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Wednesday

Month 1 – 12th July to 19th July

Today I went for my ONE MONTH post procedure checkup. Anxious as ever for the eye test, I reached a little early. I handed in my file and waited. Before they could finish calling my name, I was in the seat staring up at the eye test board. The light came on.

A E R K V

Piece of cake. Move along, move along.

W, I, U, R, O.

Come on, give me a challenge

C, V, R, M, W.

Is that all you got?

W…. E…. Y… V… F….

One more to go.

T….

N….

M….

G….

A…..

Any strain? Nope.
Nothing smaller? Nope.
All correct? Yep.
What about halos around lights in dim lighting? 95% gone.

As were the burst blood vessel marks. I had 20/20 vision. A super success. All good news until…

The doctor said my eyes were dry despite the drops. Yes, I know my eyes were dry despite the drops. I could feel my eyes dry despite the drops. I could see my eyes were dry despite the drops. He said not to worry and that’ll pass in two weeks if I just blink more often and use this eye gel. A promotion, if you will. From drops to gel.

Sorry but I hate applying things on my body let alone on my eye balls. Lubricating gel, twice a day (morning lubrication and lubrication at night) Not to mention, the lubricating drops in between as I desired for extra lubricating. With all this lubrication, I felt so lucky.

Nights, my eyes were still dry and my right eye especially gets red even after an hour of the gel which should last half a day.

Please check back here in a week and I’ll let you know how it goes. Dry eye is a very common problem which is easily treatable but I uh, yeah this is me we’re talking about.

Tuesday

Week 3 - 4th to 11th July

Surprisingly the red marks were still present. I called the clinic up and they said it’ll pass. I checked online and from what I read, the marks usually pass within 2 weeks. Mine were fading away but very, very slowly.

A few days passed and my eyes continued to experience dryness. Worse even. I e-mailed the doctor directly and he explained it was the drops and to not worry about the marks. He reminded me of my one month checkup and said he’ll check it then.

I‘ll get back here in a week and write more. Plus my one month post procedure checkup. *De de de dum.* (dramatic classical tune) Till then, take care and please leave feedback.

Week 2 - 26th to 3rd July

My vision continued pretty much the same. The only changes I felt was how comfortable my eyes were starting to feel. It was like I never had glasses. The halos were still present. Dryness and drops did continue.

What was important was that I found the right doctor that made me feel safe. I’m glad I met all the doctors I did because this one was by far the best and one I could trust with my, eyes closed.
Hahahahaha. Sorry.

I can’t say this enough but it’s very important to be relaxed with your doctor before the procedure, after the procedure and when healing. You want someone who gives a shit for his patients and not some guy who’s pushing you out so he can see his next patient. There are plenty of them out there. Just ignore them.

Day 7 - 25th June - First checkup !!

I went for my 1 week checkup. The ophthalmologists were happy after the topography report (this measures the curvature of your cornea). My right eye could read perfectly. My left, still not as great but 3 of the 5 characters of the last line was legible.

The Doctor looked at my eyes and was just as happy. I told him I’d be starting a blog for other nervous wrecks such as myself and he agreed to help me with any questions I might have. My next visit would be in 3 weeks. I could start washing my face but I had to be careful with dust entering my eye.

Day 6 - 24th June

Watched a movie. Left the Children alone. A peaceful day for all.

Day 5 - 23rd June

The halos are irritating but I did watch an hour of television today without any problems. Every person heals differently, the important thing is not to strain your eyes. The burst blood vessels are making me nervous so I checked online for more information. Just like the clinic said, usually within 2 weeks. And I’d like to take this opportunity to apologize to those terrified children and their parents. It’s not my fault, I wasn’t allowed television, reading or the computer.

Day 4 - 22nd June

Woke up with dry eyes at 8 am. Images were much sharper. Eyes were starting to feel comfortable. But still, it felt like I was wearing contact lenses. Since 3 days had passed, I was allowed to watch minimal television. After 30 minutes of the intelligent box, my eyes once again were dry.

