Wednesday, March 23, 2011
PRK update
POD12 - reading is getting easier and easier. I can read a sheet I printed out with size 6 font today which I was having difficulty reading for the last several days in a row. Still, sometimes my vision blurs and I have to blink a lot to read small text. For example, I went to Saks today and I was having difficulty reading the clothing tags that list washing instructions/material/size and I had to either pull the tags close to my face or blink 5-10 times. No sensation of eye dryness but eye drops improve my visual acuity.
Saturday, March 19, 2011
POD 8
POD 5 - painless but with mild photophobia relived by wearing sunglasses. Visual acuity was 20/40 at post op check. Bandage lenses removed. Vision felt significantly blurrier after bandage lenses removed. a rough, gritty sensation against my eyelids was present all day.
POD 6 - gritty sensation resolved. Still having difficulty reading the computer all day. Big things were visible.
POD 7 - easily reading the computer if i enlarge the font to size 14-16. Painless.
POD 8 - Much improved, reading size 8 font with ease, size 6 with relative ease. Size 4 is impossible from a normal distance.
POD 6 - gritty sensation resolved. Still having difficulty reading the computer all day. Big things were visible.
POD 7 - easily reading the computer if i enlarge the font to size 14-16. Painless.
POD 8 - Much improved, reading size 8 font with ease, size 6 with relative ease. Size 4 is impossible from a normal distance.
Tuesday, March 15, 2011
post op continued
POD3: went well. I walked outside to petsmart and came back with a bag of dog food. I was having issues reading because my vision is really blurry and I had to enlarge the font and put the monitor 3 inches from my face. Haloing effect continues but only about 1/3 as severe as POD2.
POD4: went running this am. no issues so far. Vision is still significantly blurry.
POD4: went running this am. no issues so far. Vision is still significantly blurry.
Monday, March 14, 2011
PRK adventures
POD1: Feeling good. I drove to my post op check with my nervous mother in the passenger seat. Dr Koch asked how I was feeling? "Good." I said, and he said, "The pain will probably begin tomorrow, so party today" so I raised the roof. He liked this and raised the roof with me. This reaffirms my observation that roof raising unites people and strengthens the therapeutic alliance. In the afternoon I went shopping and blew my budget on jeans and a pair of cool shoes.
POD2: worst. day. ever.
They had already warned me that this would be the worst day. For some reason I hadn't really believed that it would happen to me. As soon as I woke up, I slid up the dimmer switch on my bedside floor lamp and felt immediately like someone had punched me in both eyeballs. I started tearing profusely. My photophobia was so bad that I could not force my eyelids to open. My father had to pry my eyelids apart for my qid steroids and abx. I lay in the dark literally all day. I couldnt' watch TV or use the computer. I lay there exchanging 2 ice packs between my face and the freezer for hours. The light from the closed blinds bothered me so much that I considered hanging out in the pantry. I took 3 naps on this day and was stir crazy. I visited my dog outside at night and the moonlight was just enough light for me to see comfortably, so I spent 1 hr playing with him. The headlights of the passing cars and lights of the neighboring houses were uncomfortable to look directly at. When I was getting ready for bed, I turned the closet light on so that I could use the filtered light to see in my room. This was relatively successful but when I went to turn the closet light off I accidentally looked at the light bulb. MISTAKE. Severe pain ensued for 30 minutes and I finally decided to break open my toradol eye drops. They didn't help at all. Luckily, I fell asleep shortly thereafter.
POD3: vision is blurry today. I had been warned about this as my corneal epithelial cells grow back together and meet together in the middle, forming an uneven ridge, which should flatten out significantly over the next 2 weeks and continue to improve x 3 months. Pain and photophobia resolved. Typing on computer today! Put in my own eye drops at breakfast and lunch. Took the day off school yesterday as I couldn't forsee how I could possibly go to school if my eyelids were swollen shut, but seems to be back to normal today. No school + no pain = PARTY (per ophtho consult).
POD2: worst. day. ever.
They had already warned me that this would be the worst day. For some reason I hadn't really believed that it would happen to me. As soon as I woke up, I slid up the dimmer switch on my bedside floor lamp and felt immediately like someone had punched me in both eyeballs. I started tearing profusely. My photophobia was so bad that I could not force my eyelids to open. My father had to pry my eyelids apart for my qid steroids and abx. I lay in the dark literally all day. I couldnt' watch TV or use the computer. I lay there exchanging 2 ice packs between my face and the freezer for hours. The light from the closed blinds bothered me so much that I considered hanging out in the pantry. I took 3 naps on this day and was stir crazy. I visited my dog outside at night and the moonlight was just enough light for me to see comfortably, so I spent 1 hr playing with him. The headlights of the passing cars and lights of the neighboring houses were uncomfortable to look directly at. When I was getting ready for bed, I turned the closet light on so that I could use the filtered light to see in my room. This was relatively successful but when I went to turn the closet light off I accidentally looked at the light bulb. MISTAKE. Severe pain ensued for 30 minutes and I finally decided to break open my toradol eye drops. They didn't help at all. Luckily, I fell asleep shortly thereafter.
POD3: vision is blurry today. I had been warned about this as my corneal epithelial cells grow back together and meet together in the middle, forming an uneven ridge, which should flatten out significantly over the next 2 weeks and continue to improve x 3 months. Pain and photophobia resolved. Typing on computer today! Put in my own eye drops at breakfast and lunch. Took the day off school yesterday as I couldn't forsee how I could possibly go to school if my eyelids were swollen shut, but seems to be back to normal today. No school + no pain = PARTY (per ophtho consult).
