Monday, July 18, 2011

Lasik!

Disclaimer: the following post is by no means a medical recommendation regarding lasik. Every person's eyesight is unique and a consultation and research of your own is strongly recommended if you are considering the procedure. I am saying this so that you can't sue me. Clear? Good. 

This Friday, July 22, 2011, I am going under the knife. Actually, microkeratomes are definitely a thing of the past so no I am not really going under the knife. But I am going under a laser. And on Saturday, July 23, 2011 I will wake up and be able to see for the first time ever without glasses or contacts (obviously not counting my middle school years when I slept in my contacts and started to get some minor neovascularization....). I cannot express how excited and anticipatory (is that a word?) I am about this day!

I have terrible eyesight - there are always people out there better or worse, but for the most part I find myself in the slightly upper average for how bad my eyesight is comparatively. My contact prescription is a -6.75 OS and -7.00 OD and when I was measured during my lasik consultations they found that I was actually more like -7.00 OS and -7.50 OD. I know a lot of people that have gotten lasik and have loved it and said it was the best decision they ever made so why wasn't I jumping on board and getting it? Knowledge.

I had been told by one eye doctor that I shouldn't even consider lasik and that I should investigate implantable contact lenses (ICL's). I was told by my current eye doctor that I might not be able to get to 20/20 with lasik, but that even an improvement to a -1.00 myopia would be life-changing. However, I reason that if I would still have to wear glasses or contacts at a -1.00, then what was the point? Armed with conflicting information I set out to do as any good engineer would do under the circumstances - research for myself and determine what route - ICL, lasik, or nothing - I was most comfortable going forward with.

As a result I went on five, you read that correctly, five lasik consultations. The first place said that I was not a candidate for lasik and they would recommend ICL. The second place said I was a candidate for lasik. The third said I was not and recommended ICL. The fourth place said that I was a candidate for either and would recommend ICL just marginally over lasik. The fifth place said I was a candidate for lasik. Confusing? I thought so too - enter my massive research findings.

Here are the facts I found that helped me to weave through the fog of information:
(1) There are a variety of different FDA-approved lasers being used today, but the two most common appear to the Star Visx S4 and the Allegretto Wave EyeQ. I was able to find a chart that discussed the specifications fo these different lasers and the myopia's that they are rated to correcting. The Star Visx S4 is only rated to a myopia of -7.00 and was the laser of choice at all of the places that recommended ICL over lasik. One of the doctors told me that the Star Visx S4 can correct higher myopias - this was the place that only marginally recommended ICL over lasik. The Allegretto Wave EyeQ laser does not correct for cyclotorsion, but that should only be a concern if you have a high asitgmatism which fortunately I did not. Both laser correct for high order aberations, another important thing to inquire about. However, the Allegretto Wave EyeQ appeared to be advantageous for me over the Star Visx S4.

(2) The calculation used to determine eligibility is a measurement of your cornea thickness minus the thickness of the flap created by the laser (approx. 110 um) minus the amount of ablation necessary to correct your vision. There is no FDA-recommended cutoff and its at the discretion of your surgeon to determine if they believe your cornea is thick enough for the procedure. The two main cutoffs are 250 and 300, the latter being more conservative. There are articles amongst surgeons debating these "cutoff" values in detail, but there is no consensus. Guess what I am? Around 275 in both eyes. Awesome.

(3) The ICL technology has only been around for 10 years. Even though the material is biodegradable and should have no long-term impacts on your body or eyes, no person has had them for 10+ years. I am 25 years old and that contact would be in my eye for at least 40+ years. I pushed one of the doctors in this area and he agreed with me that there is no long-term study on the contacts. He said that if I were in my 40's he would definitely recommend ICL over lasik, but because I was 25 he would be comfortable doing lasik on me if that was the route I chose.

