Thursday, September 8, 2011

LASIK

Well tomorrow I will go through a processing I have been interested in for many years. Since I was little kid I have to wear glasses full time. As many of you wearing glasses has it plus but for me there are many downsides. I have to have my glasses perfectly clean, even the slightest smudge makes me neurotic. I also hate when water gets on them. The worst though is the process in which is required to switch to sunglasses. It is for these reasons that I decided this year was going to be the year when I got LASIK. I decided to write this blog to provide my story and steps leading up to tomorrow. So many people have asked me about so I figured I would write this down to help others out.

Step 1: Selecting a doctor
If you live in western New England hands down Nancy Balin is the one choose, I am sure you have heard her commercials. I-Trust. I did not jump on the bandwagon because of a commercial and neither should you. Do you research? Google is a great tool, talk to your friends, and then visit the finalists. Make sure the doctor takes your insurance (more about that in the Paying for it section). You want a Dr. that makes you feel comfortable and when that does not rush the process. I-Trust is right, you need to have trust, be sure you have it. It is your eye sight! Many people ask me is I was nervous or scared, my answer is "yes" but mostly excited. The reason for this was because Dr. Balin and her staff made sure I was 100% aware of the process, the risks, and have helped with every step. Once you trust and select a Dr. you you need to schedule a appointment to see if you are eligible.

Step 2: Eligibility
So you have chosen a Dr., good for you - step one done. Depending on the Dr. you may have 1 or 2 exams before your surgery. The first will be more of a consultation while the second will be the most intense eye exam you have ever had, don't get scared. My consultation exam lasted 3 hours and was very thorough. If you go to your eligibility exam and it is not very thorough, question it. During my exam they made sure I had enough cornea for the surgery and made sure my eye was health. I had a schalason above my left eye which I had to have removed before my surgery. Most people will not have that process done. Other tests involve pictures of your eye and and dilation eye drops. OK, get ready for these...wow.. they are powerful. You will need someone to drive home, trust me. These are not your normal dilation drops, they around 10 times more powerful. The best thing is to go home and lay down until they wear off. Because of this schedule your exam in the afternoon if possible. Before leaving the Dr. will come in and discuss your choices and the costs.

Step 3: Choices
First thing to note LASIK is more complicated than just going in and changing the shape of your eye. There are actually two process that happen. [WARNING - Medical Talk]. The first process opens the lens to expose the cornea so the second process change shape the cornea. The first process involves create a semicircle incision to create a flap that is folded back to expose the cornea. You have two options here. You elect to have the flap created with a knife (cheaper) or with a laser (more expensive). The knife leaves a jagged cut which requires you to be more careful when healing and will take longer to heal. Also the knife approach is not a clean as the laser. The laser creates a very homedic incision so that when the flap is laid back down it is perfect seal. It heals faster and is less prone to infection. The laser is more expense but in my mind it is worth. It is your eyes. No onto your second choice.

Your second choice involves how the laser shapes your eye. You can choose template surgery or custom view. Template surgery involves the Dr. inputting your prescription into the laser and based a predetermined template it removes the necessary portions of your cornea to correct your vision. This is the cheaper of the two options, but has a lower percentage of perfect vision. The second option is custom view. This involves a little more time during your eligibility exam because the Dr. take more images and measurements of your complete eye. These measurements are then inputted into the laser and the laser removes exactly what is needed to correct vision. This option is the more expensive. Keep in mind that both options do not provide 100% of perfect vision. There is always a chance that you will not get 20/20 vision. This is were the Dr. policy on adjustment surgery is important. Dr. Balin provides these for free until she can get you to 20/20 if she feels it is possible. I chose the best of both options. Why? Because it is your eyes! So you have made the choice and now it is time to pay.

Step 4: Paying for it
I will not be discussing prices in this section as those vary from patient to patient and Dr. to Dr. I will say that you should budget for $5500 for both eyes. This is what mine came up to before discounts and insurance was applied. The balance can be paid in many forms and it depends on your Dr. Try to find one that offers payment options, credit cards, and care credit. If you are lucky and your employer provides you with a Flex benefit or FSA benefit USE IT. This hands down made the most sense for me. Let me explain. My balance was roughly $4400 after insurance and discounts, again yours will be different. I decided as plan year for my work's health insurance came around to take out $5000 on my FSA. For those of you who are not familiar with FSA cards, please see your HR person. The short of it is the money is taken out pre-tax of you paycheck. So $5000/52 weeks (I get paid weekly) comes out to about $96/week. Now this is deducted pre-tax so the net affect difference in my pay was $46. So when you think about $46*52 weeks means what I feel I am paying is $2392 or roughly $1200/eye. If you did not follow this re-read a few times. How much you "feel" you are paying will be different depending on your tax situation so do not use my figures as a guide. I included them to show the power using FSA to pay for this. If FSA is not an option see your Dr. about financing options. Once you have chosen payment it is time for the surgery.