Day 3 - 21st June

Okay. I woke up at 3.30 am desperately needing to put those artificial tears. My eyes were 420 dry. (If you don’t know what 420 is, it’s better you substitute the number for ‘really’) I continued the drops as normal when I woke up. My right eye experienced blurred vision on and off in the afternoon. At night, my eyes felt comfortable. Halos still present.

Day 2 - 20th June

I can see. Still getting use to waking up with vision. My eyes do feel dry but as informed by the clinic, one of the steroid drops would cause dryness, which would slowly go once I am done with them. Images are still not as sharp for but for day 2… nice.

Day 1 - 19th June

On my first day with vision, I woke and removed my protective eye shields. These are recommended for the first 3 nights to prevent touching or rubbing at night. (Your eyes, that is)
I looked over to the clock and for the first time in many years, I could tell what time it was without holding that damn clock 8 inches to my face. It was great. I was almost too happy to go to the clinic. And then I saw these red blotches on the whites of my eye.
I looked like I belonged on the front of a Japanese horror dvd. They were burst blood vessels which apparently happens. They formed at the top of my eye, under my eye lids and were not visible. However, by raising my eye lids, I could have easily given some Children a taste of their own medicine and emptied out the entire playground within minutes. But that’s another blog.
At the clinic, they said my eyes were perfect. I was told to read the charts with each of my eyes. My right was better than my left. I could read the entire bottom line (20/20) My left eye could read most of them. There was haziness and halos did appear around light. Vision for most people will be hazy. Like looking through a slightly unclean pair of spectacles. My eyes were still not comfortable but this is all part of the healing process.

My Final Decision - Blind as a bat, or sharp as Superman

The Final Decision – Two weeks more passed and I really wanted the surgery. Enough that I was willing to do more research. Unfortunately most sites, even the ones I mention are too technical to help any of us make a decision. But I read somewhere that made complete sense. Trust your eyes with the doctor and not the machine. Which made sense. If anything did go wrong, you still had a good doctor who cared.

I never doubted doctor 3, it’s the material online that confused me. But I am glad I did all the research on the machines and the doctors. Because now I know I did go with the best care and forgive me for sounding cliché but 3rd time’s a charm.

My date was set. The time had come. I was ready. Almost. Nearly. Kind of. Maybe I shouldn’t. Ah screw it, I’m doing it anyway.

Day 0 - Day of the procedure – 18th June – As I lay there helpless, the smell of my corneas (sort of like burning hair) together with the sound of the laser, my butt cheeks immediately clenched in fear. We humans are born with this defense mechanism. If you don’t believe me, just visit your nearest prison.

But all that clenching went to waste. Honestly, the only pain I felt during the procedure was the clamp that held up each of my eyelids. But the pain is negligible. In fact, many children happily make varieties of this face. At first, I was worried about my eyes blinking but with the clamps, it is impossible to blink. Of course, I would not advise trying to blink, sneezing nor would I advise winking at the nurse.

Another concern I had was what if my eye moves while the doctor is doing his business. Relax, the machine automatically shuts down. I won’t get into specifics because each machine is different but today’s second generation Lasik machines are way, way faster than the human eye.

During the procedure, my doctor washed my eyes with saline a few times and within 5 minutes, he said “Okay Clark, your right eye is done.” I replied, “That’s it?”
After a few minutes and some more butt clenching, my left eye was done. They helped me up and I could immediately see. My vision was foggy but the objects were clear. It’s like looking through dirty glass. My eyes started to feel extra sensitive to light and I was told to shut them.
It was over. My eyes were tearing from the operation. I was happy. More tears. Shucks.

After listening to the post procedure care instructions I was on my way home. I was wearing the dark glasses, my eyes were shut tight but it felt like someone was shining bright lights straight into them. The pain shot right up into my head. I reached home and took a pain killer that the Eye Clinic said I may need.

