So since my move to Texas I really haven’t traveled as much as I’m accustomed. It’s been an interesting transition from Europe but it’s important to grow where you’re planted…or something. I’ve worked on some personal growth items on my bucket list like…
Taking care of another living creature by getting a dog!
Becoming a firearm owner and learning to hit what I aim at consistently (mostly for home defense, and fun at the range!
I want to write about all the nuances and eccentricies of Abilene that I’ve come across in my few months here but I figured I’d throw in an informational piece about my eye surgery. PRK…better…faster…stronger…mostly…
My eyesight has never been perfect but in law school its efficacy plummeted. I’m talking really bad. When I finally sucked it up and went to a Chicago optometrist to get glasses mid way through my 1L year, the optometrist stopped the eye exam half way through and said, “So…did you drive here today?”. When I told her I’d taken the train she just said, “Oh…good” and continued with the exam. I think this was when it really dawned on me that my vision was borderline abysmal. But alls well that ends well and I bought glasses and somehow made it through law school.
This happily ever after ended shortly after I decided to join the Air Force. Not that I couldn’t join with abysmal eyesight. You can get a waiver for pretty much anything depending on your career field. I remember going through MEPS (the assembly line like medical exam you have to go through before any branch of the military will actually take you). As part of MEPS I had to do an eye exam complete with colorblind test and depth perception test. The colorblind test was super easy…mostly because I’m not color blind. Feeling very pleased with myself for picking out colored numbers on a different colored background, I proceeded to the depth perception test, which I’m pretty sure I failed. It went something like this:
Examiner: Ok take your glasses off and look through those lenses at a row of circles and tell me which one stands out to you.
Me (looking at the circles): Trick question! None of them stand out!
Examiner: Umm…nope one of them should be more prominent…just take a guess.
Me: Two? Is it the second one? I think it’s the second one…
Examiner: Nope guess again.
Me: Six? Is it the sixth one?
Examiner: There’s only five circles, keep guessing.
Anyway my poor eyesight didn’t preclude me from joining the military but really made it difficult as I was going through Commissioned Officer Training. COT is an effort to make the professional types of the military more military-esque. Regular line officers train lawyers, doctors, biomedical engineers and chaplains on how to comport themselves in the military. This includes obstacle courses, ropes courses, and team building exercises that resemble the MOST EXTREME ELIMINATION CHALLENGE!!!
Unfortunately anytime you’re doing anything the least bit tactical, the AF really doesn’t want you to wear your contacts and mandates you wear your glasses. I’m not sure why. They say it’s because you could injure your eyes by potentially getting an infection. In my mind, wearing metal-framed plates of glass flush against your face/eyes while climbing/jumping/falling…mostly falling for me, seems a little more dangerous but what do I know. Pretty sure my COT instructors had perfect vision and really didn’t feel the pain of having to wear glasses while being even the least bit active. It was while trying to scale a 6ft wall over a water obstacle in 45 degree weather that I finally decided that glasses just weren’t for me. When I heard that the AF would correct my vision for free, I put it on my bucket list!
Fast forward to post-Italy (where the optometry department does not evaluate for PRK or Lasik) to Dyess where I finally begged/pleaded/cajoled the optometry department to evaluate my sight for any kind of corrective procedure. The process went fairly quickly as my eyesight hadn’t fluctuated overmuch since my previous year’s checkup. After a small waiting period, a test on some fancy schmancy machine the optometry department has (that also unfortunately breaks a lot causing a vast back log), and about a hundred or so calls checking the status of said machine and afterwards the package they sent to Lackland Medical Center, and I was approved!
FINALLY! I finally felt like a fat girl picked up at rush by her favorite sorority.
I was scheduled for the week after Thanksgiving. All I had to do is drive to San Antonio and procure lodging and a ride to and from the clinic. The corrective eye surgery is permissive TDY for most active duty members. This just means that your boss gives you free time off but they won’t pay for you to travel down to have surgery or for a hotel while you’re there. Luckily San Antonio isn’t too terribly far and I had some amazingly benevolent friends that agreed to babysit me for a week.
