I got LASIK on my right eye Friday morning, and my results are fantastic! Some people are curious about the LASIK process, so here’s my story.

As I shared in a previous post, I’ve been dogged by recurring pink eye in my right eye for the last year. My left eye is 20/15, but my right eye is badly nearsighted, so I’d worn a single contact on the right side for about 20 years. It bothered me on occasion – minor irritation and dryness, getting lost in my eye, even falling out a few times – but the recurring pink eye finally persuaded me to get this thing fixed for good.

Why Dr. Tylock?

I called Gary Tylock’s office about 10 days ago to set up a LASIK appointment. Lots of surgeons do LASIK, including my previous ophthalmologist and various doctors who advertise on the radio. I chose Dr. Tylock for a few reasons:

• He’s extremely experienced, having done over 80,000 procedures and been in practice for over 20 years. He has won numerous awards and taught eye surgery at UT Southwestern Medical Center.
• He uses the latest LASIK technology (unlike my previous ophthalmologist), helped develop the LASIK technology and procedures, and was among the first surgeons in the world to perform IntraLASIK, which uses a laser to create the corneal flap rather than a metal blade.
• He offers a 20/20 money-back guarantee. I don’t know whether anyone else in the area matches that offer.
• At least two of my coworkers recommended him. One of them already had very dry eyes before the surgery, and Tylock’s staff refused to approve him for LASIK until they could get his eyes moisturized sufficiently with various drops and gels. That process took a few weeks until he was finally ready. Apparently, LASIK doesn’t work well if one’s eyes are already too dry. I was impressed that they were unwilling to take large amounts of money from him when the outcome was questionable. That told me that Tylock values his patients’ sight more than their money.
• His office is near my parents and grandparents, which came in handy on surgery day.

Pre-Op Exam

I called on a Friday and set an appointment for the following Wednesday. It was nice to get in so quickly. At the pre-op appointment, every single person I talked to was very nice and helpful. Tylock’s staff performed a variety of tests to ensure my eye was a good candidate for LASIK. The tests included a traditional vision test with dilation and a battery of “One or two? Three or four?” exercises, eye pressure check, and a computerized eye mapping that would show Dr. Tylock exactly how to set up the laser so that it would reshape my cornea perfectly. Everything looked good, so we scheduled surgery for Friday morning – two days later. If only all medical appointments could be so easy to schedule! As with most plans, my medical insurance didn’t cover LASIK, so I had to pay out of pocket. Before I came in, they said the cost for both eyes was anywhere from $2900-3600. My cost was $1500 since I only had one eye. Being a freak pays off sometimes!

Surgery

On Friday morning, Jenny dropped me off at the office and took the boys to hang out at my mom’s house with my niece and nephew. I would receive mild sedation and somewhat disrupted vision, so they require all LASIK patients to have someone drive them home.

One reason I’d hesitated for years regarding LASIK was fear. I enjoy watching surgery videos due to my interest in medicine and the body, but eye surgery always made me squeamish. However, since LASIK had become such a common procedure with almost universally good results, and it only affected the outer layers of the eye, and I still had a good eye left if something went wrong, I decided the result was worth the small risk involved. That morning, I felt much more excited than nervous, contently watching the Olympic women’s gold medal tennis match in the waiting room.

When my turn came, I went to another waiting room and received some instructions regarding what to expect and how to care for my eye post-op. A tech administered some eye drops and offered us all a sedative, which I gladly accepted for two reasons: 1) to help me not freak out on the table, and 2) to help me sleep afterward as they recommended. Then they had me lie down in a comfortable recliner outside the operation room and gave me disposable booties for my shoes and a hairnet. (really? um, have you seen my head?)

Finally, I entered the OR. A flood of various types of drops – numbing, antibiotic, irrigation, and who knows what else. The room was cold, so the assistant covered me with a blanket. At this point I finally got to meet Dr. Tylock, who was very nice, comforting, and confident that the procedure would go well. Once my eye was ready, I lay down on the laser table, and they moved the first laser over my eye.

Two different lasers are involved in IntraLASIK. The first creates a flap in the cornea. Thinking about what was about to happen, I was a bit nervous. My biggest fear was that I would panic while one of the lasers was firing and permanently jack up my eye. Supposedly, the laser can detect any movement and adjust or shut down if needed, but…you know. They positioned the machine over my eye and told me to expect some pressure and temporary loss of sight in the eye. My job was to focus on the center of some greenish rings. They inserted some eyelid retractors, which were much less uncomfortable than I’d expected, and got to work.

