Wednesday, February 16, 2011

I WENT FROM A MINUS 14 (yes -14) IN CONTACT LENS TO 20/20 OVERNIGHT... Well almost overnight! - My ICL surgery.

 I will post a designated blog that will be open to all potential ICL vision patients & always welcome questions & comments both here and on the new blog to come soon!

My story:
I began my quest for options of what to do about my eyes after a recent visit to my OD.
I had taken my teen to have her annual eye exam, and her optometrist said to me, “Why haven’t you come in to have your eyes dilated, like we talked about?” I said, “Well, I really don’t see the need for it.” Knowing full well he was going to give me a hard time about how badly I take care of my vision, I added, “I am going to be in contact lens forever, so what is the point, really.” Now, I know there is no logic to this, but I just didn’t want to hear how bad things really were, since I did not feel that there are really many options anyway. I can’t wear glasses, as they give me the such an intense feeling of vertigo that I cannot even begin to describe it, not to mention that they are as thick as Coke bottles. Anyway, he responded to my statement with, “You will wear contacts as long as your eyes will LET you. You are growing several little new blood vessels to your eyes, and you may not be able to be in contact lenses for much longer.” In light of this, I started searching for options, and found Visian ICL’s Facebook page. I watched the posts on the page for quite some time. There was one doctor that kept standing out from the rest: Dr. Robert Rivera. He seemed to keep in touch with his patients, and I often found him reaching out to other people who asked questions who were not even his patients. He was clearly an expert in the field, keeping up with what is new and current in technology. This makes for an amazing doctor.

I finally made the jump to check and see what was available in my area in ICL doctors. My first call was to the office that did my neighbor’s cornea transplants (as, I already knew they were great). I set up an appointment to visit them, telling them that I wanted an exam for Visian. They scheduled the appointment, and we went through all the beginning tests to see if I would qualify. I saw the doctor and he said that I was a fraction of a millimeter short of being able to get the Veriseye. I was a bit confused and said I was there for Visian, and they told me that they did not implant this particular lens.
I then called Visian, and they told me to check their website. I did so and found that there were two additional doctors who put them in, here in my area. I checked those two places, and for reasons I will not say here (if you would like information on why I chose NOT to go with them, please send me an email and I will explain), I decided that I would not be having my surgery done by either of those two centers.
Next, I sent a copy of the OrbScans that I had done at Texas Cornea Associates http://www.corneatexas.com/ to Dr. Rivera. I had not contacted him before and was not a patient, and I really had no idea whether he would respond or not. He did, in fact, respond, even at somewhere around 1:00 am CST (12 am MST)! He was so kind, and answered all of my questions (and there were A LOT of them!). By the time we had finished up that email, though I had not told him, I had pretty much made up my mind that it was going to be Dr. Rivera who was going to do my surgery. I was completely comfortable with him already! Dr. Rivera gave me the number of his lens counselor, Wendy, and he also gave her my number. I am not sure who called who first, but she answered each and every single question, sent me information on all of the local hotels, sent me my prescriptions (so that I would have them prior to even leaving home), and was there for each and every question I had along the way. Even today (several days after the surgery), I called her with a question, and she gave me an extra tip that helped me with the Durezol drops. These are a bit tough on the system, but Wendy told me to hold my finger in the tear duct area when I put them in and they will be less hard on me, and she was right, and they did not even sting for the first time! She was always prompt in calling me back and just over all amazing! I now consider her a genuine friend!

I traveled from Dallas, Texas to Phoenix, Arizona on Monday night. This was very difficult in my new glasses that were -12 and -12.5 (intentionally under-prescribed I was told by my local OD), as I had severe vertigo. I had worn them for seven days prior to the exams (as was required), and it was brutal. I think, at this point in my journey, I would have been ready to have my eyes clawed out just to get out of these glasses!

