Two years ago I took a risk and had Lasik done. The results were spectacular...
So, when Tanya (my fiancé) and I thought about moving in together there was something that had to be contemplated: I had allergies/asthma and could spend only a few hours in any environment with dogs or cats during any given week. Tanya is a major dog person. Our options could be summarized as: Figure out how to stop Alan from reacting, or get rid of the dogs. The latter was not a happy thing to contemplate, so it was time to see if I could do anything.

I started doing research and discovered a body experiment I could partake in with a couple of potential outcomes:
1. Spend months of your life sitting in doctors offices over 2-5 years with nothing to show for it other than a damaged wallet.
2. Spend months of your life in a doctors office over 2-5 years with some allergy resistance.. and still damaged wallet.
3. Spend months of your life in a doctors office over 2-5 years and be cured of your targeted allergies.. and yes, still a damaged wallet.

After having Lasik done, allergy shots and the potential of changing how your body reacts to allergens seemed like a very worthwhile experiment. My asthma has always caused issues and allergies are something I’ve always fought using antihistamines and the like. The concept of getting rid of my allergies was awesome, and like getting rid of glasses/contacts, is a quality of life improvement worth some risk (if I must rate it - in my case more worthwhile than the Lasik - since glasses didn’t limit me from doing things, but my allergies and asthma did).

If you are not familiar with allergy shots (immunotherapy) the basic concept is this (layman non-doctor explanation):
You are injected on a regular basis (twice a week, then once a week, and now every other week in my case) with the substance you are allergic to (allergen), in doses that are gradually ramped up over time. The hope is that your immune system adapts to the higher level of allergens through production of specific types of antibodies, which block the allergen from having an effect rather than the natural response of someone with allergies, which is to become hypersensitive to the allergen and cause the symptoms we all know and love. The net effect is that you are raising the bar at which your allergies are triggered, eventually to a level where no natural level of the allergen will cause you to react badly. Wikipedia has much more detail than this entry if you want a better explanation.

As for drugs, you are probably going to stay on them for quite awhile. Even allergy shots are not perfect, and the doc made it clear up front that if anything my drug dosages and types would probably increase for the first few years as they tried to control my allergies/asthma while working toward immunity, which they did.

The process is supposed to take 2-5 years although many places recommend staying on “booster” shots. Based around my reading many people quit the shots and years later are still fine from what I’ve read. Mileage may vary. I haven’t made it that far yet, so I can’t testify to the result in my case.

One mistake I made in relation to this blog entry (and wasn’t contemplating at the time) was I didn’t start documenting the Allergy shots until now, which is well after my initial impressions have worn off, so these observation are a bit late and probably a bit skewed....

Things to know about the Allergy Shot experience:
1. Getting started is not cheap - I’ve maxed out my insurance out of pocket the last two years, and will probably continue for at least a few more years. First there are doctor exams, then there are allergy tests (both scratch and blood tests in my case), then there are follow-up appointments, drugs to control your allergies/asthma and the ongoing costs of the shots, which are about $35 every other week for me at this time. My out of pocket cost so far has been at least $4,000 between all components since I showed up for my first exam. Side Note: Thanks to my employer for providing great insurance and being a awesome employer for many years.

2. Allergy shots require commitment. Commitment to see doctors every 3-6 months to grade your progress/adjust medications and 2-5 years of your life of allergy shots themselves - then there is the biggest commitment - time sitting around..

3. Time sitting around - You show up at your docs office, wait for your shot (5-20 minutes typical in my case), then after the shot (takes 5-10 minutes or so to get), you must stick around the doctor’s office for half an hour to make sure you don’t suffer any major effects or go into anaphylactic shock. This means on you are burning close to a hour of time minus travel each time you go in for shots. On a positive note, my doc office has Wifi so that you can bring along your computer and use the Internet or work while waiting.

4. Additional Notes on Time - If you miss a few shots (no two month europe trips in the first few years), they back your dose down and ramp back up, in addition if you have a major reaction, that can also delay your progress. One other schedule impacting item is when moving to new vials of allergen you must ramp-up again over a period of 3 weeks, which means every 2-3 months having to revert to a once-a-week schedule (at least on my current dosage/visit timing).

So how are the shots?
Due to my allergy set (shrubs, trees, grasses, mice, dogs and cats if I remember correctly), they give me two shots each time. One in the back of each arm. The shots are using pediatric needles, so it’s a VERY small prick, most of the time no bleeding, or if so only one or two drops. During the initial ramp-up I had much arm soreness. At a certain point the soreness and swelling reduced, but now that I’m at maximum dosage every shot is followed by arm swelling and minor pain for a few days. It is nothing major, but is a bit of a distraction.

