Thursday, December 29, 2011

A complete account of my Lasik experience

Friends and internet-dwellers who are interested in hearing the complete process of my Lasik adventures: here is a complete account of my experience, from choosing the doctor to details of the surgery itself (with a warning for the squeamish).

Choosing a Doctor
I went with Dr. Scott Hyver, because of name recognition, recommendation from my husband, and his success rate. If you live in the San Francisco Bay Area, chances are you've heard his radio spots. The man has literally become an institution (his 3 Bay Area locations are called "ScottHyver VisionCare"), and your interactions with him during the process are fleeting -- once during the sale/evaluation appointment, and then on the operating table on surgery day. Otherwise, you are working with nurses, auxiliary doctors, and a personal sales rep.

If you like your doctors touchy-feely, this may not be right for you. For my part, I didn't care about learning much about Dr. Hyver himself; I just wanted to know that the surgery would go off without a hitch. And the ScottHyver group made me feel that way throughout the process.

Because their offices go through so many patients, they have everything down like clockwork. Each incoming patient is presented with a blue baggie of eye drop medications for their recovery. The somewhat complicated medication instructions are boiled down to their essentials in an idiot-proof chart. The day-of 'what to expect' FAQ is laminated so that it can be re-used for hundreds of patients. Because Dr. Hyver himself doesn't have to bother with the prep work, he remains in the operating room and can do (I estimate) two dozen surgeries a day.

Some people may be turned off by the feeling that they're just another pair of eyes getting churned out by the ScottHyver machine. Honestly, I found it very comforting to know that I was nothing new. The procedure, my extreme nervousness, any inane question I had -- they'd seen and heard it all before.

Evaluation Appointment
I went into the offices exactly twice: once for my eligibility evaluation, and once for the surgery. I did not need a hard sell since my husband had already gotten the surgery.

At this appointment, they did the following:
1. Got a rough digital reading of my prescription using one of those "look at the house" machines;
2. Fine-tuned that reading using one of those "A or B" machines you're used to using at your normal eye doc;
3. Compared that reading against my contacts prescription and my glasses prescription;
4. Checked the health of my eyes using various eye drops and implements (nothing beyond what my normal eye doc does);
5. Numbed my eyes with some drops and then touched a device to my eyeball to measure corneal thickness (this was mildly disconcerting: while I couldn't feel it, it caused a 'ripple in the matrix'-like visual effect).

All of the preceding was done by nurses and a doc who was not Scott Hyver. Next I was brought into a room where Dr. Hyver himself explained which procedure(s) I was eligible for, based on the tests. (In short, comparing current prescription to glasses and contacts shows whether your prescription is stable and therefore worth permanently implementing into your eyeball. Corneal thickness helps indicate whether you're eligible for Lasik vs. PRK.) Again, since I was already sold on the procedure, I didn't need him to say much, but he answered all the questions I had.

Finally, I was brought into a sales rep's room to talk about pricing and payment options. Although prices change somewhat depending on your vision insurance and the type of procedure you're getting, a good ballpark figure is $5K. That's for both eyes, and (in Scott Hyver's case) "lifetime upgrades" in the event that your eyes change prescription over the course of your lifetime. At 25 years old, that amount of money seems worth it, given that I will no longer have to spend $500/year on glasses, contacts and their maintenance.

Between Appointments
I walked out of the evaluation appointment with a script for antibiotic eyedrops, to be started 24 hours before the surgery. Because this meant dealing with Kaiser Permanente's pharmacy, this was actually the most annoying part of the whole experience.

Surgery Appointment
I was incredibly nervous for the surgery, because you have to be conscious and actively involved, training your eye on a green dot. Before the actual surgery, they did the following:
1. Had me sign a form verifying the type of surgery I was having (Lasik vs. PRK; one eye vs. both eyes);
2. Handed me the pouch of post-surgery medications and walked me through them;
3. Re-tested my prescription, both digitally and then using the "A or B" machine;
4. Put some numbing drops in my eyes and offered me a valium for nerves (I did not hesitate to accept);
5. Gave me some stylish booties and a hairnet.

Then a nurse walked me into the surgery room, where there was Dr. Hyver and two additional nurses. I lay down on the surgery table, and they asked me to verify my birthdate and surgery type. (I appreciated this; a last-minute triple-check to ensure they were burning the right prescription into my eyes!)

Warning: a description of the surgery as I remember it follows. Lying face-up on the table, a few inches over my head was a green LED light. They flooded both my eyes with numbing drops, then put a patch over my left eye. They then used tape to open up my right eye, then used a device to make it stay open -- no blinking. I have no idea what the device looks like, but in hearing about it before the procedure, I kept thinking about the torture devices from A Clockwork Orange.

Then, the most painful part of the procedure: Dr. Hyver took some clear plastic (through which I could see the green dot) and pressed it against my eye, hard enough to immobilize my eye and keep it from twitching. My job through all this was to stare at the green dot with all my might, but as the pressure got more intense, basically my vision blacked out until all I could see was a night sky full of stars. Then the plastic stayed in place for a few seconds while I imagine they cut the corneal flap.

Then the pressure was released and the green dot came back. For a second or two, Dr. Hyver manipulated my eye in such a way that it caused the green dot to go streaky, sort of like a barista making foam pictures in a fancy latte. I imagine this was the point where the corneal flap was lifted, because when I saw the green dot next, it was far less in focus. Imagine the halo you can sometimes see around a street light -- that's what the entire green dot looked like. (It was a little scary knowing that my eye was currently that much out of commission!)

Then, the most anxiety-inducing part of the procedure: I was supposed to watch the center of the green dot ("even if it moves") as closely as possible while a laser burned my prescription into my eye. The "even if it moves" warning made me wonder if it would bounce around, but I didn't really sense it move much if at all. So for the good of my future self, I stared at that green dot with as much intensity as I could muster. The laser itself was painless and took a few seconds.

Then Dr. Hyver announced he was going to put in a drop of saline, during which I think he also flipped the flap back over, because the green dot suddenly came back into focus. They took off the eyelid holder and tape, and started on the other eye. The whole surgery (both eyes) took under 5 minutes.

After the Surgery
Immediately after the surgery, they gave me a pair of sunglasses and suggested I keep my eyes closed as much as possible for the next 6 hours. My husband drove me home and I sat in a baseball cap and sunglasses in our den with the blinds down. I listened to an audio book and tried to take a nap. By the afternoon of the surgery, I was on the computer without a problem, and my husband and I watched a movie that night.

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