My Experience: Young and mildly nearsighted, opted for PRK

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My Experience: Young and mildly nearsighted, opted for PRK

Postby ssmarsh8 » Wed Jan 31, 2007 5:08 pm

I went into this process with mild myopia: -1.75 right, -2.0 left, as well as mild to moderate higher order abberations (they affect the quality of what you see--halos around lights at night, etc.) according to the surgeon's wavefront diagnostic. I had 20/15 vision until my teens, and then 20/20 until midway through college. I had to get glasses when I was 20, and now at age 26 (and with my first flex spending account!) I figured laser surgery would be a) a big relief, as I'm athletic (glasses/contacts are a nuisance) and a writer (contacts bother me at the computer); and b) cost-effective in the very long run.

Because I had "plenty of cornea" and adequate eye wetness, I scheduled a custom Lasik procedure, which was recommended by the surgeon (well, he recommended the Lasik part, and I personally opted for the more expensive "custom" part to correct any of those higher abberations). However, research and visits to this forum, in particular, led me to inquire about surface ablation, and I found its long-term advantage of no flap incision to outweigh the short-term disadvantage of pain and slower vision recovery. I talked at length with my surgeon, and switched to custom PRK.

Day Before Surgery
Started taking Vigam*x, an antibacterial drop, four times a day. Accidentally instilled all four drops at once in the morning, but was told this was OK--excess just drains out. Bid my office job farewell for a bit. Got a good night's sleep and said a prayer.

Thursday, Jan. 25, 2007--Surgery Day

Boyfriend drove me the half-hour or so to the surgeon's office. No one re-checked my vision to ensure proper numbers, as they believe measurements are good for three months, and my exam had been done in early December. This bothered me a bit, but I had been so anal over everything to this point that I decided to just let go and trust their expertise. This particular doc is indeed one of the eminent researchers and surgeons in my region (the Midwest). I was letting him dice up my eyes because of his impressive resume, good reputation, and a referral from my best friend. So I figured I should at least give them credit on this eye measurement thing.

They did look at my eyes with the high-powered light thingy to make sure things were OK physiologically. They numbed my eyes with drops, gave me a hair net and booties. I got a little bummed when I heard a Lasik patient emerge down the hall, virtually in tears because she had been extremely nearsighted and could suddenly see. Which is of course a miracle for her--it just gave me a last-minute "Why am I choosing PRK when the world chooses Lasik!" moment. I mentioned this to the surgeon, and he said, "PRK is a little safer in the long-term," which was probably just to get me to shut up and move along with the day, but it made me feel better, especially since he's huge on Lasik and had it himself.

I waited forever in the surgery room, and accidentally touched my eyes at one point, so the assistant had to re-wipe my eyes. More waiting. Touched the bridge of my nose accidentally and confessed to the assistant, though she said that was OK and didn't re-wipe yet again, which gave me one more thing to internally agonize over. ha

Surgeon came in, slipped the speculum into my right eye, which surprised me by being quite uncomfortable, especially since I'm a touch claustrophobic. I tensed up very hard and the nice assistant lady patted my hand and helped me relax. I stared into the blinking red dot as directed. Surgeon brushed some fluid over my eye and then went about scraping off the top layer, which didn't hurt but created a very uncomfortable and surreal feeling of pressure and instinctual panic ("dude is NOT supposed to be scraping at my eyeball!"). I breathed my way through it and found the humor to say, "This is INSANE." The assistants laughed and the doc said he'd never heard his job described as insane.

My vision was so blurred at this point that it was difficult to tell the blinking red light from the not-blinking red light, so I hoped to God I was looking in the right place. The machine made a Star Trek zapping noise, and the smell was quite repulsive, which the assistant assured me was "the gases from the machine mixing with the air in the room" (ha--I was like, give me a break lady, if I was squeamish about the smell of my eye flesh singing, I don't think I would have made it this far).

Onto the left eye. Speculum, dabbed fluid, scraped epithelium, laser zapping. But this time the doc stopped the laser and said, "hand me the blah blah blah real quick," and went back to scraping my eye. Then the laser resumed. My boyfriend was watching on the video feed and claims you could actually see a bit more surface tissue that the doc went after to clear it out for the laser. This still troubles me but, hey, all's well that ends well, and let's hope it ends well (with eventual crisp vision)!