You can read about one of these wonderfully giving friends here:
Since both of them had courts and related justice activities scattered throughout the week, they shared custody depending on their schedules but they both took a lot of time to make sure I was doing ok and got where I needed to go. AND Anna let me recover the week in her spare bedroom which made her cats insanely jealous.
My pre-op checkup was the day before the surgery and only lasted an hour or so. When I first sat down in the waiting room the secretary called me up to the desk to finish filling out the things I left blank on my form. I was confused as I thought I’d been incredibly thorough when I sent up all of my information. The blank I left was the box that asked “what do you hope to achieve from this surgery?”
Me: Do I have to fill this out?
Her: Oh yes, you’re not allowed to leave anything blank.
Me: Ok, well I kind of just want to be able to see without wearing contacts or glasses. Her (scoffing at my reply): That’s not something we can guarantee.
Me: Right I understand that, but that’s kind of my end goal with this whole eye lasering thing.
Her (pushing a pen towards me): Well I wouldn’t bother putting it down.
I stared at the paper somewhat perplexed at this seemingly inane question that, for reasons beyond my comprehension, was oh so important to my surgery. I started writing… “I want to be better…faster…stronger. I want amazing eye, hand coordination. I want to be better at team sports where throwing and catching objects are involved, I want to leap tall buildings…” she just sighed and took back the paper. I wasn’t really trying to make her job harder but I did give myself a small pat on the back for using sarcasm to make a point (it so rarely works like I want it to). After that the pre-op went quickly. Some crazy machines mapping my eyes in a hundred different ways. I was out of there and making the most of San Antonio by lunchtime…albeit with massively dilated pupils. It’s probably a good thing I was never subjected to a random traffic stop as I probably looked like I was on meth. I met up with Anna for dinner and we went to the grocery to plan my meals for the next week since I would be at the house recovering (and blindish) and needed some easy things to make.
I was actually a little nervous when Kurt dropped me off at the clinic the next day. The last time I’d actually had any sort of medical procedure done was when I had my tonsils out in fourth grade. I sat down in the waiting room with around twenty other people. It was clear that this was old hat for the staff who do this on a weekly basis. The procedure was assembly line to them: paperwork, pre-surgery prep, surgery, post-surgery review, out the door. They were relaxed and doing their respective parts like they’d done hundreds of times before. For the rest of us, there was a kind of somber quiet that settled over the waiting area. It was a palpable bundle of nerves which only got worse as individuals started disappearing through the doors in the back. And finally it was my turn.
Lasik v. PRK
I’d like to break for a second to discuss the difference between PRK and Lasik.
I was under the mistaken impression that the AF would only allow its members to get PRK rather than Lasik. This isn’t true. SOME career fields with accompanying hazards do not have the Lasik option due to the healing process of the procedure (discussed later). Funny enough JAGs don’t usually encounter these same hazards…like pulling Gs, defusing bombs, or engaging in hand to hand combat. Therefore I had the option to choose either.
Johnny Utah convinced me to go the PRK route. He had it done a few years ago and sang its praises ever since. My doctor also recommended it, despite the longer healing process saying that, in the long run, PRK is preferable to Lasik. If you get a little squeamish regarding eyes or surgeries generally you can skip the next few paragraphs and just chalk the entire thing up to the ocular fairy.