Luckily I didn’t sleep much the previous night and took a nap. I woke up and the pain was gone but my eyes felt dirty. Sort of like contact lenses at the 12th hour. But hey, I had vision. I was Superman. Well, almost Superman. I had to report back tomorrow morning for the first check up. A week later for the second checkup. And a month later for the third and final. I had steroids drops for the first two weeks and artificial drops for the next four weeks. (Each Doctor has his own idea on which drops and for how long. It all depends on your location and your doctor and his machine and probably his upbringing. Just do what they say and understand that they’re important to prevent infections and inflammations.)

Day 1 – 19th June – On my first day with vision, I woke and removed my protective eye shields. These are recommended for the first 3 nights to prevent touching or rubbing at night. (Your eyes, that is) I looked over to the clock and for the first time in many years, I could tell what time it was without holding that damn clock 8 inches to my face. It was great. I was almost too happy to go to the clinic. And then I saw these red blotches on the whites of my eye.
I looked like I belonged on the front of a Japanese horror dvd. They were burst blood vessels which apparently happens. They formed at the top of my eye, under my eye lids and were not visible. However, by raising my eye lids, I could have easily given some Children a taste of their own medicine and emptied out the entire playground within minutes. But that’s another blog.
At the clinic, they said my eyes were perfect. I was told to read the charts with each of my eyes. My right was better than my left. I could read the entire bottom line (20/20) My left eye could read most of them. There was haziness and halos did appear around light. Vision for most people will be hazy. Like looking through a slightly unclean pair of spectacles. My eyes were still not comfortable but this is all part of the healing process.

The Technology Shootout

The Technology – I more or less had a choice between a doctor who I admired or a doctor I didn’t care for however who did use the Lasik machine which most American websites claim to be the most accurate in results.

But what did that mean? Was the difference in the two machines the same difference between a Ferrari F 550 and a DeLorean. De Lorean, I believe sold two of his self titled cars. One to the producer of ‘Back to the Future’ – the car with the gull-wing doors and the other to his mother at a huge family discount). Or was the difference in the two Lasik machines more like the difference between an Airbus A320 and a 737-700, or the 737-800?

A new problem arose. I had a shit load of research before any flying. However, if you do want to get involved in the equipment, this might help. The FDA approved machines are here for you to get confused with… http://www.accessdata.fda.gov/scripts/cdrh/devicesatfda/index.cfm?search_term=LZS%20or%20LASIK
The VISX, Allegretto, Nidek, Bausch & Lomb seem to be the most popular from what I witnessed but each Doctor has his own preference. Just like Shaq played better for the Spurs. Or did he step up only with the Lakers. Point is, leave that to your Doctor but DO ask him all the questions about the technology. This will help you decide whether he himself went through the research before choosing his machine. Or, if he went with the machine that charges the lowest royalty rates. Yes, most of them do but that doesn’t mean the ones that don’t aren’t good.

Another problem that I faced was that some machines were only tested on Asian eyes but the results were shown to Americans. And some machines statistics were based on reports on American eyes but were shown to Europeans. Again, I don’t have an answer but do ask your Doctor or his staff all you want. This is an elective surgery and you shouldn’t be in a hurry to make a decision.

And finally… Custom Lasik is what people should insist on because this technology is a step up. Second generation stuff, if you will. The difference is, instead of giving you a factory fitted seat, you’re given a custom designed one. Like they get in Formula 1. Michael Schumacher and the others, all sat in butt moulds for 30 minutes just so they get the perfect seat before the car was further tuned for them before they drive the car into the kitty litter. Which doesn’t mean, you or they can’t sit without a regular seat but if you have the choice, then Custom Lasik is obviously better.