On Tuesday, I went in for a series of tests, one of which was the B-scan ultrasound. This is a very strange test where they put a little circular plastic cup-like ring, just inside your eye and fill it with saline. It is very odd, but not at all uncomfortable. I would describe it as the feeling that you are drowning, but only one eye. The technician, David, who put them in was incredibly nice, and kept asking whether I was alright. I was perfectly okay with the procedure, and he told me that if I was doing okay with this part, it was a pretty good sign that I would do fine during surgery. I did not really find either of them difficult at all, not this part nor the actual surgery.
Then, I went in and had the eye exam. I have always hated these, because I really dislike the portion where I have to choose which lens is clearer. Sometimes, I think I pick the clearer one, but the ODs still change back to the other setting. (you know what I mean, you find the one you wish you could keep, but it is always just one of the many, "here or here" settings that is honestly, probably most impossible to achieve in reality) Oh well, I guess they know what they are doing. As long as I can see well at the end, I trust that the process and the results are good.
Next, I got to see the wonderful Dr. Rivera. He made me feel totally at ease with what would happen during and after the surgery. I have never met a kinder person. He is the type surgeon that you would readily trust with your vision, or, for that matter, even your life, and he’s definitely someone you would wish to have around in any emergency situation! He is someone I would have never hesitated to trust with the care of my mother or my child, and that says a lot, because, as a general rule, I am quite skeptical about doctors. We ended up moving my surgery to the next day (Wednesday), so that I could have one more day to recover before flying home. I was completely unafraid and, frankly, I was so excited! I did not think I would feel so happy at the thought of having an operation, but I was!

Next, the wonderful  Mrs. Wendy made arrangements for the Barnet Dulaney Perkins driver to pick me up at the hotel.
He, too, was unbelievably sweet! He showed up right on time, and as we drove from Phoenix to Scottsdale. As he drove, we chatted about the wonderful flora and fauna of Arizona, some of which can only be found in this one place in the entire world!
I asked about the fruit trees, since I was seeing the most amazing oranges dangling from trees everywhere. He explained that there were all sorts of citrus trees there, lemon, lime, orange and more! Since I had not eaten the night before, the very thought of them was making me hungry. 
After the surgery, he was promptly back at the center to pick me up, he even walked me out to the vehicle, then at the hotel he was ready to walk me back to my room. I declined since I was seeing almost perfectly out of one of my eyes. I think I do this because I am an overly independent person. Probably to the point of being annoying.
But hey, it is what it is.  Anyway, he was wonderful, and I would like to send a big thank you out to him as well!

Things went very smoothly at the Scottsdale office on Wednesday. Dr. Rivera travels with his entire team, so you are assured that you will get the best of care, no matter what location you select for your surgery. I got there and we very quickly played a bit of musical chairs, where you go through one step, then move to the chair just to the right, until you end up at a hall where there are maybe four people, ready for surgery. This part goes much more quickly than it sounds. The musical chairs only lasts for maybe five minutes. The strangest part of this entire process is where they draw on your eye with a Sharpie. Again, not at all painful, but definitely a very strange, funny,  sensation. Next you are brought in to the surgery room where they give you some IV meds, and then you’re ready to go. (As a note to those planning to undergo this surgery: be sure to wear a button down, short sleeve shirt, so that they can add the little pads that monitor your body readings.)

The surgery begins and I don’t really remember much until they told me to “stare at a light, look up, look down to your knees” Then, shortly after, they said, “Okay, here comes the worst part, we are pulling the tape off now,” and that part can be a bit terrible. I would probably describe it as the way it feels when you pull off a Band-Aid.  I can honestly say that it is, truly, the worst part of the entire surgery. My point here is, the entire surgery was not much worse than pulling off a Band-Aid, one quick few seconds, and in this case minutes, and it is over. It’s clearly not too much to have to go through to have amazing vision!

I did have a slight bump in the process during my second eye, but it was nothing all that traumatic. I started coming to, a little bit when they were working on the left eye. I (only for what was probably a fraction of a second) felt something, I am not sure what, but in retrospect, I would not describe it as pain I felt, but more of a bit of an over-awareness of what was going on, or at least that is what I thought at that very moment. Since I had the eyes done bilaterally, there is the possibility that I was actually "supposed" to be aware so that I could follow the commands, but when I voiced a quick,  “Woah…” I probably (though dazed and I don't quite remember, really there is no telling what I said) left the impression I was in pain, because they quickly put in some numbing drops and another shot to the IV. I am guessing that, after that,  I must have been totally out, because I did not hear any of the commands on the second eye. I think this may have caused a bit of  extra difficulty for Dr. Rivera, and, somehow, I ended up with an abrasion on my left eye. I don’t know how the whole thing happened, since I was fast asleep, but maybe he had to use a tool or his finger to manually move my eye, but I am just guessing here. It does not really matter anyway, as this is really no big deal to me. I seriously can’t count the number of times I’ve had major abrasions with contact lenses over the thirty years I have been wearing them. I must admit, however, right after surgery, when the pain from the abrasion kicked in, I was a little let down that this happened. Mostly because I could almost instantly (less than twelve hours after the procedure) see 20/20 or so, in my right eye. But, honestly, it really wasn‘t that upsetting. I guess I was just missing that instant gratification we all get so spoiled with and used to. Plus, I was a little scared at the thought of having to board a plane without being able to see at all out of my left eye.