Ok for those of you that had the balls to keep reading:
PRK and Lasik are the same in essence, at least the end goals are the same. For both procedures, you have lasers shot in your eye which reshapes your cornea to correct your vision. The difference lies mainly in how they move or remove the outer layer (epithelium) of skin cells on your eyes in order for the laser to really penetrate. With Lasik, the doctor uses a laser (this used to be done with a thin metal blade) to cut a flap on the surface of your eye in the tissue. This flap is folded back on itself which opens up the part of the eye so the laser can go in and correct your vision. (all based on the maps of your eye and vision tests you’ve been subjected to for the past year or so). Once the laser is done reshaping your cornea, and fixing your vision (this only lasts a few minutes), the doctor folds the flap back down to where it fits back onto your eye and seals it back. However, despite the seal, the flap is always a weak spot on your eye. This procedure leaves the small chance that, if hit in the face in just the right spot, the flap may come undone again, causing serious damage to your eye and necessitating further procedure. However, the plus side is that the improvement to your vision is almost instantaneous. The healing time is much faster and you’re able to see/drive almost the same day.
PRK or photorefractive keratectomy involves brushing away the skin cells or epithelial of your corneal tissue rather than cutting the flap. This opens up the eye and leaves it open for the laser to go in and correct your vision. Once that’s done (same amount of time as Lasik) the doctors put contact lenses that act as bandages in your eyes. These lenses act as a shield so your corneal tissue can regrow and reform over the next week while you are recovering. Long term this is supposedly better as it does not leave a weak point in your eye. It just takes much longer to heal as your vision stays cloudy while your epithelium is growing back and filling in.
When my time came to start on the assembly line, I sat down in a chair next to the surgery suite. As the tech was briefing me on the procedure and putting a multitude of drops in my eyes, I watched those that had just completed their surgery being led out of the suite by the arms. Their eyes looked unfocused and puffy and mostly they looked confused (but at least not in any noticeable pain). Then it was my turn to walk in.
The nurse led me to a narrow bed where I laid down. In order to keep me from freaking out they kindly gave me two stress balls to squeeze, which wasn’t nearly as helpful as they may have thought. I focused on my breathing and went to my happy place as they started the procedure. They started with my right eye and inserted what’s called a “lid retainer” in order to keep me from blinking and to keep my eyelashes out of the way. This piece of equipment keeps my eye lid pried open which also happens to be incredibly uncomfortable. At this point my cornea was already numb from the drops the techs previously gave me. Step two: the optometry surgeon took what resembled a rotating toothbrush and started brushing away the layers of my epithelium (the thin protective layer covering the cornea). It wasn’t painful, just incredibly discomforting. I saw it as the doctor started closing in and felt it rotating on my eye but it didn’t actually hurt. I did start utilizing the stress balls. He would brush for a few seconds then take what can only be described as a tiny mini squeegee to wipe the epithelium cells away from the hole he was making on my eye. This continued for about a minute and a half until enough of the epithelium was worn away in order for the laser to reshape the cornea. That’s when they set the laser and began to shoot it into my eye in order to actually correct my vision. I didn’t feel anything at all while this was occurring but I did see bright flashes and smelled the ozone which was also discomforting. When the doc was done lasering my eye he put some more drops on there and placed a protective contact lens (which fit just like a normal contact) to cover my eye while my epithelium grew back. These contacts stayed in until my final appointment with the clinic five days later. He then rinsed and repeated for the left eye.
Here’s a youtube video I found with a real eye surgery:
Again, not me…and not for you squeamish folks. But that’s pretty much what I went through.
I actually wasn’t feeling that bad when all was said and done. My eyes just felt dry and everything was incredibly blurry but for the most part I could see macro shapes. The techs handed me my post-op bag containing all the mandatory eye drops as well as some sleep and pain meds (Percocet actually). I called Kurt and he drove me back to Anna’s to convalesce. The best recovery strategy is to just sleep through the fist day of your post-op. I, in my ultimate wisdom, and upon a recommendation that I “keep ahead of the pain” decided to take two of the Percocet (which comported with my prescription just FYI). Honestly, I never take pain meds. I never even take Tylenol or advil unless I’m prohibitively hungover. I should have probably taken that into account when I started popping narcotics. I slept most of the afternoon, got up in time to put Anna’s and my pre-made dinner in the oven (I didn’t want to be a complete freeloader) and lay on the couch waiting for her to get home. As soon as dinner was ready, I hopped off the couch and the room immediately started spinning. At first I thought I’d simply gotten up too quickly. Soon after I realized 10mg of Percocet was not only “keeping me ahead of my pain” as I really felt no pain at all, but also throwing off my equilibrium and normal physiology. The end result was throwing up dinner and falling back asleep. Afterwards I decided to chance the pain.
