update - 4 weeks out -I was wrong

[chickenlittle]

I went to see my surgeon today - hoping that my dry eyes were better. He said they were very dry - Schrimer test 1 in right, 4 in left. He put in plugs on bottom - said they were permanent but could come out. - Also gave me Optima drops and told me to use a humidifier. Said my vision right now is 20/25 in each eye. I am so confused since I SEE better and sharper out of my right(dominant eye) plus, I still have blurriness all the time and discomfort. He said I should be happy since I was -6.75 and -6.00. Also said I have slight epithelial ingrowth on my left from having to smooth the flap out - since it got displaced the day of surgery. Said the growth was slight and on the outer edge of flap and that it shouldn't cause any problems with vision, but it needed to be watched for growth??? I am so depressed and I cried all day today. I have two small children 7 and 5, and I haven't been able to really focus or work since I had lasik done on 12/28/07. I thougth the homeopathic drops (Similasian) were helping since they didn't irritate me at all. All the other drops - Systane, Bion Tears, Refresh Tears, seem to irritate me after I use them all day - every 30 minutes. I am using the tranquil eyes at night and it seems to help some. I've been doing a total omega - 3's and 6's, plus I just added BioTears. I am filled with anxiety - BUT I'm afraid to go on an anxiety medication because it might dry my eyes even more. I did schedule an appointment with Dr Foulks in Louisville, KY - he's the only dr I found on your site close to where I live in TN. I so need encouragement because I waited so long to do this, 10 people from work had it done at same place with great results. I feel like I'm headed to a really dark place with no return

[Rebecca Petris]

Please don't panic

I'm sorry you had a discouraging appointment today. To put things in perspective, though, I want you know that there are a great many people who go through a lot of bumps and worries in the weeks after their surgery that cause a lot of anxiety at the time but who turn out absolutely fine within weeks or months. So hang tight, chin up, and try not to let it get you down.

Said my vision right now is 20/25 in each eye. I am so confused since I SEE better and sharper out of my right(dominant eye) plus, I still have blurriness all the time and discomfort.

There's a very important distinction between visual acuity and vision quality, and it's a good idea to learn about it because communication about this is one of the top causes of tension between lasik patients and their surgeon or whoever is caring for them post-operatively. Whatever you see on the chart is acuity, and you can have great acuity but still feel like you see lousy. The best doctors will understand when you're upset about lousy vision quality, but less understanding doctors may expect you to be excited about your acuity even when your quality is not there. Both quality and acuity can change a lot in the weeks after surgery.

He said I should be happy since I was -6.75 and -6.00.

Typical appallingly bad bedside manners from a lasik surgeon.

Also said I have slight epithelial ingrowth on my left from having to smooth the flap out - since it got displaced the day of surgery. Said the growth was slight and on the outer edge of flap and that it shouldn't cause any problems with vision, but it needed to be watched for growth???

If you have confidence in your surgeon's overall experience, credentials and reputation, I wouldn't stress about the ingrowth. I had a little of this after a flap relift and it subsided - we just monitored it for awhile. It's a common problem if a flap needs to be lifted. But why was the flap displaced? - At any rate, Dr. Foulks will be a very good second opinion on the epi.

I am filled with anxiety - BUT I'm afraid to go on an anxiety medication because it might dry my eyes even more.

Personally, my opinion about this is that if anxiety or depression are severe, the tradeoff is a no-brainer: The limited possibility of a slight increase in dryness vs. the benefit of helping get more stable feeling so that you can cope with the short-term stress.

I did schedule an appointment with Dr Foulks in Louisville, KY - he's the only dr I found on your site close to where I live in TN.

Glad to hear it. Dr. Foulks is a very nice man and very competent.

I feel like I'm headed to a really dark place with no return

Anything so totally unexpected affecting your eyes can cause intense stress. Cut yourself some slack, try and pamper yourself as much as you can, and try to just be patient for awhile. You're going to be OK. Keep us posted on how things go and just know that there are lots of people here who understand what you're going through.

[chickenlittle]

Thanks for encouragement

Thanks so much Rebecca, I really appreciate your feedback. I am definitely going to get in touch with my GP for some anxiety meds. I asked for a glasses prescription today, but surgeon said to wait. It is so incredibly frustrating to not be able to see with clarityI

[chickenlittle]

flap displacement

It was displaced when I woke up after sleeping for 4 hours - after the lasik was done. Surgeon asked "what did you do?" I have no idea. I had patches on and sunglasses in the bed. I may have rolled around on my face and somehow squished it out of place. I love how he makes it my fault. So by the time I woke up, the office was closed and I called the OT on call. He looked at me and said flap was displaced and put a bandage contact on it. Surgeon smoothed out the next morning.

[Lucy]

Chickenlittle - anyone with a moniker like that cannot not succeed at this healing business!