(4) Thickness of the flap - the flap is usually 110 um. Some doctors used 130 um in their calculation to be more conservative in addition to a 300 cutoff. I pointed out this "double dipping" on being conversative with one of the surgeons and asked if he would actually measure the true thickness created on the flap once it was cut before going in for the ablation (in order to know exactly how much he could remove). After giving me a very impressed look he answered honestly saying no he does not. In cases of touch ups where it's more crucial he would, but that otherwise he doesn't and that's one of the reasons he would still be willing to do lasik on me. True, but with a high myopia like mine I would feel more secure if the thickness was actually measured. The final place I am going to do indeed measure the thickness after the flap is cut so the surgeon is positive of the ablation he can remove.

(5) Once I determined that I wanted to use the Allegretto Wave EyeQ, then I stumbled upon another quandary - I was reading on different websites about iLasik and zLasik. Both were advertised as all-laser lasik, but of the two places with the Allegretto Wave EyeQ one advertised iLasik and the other advertised both iLasik and zLasik. At this point I had not been on the fifth and final consultation. I had already been considering a particular location because it was listed on the approved ICL doctors in Houston (which is actually quite small), but I had seen the name elsewhere a couple days earlier - Groupon. That's right people - there was a coupon for lasik and it was going to expire in just three hours and I was actually considering buying it!

I went ahead and started researching iLasik versus zLasik and discovered that it was the technology that was referring to how the flap is actually created. (The previous lasers are excimer lasers used for the ablation portion.) The iLasik or intralase was the American technology which had been around slightly longer than the zLasik, the Swiss alternative. There were no studies on the two types and any information I could find was opinion. The Groupon location though appeared to have both and it provided an opportunity to inquire about the difference.

The deal was only $100 and in the end I decided that the value of information to inquire about the iLasik and zLasik was worth the purchase. I am ashamed to say that I did not make a decision tree, but I knew that's the outcome it would have led to in the end. I went ahead and purchased the deal and was careful not to say in my exam, my paperwork, or where I heard of them that it was through Groupon. I wanted to see for myself what they said about eligibility prior to knowing I had the Groupon. I inquired about lasik versus ICL and got all of my detailed questions answered before being told that they would recommend lasik over ICL, but I could choose to do either.

At the visit I got to meet with the surgeon who would be performing my surgery (I would highly recommend you meet your actual surgeon ahead of time). I asked him my detailed questions about the two lasers as well as the iLasik and zLasik. I was incredibly impressed with his knowledge and found out that he actually has both excimer lasers and had decided to use only the Allegretto from now on because his studies showed that fewer people needed enhancements with the Allegretto laser. I inquired about the iLasik and zLasik and he said that both methods were used and that unless I has loose tissue he would recommend iLasik. He said that at three months the iLasik method has slightly better results, but that the six month mark shows the two methods to be identical.

I was asked twice if I was an engineer and once if I was a medical student because of the questions I asked of the doctors and surgeons. Impressive. In the end, I feel good about my decision to have lasik done and I am confident in the research I did and the final place that I chose to use, despite the amount of teasing I know I will incur when people find out I used a Groupon for lasik...

There was a lot of information in that post! If you are considering lasik and would like for me to talk to you more specifically about lasik I am willing to share all the places I visited as well as pricing, opinion, etc. I would encourage anyone to do some of their own research though and be informed before going on your consultations so that you know what the doctors are talking about. If you are blessed to have eyesight that's not as bad as mine you probably don't need to be as detailed as I was in my evaluations...

I cannot wait for it to be Friday!! :-)

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Thursday, July 14, 2011

My new (somewhat acceptable) obsession...

I have a confession... I have recently become obsessed... with TOMS! I am now the proud owner of two pairs of TOMS. And the angle I used to convince my husband? It's really like giving to charity because of their One for One program that donates a pair of shoes to someone in need with every purchase. For more information visit their website.

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Friday, July 8, 2011

First Blog Post!

People start blogs for lots of different reasons - weight loss, physical training challenges, businesses, arts and crafts, etc. I have no reason in particular for starting this blog, no "theme" as it would be.