Oh yeah, he put a bandage lens on both eyes.

Doc said, "Everything went perfect," which surely is the line given everyone, but it feels nice to hear it, especially for Anal McAnalsons like me.

The office had called in my Vicod*n prescription several days earlier, so I had it in hand. Rather than taking the Tylenol PM they give people on the way out the door, we went through a drive through for some grub and I popped a Vicod*n at about 3pm. I had never before used a high-powered pain killer and am generally averse to medication, but decided that I would knock myself out for a couple days to avoid whatever pain lay in store. By the time we got home I felt woozy. Went right to bed. Eyes didn't hurt--just felt irritated and scratchy.

Got up in a few hours to take my antibacterial drop, anti-inflammatory drop and artificial tears. I felt very nauseous, presumably from the Vicod*n. Called my mom to ask if she'd ever been on Vicod*n--thought it prudent to see how genetic relatives reacted to it. She took one or two pills once, wasn't sure if it was that particular drug, who knows (*foreshadowing*). Decided to switch to Tylenol PM (that's what the office sent folks off with, so I figured it was the way to go.

Took Tylenol PM at 9pm and went back to bed.

Friday, Post-Op Day 1

Wake up at 3am, starting to feel pain in eyes. Second round of Tylenol PM, some more drops, a bite to eat, back to bed.

A couple hours later, OUCH!!!!!! Woke up with searing pain in my eyes. It was kind of like loose-gravel-meets-gasoline-and-match. My eyes would periodically gush tears. I kept rubbing my forehead to stay sane. Wished I could return to Vicod*n (nausea? who CARES), but knew I should wait with ineffectual acetominiphen still pumping through my system. Drifted in and out of sleep. Rubbed my forehead raw. Felt sorry for self.

9am, returned to Vicod*n. Within half hour the pain had lessened though not disappeared, and I was able to fall asleep. Spent the rest of the day getting up every few hours for drops and/or the pain killer, feeling pain, trying to sleep. I should mention at this point that I had NOT used the "comfort drops," which are numbing agents, as an assistant had instructed me to use them sparingly, indicating they might slow my healing. I had written them off, truly forgotten I had them, having resolved that I wouldn't use them (in hindsight, this was foolish).

More to come!
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Joined: Tue Dec 05, 2006 6:27 pm

Postby ssmarsh8 » Wed Jan 31, 2007 6:14 pm

(cont'd) Friday, Post Op Day 1

Forgot to mention that this day I also went back to the doc for a day-after checkup. They claimed I was 20/40 in my left and 20/25 in my right, though I was so light-sensitive I could hardly keep my eyes open to see anything. I was late to the appointment due to my pain killer coma and a boyfriend who overslept. This caused me a lot of stress, as I almost missed the surgeon, who had to leave soon. Another doc came in his place initially, and did the bright-light-thingy not once but twice. I asked what that machine looks for. He said infection and such, and that it looked "pretty good," which didn't seem an excellent diagnosis, and I started freaking over infection (I changed the cat litter this morning! Aaagh! etc.). Then I heard him whispering to a nurse and then the surgeon himself did make an appearance.

He said things looked fine, and that the bad pain I felt the first night on Tylenol PM, while still attempting to avoid Vicod*n, could be better helped with Ibuprofen. However, I'd decided to stick with Vicod*n as it at least somewhat knocked me out.

Saturday, Post-Op Day 2

3am, I wake up for my timed Vicod*n dose, and realize that, gosh, I've been itching a lot. I mean, a lot. Like I'd wake up scratching my stomach and all over, really. I read the fine print and itching is a symptom of allergic reaction to V. Fearing a return of the levels of pain I felt on night 1, I call my 24-hour pharm*cy to see if I really need to stop the V. At this point I've been on it 36 hours, and she says that I would've already had respiratory and other more serious reactions if that was going to happen. V apparently increases histamine production, and that's causing my itching, she says, so I pop another and go back to bed. More pain, oozing eyes, overall horror but not as bad as the first night, so I feel thankful for the V. I should mention that I'm not traditionally a wuss and in fact believe I have a high pain threshold.

