Thoughts

With Frickin' Lasers...Part 3

And so it is done. After a little over 2 years of talking about it, and figuring out whether I really wanted to spend the money etc., etc. I have finally had my vision corrected...with frickin' lasers! As I type this, it is 2 days since I had the treatment. The first 48 hours I was not allowed to watch TV or use my computer, as they tend to cause you to stare which lets your eyes dry out too much.

To be honest yesterday it was hard not to just go back to normal. I felt fine, and that is probably what makes it a dangerous time. You still have to be careful, but it feels fine.

Anyhow further to my previous posts I wanted to write about my experience going through the process. And I have a tale to tell...

My appointment was for 12.30 on Friday the 22nd May. At the Southampton Ultralase clinic. It had been about a month since I signed on the dotted line and made the booking. Something that I was very aware of during that month, was just how much my eyes itched, and generally wanted to be touched or rubbed. All things I knew I would not be able to do for the 2 weeks after treatment. Also interesting to note that my perfectly healthy eyes where always giving me little niggles. So I have a reasonable view of a 'base-line' of sensation from my eyes, with which to compare things afterwards.

I turned up to the appointment with my wonderful girlfriend on hand to drive me home and take care of me. The first thing I had to do was sign the final paperwork on the finance agreement. I guess this has to be done, but they could have got us seated in the waiting room first. But no, first thing in reception. Sign away the money...

We were then led through to a waiting room. Upstairs this time. So not where I was for the initial appointment. We were a little early, so we then had to sit and wait for a while. After a few minutes into what would have been my appointment time, someone came to let us know things were running a little slow, but they would be with me shortly.

A few minutes later I was called into meet the surgeon who would perform the operation. He informed me that everything looked good to him, no problem with what was planned. He checked my eyes etc, and we went over the consent form we had to sign together. Basically whilst they can apply experience of thousands of previous treatments to have a high degree of confidence that they can achieve the desired result, at the end of the day, human beings are extraordinarily complicated, and we are all slightly different. So there are no guarantees. Having signed the forms and checked I had no further questions, it was back to the waiting room for a bit.

Next up I was called into the ante-room to the laser room. Where a nurse explained the aftercare, showed me the eye drops I'd need to use every 2 hours for the first 48 hours (excluding when I was sleeping)  and 4 times a day for the remainder of the 2 weeks. She also showed me the eye shields that I'd need to tape to my face when I sleep. I'll come back to these later.

All the bits, and an information sheet were put in a goody bag which my girlfriend took hold of. As now I had some anaesthetic drops put in my eyes. These were the same as ones used during the initial appointment. I was then given little shoe covers to put over my shoes. And a silly shower cap type thing to put over my hair. It was about this stage that I thought I was going to be given something that would help keep me calm. I decidedly remember being told I'd get such a thing... it never came. Just before actually going in, I got more anaesthetic eye drops, and the area around my eyes was painted with iodine. At this point my loving supportive girlfriend took pictures :-)

So this was it. The big moment. Kat went back to the waiting room. I was led into the laser room. The main thing is a long 'bed' whose head end was over hung by two big bits of kit: the two lasers used. I sat on the end of the bed, and when they were ready I was asked to lay back, and they helped my head into position, avoiding clonking the machines which meant sort of sliding up into position.

WARNING: if you're squeamish don't read on. In fact if you're nervous about such things at all, probably best to skip to the end. The basic gist is that it's not a terribly pleasant experience, but worth it.

Ok still with me? I did warn you...

Before I start with the detail, I should note that I knew that I one of the benefits of the treatment I was paying for is that it only took about 30 seconds per eye to do. What I don't think I appreciated was all the stuff that has to happen before and after that 30 seconds of laser use that brings the whole experience up to something like 20 minutes...

It's a slightly weird experience that people are talking to you from behind masks which muffle them slightly. But there is a pretty constant stream of updates to keep you calm and informed. Before anything happens there is a 'I'm just going to...' warning. More anaesthetic drops first. And a shield over my left eye whilst they work on the right eye. At this point they use a speculum, which is a little wiry spring thing which they use to clamp open your eyelids. Whilst your eye is anaesthetised, you can feel the sideways pressure against your eye socket. As the pressure mounts you just start to think, much more and this will hurt... and it stops. I found it hard not to involuntarily twitch my eyelids in response to it going in. But the surgeon managed to get it in place just fine. It's hard to describe how unpleasant this experience is. Whilst you instinctively blink, and you can't really tell that you have not. Your main instinct at this point is to close your eyes. But you cannot and are forced to see, blearily, what's going on. More eye drops are applied, and then they need to put something in place which holds your eye still. They warn you they are going to apply it and that you will feel pressure (but no pain) And so this thing is pressed down onto your eye. Again the pressure increases quite alarmingly. I believe they apply suction. It is very unpleasant whilst the pressure is increasing. Once it stops this is actually one of the nicer parts. You stop being able to see out of that eye. ( They warn you this is going to happen and is normal) And you then have about 20 seconds whilst the flap is being cut. I found this bit fine. Obviously you feel nothing. I couldn't see anything and was not required to look at anything etc. And then it's done. The pressure is released, and you are warned your vision will be odd out of that eye for a few seconds due to air bubbles. One of the more disconcerting things about the process is that your vision is a) pretty much always on, and b) mostly shifting through blurry and distorted states.