What are the results like after a year+?
A Drug Disclaimer: The antihistamines I’m on haven’t changed much - I’m on the same basic stuff I have been since a few years before the shots, which is a Claritin or Zyrtec generic. In addition I’m on some other drugs/steroids to keep my allergies under control. The asthma meds I’m on have changed dramatically. I’m now on two types of inhaled medicine to control my asthma, one being a emergency inhaler, which I’ve been on for many years and the other being a daily use control inhaler. In October 2009 I started exercising every other day, which I’m happy to say is still occurring. When I started exercising my asthma stepped up so they had to adjust my dosage of my daily inhaler, but my asthma is now is a very good place.  Feel free to contact me for additional gory details :^).

So Really - what is it like after a year now that there has been a mega disclaimer?
Huge Improvement. Probably best indicated by example (keep in mind, this is shots + medicine modification):

Before Shots - Emergency Asthma Inhaler + Daily Antihistamine: 2 Hours around dogs and I would have 3-5 days of asthma flare-ups and congestion for at least 8-10 hours, if not a full day. Petting the dogs would result in itchy skin in only a few minutes, heaven forbid I rub my eyes without washing my hands, they will be irritated all day. Visiting anyone’s house with pets and less than perfect house maintenance (LTPHM from here out) or significant airflow would cause reactions in 15-30 minutes, which depending on the situation could cause me to have issues for several days. Inhaler sometimes needed before exercise and before bed.

6ish months - Emergency/Long Term Asthma Meds + Increased Allergy Med Regiment + Shots: I could sit in a room with the dogs for 1-2 hours a few nights in a row, but then had to spend very limited time around them for a few days to let my asthma/allergies calm down. Petting the dogs still resulted in a fairly quick reaction. Most of the time I don’t need my emergency inhaler unless I’ve pushed my luck too much recently with the dogs. LTPHM environments would cause reactions in a few hours, followed by minor annoyance over the next several days such as needing a inhaler that night, and a OTC decongestant to help clean out my system. Not as bad as before. Inhaler still needed sometimes before bed, and often during exercise.

1 Year - Increased Exercise for a few months, no other adjustments: Asthma started kicking up significantly at night, during the day and during exercise. During a doc visit they doubled my daily inhaler dosage. Within a week or two my asthma issues dramatically reduced. On the allergy front I was able to sit in a room with the dogs almost every night without any major issues sharing the same airspace, although close contact, or sitting with the dogs on the same chair still caused problems.

1 Year 3 Months - No additional adjustments: I can spend significant time around the dogs without reaction as long as there is no direct contact. If I sit with them (dog on lap) for more than 5-10 minutes at a time I can still force a allergic reaction, or if I touch on them and don’t wash my hands within 5-10 minutes. I can inhabit the same airspace (same room) with them daily for several hours without any issues. Exercise doesn’t normally require a emergency inhaler, and the vast majority of the time I don’t need to utilize additional decongestants or inhaler before bed.

Summary: Over the last Year my allergies and asthma have improved dramatically. We are not only keeping our two small dogs, we are eyeballing a puppy to be a partner for our younger dog, which a year ago was not even a option. I can still force allergic reactions, but they are no where near as severe as they were, and now living with the dogs is mostly pleasure rather than mostly avoidance and coping. Even better, now I don’t have to think before I visit a new place, such as homes with large dogs or LTPHM - which ever since I was a little kid was always a major consideration. Big quality of life boost.  At this time I’m thinking the results are 50% drug adjustments and 50% shots, but I’m already feeling MUCH better about my ability to manage my allergies and asthma. We’ll see how the future develops.

In both my personal and work life over the years I’ve had a theory about communication - that theory has been that you need to deliver on the intent of the person asking for something, not the specific thing they are asking for.

Example: When your mom said “Clean the floor in your room” when you were a kid - did that really mean clean stuff off the floor, or clean the room? Would she be happy if you piled everything on the bed, or perhaps shoved it into the closet (guilty :^))? No. That is because the intent of her message is different from what she asked for. What she really wanted was for you to clean your room, and taking her literally could backfire.

This same concept applies in business and personal communications. How many times have you asked for something, or been asked for something, then when you deliver the goods the other person isn’t satisfied? It was the concept, the goal, the intent they were seeking, along with all things that go with it - a certain amount of comprehensiveness, ownership, and quality that was not directly spoken to, but was very important to the end product and their satisfaction level with the result. Sometimes it takes effort, and if you are overworked or stressed sometimes delivering anything more than the specific request seems like a pain, but will result in a better product.

So that’s my thought of the day. Understanding and communicating intent and goal, not just the specific deliverables requested when generating, or requesting something will make both parties much more satisfied in the end, even if it means doing a bit more work.

After going through the vast majority of this winter there are only a few additional thoughts I have on the lasik experience:

1. When my eyes get tired, they are tired. It’s time to shut them for a bit, otherwise I’m blinking for the rest of the evening and they feel slightly irritated.