Anyway, sorry for digressing, back to the process.
When Dr. Rivera finished the left eye, he woke me and told me that I had a contact lens in that eye that would come out the next day. And so, I returned to my hotel room. I guess all of the numbing medication must have started to wear off, as I put in the first set of drops and the pain began. Now, this felt similar to my last OD appointment, here in Dallas, where they tried to change contact lens brands on me. I know I have a tiny, old scar on the top edge surface of my left eye, and it felt like this contact lens edge was scraping that old scar. This may not be accurate as to what was actually happening, but it is exactly what it felt like. It made the abrasion seem minor in comparison (or, at least, that was my perception). I called the office and was promptly called back by Dr. Jared Anderson OD. I told him I would gladly take the contact lens out or I could go up to the offices and he could, but that it needed to come out. He asked me a series of questions, and when I told him I could not open my eye, he said he needed to see me. He came from the Mesa office to the Phoenix office and was there lightning fast. He called me when he arrived, so that I would not have to wait out in the cold, saying that he would wait while I walked from the hotel to the offices. He asked me on a scale of one to ten how strong the pain was, I told him a ten, and he put in some numbing drops, which did not even begin to lighten the pain. Next, he quickly removed the lens, and it was INSTANT relief! Yes, I knew the pain would return as the numbing drops wore off (and so, I asked him for numbing drops to take home. My request was denied, with a laugh, a smile, and an explanation to follow). He checked the pressure, changed my antibiotics to a couple of small sample bottles until I was to see the OD the next day (since we thought maybe they were causing an issues (I have an allergy to Avelox and this is in the same family), patched the eye up for me, and then asked me if I needed some pain medication. I refused, since I really did not want to take a taxi to the drugstore. That night was a bit painful, just like it is when you have any abrasion, but pretty much what I expected. Abrasions, just by their nature, are incredibly miserable to deal with (and, truthfully, much worse than the entire surgery itself).

The next day (Thursday), I had to go see the OD again. I was sat down by a very nice technician named Steve, and he gave me the eye test. From my right eye, I saw pretty fuzzily, but not at all badly. I saw really well through the little device with the pinholes. However, we do not see that way in daily life, so I am not sure what this is for, but, apparently, it does have some sort of application. From the left eye, I could not even see the large, sideways E, and everything was very blurry. I am sure I was quite let down, but Steve told me not to worry, as I was seeing around 20/30, and it will get better later on. He gently checked my pressures and said that they looked good. When the OD came in, I explained that the drops burned badly, and that I think there is a difference between a burn and a sting (which a sting was to be expected with the drops), and this was burning. He changed my drops and gave me Tobradex, which I had used before, so I was happy to hear this. However, I had been told I could see 20/25 and I knew I could not, and right after the technician told me, only moments before, that I was seeing at 20/30. I was a  bit uneasy, so I just sat and listened halfheartedly. I went back to the room to sleep again.
Friday, I awoke around 7:00 am and took the bandage off. I figured, with the blinds to the room cracked, if I could stand the light as it slowly crept in, that I would be okay to keep the patch off. If I could not, then it was right there on the nightstand to put back on if needed. I had to go see the OD again a few hours later. He began with the eye chart test, and I saw okay with my right eye, but, with the left, I still could not see the big E that is sideways on the chart. I had a bit of dismay at this, and felt a bit sad and worried about having to travel the next day and manage the airport. This eye was not even yet as clear as the right eye was the day of surgery, even at it’s very blurriest stage.  I expressed that I was worried, I was told that I could pass a driver’s test with my current vision. That seemed really inaccurate, since, as I stated, I could not even see the big sideways E, let alone anything else on the chart. At this point I was quite disheartened, so the rest of this entire visit seemed to be a waste of time to me, so I guess I did not engage much.
I realize I was not completely in my happy spot. I mean, I had an abrasion that was huge (from the drawing the doctor made of my eye showing me the abrasion, I am guessing it began as being quarter-sized, but had  shrunken to dime-sized or maybe a bit smaller, by this time. Now, this is not science, it is just what I saw when he made the drawing of the eye and drew on the abrasion, but it appeared to be at least three-fourths of the exposed portion of my eye.), I was not excited or happy, since I was still in pain and my eye was still entirely blurry, so I made the comment, “If I had to do this all over, right now, I would not do it.” I was sure to put a lot of emphasis on the “right now” part. This is after the driver’s test comment, and I was disappointed, because that comment led me to think that he thought this was acceptable vision. I guess at this point, I was still not ready to accept the fact that I may soon be able to see 20/25.  The world had never been 20/25 for me, so I am sure I was not ready to accept the possibilities yet.
I used the drops the remainder of the day, as I was told, and things started to be clear enough to, while not seeing perfectly, at least enough to make my way through the checkout process at the hotel and get our taxi to the airport on Saturday. By the time we were at the TSA, I had almost forgotten I could not see very well from my left eye. It just sort of felt the way you do when your contact lenses are dirty, something I am pretty used to. The more time passes, the clearer things get.
My left eye is still healing, but knowing that these lenses were inserted by the best surgeon in the entire globe makes me know that, in a short bit, I will have amazing vision.
I will keep you posted as the days pass.

