A LASIK Story

My LASIK story starts in 1989, my senior year in high school, when I saw an episode of 60 Minutes on a new surgical procedure in the former Soviet Union. The procedure was called Radial Keratonomy (RK), which involved making small incisions in the cornea to change it's shape to correct a person's vision. I remember watching the show in complete amazement. I had recently convinced my mother to let me get disposable contact lenses - thanks in large part to the fact the NY State Employee Health Insurance Plan finally started to cover them. Even though the Cold War was still on and all that cutting kind of freaked me out, I knew having better eyesight was possible and by the time I grew up the procedure would come to the US and be much safer than cutting your eyeball.

Fast forward to October 12, 2008, my 36 1/2 birthday. I attended Myron and Anna's lovely tango-themed wedding. Weddings always get me thinking about the future (usually along the lines of, "He'd better show up soon. I'm running out of good eggs.") and my half-birthday always gets me thinking about the next birthday. For three years running, I have done something BIG on or around my birthday. In 2006, I cut off "all that beautiful hair" and went natural. In 2007, I threw a party for my 35th birthday in my new house. The 2008 birthday present was a skydiving adventure with my good friend, Natalia. What would it be for 2009?

A confluence of events prompted my decision to finally try LASIK:

1. Running out of contact lenses, which meant I needed to go to the optometrist and get my eyes checked. It would be a good time to see if my eyes even qualified.
   
2. Annual Enrollment, which meant I had to decide how much money I was putting away for my health spending account.
   

My eye doctor took a picture of my retina and confirmed the health of my eye for LASIK. So I opted to put away three times as much money as last year in my health savings account.

March 2009 rolls around. I know I want to get LASIK this year, but don't know if it will be scheduled in time for my birthday. I convince myself that doing on or around my birthday is not the point; waking up and seeing clearly for the first time in a long time is what matters. I schedule the appointment with the eye doctor for the first LASIK consult. She confirms I am a good candidate and recommends Duke (I already knew I wanted to go there). She also advises me to stay out of contacts two weeks before the consultation, since contact lenses affect the shape of the cornea. Thus, the dreaded glasses for the month of March. I HATE glasses. I can only see what is directly front of me. Once I move my eyes up, down, or to the either sides - all clear vision is lost. So I suffered through those weeks before the appointment (though my vanity did not allow me to go to the milongas with glasses on).

March 23rd - LASIK consultation appointment at Duke Eye Center. I took a series of tests to measure the thickness of my cornea and gauge the overall health of my eye. Then I waited to see the doctor. And waited. And waited. Almost finished Paulo Coelho's "The Witch of Portobello" while waiting. I waited so long, Karen, the care coordinator, took pity on me and didn't charge me for the visit. Then Dr. Carlson came in. He looked through all of my results and said everything looked good, but then asked, "Do you rub your eyes?". I told him I didn't think so. He looked at one test in particular and said, "I should be seeing red, yellow and green on this one. These results tell me you're an eye-rubber". Suddenly I felt like he was assigning me to special ed classes and I had to ride the short bus with the other drooling kids. He advised me to stop rubbing them and then said I could schedule the surgery whenever I was ready. Whenever I was ready. The words floated above his head like a balloon. I went there prepared for the worst. I had been a contact lens wearer for 20 years. Maybe my corneas were badly misshapen. I didn't want to get ahead of myself and think about scheduling surgery, only to be disappointed by the test results. I closed my mind off from thinking about the future, but here it was. I needed time to think about it a decision that would change my life.

April 1 - After a wonderful weekend at the Atlanta Tango Festival, I decided I was ready. I called the care coordinator to schedule the appointment. I was fully prepared for the next available appointment to be some time in May, but she said, "I have an opening on April 10th and April 17th". Naturally I chose April 10th - two days before my birthday, Good Friday, and a state holiday to boot! In nine days, what began as a glimmer of hope for a 17-year old would become a dream fulfilled for her almost 37-year old future self.