Doctor 4 - Driving over patients toes since '99

Doctor 4 – A doctor friend of mine and I were talking on the phone and catching up. I told him what I went through and he said he’ll get me a name and get back to me. Soon enough, I was doing the same tests. At this point in time, I didn’t need a doctor to do anything, I could have shined the torch and performed all the tests on myself.

But for the sake of respect, I pretended it was my first time. I didn’t want this doctor to have an edge over the other one, or the other one, or the other one. So he continued with his examination and as he came towards me, the wheels of his chair went over my toes. I kept my mouth shut to see if he would realize what he had just done. Oblivious as ever he says, “Don’t worry, your eyes are in safe hands.”

We continued to do the other tests and as we checked my power, he dropped a bunch of lenses. As he bent down to pick them up, he was an inch away from banging his head. Yeah baby, I couldn’t wait till this man worked laser magic on my corneas!

Disappointed and squinting against the bright light, I left his clinic and my search ended.

Doctor 3 - The well-oiled machine

Doctor 3 – I got his number from a friend of a friend’s relative who I never met or knew. Apparently his distant cousin did the surgery and was happy. Heck it was worth a shot.
I called and they put me through to him. Knowing what I knew from all the research I did, I first asked what machine he was using. I asked him more about it and he told me not to worry about the machine. His voice was very calming and I asked if I could come by today because I had been off my lenses for 3 days anyway.

An hour later, I reached his clinic. It was busier than I could imagine. I was surprised he let me come in. Different people did the different tests on me and his clinic ran like a well-oiled machine. I met him and asked him more of my questions. He was in no hurry, but with the atmosphere around I somehow was. He told me that the machine he was using has given him great results and so they’ve upgraded and he’s very happy with the consistency of it. Sounded fine. I was set. A good doctor who trusted his machine. I left, pretty shocked how convinced I was so quickly after meeting him.

I went home and did more research. There was material on his machine, doctor 1’s machine and test results for all of them. Doctor 1 and 2 were using the same machine and swore by it. In fact, they promoted it and highly recommended it over all the others. Sort of like children talking about their table tennis bats. Doctor 3’s machine didn’t have as much material online as the others so I looked through their catalogues. Doctor 2’s pamphlet showed a chart from the FDA which showed everyone else’s machine declining with consistency as the power increases. I was more confused.

I called Doctor 1’s clinic and asked more questions. I mentioned that the Doctor said I could choose between Epi Lasik and Custom Lasik. Epi Lasik is where they don’t make a flap which may sound better but it’s only recommended for people with thin corneas. But heck, why not do it anyway I asked. The response was, the healing time is longer and the first few days are uncomfortable instead of the first few hours. I did more research online. Epi-Lasik wasn’t as popular as Doctor 2 told me.

Doctor 3 told me it was not a common procedure but they had it. So I called Doctor 2’s clinic back. They said, we spoke to the Doctor 2 and he recommend Epi Lasik because you have dry eye. What? He never mentioned dry eye. I only enquired about Epi-Lasik because I thought it was newer and hence, safer.

I wasn’t sure if I was the one looking for problems or someone up there was trying to tell me something by making each doctor tell me something else. I put everything on hold. I had a busy work schedule as well so the wait was needed anyhow.

Doctor 2 - Sir Ben Kingsley

Doctor 2 – A week later and after more research, I heard of another doctor who had the latest and most accurate equipment. I took an appointment and went to his clinic after not wearing my contact for a full 3 days. There, the receptionist told me, I’d have to go to his other clinic for the tests. So then why take my appointment here. The doctor realizes I’ve come all the way and agrees to see me. He was very kind and told me to do my research online and prepare a list of questions for him for the next appointment.