At this point I felt the bed jerk a little to one side. Then repeatedly be wobbled from side to side... odd, I thought. After a certain amount of wordless messing around, it transpired that the bed was stuck. Basically the two lasers each have a motorised section to control movement beneath them. But the bed is supposed to disengage and swing freely between the two.

But it would not disengage. Initially I was vaguely amused at calls to switch it off and on again... But after several minutes this was not terribly funny anymore. They apologised and got me to go sit in the recovery room for a bit whilst they dealt with this problem. I was given the option for them to go get Kat, but I said there was no need to worry her just yet. ( I discovered later that someone went and told another couple who were waiting that the bed had broken, so she knew straight away anyway)

After about 20 minutes, it had become clear they could not fix it. They did go and get Kat when they realised they weren't going to be able to continue. As I'm sure you can imagine. I was not best pleased at this point. I was worried that this might mean a delay of weeks, and initially they did say they were fully booked up for a couple of weeks... this is really not what I wanted to hear.

Fortunately the surgeon returned a few minutes later to say that they could fit me in first thing the next morning in Reading. Everyone had agreed to turn up 30 minutes early to fit me in before the normal schedule. They would pay for transport there and back. I accepted the offer. Somewhat relieved that it was only a one day delay.

Before leaving, the surgeon once again examined my eye, and explained there were no medically problems from this delay. There was a small chance he'd need to use a needle to re-lift the cut if it healed slightly over night, but this would not be an issue. I would, of course, have to use eye drops every couple of hours or my right eye, and I would unfortunately experience a few hours of discomfort.

So we went home. I was pretty frustrated that I had one very sensitive, watering eye, that was not even healing towards being fixed. But I accept that this was not the fault of anyone really. As far as random unlikely things that could happen, better this than an infection or other nasty complication. The surgeon noted with some frustration that it was such a stupid problem to have. The bed didn't matter, it didn't NEED to swing and motor, anything would have done as long as I could keep my head still.

To be fair to Ultralase I have to give them credit for how they handled this. I always think the measure of a company really comes with how they deal with difficult situations. With no fuss they arranged a taxi and told me what time it would pick me up. All the staff came in early. And at 8am the next day I was in the Reading branch, with the same team, and ready to start again. The taxi cost something like 70 quid each way, and was prepaid by Ultralase.

And so after a slightly annoying delay, and a few hours of extra discomfort I return to the the process... The surgeon inspects my eye, and after applying more anaesthetic drops he does use a needle to just undo the small amount of healing that has occurred over night. Then it's to the ante-room, back on with the hair cover and shoe covers, more drops, more iodine and were ready to roll again.

At some point I commented that if this bed broke down, I was going on a diet.

I got back in position under the lasers and waited. For some reason the surgeon was delayed doing something else. And I laid for what seemed like 5 or 10 minutes. With the technician type people trying to look busy whilst we waited. But soon enough we were on again. We started by cutting the flap on my left eye. This was a repeat of the experience of the right eye. No less unpleasant for knowing what was coming. Or even for knowing how much pressure to expect. Throughout I found myself tensing as pressure was changing and then forcing myself to relax again when it leveled off.

Now for the fun part... if you only just made it through the last bit... Skip ahead...

So the speculum is applied again to the first eye to be lasered. Back to my right eye. More drops applied. And a sticky paper ring stuck around my eye socket, I have no idea what this is for. At this point you are laying under something with a blinking red light which you need to look at. This seems easy, but vision is not clear at this point. And you would really rather have your eye shut. The surgeon had either 1 tool with two uses, or two tools that looked similar from my vantage point. Basically a needle-like thing with a 90 degree kink in it. In one mode it was able to shoot cool water over my eye, in the other he was using it to pull up the flap. This was the eye that had had a day to heal slightly, and he had to try a few times trying to pull it up. Trying to focus on a red flashing light, when the very thing you're looking through is being moved and distorting vision is not easy. You are warned that the main thing that can damage the flap at this point is you moving your eye too much. I much preferred the flap cutting bit where I couldn't see. And had no impulses to move the eye. After a couple of tries my vision went all bendy as the flap was peeled back. Interestingly whilst the LED is several inches above your head, once the flap is removed,  all you can see is a big red blinking splodge.  This actually made things easier. I couldn't see anything else, and it was a bit like seeing weird patterns with your eyes shut. I was told the treatment would be take a total of 23 seconds in three bursts, finally we were at the bit that would only take about 30 seconds :-). The laser makes a noise when it is doing its thing. You are warned so that it doesn't make you jump. Many people have said that it is at this point you can smell burning. I do not believe this is true. What I could smell was chemicals, I suspect this is part of the laser's operation and nothing to do with the incredibly small amounts of cells being destroyed to fix my vision. Once done, the surgeon replaces the flap, and then there was a lot of having my eye washed out with water, drops applied, little swabs being brushed across the surface of my eye. And repeated, I presume as he made sure the flap was back exactly right. This was really very unpleasant, as you can see more of what is going in, and watching jets of water falling onto your eye, and swabs going back and forth is not so nice. The last piece of discomfort is to peel of the papery thing that served no obvious purpose. It was very sticky, and I was told to try not to tense against it as it was pulled off.