Alarm clock, various eye drops, bits of food to negate V-induced nausea, in and out of sleep. The pain increases as the V wears off, and then decreases about 30 minutes after popping one.

At about 4pm I take my 8th V pill in 48 hours, and take a quick shower (my first post-op, ha, gross I know, but I was OUT of it!). By now I'm SUPER sensitive to light, as in overhead lights are out of the question, so I hang some towels over my bedroom curtains for a darker room during daytime. I crawl into bed, put on my sucky claustrophobic goggles I'm supposed to wear for a week. As I lie back I see a bit of light coming through in between the towels on the window and...


This was one of the most confusing, terrifying moments of my life, as I had no idea what was going on. If I hid my head under the covers and held very still, the lights seemed to go away, but it was truly like a strobe light behind my eyes, whether they were open or closed for 30 minutes to an hour and I finally drifted to sleep. When I woke up I experienced another short spell of this, and finally decided to call my surgeon at home on a Saturday evening.

He said the itching meant I should stop V right away ("and take Ibuprofen like I told you," which was not entirely accurate, and I didn't appreciate his tone!). Also said I should've been taking the comfort drops all along, and that I misunderstood the assistant regarding slowed healing. He said the flashing was an ocular migraine or the goopy anti-inflammatory drops "moving across the surface of the eye." The latter clearly was not the case, so I had my boyfriend Google ocular migraines. Sounded right.

Luckily it didn't turn into an actual migraine headache pain, as ocular migraines often do. They're fairly mysterious, with causes including stress (check), oral contraceptives (check... though I'd been taking these for a couple years with no problem) and even the rare Lasik surgery (no mention of PRK, but who knows). I have decided that my pain, stress, unease over my first long-term bedrest since infancy and sense of no control for this control freak, as well as my allergic reaction to Vicod*n, with the oral contraceptive factor thrown in, all led to my ocular migraine. I can speak to the stress factor directly--for one thing I had begun waking up in a virtual rigamortis, so stiff and tense that I could hardly ply myself into motion. Also, I was upset with my boyfriend, and when he came into the bedroom the flashing appeared. It would literally flare up each time he spoke, almost as though it was correlated to my blood pressure. ha I swear I am not making this up. It was scary but looking back it's pretty fascinating.

Took 600mg of Ibuprofen and comfort drops and went to bed, switching to tape-on individual plastic eye covers as goggles now give me PTSD from ocular migraine. ha Pain had lessened by this point but I still had flare-ups of burning/aching/oozing. Took another 200mg in the middle of the night. More comfort drops.

Sunday, Post-Op Day 3

Woke up feeling much better. Eyes very irritated, contact bandages beginning to worry me and drive me nuts. Kept on with arsenal of drops. Vision blurred but bigger concern was EXTREME light sensitivity. Kept on with the Ibuprofen. No more strobe lights, possibly because the V was gone (or almost) from my system, possibly because I felt better and had chilled out. Mild pain, lots of dry/irritated discomfort. Had to teach a two-hour adult writing class in the evening. Could barely keep eyes open through first hour, resorted to comfort drops and then felt nauseous the rest of class, though the doc swears these drops don't cause nausea (I beg to differ, though maybe it was just being out of the apartment and in the real world for the first time in a few days?).

Took last dose of Ibuprofen before bed.

Monday, Post-Op Day 4

Woke up and despised my contact bandages. They were to come out at a 1:30 appointment but I called and asked if earlier times were available. We went for a 10:45, waited a half hour, and at about 11:30 an assistant started trying to get them out. I couldn't keep my eyes open while looking up. I informed her that there was a bright light right above my head. Riiiiiiight. She turned it down and I was able to keep them open, though she had a tough time getting ahold of the contacts. Once they were out, though, SWEET MOTHER OF MERCY, THANK YOU GOD. I immediately felt better. Not sure they should've been in that long, but again, they're the experts. Doc looked at me with the bright-light-thingy and said my epithelium had healed, and that he could see a fine seam over the middle of my eye. Sweet! He started fleeing and I quickly reminded him of the ocular migraine and reported that it recurred Saturday evening. He said that was likely the correct diagnosis, with another unlikely diagnosis being early signs of retinal issues (re: detachment... HOLY CRAP). He said to monitor it and let them know if it came back. I found this kind of scary but was fairly certain that my retina had no reason to detach, and that I had simply blown a gasket in my occipital lobe.

