Day 0: Here Goes Nothing...

I booked my appointment for 11 AM so it was in the middle of the school day for our two oldest kids. We dropped them off at school and my wife (and newborn in the baby carrier) accompanied me to the doctor's office.

They told me to arrive an hour ahead of the surgery time as they would run a bunch of tests again just to make sure my eyes hadn't changed. As a (nearly) life-long contact wearer who had been wearing glasses for the longest stretch since I was 12, I liked that they checked again as I convinced myself that my eyeballs would take time to get back to their normal shape. In retrospect, I have no idea what difference a couple weeks makes vs the few days I had to wear glasses ahead of my initial consultation.

The doctor's office was pretty empty and I only had to wait a few minutes. I asked if my wife needed to be around for the next hour and they said, "no, unless you need her to go get you some pills from the pharmacy to help you stay calm." At first I said that I wouldn't need that, but then I thought about it a bit more and said, "why not? I should get some." The nurse made some light jokes that I'm a wimp or something like that. Also, Dr Mandel said it was unnecessary, but whatever, when else do you get to take happy pills?! They called in the prescription and my wife went to pick it up down the street.

Meanwhile, they had me come back to start the tests. I had to stare into this white dome-shaped thing with a bunch of sensors on it and keep my eyes open wide for about 10 seconds at a time. There would be pictures that started blurry and then because clear as the machine measured my eye ball. Apparently, the machine can precisely determine the shape of your eye ball and determine a precise prescription. I was told that Dr Mandel was the only ophthalmologist in the tri-state area that had this particular state-of-the-art machine (shrug... whatever). The nurse ran that thing a bunch of times and I think my nerves were messing with me because I kept blinking. She was annoyed with me, but we got all the measurements we needed. I did a normal eye test where I had to read the letters on the lines with and without my glasses. Not sure why they even bothered without my glasses because I was blind as a bat (-6.5 in the right and -7.0 in the left).

After all of that, Dr Mandel walked me through what was about to happen. He explained that they would numb me eyes with drops, then some more drops that allow the top layer above the cornea to be scraped off, then he would scrape it off with a brush, the laser does its thing, and I'm done. Easy peasy, I guess. I asked why he used a brush to scrape off the eyeball and didn't use a laser (I had read that some docs do it that way), and he said that he could be more precise with a brush but it didn't really matter much anyway. That didn't make much sense to me, but he seemed confident in his convictions.

Now I had to wait a bit until they were ready in the operating room. They put me in a small waiting room with some snacks and drinks. I got to take the pills to calm me down at this point and wait for it to kick in. He had massage chairs in this waiting room, which seemed a little over the top for my taste. I waited in there for about 10 minutes. I didn't bother turning on a massage chair, in case you're wondering.

In the operating room they had me carefully lay down and positioned my head exactly where they needed it. There was a machine to my right that did PRK surgeries and one to my left for Lasik. I stupidly asked if there were two machines so there was one for each eye. First they put a numbing drop in both of my eyes, which didn't really feel like much. I had to keep my eyes shut for a few minutes. The nurse turned the laser machine on so I could hear what it sounded like. Next came the worst part which is the thing they put under your eyelids to keep them open. Out of the whole thing, that was the most uncomfortable. They did the right eye first, push some drops in and then scrubbed my eye with a brush thing, which only took a minute, maybe two. Then I had to hold still and look at a blinking light while the laser went to work. Again, it was only a minute or two. They took the uncomfortable eye opener things out of my right eye and moved onto the left. For some reason, the eye opener things bothered me more in the left and I had a harder time staying still. I could tell I was frustrating the doctor, but in all it didn't take that much longer than the right eye did.

Just like that, it was over. They had me stand up slowly as my happy pills had kicked in while I was laying down. To my surprise, my wife was there. She had been able to watch the procedure on a screen just outside the room, which she said was really gross. They took us in another room to give us directions on eye drops, pain killers, etc. I was told to take some pain killers and go to sleep until the next day. Antibiotic eye drops and steroid eye drops four times a day. I was also given some heavier pain medicine for day 3 (Saturday), which I was told would be the worst (more on that later.

We took a cab home, ordered some Shake Shack delivery, and then I went to sleep. At this point I could see way better than I could before, without glasses or contacts of course. However, things were still a little fuzzy and my eyes were tired and just wanted to be closed. I slept for four or five hours and then woke up in the evening for a while. I really just wanted to sit on the couch with my eyes closed as any light was bothersome. After a little while I took more pain pills, eye drops, and fell back into bed.

The day after surgery (i.e. Day 1) was a roller coaster, but stay tuned for those details.