2. I still get dry eye occasionally, which rarely (never?) happened before Lasik, but it’s a pretty minor experience. A bit of rest, or hanging out in a slightly humid environment fixes them up pretty quick. One other trick I can use in emergencies is to put a eye drop or two in each eye and close them for five minutes or so, that usually gets them back on track. The one time when the dryness of my eyes is more apparent than others is when driving with the A/C on - airflow on my face without enough humidity will suck the moisture right out of them. It’s quickly remedied by turning off the A/C for a few moments in most cases.

That’s about it. The vast majority of the time I don’t think about my vision or have any issues with it. Still have 20/20 or better and am very satisfied with the experience.

In interest of full disclosure I’ll state that my near-sight vision is a bit worse than it was a few years back, but I started to notice that a bit before the Lasik. That particular issue is a side effect of age, not eye surgery :^). I just need to stop opting for the highest resolution possible in the smallest screen size when buying computer monitors, for day to day reading and non-monitor activities my vision is still great.

Rating of Lasik so far: Absolutely worth it.

For those of you who want a second opinion, there was a article on Lasik in Consumer Reports at some point in the last several months. Here is a link to a tidbit about it: Consumer Reports

Seeing clearly has changed my life. Reversed childhood trauma from being a geek, caused me to re-live my teenage life with all those girlfriends that I never had, it is the fountain of youth, a winning lottery ticket and the capability to live for all eternity, much like a vampire with a ready supply of victims.

Alright, maybe that is a bit of a exaggeration but the Lasik surgery was still excellent money spent.

The Good News:

-Vision is 20/20. My drivers license now has no restrictions.

-I’ve completely adjusted to not having glasses. No more reaching for them in the morning or feeling naked without them. About 3 months ago I donated all of my used pairs to charity (there are drop boxes in many prescription glasses stores).

-My Televisions/Computer Monitors are still noticeably larger than they were when I was wearing high-diopter glasses. Right now I can see a 46” LCD and it looks at least 5” bigger than it did before vision correction.

-My night vision is about equal to before. I traded big fuzz-ball headlights for slightly different looking snowflake-style headlights. I can see how people would report that their night vision worsened but in my case the degradation was about a equal trade to how it was before the procedure.

The Bad News:

-Occasional Dry Eye – I use drops every 1-2 weeks depending on the weather (read: humidity) and how much I ride my motorcycle or do other high airflow/low humidity activities such as fly on airplanes or drive with air conditioning on high. This isn’t much of a issue or concern, I just carry some instant tears somewhere in one of my bags when I travel or when riding. As of this writing it has been 2+ weeks since I used instant tears.

Normally the dry eye manifests itself as slight discomfort in one or both of my eyes and some blurriness. If one of my eyes has been dry for several hours it won’t focus quite right until I give it a break or lube it.

-I can tell I’ll need reading glasses one day. Before the surgery I was starting to notice it was hard to read small fonts on high-resolution screens (dang all that getting old stuff). After the surgery it’s more noticeable. I’ll contemplate in the future whether to always buy the highest resolution screen possible on new laptops I purchase. Ctrl-+/Command-+ to enlarge fonts in browsers is a godsend.

-My eyes get tired easier than they used to.  At a certain point of night I can keep going, but my eyeballs (normally just one of them unless I’m REALLY tired) starts to tell me to shut them for a bit by getting a bit uncomfortable. I can avoid this issue if I can find 10-15 minutes to close my eyes after work. Usually it’s about 10-11PM when they are telling me to go to bed or at least take a break.

The Verdict:

Still some of the best money I’ve spent. After posting the last Lasik post I started assembling a list of the best and worst things I’ve spent money on for another blog post, other than long-term investments such as retirement and buying a home it’s the top of the list of best money spent. In addition, all my childhood emotional scarring has been healed, and that is what really counts :^).

Went in for my three month check-up on Wednesday this week, Dr. said my eyes were looking good. As a whole I’m using my eye drops less and less, although I tend to still put drops in three times a day or so, usually when I wake up (flush them out), once often sometime during the day, usually right after work, then before I go to bed. I find that by doing it this way my eyes never get all gunked up.

I still turn off overhead lights while sitting in rooms alone or close blinds (still getting Hermit jokes at work :^)) to keep glare down, but I no longer am irritated by glare, it’s just more comfortable to work without the little glare that is left.

Car defrosters (or any vents that blow air directly onto your face) are perhaps the worst now, they will dry my eyes out really fast. I tend to use vent modes that put air as far away from my head as possible unless it is needed to defrost the  main windshield or keep things from fogging up and in that case I’ll do what I can to prevent the air from hitting me in the face.

Eyesight is 20/20ish in one eye and 20/25ish in the other most of the time (seems to shift a bit depending on how moist they are), plenty acceptable. No need for additional correction at this time.

Still happy with the decision to have it done? Yup, still some of the best money I’ve spent. Next year’s event – immunotherapy for all the stuff I’m allergic to (17 of 39 things they tested me for I respond at a moderate or higher level) to try to numb up my allergies and make Alan dog friendly.