Update:
It is February 16, 2011, and I am now two weeks post-surgery. I, unfortunately, had an allergic reaction to the Durezol steroid drops and ended up at the ER several times over the last two weeks. Blood was drawn on each visit, and it was found that I was in no way sick aside from the vomiting, caused by the drops, (which was severe and included lots of blood).  Anyway, several bags of IV fluid, phenergan, and 8mg Zofran (which none of this was able to stop the vomiting) 24 lbs less and a few days later, I am getting much better! Please watch for potential reactions to the drops. However, it is possible that my body reacted in the manner that it did because I am only used to eating all natural and organic foods. As such, my system probably doesn't know how to handle steroids. I am hopeful that that's all it was.
Despite this experience of mine, do not be paralyzed by fear of this potentially happening to you. I liken it to being similar to a bee sting--- I can get many of them and have no reaction, but my neighbor can get stung once and need a trip to the ER or worse--- die from anaphylactic shock. While the probability of having a reaction is slim, be aware of any vomiting, as some of the drops are fairly new to the market.
As for my vision, it is AMAZING! While I do still have a bit of swelling from the drops, I am healing well and seeing 20/20 now, and there is still room for me to make it to possibly 20/15 or even 20/10!
I could not be happier with my outcome, or the care given to me by Dr. Robert Rivera at Barnet Dulaney Perkins!
Please check out his bio here: http://www.goodeyes.com/Robert-Rivera-MD-Phoenix-AZ.asp
Though I know I am biased, I must say, his bio does not serve him justice. This doctor has some of the most talented and skilled hands in the business!

One final word for now. If you asked me if I would do it again? One hundred times over it was required.
I am two weeks out now, and I would say that any inconvenience could be described as transient, meaning... I hardly remember any part that may have been at the time, perceived as pain.
Mothers, it is sort of like the joy of childbirth. So worth the end result that you forget there was ever any pain at all during the entire process. You just see the beautiful end result!
I have not yet been able to throw away those left over, unopened,  underprescribed (and now rejected) contact lens. For some reason, I keep feeling like I will soon wake up, and it had all been a dream.
It is truly that wonderful!

UPDATE:
Dr Rivera. has now moved to Hoopes vision in Salt Lake City Utah.You can find him at the following link:
http://www.hoopesvision.com/

You can also find Dr. Rivera on facebook as Robert Rivera

5 comments:

  1. so glad you're on the mend hun, you'll soon be back to normal :o) xXx

    @KokokelliWomble

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  2. As you all know, I actually do not like blogging! So a big thank you to all for sending the direct messages to my twitter account. You all are so sweet for keeping it simple for me! Hugs!!! GG

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  3. Oh, do feel free to comment or ask questions here as well if you wish, otherwise, you all know how to reach me.

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  4. I was so happy to read your post. I have thought of you often and hoping that everything turned out better then better.

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  5. I've followed your posts on the visian facebook site also. I'm really glad to hear the surgery went well for you. I'm seriously considering the surgery myself. Currently in the process of finding a doctor -I would love for Dr Rivera to do my surgery also but I'm on the east coast. You seem to have had your surgery within 5 days -I'd like to know when they performed the YAG iridotomy since I didn't see any mention of this. Thanks and congrats on your new vision! :D -K

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