Step 5: Pre-Surgery
The Dr. will prescribe two different eye drops. One of them you will need to use the day before. 4 times - one drop - both eyes. This drops sting a bit, but not too bad. The other drops you will need to bring to your surgery appointment. You will be asked NOT to drink alcohol at least 24 hours prior and 24 hours after the surgery. You also will not be allowed to wear contacts for 3 weeks prior. Lastly the Dr. will provide a list of other restrictions that he or she recommends. Oh I almost forgot....buy goggles. You will not be allowed to rub to touch your eyes for 2 weeks, so buy sport goggles to wear at night and when you are in situations where you eyes may get irritated. PS.  Dr. Balin provided these for me.

Well that is it for what I have experienced so far. Tomorrow at 9:30 am I go for my appointment. I will post later next week on how the procedure when and the outcome. Feel free to comment and ask questions.

Step 6:  The Surgery
Again this is were is is important that your trust your doctor and Dr. Balin is simply amazing.  Arrive to your appointment early as you will need to sign a consent and pay your bill.  Make sure you have your payment ready.  Thank heavens FSA took the full amount.  Shortly after the admin things are done you will be asked in to see the pre-op nurse.   Dr. Balin has a great staff that made me feel at home, joked with me, and were willing to answer the answer the silliest questions.  Like, when could I have my next cigar?  The pro-op nurse takes a few vitals and preps you for the procedures.  She asked if I would like a mild sedative and I said sure and the last thing I wanted to do was flinch or move during the procedure.  After waiting for the sedative to kick in I was escorted to laser room.  PS it was very cold, but they provided me with the nice blanket and stuffed animal to hold.  They joked they would not put it on Facebook.  I said I don't mind self humiliating myself and they all chuckled.  The surgey goes real fast so I am not going to provide a blow by blow, but what I will tell you are the major steps.  First the numb your eye with eye drops, second then put a clamp on eye lids to keep them open (the worst part I thought), then they position under the machine that creates the flap (you will lose eye sight during this time, but it comes back instantly), lastly they shift you over and they start the laser.  Before you know it it is over. The lasers makes a loud clicking sound when turned one, keep staring at the red light, it only takes seconds.  I mentioned the clamp was the worst the part.  It was not painful just uncomfortable. I would rather go through this process 100 times over getting a cavatiy fixed.  I hope that puts into perspected.  Afetr the surgery two clear plastic shields are placed over your eye and a quick exam is done to see how the flaps are doing.  Then go home and sleep (Take the meds they prescribe).  You can be hero but the best thing it to KEEP YOUR EYES CLOSED.  Take the drugs and sleep until the next day. PS.  Put the drops as directed, unless you are sleeping.  It is your eye sight, don't screw with it.


Step 7:  The day after
You will wake up wanted to check out everything.  You are going to want to open you eyes and read and test what you can see and what you can't.  DON'T.  I tried reading my email on phone and was quickly told not to by nurse (girlfriend), who was looking out for my best interested.  You will be excited, like Christmas morning when you were 5, but do you best to wait until your appointment.  Your follow up appointment is quick and consists of a regular eye exam.  Now is not the time to hold back information either.  Ask all of your questions and tell your Dr. how you feel.  I felt like my left eye was gummy and told Dr. Balin.  She instantly took another look and cleaned my eye and WOW what a difference.  PS.  The gummy is caused from the Pred Fotre drops which aid in healing.  They are milky but are needed.  Once the exam is over the Dr. will give the do's and don'ts.  Follow them.

Conclusion:
Although I am still taking all of my drops 4 times a day and I am only 2 days after my surgery I could not be happier.  I drove today, I watched TV, I am writing this, and I did school work all without glasses.  These are things I have not done without glasses in decades.  This is an amazing thing and what doctors like Dr. Balin is simply shy of a miracle to me.  Her staff and her helped me through the process step by step.  I never lost trust in them and that is important.  One thing I can not overly stress is that all of the responsibility is in your hand.  Follow the instructions to the T.  As a wise women said to me... "you take 3 weeks out of golf, cigars, etc" to have perfect eye sight for the next 20+ years.  She was right.  Take it easy, take the meds, do the drops.  You will thanks yourself later. A special thanks to Melissa the love my life and my nurse, Dr. Balin and her wonderful staff, and all of my friends and family that wished me well.




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