I tried my hardest not to move my eye, which was a bit of a challenge once my vision went dark since I no longer had anything to focus on. The pressure was firm but not painful, and the whole flap creation only took 10-15 seconds, I think. I saw some different lights and weird stuff. No big deal, really. Then the bed slowly moved me across the room a bit and under the second laser, which does the actual reshaping of the cornea.

My assignment now was to focus on a fuzzy green light inside the device. I saw more flashing lights and weird stuff while the laser did its work. I remember Dr. Tylock telling an assistant that it would fire for 14 seconds. Suddenly, I noticed that the fuzzy green light was now a green pinpoint. It had worked! After that came the strangest part when Dr. Tylock used an instrument to fold my corneal flap back down and slide it back into its proper location. The numbing drops kept it from hurting, but it was still a bizarre sight to see. The flap quickly adheres into place without stitches. Dr. Tylock said it went beautifully. They sat me up, checked out my eye with one of the standard eye exam devices, and then sent me to recovery. Although I was dying to test out my new eye, instead I followed my instructions and sat in a recliner with my eyes closed to let the flap set.

Post-Op, Day 1

I was supposed to go home and straight to bed, but instead I had lunch with my family first. My vision was hazy all that day, almost like peering through a fog that drifted in and out, but through the haze the image was sharp. This wasn’t hocus-pocus or a marketing gimmick. LASIK really did work, and work very well. I had a blast reading things across the room that were previously a blurry mess without my contact. Minus the haze, my right eye seemed comparable to my left. I later learned that the haze resulted from slight swelling in the cornea caused by the surgery. I was prescribed anti-inflammatory steroid drops to combat the swelling and moisturizing drops to keep the eye wet. While it healed, the flap was also sensitive to impact and rubbing, so I wore safety goggles during the day near the boys and a different pair while I slept. I slept all afternoon, watched some Olympics, and then slept several hours that night. Sometimes I felt minor discomfort in the eye, but some drops usually returned it nearly to normal.

Post-Op, Day 2

Day 2 was pretty similar to Day 1, only with a bit less haze. I pounded the drops as directed. At my post-op appointment, the optometrist said my eye looked great. I could read 4 of the 6 letters on the 20/15 line and probably would’ve had the other 2 if not for the haze. We went to a baseball game that night, and I kept amazing myself by reading the advertising signs across the field with my formerly bum eye.

Post-Op, Day 3-4

The haze is mostly gone. My eyes are nearly identical in focusing ability. I know it’s technically not a miracle because LASIK is a medical procedure made possible by medical technology, skill, physics, and other human factors, but it really feels like a miracle. I once was practically blind in my right eye without my contact, but now I could see almost perfectly. It’s amazing.

The main problem I have is dryness, so I’m still using lots of eye drops. The dryness is especially bad when I wake up. This is a common problem that should improve over time.

One quirk may be specific to my situation. When I test my eyes separately, each one seems to focus at a slightly different depth. So when I switch from one to the other, the image starts out mostly sharp but takes a moment for the image to reach full sharpness. I believe my left eye was always dominant, and my eyes are adjusting to the new reality. It’s a good problem to have.

That’s all I have for now. I am very pleased and wish I could’ve done it a long time ago. That seems to be a common sentiment among LASIK patients, and now I know why.

What’s better than a little data? A lot of data. We just got a new toy that generates all kinds of data: our first bathroom scale. But this isn’t just any scale. It displays my weight like you’d expect but also uses a harmless electrical current to calculate my body fat, total water content, muscle mass, and bone percentage. Plus it looks slick and has a nice, clean display for our information. Except for getting my body fat measured back in junior high or high school, I’ve never had any of those measurements taken by a medical professional. But as far as I can tell, the extra information seems to be fairly accurate, or at least reasonable. We’re both trying to lose some body fat, so I hope this scale will help us track our progress.

With accuracy down to 0.2 pounds, it also allows me to perform some interesting experiments. For instance:

• How much does my weight vary throughout the day and from day to day? (as much as five pounds)
• How much weight do I lose during a trip to the bathroom?
• How much water weight do I sweat out during a short run or a long run? This information can help me know how much replacement water to drink.
• With my workout program and diet, does my body fat drop as quickly as my muscle mass increases, or is one faster than the other?

I haven’t decided yet what to do with all this data. Several iPhone apps let you track your weight and other data points. I could also set up an Excel spreadsheet or use some other tool. We’ll see. Right now I’m just playing with it.