Yet still I have toyed with the idea of starting a blog for some time now. I enjoy reading other's blogs and envy how they have captured so many wonderful memories and experiences. Already being married for three years I feel like Jason and I have experienced so much that I don't want to forget (and for this reason I have added posts for some of our earlier travelling adventures and other memorable events).

I started this blog for Jason and me. As a way to remember and share with friends and family the places we've travelled and the things that we've been involved in during our crazy busy lives. A way to share all the joys, sorrows, and lessons we are learning and will continue to learn as Jason and I grow in our spiritual walk with the Lord, as we learn to become one in our marriage, and as we experience all that God has planned for us in the years to come.

I can't promise it will be interesting (we are pretty average, boring people!), I can't promise it will always be happy, but I can promise that it will be honest and hopefully mildly entertaining! Enjoy!

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Saturday, July 2, 2011

Europe Part 3

The start of our trip is here in Europe Part 1 and continued in Europe Part 2 here.

Munich, Germany
Munich was by far the most emotional time of the trip. We chose to take a day trip to visit Dachau, one of the worst concentration camps of WWII. There is no way of describing the absolute evil that was once in that place. The museum itself is a great tribute to those who experienced its horror – we spent hours walking on the grounds, reading the victim’s stories, and thanking the Lord for how blessed and fortunate we are living in America.



Around Munich we walked the Karlsplatz Stachus – a strip of shops, restaurants, and cathedrals. We also visited the Propylaen, Munich Obelisk, Konigsplatz, Konigsplatz, Alte Pinalothek (art museum), and Muncher Stradtmuseum (an amazing museum free on Sundays).

Aside from Dachau, we spent a good chunk of time at the Deutches Museum. We arrived right as the museum opened and stayed late into the afternoon.  This is the world's largest museum of science and technology so of course we had to visit it! The museum has 50 different exhibitions covering 6 floors and 47,000 sq. meters. They had fabulous mining and petroleum exhibits and a beautiful view of the city from one of the rooftop balconies.










Strasbourg, France
We only stayed in Strasbourg for a short time and had the impeccable timing of being there on a Tuesday, when all of the museums are closed except one. We attended the Musee Historique, a museum about the history of Strasbourg. We visited the city’s Christmas markets and toured the Cathedral Munster and saw its  Astronomical Clock.




Paris, France
With the limited amount of time we had in Paris, it was hard to decide what to visit. In the end we opted to do a walking tour of Paris. We didn’t go inside the following places, but we walked them as we hiked across the majority of the city:  Notre Dame (we did tour the inside of this historic cathedral), Pantheon, Palais du Luxembourg, Les Invalides, Petit Palais¸ Grand Palais, Obelisk du Luxor at Place de la Concorde, Arc du Triomphe, Trocadero to name a few.









We did save time for visiting The Louvre museum. A must-do in Paris! There are over 35,000 exhibits in the museum; it would take weeks to fully visit and appreciate the museum, but going and hitting the highlights is definitely worth it. We were able to find an entrance underground through the mall area – a significantly shorter line than the one wrapping around the grounds outside. We opted to take a formal tour that would guide us to the main exhibits – the Mona Lisa, Venus de Milo, Winged Victory of Samothrace and then walk around leisurely the rest of the time. Definitely stay together in the museum. It’s not fun trying to find one another if you get separated…








We definitely wanted to see the view from the Eiffel Tower! Again the lines were ridiculous (probably because we were so close to New Year’s Eve). However, again we found a short line… the stairs. The longest lines around the tower were for the elevator and since we’d been carbo-loading the entire trip we figured a few stairs wouldn’t hurt us.  1,652 stairs later we arrived at the top of the second level. It was too foggy to go up to the next level, but we enjoyed the view from where we were at!





We spent New Year’s Eve watching fireworks at the Eiffel Tower. We watched them from the Pantheon, a short walk from our hotel. It was SO cold!! We brought dinner with us and – get this – Dr. Pepper! It’s not a common drink in Europe and a small and sketchy convenience store by our hotel had a can (no comments on its expiration…) that Jason had to have due to his withdrawal. This year was the 25th anniversary of the Eiffel Tower so in addition to fireworks at midnight there were light shows every hour. We had a wonderful midnight kiss in Paris!