Rebecca gave you very good advice. Things will get better. It takes time. When it's fresh, it seems like a day is a week and a week is a month. I agree it would be good to talk with your GP about meds to take the edge off while you work your way through this. And, YOU WILL work your way through.

If you're not stressing as much, you can concentrate more on what you need to do. Work, care for your family, get enough rest etc. The lasik docs always make things seem like your fault, so you're not special in that way. :-)

Try resting your eyes when taking a break at work. I used to take small gel-ice packs and keep in the frig at work. I'd grab one on my break and lunch and head somewhere with a little privacy and close my eyes with the chilled gel-pack on my eyes. It helped me a lot and made it possible for me to make it through the day. On the weekends, take as much time to keep your eyes closed as you can. You're thinking, yeah with two little kids, I can't do that. It might be hard! Try a game of listening to music (kids choice) with your eyes shut. You can vent here and we usually know what you're talking about.
Lucy

[dianat]

CL,

I think our LASIK surgeons were schooled at the same place. You should NOT be happy with your results. That's ridiculous. Mine told me during a mild panic attack in his office that I, "Need to be looking at other parts of my life." I wish my husband had assaulted him just then. Can't say how he managed to abstain.

I'm glad to know you are getting meds to help you through this. This post-LASIK trauma is very, very hard on the psych...we've all been there. I too had young children to tend to. It was a horrible struggle laden with anxiety, guilt and helplessness.

Please know that you are so early in your journey that things will change a lot for you. It will get better in time and you will live your life again as you did.

Lucy is correct you need to rest and take care of yourself. Seek distractions that are easy on the eyes. Audio books, music, see a movie with your goggles on...

Best of luck to you and keep us posted. Don't let your surgeon walk all over you. I had to leave his office behind when I realized I was getting nowhere.

I'm a patient of Dr. Foulks. I hope he is of some help to you.

Diana

[chickenlittle]

Saturday

Thanks Lucy and Diana - It really helps knowing I'm not alone in this.

Last night, my 5 year old little guy said the tranquil eyes scared him. I just said I was a big blue butterfly with big blue eyes, and that made him laugh and he was okay.

I just am having such a hard time adjusting to a new normal.

The surgeon is a complete waste of time for me. Yesterday, I asked if he tested patients for dry eyes prior to lasik and he said it was'nt necessary!!! Plus, when I asked if he had other patients like me, he said no. I was atypical.

It's so bizarre because I get in a state of shock when I'm there,and I can't respond to his complete disregard of my feelings or condition. It's only later when I've processed it, that I lose it.

[Rebecca Petris]

Here's a pic of my 5-year-old in a pair of Tranquileyes... she adores them.

The surgeon is a complete waste of time for me. Yesterday, I asked if he tested patients for dry eyes prior to lasik and he said it was'nt necessary!!! Plus, when I asked if he had other patients like me, he said no. I was atypical.

"You are atypical" = fair enough. It's true.

"Dry eye testing before lasik unnecessary" = REALLY BAD SIGN, this is CONTRADICTORY TO INDUSTRY STANDARDS, MEDICAL LITERATURE AND COMMON SENSE. If those were his words, well, a surgeon who could look you in the eye and say is not merely a waste of time for you, he's a live hazard for other patients. With such a doctor, I would return only for perfunctory pre-scheduled follow-up appointments so that they can't put you down as a no-show - but other than those, I would never return, and when I was beyond the stressful part of this whole business I would write a potent letter of complaint to the practice manager urging them to bring their pre-operative testing up to industry standards.

That kind of thing really pisses me off.

[chickenlittle]

Too cute

Rebecca, thanks for pic - she's too cute. If they came in pink, my daughter would probably wear them too!

Frankly, I felt like he was a pompus (sp?) ass. It was Friday, and the last thing he wanted to deal with was a problem patient. I WILL get the word out regarding their lack of pre-testing dry eye conditions prior to surgery.

[dianat]

CL-

...a quick note to your local newspaper wouldn't be a bad idea, either.

I think the only other good reason for seeing this surgeon of yours is so that he can realize that you are a statistic. My surgeon told me time would solve my issues. I stopped going in to see him when it became too upsetting and a complete waste of time. Unless he's lurking here (and wouldn't that be something?!) he probably thinks I'm fine. That bothers me.

I really should send him a letter to update him. The problem with that is that I'm reasonably healthy in terms of my mental state right now that I hate to shake things up for myself.

D

[Lucy]

Chicken (I love that) you might tell him your opinion. You should also consider if you're going to use this doc to help you manage things for a bit. Usually a year of care is included in the price. For me, it was a win situation for me because my doc treated me for 3 years on my lasik charges. I say win, because I saw him every week or two the whole time and he didn't charge me. However, my vision is for S**t, my eyes are still dry and sore years later. He lost $$ on me because I more than cost him the $4400 in chair time after the surgery. Some people can't understand how I continue to use him. Well, sometimes I don't either, but I need a doc who will see me in an emergency and knows my history.