The process is then repeated for the left eye. This seemed slightly shorter to me. Less faffing around, possibly due to the freshly cut flap. 24 seconds of laser to this eye, which was slightly worse prescription wise. And then we were done.

SAFE TO RESUME--- if you skipped ahead, it's safe to start again now.

As I sat up my vision was sort of clear, but through a layer of milk or something. This clears quite quickly, and it's pretty hard to keep your eyes open at this point anyway. I was lead to the recovery room where I could at least, this time, feel better in the knowledge that from now on I'm recovering towards fixed vision.

After 10-15 minutes the surgeon called me back to get my eyes checked again. It was very hard to open them at all, let alone when bright lights are being shone into them. But obviously it was enough to say everything looked good. The surgery had gone perfectly, and I could go home now, to return tomorrow for the first checkup.

A taxi was called to take us home, and I basically spent the next 2 hours with my eyes shut. It's an odd combination, they feel quite uncomfortable, in part because they are watering and the water is being held in place. But it's really hard to open your eyes to let the tears go. And of course you may not touch your eyes. I kept my eyes shut for the entire taxi ride home. Kat provided me little updates on the way for where we had gotten to. This was nice as it's hard to judge and keep track with your eyes shut.

At home I laid on the sofa, and kept my eyes shut. And when the first drops were due I was glad to have Kat do them for me. It was still hard to open my eyes, so I didn't want to co-ordinate eye drops myself. I pretty much slept between these and the next due set. I was listening to an Eddie Izzard DVD, and I think I was in and out of sleep for most of it. By hour 4 I still had Kat apply the eye drops, but was finding it a little easier to open my eyes for a few seconds at a time. Another 2 hours of listening to comedy DVDs. By hour 6 I was ready to apply the drops myself. Feeling much better about having my eyes open, but still resting them. By hour 8 my eyes felt pretty OK again. And my vision was already good. I was trying to figure out if it was as good as it had been with glasses yet. I should have set up some kind of benchmark before I had them done.

The eye drops quickly become annoying, every 2 hours they're due. And one set leave a nasty taste at the back of your throat. I was looking forward to only having to do them 4 times a day.

That night I had to sleep with the eye shields. Obviously the previous night I slept with one on my right eye. This time I had to have both. These are kind of weird. They are clear plastic. With little air holes. And you have a real of what looks like masking tape with which to stick them to your face. The tape sticks very well to skin. Kat was worried about them falling off, or me pulling at them in my sleep, but the tape held very firmly, and I didn't find it too difficult to sleep in them. In the morning the tape was still stuck firm, and it was a little uncomfortable peeling it off.

By now my vision felt great, really clear, and I was pretty convinced my vision was better than it had been wearing glasses. It was so good that it was a little annoying to have to go all the way back to Reading just to have a 5 minute checkup to tell me they are OK. Again Ultralase had arranged a taxi. This time they arranged for him to wait whilst I was there since it would be such a short stay. So an hour driving there, and after a few minutes in the waiting room I was called in to read the eye chart. With both eyes I can read the bottom line! Yay! With my right eye I could read one line better than 20:20 and with my left eye just about 20:20. At this stage they only expect you to have gotten back as far as driving level, which is one step worse than 20:20 But since my op had been so early in the previous morning, it had been longer than normal before this appointment. Happy that everything looked good, I was sent on my way again. And driven another hour back home.

Today, I am allowed to use my internet tablet again. My eyes feel great. Although my left eye has been itching slightly this morning. This is the sort of thing that normally you'd just rub your eye until it felt better without really thinking about it. But I am putting up with it, and not touching. Though I am going to buy some cotton buds, which I can use with boiled (then cooled) water to clean my eyes and eye lashes. which I hope will help.

Overall I could not be happier with the result. I'm also glad to be at the stage where I only need to do eye drops 4 times a day. Every 2 hours was quite annoying. I shall possibly update again once I've done a whole 2 weeks of recovery. But I really appreciate that whilst very expensive, some of what I paid for was the recovery time. Realistically I was functional again in under 8 hours. And of course I was paying for the kind of service that handles little 'difficulties' with speed and efficiency. It cost Ultralase the better part of 300 quid in taxis which is no small chunk of what I was paying, and they handled things quickly and without fuss.

Anyway, I hope this hasn't put anyone off that is thinking about it. I wanted to document in some detail what it is like, and I'm not sure how I would of felt about it reading such an account before taking the plunge myself. But the important message is that whilst it is not a terribly enjoyable experience. I can now have glasses free existence for at least the next 15 years before I will probably need reading glasses. I think it was worth it.

Read about my thoughts one year on