Zurich, Switzerland
Our last stop in Europe was Zurich. We had two or three days in the city before our flight home and it was a great chance to catch our breath and relax (yes, we somewhat know the definition of the word…). The city is mostly a business city so there isn’t a ton to do or see. We did take a day trip out to see Kyburg Castle in Winterthur, Switzerland. We also walked around Bahnhofstasse and visited a botanical garden at the Universitat Zurich.











We tried roasted chestnuts, caught up on sleep, and I did my final 12-mile taper run. And my water bottles froze while I was running. It was just a little cold…

All in all the trip was absolutely amazing! We got to see so many different sites, places, and experience some amazing food and culture. We can’t wait to go back and visit Europe again someday!

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Europe Part 2

Don’t forget to read Europe Part 1 located here so you aren’t lost for this one!

Venice Cont.
When we arrived at the train station everything was closed and we could see from the TV monitors that our train was delayed. We found the waiting room and Jason took a seat in the last chair on the edge of a row and I sat on my bag on the floor beneath him.  Every time we checked the monitors our train was delayed another 20 min, 40 min, 100 min…

The waiting room was full of tourists like Jason and I, but also homeless people that were using it as a shelter for warmth. Two of them sleeping on the floor turned and I could see that one of them had a knife. Not comforting. Later they began fighting and to our joy the police came. And then promptly left again. Boo. Later a homeless man, either drunk or high and seated in a wheelchair, started arguing with a couple of tourists. He tried to stand up out of his wheelchair and fell on me. You read that right – the man landed on me. Jason frantically jumped up and screamed for someone to help him as he tried to lift the man back into the wheelchair. I was definitely regretting emailing our families before we left Venice and telling them we were alive.

Finally at 6 am, 7 hours past our train departure time, the station began to open. We went to the lounge and a man, Gui, who had been in the waiting room with us all night started talking to us. He was from Paris, but his wife was Austrian and he was trying to get to Vienna as well. Gui and Jason went to information and were told that they had no idea about the train – where it was located, when it might arrive, if it would arrive… nothing. Gui said if we could catch a train to Villach that his wife would come pick us up and could take us to another train station to catch a different train to Vienna. When did that train to Villach leave? 3 min. We ran and jumped onto the train with him. A total stranger. Best thing we could have ever done! We visited the entire train ride to Villach, went to information and found out that it was better for us to take a bus and a different train to Vienna. We waited with our new friend until his wife arrived, met her, and waited another hour for our bus. We took that bus and another train and FINALLY made it to Vienna. We were supposed to arrive in Vienna at 7 am. Instead we pulled in at 7 pm. Exhausted, tired, and in need of a hotel.

We had booked a train for the following morning to ensure our arrival in Prague for Christmas so we really didn’t have an opportunity to see any of Vienna. We walked around the Christmas markets, bought a weinerschnitzel, and booked the cheapest hotel possible a short walk from the train station for our early departure the next morning.


















Prague, Czech Republic
We arrived in Prague early in the morning and made our trek through the city and across the Charles Bridge to our hotel. After checking in we visited Prague Castle and had hot wine and Trdlo (Czech pastry rolled in cinnamon, sugar, and pecans then baked over flames - YUM!!) Prague was our other favorite city in Europe!

The following day after a 10 mile jog (did I mention that I was training for a marathon while we were in Europe?!), Jason and I walked up the hill to Petrin Tower. Afterwards we walked around Josefov (the Jewish Quarter) and visited the Jewish Cemetery, Maisel Synagogue, Pinkas Synagogue, and Klaus Synagogue.

The food in Prague was amazing (I might be partially biased since I am 50% Czech…), but Jason and I LOVED the garlic soup and potato dumplings!

We also attended a Christmas Eve concert and called our families to wish them a Merry Christmas. We had such an amazing time in Prague and I would love to go back to the Czech Republic one day!















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