peregrinerose

Hate to be the bearer of bad news, but that's just a product of too many birthdays

My brain is always churning about something. The only thing that gets my brain focused on one thing is packing. Jumping too most of the time. But definitely packing. Do or do not, there is no try -Yoda

Oh shit. I never thought to leave the caps lock key on. Mental note for next time, thanks!

It's the only show my husband and I actually watch on a regular basis, very very good!! Do or do not, there is no try -Yoda

Damn, it's kind of funny reading people analyzing my attitude or bedside manner on here Bear in mind that typed words and spoken words come across completely differently. 'Tone' is tough to interpret via this kind of forum. I'm sorry if it came across that way, but don't be so quick to judge me either. Do or do not, there is no try -Yoda

In the exam room setting, I have one person in the chair who asks specific questions regarding LASIK (or whatever), so it's pretty easy to get a feel for what they know, don't know, concerns, interest in the procedure, medical/ocular history, etc. Here, a large number of people are reading, with varying degrees of having actually read up on risk/benefit, so I have to be broader, more generic. If I base my comments on the least amount of background knowledge of a person, then I know nothing will be missed, mis-interpreted, etc. I honestly do not believe you have the right to determine how condescending or not a person is through posts like mine that have to cover a hell of a lot of information for a wide variety of people of varying background knowledge. Should you meet me in person and feel I'm condescending, that is absolutely a fair call you can make. Until you have met me in person, on the DZ, in the exam room, or any other setting, you don't really have a basis to make that call. Jen Do or do not, there is no try -Yoda

For the first part, presybyopia is inevitable, the way to avoid it is drop dead before the age of 40. Assuming that both eyes are corrected perfectly for distance (glasses/contacts/refractive surgery), the natural lens of the eye changes shape to change the focal distance from optical infinity (6+ feet) to up close. Just like changing the focus on a camera or binoculars to adjust for the distance away the object is. The older you get, the less plastic the lens of the eye is, so it can not change shape as easily. The farther past 40, the less it changes shape, typically around 60-65, the shape doesn't change much at all. That's what bifocals or reading glasses do... optically change how light bends since the natural lens of the eye can no longer do so. So yes, assuming that both eyes are corrected for distance perfectly with LASIK, sooner or later reading glasses will be needed. This varies by age, health, body type/arm length, lighting available, pupil size, and a lot of other things, but it does happen. If the eyes are slightly undercorrected at distance, it delays needing bifocals. There is also monovision correction done with refractive surgery or contacts, where one eye focuses at distance, the other at near. I'm not a big fan of this since it does decrease depth perception. About my lack of empathy. I'm sorry if my words come across that way, my patients in real life would emphatically differ with you My goal here is not to give the warm and fuzzies, my goal is to give a more balanced source of information. Yes, a vast majority of my refractive surgery patients are absolutely delighted and see 20/20 or better in each eye without correction and have absolutely no health affects at all. All of them also experienced an increase in dry eye sensitivity to varying degrees, but again, a very small number feels that this actually affects their lives in any functional way. Yes, a fair number experience decreased contrast sensitivity/increased glare at night, but most don't consider it a big deal. All of them knew exactly what could happen. They also know that I only work with extremely talented surgeons with a proven track record of exemplary results to keep these risks as low as possible. Some of you quoted prices... these vary greatly by prescription and cornea. I would hope that you wouldn't shop around for the cheapest triple bypass surgeon in town, you would go to the best. Do the same with your eyes. If interested in LASIK, etc., talk to your eye doc about this and all the options (see big huge post, there's a lot more out there than just LASIK). Find out what surgeon they work with and what the outcomes have been from that surgeon. Call around to a couple other eye doc offices that you are not a patient with and ask who they recommend as the best LASIK surgeon in the area, that way you have several opinions to base on. Be aware of the risks and decide accordingly. As jumpers, we all know the risks of jumping and feel the benefits are far greater than the risks, but we do our best to minimize those risks as much as possible. Giving the potential side effects of LASIK enables you to more accurately assess the risk/benefit ratio and decide accordingly. Jen Do or do not, there is no try -Yoda

CRT is also called Orthokeratology (terminology varies by geographical location). Like surgery, it isn't for everyone. There are limits to how much myopia can be treated... those who were -13.00 for example, wouldn't even be close to being candidates for CRT. Those that can not have LASIK due to dry eye, large pupils, etc, are often very good candidates for CRT. Of course there are risks to everything, eh? Risk of CRT can be corneal changes from not enough oxygen, discomfort with the contacts in (though not as big an issue since you're asleep with them), and having some residual refractive error. Nothing is perfect. Jen Do or do not, there is no try -Yoda

Honestly, my specialty is low vision rehab, so my practice doesn't revolve around either glasses or contacts. I make more money doing pre/post op work for LASIK than on any glasses/contacts. I also get paid a fortune to fix problems induced by refractice surgery, usually with custom RGP contact lenses. My job is to enable my patients to make informed decisions. The most important part of my job is patient education and unless there is a vision threatening issue that must be treated, the choice is up to the patient, not me. I give the pros/cons of every procedure in the exam room. Here, there is only anecdotal advantages to LASIK, the pros. I am only trying to give a more balanced perspective than only hearing one side of the story. I don't need to go through the advantages, as they have already been well covered both by all of you Jen Do or do not, there is no try -Yoda