A few days later, I took my 31 questions over to him. After the tests were done and he was confident that I was a good candidate he asked for my questions. I started asking and he started looking at his watch on the third question. By the fifth, he seemed irritated. He answered my questions with arrogance and came across like Ben Kingsley demanding to be called Sir Ben Kingsley. Now I respect all doctors, even the quacks. I respect all professions and races of people. So it really gets to me when someone doesn’t give me the respect I give them. I don’t care if you’re a doctor, a celebrity chef, or a politician. Even Hannibal Lector had the decency to be polite and I think that’s the least we owe each other. But what the hell? This was the probably the best doctor with the best equipment and he explained how the other machines in the market have greater chances of complications. I left, confused as ever.

On one hand, it was a doctor who was sure nothing could go wrong. On the other hand, it was a doctor who would probably push me out the window if something did. Maybe he was in a hurry because with the appointment mix up he saw his patients twice instead of once. Maybe he needed the loo. Disappointed and squinting against the bright light I left his clinic and my search continued.

I should add that I did pay his consultation charges and fees for the tests. Doctor 1 however was free but I did offer again before I left.

Meeting Doctor 1 - "Don't call us, we'll call you"

Doctor 1 – It was a sunny Sunday and I made my appointment. As requested, I was off the contact lenses for 3 full days. (Contact lenses alter the shape of one’s cornea). I met the ophthalmologist who was very kind and definitely knew her stuff by the way she explained everything. And I’m sure she did.

I should first mention that back then, I had no idea what the surgery was about. A good friend of mine had done his Lasik some 5 years ago but being the fearless person he was, I wasn’t surprised nothing went wrong. But with me, a paranoid skeptic and with my luck, I had no choice but to be careful. And to make things worse, I just met an uncle who advised me against the surgery because he was facing many problems. (Shadow images and halos even 1 year post surgery). Obviously I didn’t go to his doctor but his was supposed to be the best. But busiest and most expensive doesn’t always mean best. It does sometimes but not this time.

Back to the room of Doctor 1. So all was fine and the tests went great. I met the Doctor who said, “You’ll be a good candidate. When do you want to make your appointment?”
Woah, hang on. At least buy me dinner first.

I told him that I was a skeptic of the procedure and that I’ve only heard of unhappy patients. He threw down the gauntlet and told me to ask him anything. Now when people do this, I secretly have this desire to ask them about their favorite color but since this guy might be behind a laser directed at my eyes, I decided to lose the humor.

I asked him about what vision to expect and what would be the worst thing that could happen? He told me about infections, inflammations but as nervous as I was when he answered and I’m not even a scary person. He went on to explain that the chances were very slim but with his tone, I didn’t want to take a 3 pointer shot from the half court.

He then told me the only risk would be halos because I have big pupils. Oh, so the halos would be my fault then? (Halos are glows around lit objects that appear in dim light) He told me that I see halos without the Lasik anyway which is not true. He then said, the steroid drops are for a week and then that’s all.

I wasn’t at all at ease. “Well, everything sounds good doctor. Don’t call us, we’ll call you.” I went home with my eyes diluted. Disappointed and squinting against the bright light wondering if I’d ever be able to lose my spectacles.

The Beginning - Clark Kent's search for the 'Ultimate Lasik Operation'

After being taken upstairs, I was asked to take off my shoes and wear sterile, plastic feet covers. I was shown into a prep room where I washed my hands and face.
One of the staff members helped cover my head with a sterile, green cap. Another kind female assistant handed me a robe and I started taking off my shirt. She looked at me and asked, “Did they go over the instructions with you?” I replied, “Of course. I’m changing into this green thing.” As I continued unbuttoning.

“Eh, sir. The robe goes over your clothes.”

I squinted to see her expression, she wasn’t kidding.

“I, I knew that.” I replied. Without my glasses, I couldn’t tell if she was smirking or at least trying to hide it. This would be the last time I would have this problem. With my eyes sight. (Looking like a fool in front of a young woman sadly happens often.)

But it wasn’t all laughs. Before deciding to undergo the Lasik procedure, I had to be certain my eyes were safe. And safe for the rest of my life. What this blog aims to do is simply present what I went through before, during and after the Lasik procedure in a light hearted way so that you the reader, can relax and make your own decision about whether you’re ready for it or would rather wait a little or continue with contacts and or glasses.

