Technology.Life.Insight.

My Lasik experience - consultation

If you've found this blog that means that you're considering lasik, know someone considering it, or just had it and are doing research. These entries chronicle my experiences pre and post lasik surgery. There is a great deal of both misinformation and fear-mongering on the internet. I've done a lot of research and will post my findings to save you the trouble. :-)

12/07-
FSA re-enrollment is coming and I've been considering Lasik for literally 10 years now so I need to know if I should plan for flex monies. I'm -375 + astigmatic so I figured now is the time if I'm going to do this so let's check it out. The technology is supposed to be at it's height with all laser procedures and complications vastly reduced. Wavefront custom Lasik with Intralase is the latest and the best you can get. I've heard all the stories from a LOT of people on where they went, what they've heard, who loves Lasik, who's been ruined by it, etc, etc. 3 of the 7 guys I work with all went to Dr. Boothe in Plano, TX at varying times over a 7 year span, all with rave reviews of their experiences. So I make an appt for a free consult.

My first impression of the Boothe eyecare clinic is that they are BUSY! There are 5 people in the waiting room, the reception desk have at least that many behind the glass buzzing around, and people are shuffling between 2 doors on opposite ends of the waiting room. On the wall between these doors is an LCD TV playing Boothe's various TV spots, interviews, and customer testimonials. From the commercials where Boothe is actually speaking he seems sub-human. A droning monotone and complete lack of vocal inflection pretty much sums his delivery. I was warned about this.

After a few minutes I am called back to meet with a scrub-ladened "eye tech" who performs a few basic tests to determine initial candidacy. This is the "free" part. They look at my eyes through a scope, check my prescription, and perform a tear test by hanging a straw-like strip from the bottom of each of my eyelids. This is to test the tearing response from the eye. A person that normally suffers from "dry eye" might be disqualified at this step. I was told I was a good candidate and moved into a room across the hall to meet with "Bob" who is a sales consultant. I'm sure these guys make commission so haggling is expected and happens here. He had a general knowledge of the procedure, the options, the possible side affects, and showed me some documentation showing that Dr. Boothe was recognized by the manufacturer (VisX) as the highest volume doctor on the planet. This just backs up his claims of the highest number of procedures performed over the competition. Fine.

I tried to play Dr Tylock against Boothe having just called them prior to my visit. The Tylock clinic uses the same equipment as the Boothe clinic but Tylock bases his prices on prescription alone. So the worse your eyes are the more you pay, period. I was told their range was from 3100-4k+, depending. After quoting me $5000, Bob tells me that Tylock still uses the blade and that's why he costs less. Boothe later disputes this but not knowing for sure at the time I accept his response. They offer financing options and are very fond of cash payments so my intent to use FSA dropped my price to $3200. $1600/ eye is considered high by some but I only want to best procedure possible and your eyes are not the thing to be cutting corners on. Further research reveals that this price is fairly average for a well-known facility with state-of-the-art equipment. Choosing to move forward to the next step of the consultation will cost me $150, non-refundable and applied to my principal balance as down payment.

Back to the main waiting room. I am eventually called back into an adjoining room with a handful of optical equipment set up into stations. I move through 3 of the stations where various eye measurements and tests are performed then back to the waiting room again. After several minutes I am called through another door and escorted to another, much smaller, waiting room where 8 people facing each other are seated almost knee to knee. The one free chair remaining is mine. These people are in various states of their consultations and most have been through one round of dilation already. We are all strangers but we speak openly and freely. We joke about the assembly line we are on and why we are there. I am by far the youngest at 30 and each of them knows someone else who has already undergone the procedure by Boothe.

After a few minutes a tech comes in to administer my drops. It BURNS, it BURNS!! For real, dilation sucks! Once the burning has finally subsided and the people in front of me begin to look a bit hazy, here comes the drops girl for round 2. After more burning and a few more minutes I am called to go through another round of tests which include eye pressure, cornea density, and a meeting with the on-staff optometrist (not Boothe) to verify my correction. Some people boast that other surgeons do this part but honestly we've all been through this more than a couple of times and it's pretty straight-forward. "Which looks clearer, 1 or 2, 1 or 2..." No surprises here. The pressure test tech administers numbing drops before sticking his device in my eye. Having worn contacts when I was younger for years has eroded my reflexive response when things are [intentionally] entering my eye. Not having worn contacts for almost a decade now I can still put my finger straight into my eye without flinching. Good or bad it made some of these tests a little easier (on them for sure). Back to my chair in the 9 seat closet. People around me are randomly called up to do various tests.

