Thursday, September 27, 2007
SPRING AND SUMMER 2006
I have a symbiotic relationship with my yellow hibiscus plant. When I have troubles, the plant’s leaves turn yellow and fall off at a rate consistent with the degree of grief in my life. When things are going well, the plant’s leaves are a deep green and it explodes with gorgeous blooms. This has been happening since my husband and I bought this house in 1998.
All through 2004 and 2005, the plant thrived as did my life. I took good care of her as always. All through the winter of 2005 she was hale and hearty.
Then, in April of 2006, something went wrong. Her leaves started yellowing and falling at an alarming rate. I amended her soil early. I pulled off the yellow leaves. I talked to her sweetly. I fed her. To no avail. The leaves kept turning and falling.
Wednesday, May 10, 2006 I had a Lasik procedure performed on both my eyes.
The next day, at the post-op appointment, my vision was 20-20 and the mono-vision that was created for reading, was working fine. On May 17, at the one week post-op, everything still seemed fine, though my left eye was feeling uncomfortable. My next appointment was not until June. I was doing everything as recommended by the doctor’s office.
The weekend of the 20th my left eye grew more uncomfortable. It felt as if there was something big in my eye. This feeling was not going away. And the hibiscus was dropping leaves faster than a rabbit drops litters. I called the doctor’s office and they made an appointment for me to come in right away. The vision in the eye was shifting in and out and I could not read. The week before I had to buy reading glasses at a higher diopter than the one’s I’d had with my mono-vision contact lenses. Like Han Solo, I had a bad feeling about this.
On the 23rd I went in to see the doctor. He looked at my eye through the scope and told me that I had skin cells growing under my flap. He said that this needed immediate attention and that he wanted to cut the flap off. As in, cut off the top of my cornea. I said....”NO”. And of course, was not at all happy. It seemed to me that if the flap was that non-essential, then why bother keeping it at all after the initial procedure? And, it seemed to me, that if God made my eyes with this covering, there must be a very good reason I should try to keep it. I asked, “Isn’t there something more conservative we could try?” The doctor then said that I could get some drops for my eye, and come back in two weeks to see if the growth stopped. I’m thinking, “either emergency surgery right away to take off the flap, or use some drops and come back in two weeks. Hmmmm.”
You know that feeling. That gut feeling that something’s just not right, but you don’t have the information to back it up. I had that now, big time. I got the prescription for the steroid drops and went home and hit the internet. I read medical journal articles on Lasik complications.
The articles I read described my condition as “epithelial ingrowth”. A growth of corneal epithelial cells under the flap and on the stromal bed of the cornea. All articles indicated that treatment of this starts with lifting the flap, cleaning off the epithelials by scraping and rinsing the flap and the stromal bed, then applying a therapeutic contact lens bandage for healing.
If that doesn’t work, and the articles said it’s likely that it won’t, then you lift the flap again, clean again, and suture the flap down. As in stitches. Ow. On top of the feeling of something in my eye, I was growing more uncomfortable by the moment.
Only after aggressively trying to save the flap did any of these articles recommend cutting it off. All articles said that if you don’t fix this, the epithelial cells will excrete an enzyme that will melt the flap and stroma, resulting in vision loss. I could hear the hibiscus plant screams now in harmony with my own.
I got on the phone to my former opthalmologist and got a referral to an eye surgeon with many years experience. His name is Dr. Alan M. Berg with Berg-Feinfield Vision Correction. I made an appointment for May 24. The next day. I was in a hurry.
Dr. Berg looked at both my eyes. The left eye had aggressive epithelial ingrowth, considering that my surgery had just been two weeks prior. The right eye also showed epithelial ingrowth, but less than 2 mm, which, if stabilized, would not need treatment. He said I needed to take care of this right away and recommended, as in the journals I had read, lifting the flap and cleaning those epithelials out.
When I told him that the other doctor wanted to cut the flap off, Dr. Berg said "I’m sure he wouldn’t have recommended that”.. Oh, but yes he did. I booked the surgery with Dr. Berg for the next Wednesday.
Arriving home to find more yellow leaves on the poor hibiscus, I called the first doctor. I did not tell him about Dr. Berg, but I did say that I had read a lot of medical journals. None recommended cutting off the flap. He told me he was surprised, because he had just done this to a patient this week who was very happy now. I mentioned the process of scraping and cleaning. He said he would be happy to scrape the cells off if I wanted to try that. Well now, at this point I had lost confidence in his ability to fix problems. Both he and Dr. Berg said that what was happening to me was rare. Even so.... I asked the first doctor, “no offense, but how many times have you performed the scraping procedure?”. His answer was maybe six times. I said “no offense, but I’d be more comfortable going with a more experienced doctor”. He said he understood.
Then I told him the other hard part. That my insurance was not going to cover any of the cost of this and it would come out of my pocket. He offered to pay for some if I would send a copy of the bill. (He ended up paying for half the full fee)
The week between May 24 and May 31, my left eye grew more uncomfortable and the vision continued to deteriorate. On May 31, my friend, Linda, drove me to Dr. Berg’s Sherman Oaks office. The nurse asked me if I felt stressed and needed the valium. Why, oh yes I do, please. I took it. The doctor numbed my eye, and I went into a darkened room and sat behind another scope. Dr. Berg, gently lifted the flap to start the procedure in the surgical suite.
