18 April 2017

lasik, part one

I wasn't sure until the morning of surgery that I really was going to get lasik, because at my pre-op appointment two days before, I tested as needing an entire diopter of correction less than I had needed in October. 

It seems that some people with myopia will accept just about as much correction as they can get, and I am one of them. 

You know when they keep switching the lenses in front of your eyes and asking if 1 or 2 is better, or 3 or 4? Some of us nearsighted people will keep saying that a stronger prescription is better, even after we can see 20/20 with a weaker one. This is because, the doctor explained to me, the stronger prescription makes the shapes darker, and we mistake the darker shape for a clearer shape. 

So I brought in my contacts and glasses prescriptions from the last ten or 12 years, digging them all out of my wee little filing cabinet, and the doctor re-tested my eyes herself the morning of surgery, rather than having her assistant do it. "It's valuable information for me to know if something is darker or lighter, even if it isn't clearer," she said, "so just tell me what you see." 

I kept making her go back and forth, leaving each one for longer than usual, to make sure the prescription we came up with was exactly right. Lasik is a permanent change, after all, and if you do too much correction for nearsightedness, you might need reading glasses sooner. 

We settled on the same diopters as my contact lenses have been for a decade, and the middle of the astigmatism correction I've had. My astigmatism correction has, shall we say, fluctuated. Probably because, "which is better, 1 or 2? 3 or 4? 5 or 6?" always goes so very fast, and it feels like there should be a right answer, even through there isn't. There is only what is right for your eyes. So I've had a bunch of different astigmatism corrections - my glasses and contacts were not the same, even though they came out of the same eye exam - and they've all worked.

J. and I walked up the hill to the main hospital cafeteria and got some fish and chips. We took some photos on the deck overlooking the city, commemorating my last few hours in glasses.

After I checked in and paid crazy quantities of money ("your card isn't working," the lady said, but I looked at the machine and said, "It's a connection problem, not my card," and it eventually went through fine), I took the valium they had given me and went to the bathroom one more time. There were people in the lobby waiting for all kinds of eye surgery. A mother and grandmother waited for news of a child.

They called me back right at 1:45, and explained all the post-op procedures, which I promptly forgot. 

For every other surgery I've had, I've been half-asleep, even if I was talking. I can't remember any of them except a snippet of the wisdom teeth removal. But for this one, I was awake. You have to be awake so you can direct your eyeball. I remember it all.

This is where you should look away if eye surgery makes you squeamish.


The surgery takes place in two parts.

First, in a room with a big laser, they numb your eyes and put betadine in them. "I bet that would sting if my eyes weren't numb," I said, as the brown washed over my vision.

They cover one eye and move your chair so the other is directly under the machine. A round piece lowers onto your eye and suctions the middle up. Everything goes dark, but you try to look at a light. The laser does something that you can't really decipher, and when the machine moves, everything looks like you are looking through a foggy glass. 

What's just happened is that a laser has made a bunch of little air bubbles in your cornea (pulses of one quadrillionth of a second!), creating a flap at the front of your eye.

The second eye, the left, hurt more than the right. I felt like someone was pushing through my eye into my sinuses. Instant sinus headache. But that was the only real pain of the whole thing.

When both eyes had been air-bubbled, they had me stand up and walk into the other room, looking through the fog.

I lay down on a padded bench, and the assistant moved the knee rest under my knees. 

They put more numbing drops into my right eye and wedged it open with a little eye speculum. I looked up at a diffuse green light that pulsed. I could see the doctor working on my eye with a little tool that looked like what the dental hygienist uses to scrape your teeth, sharp on one end and folded like a spatula on the other, only the surgeon was gently lifting the flap that the first laser created. 

I had to look up at the green light, which sometimes disappeared for an instant and then came back red, and then green again. Red lights moved around the edges. I could smell burning eye. It only took 15 or 30 seconds before it was done, and the surgeon was patting down the flap, smoothing it into place and tamping down the edges. 

The longest part of the whole thing was waiting for the flap to re-adhere, it seemed. Finally they took out the eye speculum and let me blink, then re-checked with a bright white light to make sure it was smooth.

The surgeon and the assistants kept telling me how calm I was, which surprised me, because they seemed surprised, but who would flinch while someone has a sharp tool and/or a laser near their eye for surgery purposes? That would end badly.

Between eyes, I asked if they had any blankets. It was so cold in the room that I was struggling not to visibly shiver. I had even expected that and worn a warm fleece jacket, but it wasn't enough. Fortunately, they had pre-warmed blankets, and the second eye was much more pleasant just because I wasn't so cold.

After the second eye, they put a flexible sunglasses material mask on my face, rubber band around my head, handed me a stack of papers, and walked me out to J. 

It was 2:15. 

I tried to keep my eyes mostly closed, but I snuck peeks. At the first stoplight, I braved opening my eyes a little, and I could already see better than before the surgery.

When we got to the house, I deliberately walked into a telephone pole on video for posterity, and then I took a vic0din and went to sleep.

They had warned me that some people feel a sensation like red pepper in their eye after surgery. I was one of those people. By the time I got home, my eyes were burning. The vic0din fixed it, though, and it was gone by bedtime when the second vic0din wore off. 

Sometime after I went to sleep, I woke up and sat up, wondering what time it was. The alarm clock was across the bed, and I looked over at it and read the time perfectly clearly. It was 4:36. I never could read it from there before.

I tried not to get too excited, but I woke up in the middle of the night, since the pain pills had worn off and I'd been sleeping off and on since 3 pm, and laid in the dark with my dark mask still on, looking at the tree branches outside the window, silhouetted against the street light, and smiling to myself. I couldn't see those tree branches before.

The next morning, my vision was 20/15.