Friday, March 11, 2011
PRK, POD#0
I got PRK today. I was slightly apprehensive due to people's PRK disaster stories on the internet, but I knew that I should probably not be worrying since there is something like a 99.9% satisfaction rate.
pre-op
I arrived at 10am with my mom and was brought back at about 10:30 for the nurse to go over my meds with me. Dr Koch came and asked if I had questions - no. He told me I could go ahead and take the alprazolam if I brought it with me. I was not feeling anxiety but took the xanax just to see (in the spirit of experimentation & b/c I'd never have an excuse to use it recreationally). They cleaned my eyelids and brought me back into the room. I lay down on the bed and we did the time out. Never been on the patient side of a time out before.
op
When the laser was brought above me, I knew the xanax was NOT working. My left eye was covered with an eye patch and my right eye was held open by a tegaderm x2 + some sort of wire retracting device (not painful). The epithelium was debrided with some sort of rotating sander which was painful at first because I was inadequately numbed. More tetracaine was applied. The cells were scraped away with a spatula and sponge. I was instructed to stare at the laser - a ring of light with a blinking orange light in the center. Continual encouragement was voiced by Dr Koch while I fixated on the blinking red light and my corneal stroma was lasered x 2 minutes. It smelled like they were bovie-ing my eye. The laser was removed and I saw Dr Koch's face above me. My eye was irrigated and a soft contact lens was placed on the cornea to protect it. They repeated the procedure with the other eye.
post op
The fellow came in the room to check my eyes post op and was not communicating well with me in lay terms - I could see how it could be confusing for a regular person. I told her I was an MS4 and she could speak in clinical terms with me. She was relieved and said, "Omg thanks. I am glad you told me I could talk normally." Then Koch checked my eyes. Then we paid and peaced out. My family went to Fadi's where I had a beef shwarma and a celebratory baklava + 100 complimentary pita breads.
post op goals:
vision: I would compare my current vision to when you are wearing contact lenses but you fell asleep in them and now they are sticking to your eyes, so fine print is fuzzy. My vision improves to perfectly clear when I put lubricating eye drops in my eyes . I don't know if it is my vision, or the fact that I'm wearing this protective contact lens that is causing this issue. I don't know how long this will take to resolve.
pain: Slight discomfort, like a feeling of grittiness in both eyes. Discomfort resolves with lubricating eye drops. I hear that POD#1-3 are the worst. I am dreading tomorrow.
other: They gave me gatifloxacin eye drops to use 4x/day x 5 days. It goes down my nasolacrimal duct and tastes fucking gross. I hate it. Other things I hate - vitamin C bid x 1 year <-- can I remember to take something 2x/d for a year?!? and wearing sunglasses outside x 1 year <-- I hate sunglasses because they make the world look dark... but I don't think that I'll have too much of an opportunity to be outside in residency.
Something that is really bothering me is that I really hate sunglasses and I'm going to China for vacation, and I'm going to have to wear sunglasses. I won't be able to see all the colors on all the tourist attractions! I guess I'll bring that up tomorrow at my post op check.
pre-op
I arrived at 10am with my mom and was brought back at about 10:30 for the nurse to go over my meds with me. Dr Koch came and asked if I had questions - no. He told me I could go ahead and take the alprazolam if I brought it with me. I was not feeling anxiety but took the xanax just to see (in the spirit of experimentation & b/c I'd never have an excuse to use it recreationally). They cleaned my eyelids and brought me back into the room. I lay down on the bed and we did the time out. Never been on the patient side of a time out before.
op
When the laser was brought above me, I knew the xanax was NOT working. My left eye was covered with an eye patch and my right eye was held open by a tegaderm x2 + some sort of wire retracting device (not painful). The epithelium was debrided with some sort of rotating sander which was painful at first because I was inadequately numbed. More tetracaine was applied. The cells were scraped away with a spatula and sponge. I was instructed to stare at the laser - a ring of light with a blinking orange light in the center. Continual encouragement was voiced by Dr Koch while I fixated on the blinking red light and my corneal stroma was lasered x 2 minutes. It smelled like they were bovie-ing my eye. The laser was removed and I saw Dr Koch's face above me. My eye was irrigated and a soft contact lens was placed on the cornea to protect it. They repeated the procedure with the other eye.
post op
The fellow came in the room to check my eyes post op and was not communicating well with me in lay terms - I could see how it could be confusing for a regular person. I told her I was an MS4 and she could speak in clinical terms with me. She was relieved and said, "Omg thanks. I am glad you told me I could talk normally." Then Koch checked my eyes. Then we paid and peaced out. My family went to Fadi's where I had a beef shwarma and a celebratory baklava + 100 complimentary pita breads.
post op goals:
vision: I would compare my current vision to when you are wearing contact lenses but you fell asleep in them and now they are sticking to your eyes, so fine print is fuzzy. My vision improves to perfectly clear when I put lubricating eye drops in my eyes . I don't know if it is my vision, or the fact that I'm wearing this protective contact lens that is causing this issue. I don't know how long this will take to resolve.
pain: Slight discomfort, like a feeling of grittiness in both eyes. Discomfort resolves with lubricating eye drops. I hear that POD#1-3 are the worst. I am dreading tomorrow.
other: They gave me gatifloxacin eye drops to use 4x/day x 5 days. It goes down my nasolacrimal duct and tastes fucking gross. I hate it. Other things I hate - vitamin C bid x 1 year <-- can I remember to take something 2x/d for a year?!? and wearing sunglasses outside x 1 year <-- I hate sunglasses because they make the world look dark... but I don't think that I'll have too much of an opportunity to be outside in residency.
Something that is really bothering me is that I really hate sunglasses and I'm going to China for vacation, and I'm going to have to wear sunglasses. I won't be able to see all the colors on all the tourist attractions! I guess I'll bring that up tomorrow at my post op check.
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