Research and Preparation

Laser eye surgery has been a goal of mine since Lasik surgery hit the mainstream when I was a teenager. My vision has been pretty stable since my early-20s (I'm 34 now), but I've never really had the money, or the desire to spend the money, until the past few years. My dad had Lasik more than 10 years ago and he is always saying it's the best thing he did and I should look into it. Also, I have a number of other friends and colleagues that had the surgery done and rave about it. The idea shooting lasers into your eyeballs, just to avoid wearing glasses and/or contacts, seems a little crazy. You can find horror stories on the internet, but I never met anyone in person who had any serious complications and most rave about it, so I decided the risks were low and I should just go ahead and do it. I'm not getting any younger, so another motivator was that I'll likely be in reading glasses at some point so it's better to do it soon and enjoy 10+ years of no glasses at all.

I'm a fairly busy person at work, so the thought of going to a bunch of ophthalmologists around New York City trying to find a good one sounded exhausting. So I did was any person of the 21st century would do and I spent hours on the internet researching doctors. I cross checked reviews on Yelp, Google Maps, ZocDoc, and others. The websites of the vision centers were sometimes helpful and I didn't feel comfortable with the ones that looked like they were chop shop trying to push as many surgeries as possible. I read unappealing reviews of places that did the consultation and then started pushing payment plans on you. Or they advertised a low price only to realize that all the required follow up visits cost a couple hundred a piece. I guess I was trying to find the happy medium of a doctor that did a lot of Lasik and PRK surgeries, but one that was also professional and had the patients interest in mind.

Dr Eric Mandel on the Upper East Side of Manhattan is who I settled on. He got almost entirely good reviews across all sites. While his prices looked a little higher, it was also a full package cost that included all follow up appointments. I made the appointment for some time in November 2018.

The consultation was mostly me looking into a lot of machines that were apparently spitting out data on the shape of my eye and the thickness of my cornea. They kept bragging about their technology and told me it was the best (I never did much research to see if any of that was true). They dilated my eyes and tortured me with a light. The whole thing actually took longer than I thought, maybe 1.5 hours. In the end I was told that my corneas were borderline too thin for Lasik and so I'd have to do PRK. I said, "Ok... What's that?". He explained that instead of cutting a flap, he would scrape away the epithelium layer on my eyeball and then a laser would correct my vision and the epithelium layer would then grow back. I'm certainly not the best person to explain the difference, but I found this short video pretty informative.

After they explained the costs to me, which was $5,100 for PRK in both eyes, I told them I would think about it and told them to call me the next day. After reading about people be pressured into it after a consultation, I told myself going in that I wasn't going to give an answer that day. Also, I didn't know much about PRK so I needed to do a lot of research.

My research started with YouTube videos of people sharing their experience. I found those to be very reassuring. Going in, I'll admit that my bias was to get the surgery so I wanted to find data points that would support my decision. In reading and watching peoples experiences, I noted that while everyone's experience seemed to be different, just about everyone ended up happy with their results. That was pretty much enough for me to commit to the surgery when they called the next day.

I used a Limited Purpose Flex spending account to pay for the procedure, which helped cover about $2,500 of the cost through pre-tax deductions from my paycheck. One cool thing about flex spending accounts is that the amount you commit to is taken from your paycheck in even amounts over the year, but you are able to use 100% of it upfront. It's basically an interest-free, tax-free, loan. Also, if you quit your job or get laid off you don't have to pay any of it back.

Anyway, the point of explain all of that is to say that scheduled my surgery for January 2, 2019 as that was the first day I could do it and use the flex money. The other reason I chose that date is because the first week of the year is an easier week to take off work. I asked the doctor multiple times and was reassured that I would be able to go back to my desk job in about 6 or 7 days, in fact, the day after surgery he said I could go back the next day if I wanted to. However, one of my regrets (which I'll get into in another post) is that I didn't take off enough time. Ideally, taking 10+ days off work after PRK surgery seems like the best plan to me. Have the surgery on a Wednesday or Thursday and then take the rest of that week and the following week off.

With all of that settled, I pretty much spent December reading as much as I could. I would search for "PRK negative side effects" and get a little antsy about the whole thing, and then I would watch people YouTube videos, reddit posts, blogs, etc. and remember that that vast majority of people ended up with perfect vision and limited complications.

My wife never really spent time to research it because the idea of it freaked her out. In my recovery period, she started reading about what the heck I just did to my eyes and said she never would have let me do it if she had known what it was. So take that story and decided if its a good idea or not to have your significant other involved in your decision process.

I'll stop here, but stay tuned for my post on the day of the surgery.