April 8th - T minus 2 days. I stood on the corner of Salisbury and Edenton in downtown Raleigh waiting for the TTA Express Bus back to Durham fighting back tears. My mind had settled down after the day's distractions to contemplate the enormity of it all, the potential risks and complications. Was I sure? Was wearing contact lenses that bad? Was it going to be worth my entire Federal refund check? I went to the Poetry Meetup not too sure how long I would stay or how much I would participate. I normally bring my own poems to share, but since the LASIK consultation I haven't been in the creative flow (I'm sure my subconscious mind had been thinking about the surgery all along). On the way home, I filled up at the Sheetz gas station on TW Alexander and Miami. I had a fleeting thought to go to the tango practica at Triangle Dance Studio; I wanted to see my friend, Janet - a nurse anesthetist, for some moral support. But since was already emotionally drained, I just drove home. Janet called me when she got home from class. It was late, but I was glad she did. I was starting to freak out, which meant I wouldn't be able to sleep. She reminded me I had done the research (though I was too chicken to watch the FDA video) and chosen the best doctor, local anesthesia reduced the risks of surgery, and that she knew of and I knew of other people who had had LASIK and absolutely loved it. That was enough to soothe my nerves for the evening.

April 9th - I read through all the instructions and warnings about the surgery before heading to work. Bad idea! I got hung up on the statistic that 98% of people saw 20/40 or better after the surgery. 20/40 is what I could see in my glasses. I wanted to see better than that. I wouldn't be satisfied if I could only see 20/40. By the time, I got to work I was almost in tears. I stopped by the front desk to talk to Doris, our admin. She had cataract surgery recently and now only wore glasses at night for driving. I stood talking to her for over 30 minutes - coat on, bag in hand. Like Janet, Doris talked me down from the ledge - reminded me I had done all the research; reassured me that I would be just fine. The busyness of the day took over and my mind concentrated on the tasks in front of me. After work I attended my first Passover Seder at Yana's house and got home close to midnight (who knew those things lasted so long?). I got more well wishes and reassurance from my friend, Susan in California and my writing friend, Wes, which was enough to help me sleep.

April 10 - My mind, on the other hand, was still working things out. I had a dream I tried to call home to NY but couldn't get the number right. I woke up thinking, I'd better let someone in the family know what is going to happen. I had thought about telling my mother before I had the surgery, but after the sky diving incident, I decided not to worry her. I called home and my sister answered, which she NEVER does before going to work. She asked, "Hey did you get my email? I was wondering what big thing you were going to do for your birthday." I said, "Funny you should mention that. I'm having LASIK surgery today." She was excited for me. I told her I would text her when I was done.

I piddled around until about 11 am - ate breakfast, replied to email, chatted on Facebook, called my old professor to wish her a Happy Birthday, posted to the dream blog - then it was time to get ready. I got dressed, made some Yogi Tea and threw an apple in my bag. My friend, Lanea, who struggles with timeliness, made it a point to be dressed and ready to drive me to the appointment. There was a line to check in and the lady at the reception desk seemed to be taking her sweet time. I waited patiently - I had waited this long to see clearly. What was another 10 minutes? There was a young woman in the line ahead of me with glasses and a nervous look on her face. I thought, "She must be here for LASIK too". Finally it was my turn to get checked in. The lady looked me up in the computer and then looked around for my chart. She got up and looked in another cabinet and still nada. A momentary thought flew in my mind, "Maybe this is a sign. I bet I could run out the door and to the car before anyone noticed I was gone." The receptionist sent another nurse to the back and the care coordinator appeared with charts in hand. I guess I was going though with the surgery.

Less than 5 minutes later, I hear my name and then nervous girl's name. They took us back to separate rooms. The surgical nurse repeated the tests I took during my initial consultation, then put me in the waiting room. Another nurse came in. She introduced herself as Dee, but the name on her badge said Debra. She was there to explain about post-op care and gave me a sheet of instructions to read and a bag of items I would need for my recovery. Nurse Dee left the room while I looked over the materials and through the bag. When she returned, Dee explained she had the surgery done 10 years ago and shared what to expect based on her personal experience. Immediately after, things will look milky - not blurry - just foggy, but that will clear up as the day goes on. She wanted me to keep my eyes closed as much as possible - I should only open them to go to the car, go to the bathroom, eat dinner and put the drops in. She went through the eye drop regimen for the evening - Vigomax (antibotic) and Omnipred (anti-inflammatory) - one drop in each eye, 10 minutes apart. Nurse Dee said I would see an immediate improvement the next day, but my vision would fluctuate for the first week. After 3 months, my vision should get better and after 6 months my vision should be great. She told me tissue takes about 6 - 12 months to heal and that I shouldn't be concerned if my vision is not where I want it to be immediately afterwards. Dr. Carlson was running late because he had to do a corneal transplant over lunch. Once he was ready, she'd bring in the Valium and I would be on my way. In the meantime, she helped me put the blue caps for my head and shoes, dimmed the lights, wrapped me in a warm blanket and reclined the chair. During the time I spent waiting, I set up the "LASIK went well" text messages to send to those who had wished me luck and napped a bit.