Over the last year, I’ve gotten pink eye two or three times in my right eye. My most recent infection is still lingering, albeit mildly. I think I reinfected my eye by not washing out my contact case. (not one of my brighter moments, but I thought the contact solution would sanitize it)

Pink eye is annoying for anyone, but it’s extra annoying for me. While my left eye is perfect, my right eye (the sick one) is badly nearsighted, so I wear one contact. When you have pink eye, they recommend not wearing contacts. I suppose the microorganisms could linger on the lens and keep the infection alive or something. Normal contact wearers simply switch to glasses when they have pink eye. However, when I first got my contact, my eye doctor said glasses weren’t a good idea because they would screw up my depth perception. So I have no glasses and no contact until the infection is gone. I suppose I’ll declare the end of my pink eye sometime later this week.

Until then, I’m running around with one good eye and one really blurry, naked one. My brain gets a bit confused trying to reconcile the two images, but I actually works fairly well. My left eye is dominant anyway, so I guess my brain just tunes out the blurry image. It’s a bit odd when I can only see an object with my bad eye, such as in a mirror or around a corner. For a good time, many of you can simulate this by running around with one contact or by looking through only one lens of your glasses. Although I haven’t had many problems with my contact, it does feel dry or get lost in my eye on occasion.

My recurrent pink eye got me thinking, though. Apparently wearing contacts boosts your risk for pink eye, as does having small children. I’d prefer to keep my children, but I don’t have to use the contacts, certainly not every day. And I don’t have to be half-blind if I get pink eye again. I have three options:

1. Get a monocle. Would I look good in a monocle? I think I’d look mysterious. And wise. And a lot older. Maybe I’d grown a beard and dye it gray. “The most important men in town would come to fawn on me. They would ask me to advise them like Solomon the wise. ‘If you please, Reb Tevye… Pardon me, Reb Tevye…’”
2. Get glasses. My original doctor said no glasses. My current doctor never said that. Perhaps he might have a different opinion. If not, I’m sure there’s some optometrist somewhere who would hook me up.
3. Get LASIK. Jenny had LASIK over a decade ago and was very pleased. So have millions of other people. It’s expensive, but I would only need one eye instead of two. Even if the surgery went badly, I’d still have my good eye as a backup. Part of me wonders whether it’s a frivolous expense. It’s certainly not necessary, but it would save me from having to buy contacts for the rest of my life.

Have any of you tried LASIK? If so, do you have any thoughts or advice to share?

Thanks to various health classes, articles, and my own desire for everything to make sense, I’ve always believed the old equation that says calories in – calories out = change in weight. It’s simple. It’s easy to remember. It seems to be widely accepted.

It also provides an easy way to assign credit or blame for one’s weight. If you’re at a healthy weight, you must be doing the right things. If you’re overweight, you must be doing something wrong, and it’s your own fault for not being more disciplined. If you really wanted to, you would make the tough choices and eat better and exercise more.

However, that simple formula has a glaring problem that I tried to ignore or explain away for years:

It doesn’t work very well.

In the real world, most people want to be fairly healthy and maintain a good weight, but losing extra fat is difficult. Once lost, it’s extremely difficult to keep the weight off, and most people eventually fail and gain all of it back if not more. I doubt this is news to any of you. Having never struggled with my weight, I blew off this phenomenon as lack of discipline (“these people just aren’t respecting the equation!”), even though I knew how hard many of them fought and how much they watched their diets and how much they worked out.

A growing pile of evidence suggests that I’ve been wrong, that most of us have been wrong. Like it or not, metabolism isn’t nearly as simple as calories in vs. calories out.

The New York Times ran a fascinating article this week called The Fat Trap. I strongly recommend reading the entire article, but its main point is that your body actively resists weight loss and seeks to return you to your previous weight after you lose any significant amount. Once you reach a given weight, your body resets that weight as the ideal and tries to keep you there. Even if you do manage to lose some weight, you’ll have to work much harder to stay there permanently compared to someone who was already at the same weight, almost to the point that it becomes the primary focus of your life. Also, to make things even more difficult, people really do process food in different ways. In one study, given the same diet and same level of exercise, people lost or gained weight at different rates. That blows my mind. It also blows the equation out to the compost pile.

I’m no doctor or biochemist, but if true, this concept explains a lot. It makes me feel like a jerk for silently and ignorantly judging overweight people. It also makes me sympathize much more with those who do struggle with their weight. They not only fight the social stigma of being overweight and the difficult battle to eat better and be more active, but also their own bodies’ fighting against them.

Sure, there’s plenty of room for discussion about how and why we should prevent people from becoming overweight in the first place, which seems to be the only good solution. I’m working hard myself to stay trim, hoping to avoid a much more difficult battle 20 years from now. But for now, I merely want to open my own eyes, and maybe some of yours as well, to the nasty war that millions of people are fighting every day.