The reason I have not mentioned my name or location anywhere and opted for a secret identity is that I am in fact a writer by profession I would not want to be judged or stereotyped by the blogs I write. I also believe it’s necessary for a writer to write for writing sake as well as for money.

Getting back to the choice of Lasik. It took me a month to gather up the courage to sign the necessary forms that all doctors cover themselves with. Trust me, it is a scary form.
The form might as well say, “I hereby, so and so, legally understand someone will slice my corneas open with a laser beam, change the shape of them and then place them back. I accept the risks of the machine and the elective surgery and am fully aware that in the unlikely event of a mishap, I may walk out circumcised.”

In today’s day and age, a doctor must not only insure himself but make his patient promise that they won’t sue. Don’t get me wrong. I respect all doctors but with the government and pharmaceutical companies interfering, no one is safe and I get where they’re coming from.
However, the term quack is there for a reason and I wouldn’t settle for anything less than the best doctor in town. An attitude we all should have, especially for an elective or cosmetic surgery.

Besides, this was my eyes I was talking about. Not some organ I could abuse like my liver. My sight is probably my favorite of all my senses. I think smell is overrated. Sound, just as much with the music today. Touch has plus points but I do recall getting aroused more times without being touched and just with looking.

Yes, sight was definitely my favorite sense. If I had to wait and save up for the best care from the best doctor and the best machine, I’d do that. And so my search began…

Sunday

What is LASIK exactly ?

What is LASIK?

(LAY-sik). LAser in SItu Keratomileusis. Or to us humans, a refractive surgery in which the cornea is reshaped to change its optical power. Think of your eye as a camera, and the cornea being a lens that can be enhanced.

Pre procedure – The evaluation

Patients wearing soft contact lenses typically are instructed to stop wearing them approximately 10 to 15 days before surgery. Hard contact lens users should wait much longer as their cornea shape is effected even more.

At the clinic, the patient's corneas are examined with a pachymeter to determine their thickness, and with a topographer to measure their surface contour. Using low-power lasers, a topographer creates a topographic map of the cornea. This is that colorful diagram that is printed out.

This process also detects astigmatism and other irregularities in the shape of the cornea. Using this information, the surgeon calculates the amount and locations of corneal tissue to be removed during the operation.

The Procedure

In simple terms…. A thin layer of the cornea is raised as a flap, then an excimer laser is used to reshape the intrastromal bed, producing surgical flattening of the cornea.



The diagram above is the least scary one I could find but this is what corrects myopia, hyperopia, astigmatism but more importantly, aids the patient in looking less geeky.

Persons with hyperopia or farsightedness, have difficulty seeing near objects as clearly as distant objects. Persons with myopia, or nearsightedness, have more difficulty seeing distant objects as clearly as near objects. Astigmatism is a distortion of the image on the retina caused by irregularities in the cornea or lens of the eye.

Combinations of myopia and astigmatism or hyperopia and astigmatism are common. Geeky is when a person “appears” intellectually inclined and is disliked or unpopular. People with contact lenses are worse off. They have to pretend they’re not geeks. Sadly, I have experience in this field.

The goal of Lasik is should be to remove these vision and popularity problems although some doctors prescribe glasses even after the surgery for reading, for the computer or for driving. What is important is that your doctor delivers the vision he promises and that you can start making fun of other people who still wear glasses. Nerds. Four eyes. Harry Potters. Gandhis. George. Etc.

Post Procedure

Patients are given a course of antibiotic and anti-inflammatory eye drops to prevent infection. These are discontinued in two-several weeks post surgery depending on the climate, doctor and country. Patients are also given a darkened pair of goggles to protect their eyes from bright lights and protective shields to prevent rubbing of the eyes when asleep for the first week.