I probably waited for another 40 minutes before Dr. Carlson came out. We went through the consent form. I initialed and signed, acknowledging my risks at the appropriate places. At least I didn't have to sign away the rights of my heirs to sue like I did for the skydiving adventure. Then Nurse Dee came back in the waiting room with the Valium. She told me to dissolve the pill under my tongue to help the drug act faster. She put some drops in my eyes, and told me they would give me a local anesthetic in my eyes when I got into the room. Then the care coordinator nurse came back and put me in the first room. She helped me to lay down under the first contraption, got another warm blanket to put over me and left the room. I said aloud, "I'm not quite sure the Valium is working." I heard my own voice, but it took about 5 seconds for my brain to process what I said. Then I said, "On second thought, maybe it is..."

Before that sentence could process, the doctor and surgical nurse came in. They helped me position myself under the first device that makes the flap in the cornea. I saw the doctor swab my eye, then suction ring come down over my eye and I felt the pressure. My body immediately tensed up, so the surgical nurse scrambled to give me a stress ball. I concentrated on squeezing the stress ball, while I breathed deeply and relaxed my body from the shoulders up. Then it went black for a few seconds as the laser went over my eye and then I could see again. The suction ring was released from the right eye and put on the left. I knew what to do and expect this time, so it went much smoother.

The team moved me to the next room. Someone positioned under me the laser. The doctor put the forceps on my eye and told me to concentrate on the green light. Yana told me earlier to pretend it was a staring contest and really try to win. So I did. I saw the doctor peel back the flap, I heard the laser come on and then I saw him fold the flap back. I knew the Valium was working then because it all just seemed so fascinating. I was observing what was going on as if I was watching a show on television up close and not my cornea. The knowledge of what was happening and the fact that it was happening to me seemed to be in different rooms within my head.

Before I knew it it was over. Dr. Carlson looked at my eye and then the opthamologist, Dr. Feldman. Someone grabbed my purse and my post-op bag and walked me to the waiting room. Lanea walked me to the car like I was an old lady. Everything was milky, just like Nurse Dee said. My eyes just wanted to close. I could smell and hear the rain outside as I got in the car. I saw clearly enough to send the text messages out as we drove to CVS to fill the prescription for the antibiotic. As we waited for the prescription to fill, text responses came through. I held up my phone for Lanea to read them aloud to me.

I got home and went to bed - setting my alarm clock for 6 pm when I had to take the first dose with dinner. I woke up and looked at the clock sitting on the nightstand on the left side of the bed. I could actually see it from where I was on the right side of the bed - the first time EVER! Other things were still not too clear and I was still very much under the influence of Valium. I took the drops, ate quickly and went back to sleep. I woke up around 9:30 after a dream about recovering from my LASIK surgery, where the corneal flap in my left eye kept flipping up and would go down. Since I couldn't open my eyes to write it down, I called my home number from my cellphone and described the dream on the voicemail. I took the second dose of drops around 10:30 and called home to talk to my siblings until around 1 AM.

April 11th - 6 AM I get up and walk around the house, seeing things clearly as soon as I open my eyes for the first time in a very long time. I can read the items on my bathroom counter and in the shower - not just rely on my memory to recognize their shapes. I can see the clock on the microwave from the other side of the kitchen, the clock on the dining room wall from the bottom of the staircase, the three black boxes that spell out my initials PLT on the shelf above the television. I can see these things clearly - not in which the foggy haze that I had become accustomed to living. The best test was the public notice I removed from my front door. I could read every word from arm's length - not 6 inches away, like I would have to do without glasses.

Janet arrived at 8:45 to take me to the 9:00 post-op appointment. We arrived at the same time and older couple did. The wife had dark sunglasses covering her eyes - most likely from cataract surgery. The opthamalogist called us back at the same time. It wasn't long before Dr. Carlson came and checked my vision. He said my left eye was inflammed more than he'd like it to be and increased the number of drops I was taking. (The left eye was the one in the dream). Eighteen hours after surgery I had 20/30 vision. I asked him what my vision was before and he said, "Oh you were off the chart - something like 20/1800". And my vision will only get better.

P.S. Please forgive me if I annoy you by reading everything in sight. I'm seeing everything for the first time!