I had kindly been given a blanket, as the surgical suite was cold. I clung to this blanket for dear life throughout the procedure. It’s an odd feeling when the corneal flap is lifted off your eye. It’s like looking through a drop of moving water, as a shudder goes down your spine when you realize your eye is coming apart.
Dr. Berg began to clean, as I had read in the medical journals. During the procedure he said, “Well, I can see why Dr. ------- wanted to take the flap off. Look, there’s no hinge whatsoever”. (I learned later this error is called a “free cap”.)
I asked “What does that mean? Can you still fix it?”
Dr. Berg said “Well, I’ll try.”
After that I don’t remember much more than being extremely worried and uncomfortable. The procedure took longer, because it was harder to clean the flap and stroma without any kind of hinge to hold it to the eye. I imagine it’s rather like trying to re-roll a torn piece of saran wrap back onto the original roll. I looked at the red light as it went in and out of clarity. Sometimes I felt the scraping. It hurt a bit. I felt the rinsing. I tried to stay still and relax. Dr. Berg was very patient and kind.
My friend, Linda, took me home. I took two more valium and went to sleep. A couple hours later, Dr. Berg called me to tell me that he’d spoken with Dr. -------, who told him that there HAD been a hinge. A teeny, tiny, weensy little bitty hinge. But he just doesn’t know where it went. I’m groggy on the conversation, being post surgical and still on valium.
I went back to sleep. I woke up two hours later with excruciating pain. That kind of pain where you can’t sit still. You move about in a panic and cry, looking for something to make it stop. I managed to call the after hours number, while keeping my left eye closed, and got ahold of Dr. Feinfield. He called in a prescription of vicodin for me. My husband went to pick it up after giving me 800 mgs. of Motrin as recommended. I took a fourth valium. When my husband got back from the pharmacy, I took the vicodin, and it still took almost an hour to fall back to sleep. Hideous, awful, pain. Like the poor hibiscus, I felt like all my pretty yellow flowers and green leaves were falling off.
Here’s a rough visual of what happened as opposed to what should have happened:
June 1st was the post-op. It looked good, but Dr. Berg wanted to keep the contact lens bandage on another day, plus had me double up on antibiotic and steroid drops.
Friday, June 2, another post-op. Still O.K., but one more day for the contact lens bandage and keep the drops at 8 times a day.
Finally on Saturday, June 3, the contact lens bandage came off. Back to 4 times a day on the drops, and come back June 6th.
My eye still felt uncomfortable between Sunday and Tuesday, the 6th. But nothing like the pain I had experienced. I was still worried. That feeling of something in your eye is an indicator of epithelials growing. Being hyper sensitive about this, I was definitely over reacting to any sensation in my eye.
Between the Wednesday of the surgery on May 31st and the Tuesday, June 6th, post op, I was blessed with many friends, plus my mom, praying for my eyes. I was praying for my eyes. At one point, one of my pastors called to ask after me and he and I prayed for my eyes together. At a post op with Dr. Berg, I told him there was lots of praying going on for my eyes.
My prayer was that if I could just picture the hem of Jesus’ cloak, like in the Bible story, and see myself touch it, then I would be O.K. I did this many times.
June 6th. By this time, my vision had actually improved. I could see far and was now able to read without the reading glasses. My left eye still felt a bit uncomfortable, but the pain had subsided. I went to Dr. Berg’s Burbank office for another post op. This would be the telling one.
I was ushered into the comfy beige chair and one of Dr. Berg’s associate doctors took the readings on my vision. It seemed pretty good to me, but it was one of those situations where you keep asking “How is it? What do you see?” Especially when she looked through the scope that would show if epithelials were growing. She kept maddeningly mum. Though, she did tell me that the right eye looked stabilized. Then she left and said Dr. Berg would be in in a few minutes.
I sat and waited. As I waited, another of Dr. Berg’s doctor associates kept walking past my door and peeking in. At one point, she slipped the notes from the chart folder and snuck a peek at them, then put them back. What was going on?
Dr. Berg came in, read the notes and had a look. He was delighted. He said that he saw absolutely no epithelials in the flap or on the stroma and that the edges had adhered beautifully. Dr. Berg said that he has never seen anything like what happened to me before and has never fixed anything like this before. He expressed that he hadn’t thought this would work, but this proves “that we can do anything”. I told him about all the prayers that went up. He said that that's likely what did the trick.
Dr. Berg said that there might be some epithelials there that he couldn’t see today and that there’s still a chance they might grow back, but for today it was perfect. And he was also surprised at how good my vision is. He went to get the young lady who’d been hovering about my door so she could have a look. She was very nice and delighted as well.
As I post this into a blog in October of 2007, almost a year and a half after the procedure and second surgery, my eyes are still uncomfortable. They are absolutely fine, vision wise. But when it's dry out I have to put drops in every couple hours and I always carry drops in my pocket. This is improving, though very very slowly. And no, if given a choice, I would not have this done again.
If you are still determined to have Lasik done, research your doctors very carefully. Talk to people who have had the procedure. But don’t just take their word. I did that in choosing the first doctor who made the mistake in my eyes. If you can’t afford the doctor with the best and longest success record, don’t do it. Glasses may be annoying, but they are 100% guaranteed to correct your vision. Lasik, still, is not.
Most important, whether or not you have problems, remember to pray. Because for me, I know this was a miracle. There is no doubt of that. And the hibiscus? She’s all better. I will probably never be sure if or when any lurking epithelial cells will start to grow in either of my eyes. And my hindsight is now 20/20 thanks to Dr. Berg. I should have gone to him to start with: