Readers are probably bored with my stream of posts talking about upgrading my audio with hearables or hearing aids, but I just upgraded my video too, with a fancy new lens in my left eyeball via a quick round of cataract surgery. Unlike the audio upgrade, the video is a bit more of a schlep. According to Wikipedia:
Cataracts are "a clouding of the lens of the eye which leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry vision, halos around light, trouble with bright lights, and trouble seeing at night.
Most people get them as they age, and most people avoid doing anything about it until they absolutely have to. Some don't do anything and eventually go blind.
Two years ago my optometrist, Dr. Barbara Caffery, noted that I had cataracts and suggested I consider doing something about it. I had trouble seeing at night, and looking at my computer all day for work, I knew I wasn't seeing as well as I used to. My wife and I were fighting over the brightness and color temperature of our Hue LEDs; I keep tuning the lights brighter and bluer to the point you could do surgery in our dining room.
So, since I'm seriously into upgrades, I took my optometrist's advice and made an appointment to see her recommended surgeon, Dr. Allan Slomovic, at Toronto's University Health Network. He examined me and thought one eye was ready and the other not quite there yet.
I should give some background here. In Ontario, Canada, where I live, we have universal health insurance, which covers almost all necessary medical procedures. Cataract surgery is covered, but only the basics; fancy lenses and new robot technology cost a bit extra. You often have to wait a bit for a medical procedure like this since there's high demand; they don't leave beds empty waiting for walk-ins. Americans might get it faster, but if you don't have insurance coverage, this procedure could cost $5,000 per eye.
I first met Dr. Slomovic in May 2017, and was impressed. He saw a lot of patients, and we all gathered in the hall as he explained everything thoroughly and in language everyone could understand. When he met with me, I had just finished writing about blue light on MNN and wanted a lens that didn't block as much. He understood what I was talking about and respected my opinion. I agreed to pay C$180 for the upgraded lens.
And then, like a scene in Casablanca, I waited. And waited. (Given that it's not exactly critical surgery, this isn't a big deal or an indictment of the Canadian medical system.)
Except it is surgery. I watched my grandmother go through it when I was a child, and she had her head sandbagged for weeks. Then my mom, who was a nervous wreck about it. The longer I waited, the more I thought about it, the more nervous I got. It festered.
When June 21 rolled around, I was a bit nervous. No, I was terrified.
The Kensington Eye Institute, where the surgery was being done, insisted that I arrange for a ride home, so I asked my wife to write a note and stuck to my original plan: walk to the clinic (52 minutes) to clear my head and relax, and call her when it was done. I didn't want her sitting in the hall for hours.
This was my biggest mistake. I totally misunderstood how they work, and how they actually welcome family. They are set up for it and let a family member in the prep room for everything except the actual 20 minutes of surgery. I was just about the only person in the waiting room who was alone.
You are so right I am sitting in the hospital now waiting for cataract surgery told wife and son I would be fine and walked down here and now very sorry to be alone.— Lloyd Alter (@lloydalter) June 21, 2018
While in the waiting room, I saw a tweet from a writer in New York City who was also in the hospital; I responded. Somehow my son saw it, and the next thing I knew he was biking down. They whisked him right in to be with me. Thank you Twitter, thank you Caitlin, thank you Hugh.
A well-oiled surgery machine
As an architect who once worked on a few medical clinics, I was impressed with this well-oiled machine. That chair I'm sitting on is like a robot, rolling right into the operating room and then going flat for surgery, and then back into chair form after. I was really happy when Dr. Slomovic came by to talk for a moment before the operation; he pulled out a magic marker and confirmed "we are doing the left eye" and I said "right ... no, I mean correct!" like an old Abbot and Costello routine. But I remembered reading Atul Gawande, who in "The Checklist Manifesto" noted that you have to take basic, seemingly silly steps like this to eliminate mistakes, like airline pilots do before taking off. That L on my forehead gave me assurance that these people knew what they were doing, that they weren't taking risks. They have thought of everything, even handing out iPads so patients and family members can watch post-operative video instructions.
I suspect you won't believe me, but this was the most anticlimactic, ridiculously painless procedure I have ever been through. Flu shots hurt more than this did. The only needle is in the back of your hand to deliver a lovely sedative and the rest is history. I wanted to talk to Dr. Slomovic during the the procedure but he had to tell me shut up — I'm doing surgery, just lie still. And then it was over.
I cannot believe I was so worked up and scared about it. When it was done, they asked me to stick around for two hours so they could check it all out; in the meantime my wife came down, we went out for a delicious bowl of ramen, and then I came home.
The next day I woke up and tried out the upgrade, covering one eye, then the other, then the combined. The new eyeball is amazing; it's like someone hit the Photoshop enhance button on the world, everything is brighter and crisper. Writing this, it feels like I have a new computer. My espresso machine, which has blue lights, looks radioactive, almost glowing. It's all totally wonderful, a whole new brighter, whiter, bluer world. It feels like I'm living in a laundry detergent ad. And this is just the first day.
To be fair, a lot of people apparently don't have it as easy as this — not a second of pain and only a few of minor annoyance — but the paperwork includes lots of dire warnings. I can't swim for a month and I can't run for a few weeks. This was surgery, which means there are risks.
But I'm also younger and fitter than the majority of cataract patients. Most people in the waiting room were a lot older than I am, and apparently the vast majority of people leave it until they are in their late 70s and early 80s, probably when they might have to give up their car keys if they don't do it.
This is nuts. If your optometrist tells you to consider cataract surgery, go for it; you'll be doing it eventually anyway. I wish I had the mad Photoshop skilz to show what I see when I flip from one eye to the other. Get the eyeball 2.0, do the upgrade as soon as you find that you have a problem, get it while you can still really enjoy the bright new view instead of waiting until you have no choice. I am glad I did.