Vision blurry but eyes felt much less irritated. Dryness ensued though. Hitting the artificial tears on the hour.

Tuesday, Post-Op Day 5

Was able to run a couple errands around town. Vision blurred but better. Slight ghosting, enough to make you feel kind of woozy, and of course halos aroun dlights. Realized just how dry the air is inside WalMart when I went to stock up on preservative free tears ($15 for 70 vials was the best I could find... bought 2 boxes). Poked myself in the eye with an artificial tear tube and cussed myself. (I have since done this a couple more times. Seriously, I'm apparently not a great dropper.)

Went to the health food grocer and bought some frozen cubes of wheat grass juice after reading someone's glowing recommendation on this forum. Took it around lunch, and I am truly not exaggerating here, I almost immediately saw a difference--the rest of the day I only felt need for the drops every 2 or even 3 hours, as opposed to every hour. Placebo? Maybe. But dryness is kind of there or it isn't. And the dryness just wasn't there like it had been in the morning. Anyway, I put two cubes in with a half-cup of grape juice, and it wasn't bad at all. $15 for 15 two-cube servings.

Wednesday, Post-Op Day 6

Went back to my office job (here I sit, working hard, heh). Caught a ride for my 30-minute commute. May or may not drive myself tomorrow and Friday. Tonight will be my last night with the eye covers while sleeping, tomorrow will be my last day with the antibacterial drops. Then it will be tapering EconoPr*d and of course the tears.

My vision was not tested upon removal of the contacts, but I will report when I have numbers. My next follow-up is in a month. Thanks so much for all the support and expertise of Glenn and other fellow laser surgery folks. Hope my story is somewhat helpful to someone.

Here's hoping for crisp, perfect vision eventually for all of us!

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Joined: Tue Dec 05, 2006 6:27 pm

Postby rgonyer » Wed Jan 31, 2007 10:00 pm

You are almost 1 week exactly behind me, sounds like you had a much tougher go of it than I did.

My vision continues to fluctuate, but in general the trend is up. Today is the best day by far, in fact it seems nearly perfect. Of course it's very dry in cars and in the office due to the fun 4 degree weather, so I stay loaded up on drops.... other than that, keep us updated!

I have my 3rd followup tonight at 4:30.
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Postby ssmarsh8 » Wed Jan 31, 2007 10:16 pm

That's great that you're near-perfect so soon. I have high hopes for quick recovery despite the difficult first few days. I have to say that I'm seeing distance very sharply. It's just that everything has that nauseating ghosting thing, if that's the right term for the ever-so-slight double image. Anyway good luck at your follow-up today! Makes me wonder why I only had two follow-ups, and a month seems a long time to wait for a vision test. I guess my surgeon figures it's pointless to assess at this point as things tend to fluctuate. But it's great that your doc takes extra care. Good luck!
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Joined: Tue Dec 05, 2006 6:27 pm

Postby rgonyer » Wed Jan 31, 2007 10:30 pm

Well, I have had near perfect before and then it went down hill... some days are good, some are bad!

Every doc seems to have a vastly different checkup schedule. I had surgery Thursday, and didn't have my first followup until Monday. Then I had a second followup two days later, and now it will be weekly for the next month, I believe. Maybe a bit overkill, but luckily they let me co-manage, so I can just run across the street after work for checkups.

Good luck to you as well! Sounds like your ghosting isn't as bad as mine, maybe you'll recover faster. They say staying on the vitamin C helps a lot... so I have been doing that as well. Also, use your rewetting drops a LOT, even when you feel you don't need them. It's a better environment for healing.

If you have a Sams Club near you, they have Refresh Plus 100 pack for around $16. By far the cheapest I have found.
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