Fully dilated I am called to return to the original waiting room. Oookaaaay... A lot of back and forth going on but they seem to be organized about it at least. Eventually I am called through door #1, back to the adjoining room to sit at a new station run by the initial eye-tech that first greeted me. This machine did the 3-D mapping of my eyes and took many attempts to get right. I had to stare at, above, below this dot and had to close my eyes between tries. For some reason the tech wasn't satisfied with what he was seeing so we did it a dozen times probably. Better safe than sorry. "Close...Now open, open, open...open wide...open wide...close..." x 12. We eventually got it. I go to one more machine in this room and then am escorted back to the closet.

More people are randomly called up and disappear then I am called into a room at the far end with an eye exam chair. They make me sign the release form and print the disclaimer statement saying that I understand the risks etc etc etc. There was a video that they're supposed to show but I didn't see it. I had done a ton of research at this point and was pretty well familiar with the risks and complications. A nurse-like person comes in with my folder followed by Boothe a little later. While a nice guy Boothe has zero personality. What you see in his TV ads is how he is! No tonal changes, no gesturing, just very calm, slow, monotony speech. He looks me in the eye and patiently answers all my questions. I never felt rushed or that he had better things to do. I ask him how many people have been blinded by him to which he replies none. Ok, he's done ~100,000 procedures and hasn't blinded anyone so that's reassuring. I ask about the technology and his competition. He says that everyone in DFW has gone blade-less except for possibly carter who still uses it. D'OH! Wonder if I could have gotten the price lower? Oh well, 3200 still doesn't seem too bad.

He calmly answers my questions and looks at my eyes via the light scope. You know, "look at my left ear, now look at my right..." Looks at all the paperwork and confidently gives me his 20/20 or better guarantee. He says I'm a good candidate with a thick cornea and nothing that stands out as a red flag or unusual. I then ask if "I can meet the machine"? "You didn't get a tour of OR?" he drones. He then asks who my consultant was and tells the nurse-like person to go get him. Uh oh I think. A few moments later Bob is escorted in looking very docile and puppy-like. "Yes sir?" he says nervously. "Did you show him the operating room?" "Uh, no sir, I didn't know we were supposed to..." Bob sheepishly replies. "If you ever don't show another patient the operating room than that will be your last day working here. Do you understand me?" My eyes fly wide open at this point in disbelief at what I'm witnessing. "Uh ye...yes sir Doctor Boothe." I think he almost bowed then walked out of the room backwards. Not really but how humiliating!! Poor schmuck. I'm in total shock at this point and almost feel like addressing the doc as "sir" myself.

[I have heard from some people that staff treatment was a factor in deciding NOT to go to Boothe. The theory is that the staff would be disgruntled and deliver poor service but after thinking about it, I believe the opposite. Boothe is a hard ass, I witnessed it first hand but I believe this to be a good thing. He doesn't accept less than his standard of stellar performance from his employees which keeps everyone on their toes. Two mistakes and you're out! I'd think people would be too afraid of getting fired to be slacking or not delivering on their duties thus risking job loss and/ or public humiliation. I don't agree with his managerial style and could never work in an environment like that for sure, but it makes me feel better that he doesn't accept sub-par work from his staff. That is my perception at least.]

He calmly and politely answers my remaining questions and shows himself out. I am escorted back to the main lobby to wait for Bob to give me the tour. I apologize for throwing him under the bus and he blows it off saying that they're threatened often. We walk into the room on the other side of his little room at the end of the hall. Boothe has 2 intralase machines and 2 Lasik machines outfitted with different excimer lasers depending on patient requirements. I'm then shown back to the closet. I've been in the office for about 2.5 hours at this point and am wondering what's left to complete my visit. They said it could take up to 3 hours so I must be close. 4 of my newly light-sensitized comrades are called out to follow yet another new face, to where no one knows. They disappear and the rest of us wait. 5 minutes later the rest of us are collected. We walk back out though the main lobby as a led group into the OR. We walk passed Bob's room through the door at the end of the hall and are seated in chairs at either end of the room along the wall. 2 techs are setup with our paperwork at one of the intralase machines and call us one by one. It is very cold in the OR and I went next to last. With the paper work the techs press a sort of probe instrument to each of my eyes. This one felt very similar to the pressure test performed earlier. I assume they were confirming and entering my eye coordinates into the machine. This is the one that will cut the flap.

Once finished here they take us two at a time to a sprawling U shaped desk across from the closet where each of us speak with a customer service person. They take my money, schedule the appointment for surgery, give me a prescription with sample drops, explain what to do prior to surgery and hand over a pair of those cool wrap-around plastic grandma visors because of the dilation. Once the receipt is signed I'm on my way feeling pretty good about what I just signed up for. I set the surgery date for over a month away.

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