Honestly compared to other stories I’d read online, I was never really in much pain at all. My eyes felt incredibly dry, scratchy, and generally uncomfortable but they never actually hurt. My eyesight that first five days did not have marked improvement. This is where my frustration actually started. My eyes refused to focus. I was used to not being able to see things far away without glasses or contacts but because my corneal tissue was regrowing, I couldn’t see anything up close either. The clinic explained the healing process and told me that I should be able to drive by day five. When I heard that, I expected to be able to see really well by the time they removed my bandage contacts. Turns out I couldn’t. My eyes continued to be the same level of blurriness for the rest of the week. I tried to spend most of my time sleeping and laying on the couch listening to the TV. My two biggest concerns for my five days of recovery were that 1) my eyes didn’t seem to be getting ANY better and 2) to a lesser degree I was a little concerned that Anna’s cats would suffocate me in my sleep.
Kurt drove me to my last follow up appointment where in theory, they would clear me to leave and go back home to go forth and do great things. I’d left my car in the parking lot of the clinic because I’d assumed they would remove the contact bandages and my eyes would be miraculously better. They weren’t. While doing my vision tests I couldn’t make ANY of the letters out until the elderly gentleman that was doing my tests gave me some weird glasses to look through. According to him, they displaced the light and improved my vision. I could actually see better but only with the glasses (which they were not going to let me leave or travel with). According to the old optometry doctor, I had 20/30 vision which was on par with the recovery process timing. Even still I really wasn’t comfortable driving and when I voiced my concerns this is what he said:
Me: Look I know these glasses make me see better but my vision is still REALLY blurry.
Old doc: Well your are testing at 20/30. Technically that’s really good and is standard with the recovery process.
Me: Ok I know I’m technically ok by your charts but I don’t know how comfortable I am driving out of here. You guys said I would be able to drive.
Old doc: Well you’re legally able to drive.
Me (ignoring the fact that this old ass doctor shouldn’t be giving legal advice): At this point I’m really not comfortable driving.
Old doc: Huhuhu…well It’s a loooooong walk back to Abilene.
Me (grumbling under my breath): God you’re old but I want to punch you in the face right now.
Him: What was that?
Me: You’re not being very helpful.
In the end, I realized they were just going to release me despite my protests. At this point I was incredibly frustrated by my lack of excellent vision…or really lack of clear vision…and every tiny annoying thing was just pinging off my psyche. I won’t go into detail about my trip home but suffice to say that I made it back without hitting anything and really wasn’t feeling better, faster, or stronger for that matter. Honestly I was just tired of not being self-sufficient even though Anna and her kitties would have suffered another night with me. I did finally make it to my house despite my issues. Whatever…my dog was happy to see me…even if I couldn’t really see her.
My frustration lasted about a month until my vision finally started to clear up. During that time, Johnny Utah, the same person that convinced me to go PRK in the first place, kept trying to tell me that I hadn’t made a mistake and that I just needed to be patient…that having lasers shot into my eye to correct my vision is a miraculous work of science in and of itself and that I should stop being so negative. Patience isn’t really a virtue I hold near and dear… Ultimately, a couple months later, my vision is actually doing well. I just needed to suck it up that first month or so. The bottom line is, if you have the patience and roughly a month of total recovery time PRK is definitely the way to go. However, if you’re like me and have this Type A, control freak, why the hell is my body not just fixing itself attitude…maybe you should consider Lasik. But at this point I wouldn’t change my decision. =] …and despite being obstinate with the obnoxious secretary, I can actually see without contacts or glasses!