I have yelled at my doc, cried tears all over his floor, and blamed him for this mess all in his office. I have talked to other patients in the waiting room and told them not to have this surgery.

What Diana says about the letter: I've done numerous interviews over 8 years plus written lots of letters. At least two were printed in my local paper. The edited the crap out of them though. If it will make you feel better, go ahead and warn others. My doc might lurk here. Hi butch.
Lucy

PS. He didn't check me for dry eyes either.

I just read what Rebecca read for returning to this doc. I agree and that's what I was trying to say. Get your scheduled visits in. Good advice Rebecca. I was also entitled to an enhancement within a year. No thanks.

[Natalie06]

Chicken Little

Please consider reporting your surgeon to your state medical board and or the American Academy of Ophthalmology (If he is a member which the vast majority are) at some point.

As Rebecca said:
"Dry eye testing before lasik unnecessary" = REALLY BAD SIGN, this is CONTRADICTORY TO INDUSTRY STANDARDS, MEDICAL LITERATURE AND COMMON SENSE. If those were his words, well, a surgeon who could look you in the eye and say is not merely a waste of time for you, he's a live hazard for other patients. With such a doctor, I would return only for perfunctory pre-scheduled follow-up appointments so that they can't put you down as a no-show - but other than those, I would never return, and when I was beyond the stressful part of this whole business I would write a potent letter of complaint to the practice manager urging them to bring their pre-operative testing up to industry standards."

If they did this to you they are going to do this to others. I can speak from experience that my surgeon and his practice have had to change their screening and informed consent practices based on the complaints that I submitted. You can try appealing to him personally and directly but given his reponse to your plight so far, I wouldn't hold your breath.

I also understand what a difficult situation this puts you in as you are still in his care. I walked away from my surgeon for the last time 3 months after my Lasik when he decided to tell me then that I had ocular rosacea. I would highly encourage you to document everything they said/say to you and if you leave his care, put it in writing why you are doing so.

As far as being "atypical"? That's not necessarily true and they all seem to say that. Without knowing your medical or ocular history, it's hard to determine if you were at elevated risk. But of the 3 women I know who had surgery at the same practice as I did, 2 of us who had "risk" factors for severe/chronic dry eye have chronic/severe dry eyes. That sure does not add up to any statistics I keep hearing.

I don't want to scare you because it can get better in the next few months as you heal. And I think seeing a physician who specializes in dry eye is an excellent plan.

Please feel free to PM me if you need to vent or whatever. I feel your pain.

Natalie
Lasik induced severe dry eye 7/14/06

PS: I would get your records from your Lasik surgeon to bring with you to your appointment with Dr. Foulks.

[chickenlittle]

follow up

Thanks Diana, Lucy and Natalie.
I am going to report him. I am also going to get my records next week.

I'm hoping someone can help me with a few questions.. The lower permanent plugs I received on Friday are so irritating. Can these be easily removed if necessary and if I get incredibly lucky down the road - can I get by without them? Do you ever get used to them - a question of time, or any alternative - those lacracerts any better? I have no idea what he gave me, except to say they were permanent. I'll have Dr Folks look at them. They are hard to get used to.

Also restasis seems to keep my eyes slightly burning througout the day - I'm still trying

My routine is - 2 Tbs complete omega
4 BioTears daily, Greens superfood, 1 glass a day

restasis am
dakrina drops, they are real thick on me, so I follow with Similasian homepathic drops 5 minutes later??
Bion tears as needed
Nutra-Tear as needed

Dr gave me Systane and Optive, but not sure if I should use with other

restasis before bed
tranquileyes

Anyone have any luck with accupuncture? I guess if anything, good for anxiety and stress.

[Lucy]

Chickenlittle-Seems to me you are using too many different kind of drops. Why not NutraTear after Dakrina? Or perhaps just straight to NutraTear after the Restasis? NutraTear is nice for cutting the thicker drops.

If you like NutraTear and Dakrina, why the Bion and TheraTears? Or, if these two do a good job, why not these instead of Dakrina and NutraTear?

I'm trying to simplify your drops regimen. Then your doc gave you Octiva and systane?? To start with, don't add those to the mix. Save them for later when you're better controlled and just need moisture drops.

Look at your schedule and try to think how you could cut down on the number of drops your using. I don't know how you would know if anything is helping with all these. You don't have to answer me, of course! But looking at this, I'm sure most would say it's a lot of different things. If you go to less, then you'll have a better idea, perhaps, what's helping. Keep up the spirits chicken L. We're rooting for you.
Lucy

P.S. That would be a no for Lacriserts. I've tried them twice and they were just like a blob of jello in my eyes. Since you are just new from surgery, it would be a bad idea for you to put something like this in your eyes. You'd probably have a nice burn from them.

[chickenlittle]

overload

I wasn't sure what was working so I was throwing everything at it. Dakrina seems too thick for me - it sticks to my lashes and then they itch. I just didn't know if Optive or Systane were the best to go with.