Bhavesh

This is Vesh's account. Also well worth checking out his posts - I especially liked the one about "black-hairy tongue" (ewww). His website is at http://www.veshman.com/mt/

I finally had enough reasons to get Lasik, the most recent one being when my brother noticed the indentation and discoloration of skin on the side of my head from my glasses when I took them off. I was so sick of glasses, what with them fogging up and the most inopportune moments, falling off your head, causing glares, making athletic activities harder (like when you glasses shake on a mountain bike ride, or when you start sweating on your lenses so that you can't see). Just a big royal pain....

So I finally did it. I used the laser surgery with Wavefront technology. I am post-operative day #6 now, and my vision keeps getting better and better. I am very pleased with the results so far.

I have always wanted to be rid of glasses, but was very scared about the procedure and about the potential for side effects and bad outcomes. Going through the procedure is definitely one of the scariest things I have done, even though it is easy.

The tipping points for me finally doing it were:

# Wavefront technology
# Using one of the principal investigators in the FDA trials as my surgeon
# Success that others had 5-7 years out
# Wanted to look good for the the ladies

1 Wavefront is based on research done on NASA telescopes. It measures how light exits and enters the eye. For Lasik Wavefront, 200 measurements are made of the eye. Essentially, a corneal surface map. This is in contrast to the three measurements done prior to Wavefront analysis. The laser then custom treats your cornea for the best possible outcome, doing a little more here, a little less there. Also, the laser's eye tracking system is wicked fast and makes up for the uncontrollable saccadic eye movements that your eye naturally makes. Supposedly, the side effects such as halo, glare and starburst are near-zero with wavefront.

So, I felt a lot better about it.

2 Coleman Kraff, MD of the Kraff Eye Institute has been doing research for the FDA on these lasers since 1991. He's done over 18,000 eyes, and has not had any serious complications. That was reassuring (but I was still scared). He was very confident about my eyes, and felt that I was well within the normal range of people who can do this surgery. I really wanted to hear that. I wanted to be in the middle somewhere, not at the edge.

3 Since more and more people have done Lasik, I was just running into a lot of people who had it done. No one I'd met had had any complications, and a few of them were over 5 years out. That was reassuring.

4 Self-explanatory.

The Procedure

So I had all my pre-op stuff done, where they do all the different tests, make sure your cornea is thick enough, see how much astigmatism there is, see if you qualify for Wavefront, etc..

Now was the day of reckoning. My last day with glasses. I was trying to play it cool, listening to my iPod, and working on my iBook while I waited. But then the moment comes where they call your name to go into the operating theater.

So I go in, lay down on the operating table, and the nurses are prepping me. They put some anesthetic in my eye...no big deal, I've put tons of anesthesia in other peoples eyes. Then they swab the area to get rid of stray bacteria and then tell me not to move my hands or touch my face.

And then it was like being a 3rd year medical student in the Operating Room for the first time...all of a sudden my ear starts itching and I'm not allowed to touch it. In the OR, once you are sterile, you are not allowed to touch anything that is not sterile. If you do, the surgical nurses point you out really loudly and exclaim that you are no longer sterile, make you look like an idiot to everyone else in the room, and loudly shows her annoyance at your lack of technique in the OR. The case gets delayed, you have to go scrub again, you feel horrible and like you're the reason that anything that goes wrong in the case will be your fault. In reality, it's not that big of a deal, but when you're new, it feels like the biggest thing, and I think the nurses have fun picking on lowly medical students. But, I digress.....

I can't touch my ear and all I can think about is my friickin' ear. It's consuming like 80% of my attention...I just need to itch it..once....dammit. Just like in the OR as a 3rd year medical student.

Then the surgeon starts..forget the ear. A bunch of numbing medicine goes in and he starts to put the eyelid retractor on. I feel a little pain...Hey, I'm not supposed to feel any pain right? Did they put enough anesthesia in? What if it hurts when the laser hits?? I push those thoughts aside.

I think the next step is where he actually makes a slice of the cornea. He says that things are going to go dark for a bit...dark?? fine, I can handle that Indeed, things start going dark....but wait!! I can still see the red flashing light! is it supposed to be DARK OR NOT?? Which one is it? Calmly I tell him that I can still see the red flashing light. He says that's fine. Good....

Now I can see again, things are almost their usual blurry way. Then I can see him pull the corneal flap over, and I actually still see pretty well...everything just a bit fuzzier. (Me saying that I can see pretty well is like saying blue is actually red...maybe not that bad..)

Now it's time for the laser. Just focus on the red light. The laser is going to burn for 43 seconds. Just focus on the light. Nurses on either side of me are saying different numbers...6.2 ...... 7.8 ..... 3.4 .... I have no idea what they mean but it's in stereo.

"Ok, Bhavesh, just 40 seconds left" 40 SECONDS!! ONLY THREE SECONDS WENT BY?? Ok, focus on the light...is my eye moving....is the light moving?? I'm not really seeing the light right now....is my eye still in the right place?

"Ok, Bhavesh, you're doing good...30 seconds to go..." Still 30!!??!! That's all we've done so far? Ok, stay calm....relax...deep breath...wait! focus!! on! the! light! Holy cow...this is my one chance....don't mess it up...keep your eye still... Now, the laser is more than making up for my neuroticism, but hey, it's my eyes.

The rest of the procedure pretty much went the same. 43 seconds felt like 4.3 minutes. Numbers being announced on either side of my head, and I'm trying not to fuck up my chances of having perfect vision.

"Ok, great job Bhavesh, now it's time for the other eye"

The second eye went a little better than the first, but still scary.

Post-op Complication

Of course, my biggest fear: a complication. Shortly after the procedure was done, I felt something move in my left (dominant) eye. Like a crinkled contact lens. The surgeon confirmed....the flap moved. Of all the gin joints in all the world.....

"Wow...man, that really moved...I haven't seen this hardly at all...the last time was ten years ago.." Great....just what I want to hear....But I'm cool...you're the best, so I'm sure it will be fine

Dr. Kraff went on to re-smooth the flap down using the slit-lamp, and then put a contact lens over it to keep it down.

Just trying to get the lens in was a bit of a struggle..."Wow, you have tough eyes..." Yeah...just get it in as perfectly as possible....

The lens went in, and I was to go home and try to sleep, no reading, no computer, no TV. Just rest. After my complication, I was not going to argue with that: Vicodin and Valium to the rescue.

POD #0

The day you actually get the surgery done is not bad...everything looks hazy, maybe a little like there is a layer of water on your eyes. Antibiotics and steroids need to go into your eyes every 4 hours. I set the timer on my Timex Ironman Expedition watch to remind me. My dad came over from the office to meet me after the operation and cabbed it home with me and ended up spending the night to help take care of me...how great is that?

I went home and went to bed (getting to wear these really sexy eye shields so I don't rub my eyes while I'm sleeping)...woke up for a while, put the drops in my eye, and went back to bed...I just wanted to make it till my post-op exam at 8 am the next morning. The drugs helped. Dr. Kraff made a personal phone call to see how I was doing...that was nice.

POD #1

7 a.m. Wake up, put the drops in...everything is going to be crystal clear, right? Of course not. Better than yesterday, but still kind of hazy. My left eye is looking better...maybe the flap stayed down and is perfect now. I get over to the doctors office thanks to a ride from my friend Ted.

Slit lamp - still crinkled. Damn! More anesthesia. And a little more. Ok, some more. Removal of contact lens. Re-smoothing of the flap. Sit for a while for a recheck. I put on my iPod and close my eyes. I don't even think about opening them. Recheck: perfect. Follow up for the 1-week post-op.

My left eye is hazy again, but it starts to get clearer and clearer as the day goes on. I go home and try to rest. I need my left eye. So I take it easy until I have to go to work in a few hours.

Seeing patients was good. Got my mind off my eyes. I kept using the drops and the natural tears.

POD #2

Wake up, looking even better. Still fuzzy here and there, but getting better. I go to work again, and then to a work holiday party. My first party without glasses or contact lenses. I was so hot...:). Got home, found out my Porsche got side swiped...

POD #3

Wake up around 5:30 am..have to be at work by 7am. Ok, the vision is really starting to get better. There is no difference in haze L comparted R. Things are sharper. My Porsche was still hit...it wasn't a bad dream.

POD #4-6

My vision keeps getting sharper and sharper by the day. I feel more and more comfortable. There is a bit of halo around stoplights and headlights, but not really around signs for restaurants and things like that. I only see the halo or glare around high contrasty lights. And the light itself is really sharp. I hope it improves, but even if I have to live with this for the rest of my life, it's worth it.

POD #7

Go in for a recheck of the eyes. Vision in the left eye (the one with the complication): 20/15. Right eye: 20/25. Both acceptable, but confirms what I already knew...I could definitely see the discrepancy, but I'm sure it's something I can get used to. If I can live with it, I'm done. If it bothers me in 6 months, maybe I'll try for an "enhancement".

Conclusion: I am really, really happy so far. It's simply amazing that I am not wearing glasses. Mentally I still think I have them. I still start to look for my glasses in the morning, or try to dodge them if I have to scratch my nose or something.

Definitely one of the scariest things I've done, but also it has been very rewarding. It feels awesome, just awesome, to be cruising around with normal vision, wearing sunglasses if I want to, just really looking people straight in the eye and knowing they can look straight in yours..it's totally awesome.