practice. I told one about the fact that I was on the table waiting for 45 minutes before I was worked on, and how I could feel pain. She seemed genuinely apologetic, and told me that for some other procedures they keep track of when the numbing drops are administered, but for the Lasik, they don't (although, she said, they probably should). Hmm...that seems negligent to me.


So how is it? It's been over two weeks, and so far, so good. The first few days were pretty bad. It wasn't painful, but my vision was very, very hazy. Not blurry, but hazy. They tested my vision during that follow-up visit and said I was seeing slightly better than 20/20. However, lights, especially lights in pretty dark environments, were problematic. All lights had heavy halos around them. The best I can describe it is it's like how things look right after swimming for a long time in a heavily-chlorinated pool. Driving at night, especially in such a flashy place as Las Vegas, was quite the experience.

Over time my eyes improved. Now, there's still halos but they're very, very, slight. I actually have to concentrate to realize I still see them a bit. My vision still seems excellent. Another follow-up appointment is scheduled for tomorrow, so we'll see if my vision has changed much since the day after--some people have their vision slowly improve over a matter of a couple weeks. I had one friend go from 20/30 the day after to 20/15 after a few weeks.

The only other annoyance with the procedure, besides spending a week with all the visual effects of a weak acid trip (but, alas, none of the mental), was the eye drops. For the first week, I had prescription eye drops. 30 a day. So, on average, every half hour while I was awake I had to be putting in some kind of drops. But that's only for a week. Now, the only drops I have to put in are over-the-counter moisturizing drops. My use of them went from hourly, to every two hours, and now I'm down to about once every four hours or so, even in such a dry climate as Las Vegas, and spending half my awake hours staring at a computer screen.

Despite the clear lack of organization on the part of the office--everything from simply not looking at my file, to letting the numbing drops wear off before doing the procedure--I'm happy with the results. I can see and I'm free of glasses. My experience is downright atypical, as I know a few people who've had the procedure, and not a one experienced any pain. So hopefully I didn't scare off too many people who were considering having Lasik done. You just may want to try a different doctor than me.


Next post will be back to poker. I'll update on what I've been doing (drastic cut in playing hours, playing almost exclusively PLO) and also give a trip report of my brief shot at 25/50 NL at the Bellagio. And I promise it won't take me 12 days to get around to it.


Anonymous willyum said...

Man, the part about how the drops wore off before everything was done was really scary. It´s like a torture scene from some movie.

3:05 PM  
Blogger Greg said...

Oh. My. God. I was thinking of having the operation done, but now I am decidedly against it. I actually had to stop reading your second post for a few minutes before I finished it because I felt faint.

7:57 PM  
Blogger run 'em twice said...

ughhh I don't have the money for it at the moment...Hopefully I will have forgotten this post in a year or so!! Happy to hear about the overall results though...

5:57 AM  
Anonymous Anonymous said...

Just came across your post. I have an appointment at Siems next week for a consult. Can you give me an idea of how much they charge for the Lasik procedure. I have been wearing my glasses for a week now, and I'd really like to go back to wearing my contacts if it's not something I am going to be able to afford right now.


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