Telling someone "I had LASIK and it was the best thing I ever did for myself!" is giving your personal experience. Telling someone "I think that YOU should have LASIK" is giving medical advice without knowing the ocular health of the person and whether or not they are a candidate. Not all people are candidates. Doctors have been sued for doing exactly this. And that is why I'm so careful to be generic in statements rather than giving specific advice other than 'see your eye doc'

I agree completely with regard to the surgicaleyes web site, and tell my patients just that. To made an educated decision, you have to know the kinds of things that CAN happen, even though the risks are remote. Jen Do or do not, there is no try -Yoda

I am very non-religious, but I don't think that religion itself is the cause of any problems at all. I think problems are caused by the arrogance of humans, we all believe that we are right, and everyone else is wrong (just read a lot of Speaker's Corner posts for proof of that one!!) Religion just happens to tend to clump people of similar belief systems together. Jen Do or do not, there is no try -Yoda

My husband had just started AFF when we met. Seeing how on some weekends he looked more longingly at the sky than at me, I knew that sooner or later I'd need to take up jumping as well. So, a year and a half after we met, I started AFF. What got me out the door was knowing how proud of me he'd be. I didn't get hooked until jump 10, the first after AFF. With AFF I was working so hard to do everything right, that I really didn't enjoy it much. I was still doing it for Chad until that point (though he never asked me to jump). I had equipment ordered and everything, but was still questioning my sanity. Jump 10, I did absolutely nothing except enjoy the scenery and relax. That's when I was hooked. That first solo jump. Who knew that a year later I'd be one of those people living in a trailer at the DZ every weekend. Jen Do or do not, there is no try -Yoda

And based on what medical/optometric degree do you base this advice? When did you personally examine the person asking for information? PLEASE watch it with giving advice like this. It is the eye equivalent of telling a jumper exactly what canopy to get or give detailed information for a newbie to learn to swoop. Do or do not, there is no try -Yoda

Also This is required reading for my pre op patients. Although the odds are very against the disaster stories since I'm very picky about what surgeons I use, it's important to be aware that there are risks. Do or do not, there is no try -Yoda

This is a pet peeve of mine. If you are practically blind, then no glasses, contacts, or surgery will get you seeing 20/20 again. (this is actually my subspeciality, working with those people). It doesn't matter what you see without correction, as long as with glasses/contacts/refractive surgery, you see 20/20

To all of you who are saying 'get this surg' or 'not that surg', please be careful. That is giving medical advice and can be flat out dangerous. Even with my degrees I do not give specific information for individuals. There is no one procedure for everyone, that is why there are so many different kinds of refractive surgeries available. Not everyone is/isn't a candidate for surgery, that is between them and their eye docs. Consider some of you guys reprimanded LASIK: Uses a very fine razor blade to slice horizontally across the cornea, then the underlying tissue is molded with a laser, flap is put back where it was. Advantages: It has been around a while now, so surgeons are well practiced at the procedure. Results very good. Disadvantages: If anything gets under that flap, you can have serious problems. You can get epithelial ingrowth where the flap does not heal properly. Any trauma that flips the flap back is bad. Glare at night, dry eye are very common side effects, etc. Double vision in one eye, scarring, and infection are other possible side effects. Intralase: See above, except uses a laser instead of a razor blade (microkeratome) for the flap creation. More reproducable outcomes, but risks the same. PRK: The surface (epithelium) of the cornea is removed, basically a controlled corneal abrasion. A laser is used to reshape the cornea. A bandage contact is usually put on the eye to help reduce discomfort and increase healing time. It is a little less invasive since it only removes the surface layer of the cornea, not the deeper layers like above. Risks basically the same. RK: Uses a very fine diamond blade to make incisions in the cornea in a radial pattern (like spokes of a wheel). The less spokes that need to be made, the less invasive the procedure. Advantage is no flap, but also a little less reliable in terms of outcomes. Risks the same as above. Intacs: Rings of plastic that are embedded in the cornea to change the shape of the cornea. Not very invasive and reversable, but doesn't go very high up in prescription and only for nearsightedness. Doesn't do much for astigmatism. Phakic IOL insertion: Basically implants a lens into the eye to correct for refractive error. Right now only being used in very high prescriptions. Long term results unknown since very new, but theoretically traumatic cataract may result over a period of years. Advantage is basically no corneal insult. Refractive lensectomy: Basically cataract surgery in someone without cataracts, the natural lens is removed and an artificial lens replaces it. Same drawbacks as cataract surgery (risk of macular swelling, retinal detachment, etc.) Typically need reading glasses afterwards, only used in people with very High Rx's. Conductive Keratoplasty: Uses radio waves to mold the cornea for low amounts of farsightedness. Not a lot of information about this one right now, it is fairly new and not widely used. ASA is the same procedure as PRK. With PRK the epithelium is removed and not replaced, with ASA the epithelium is peeled back and then replaced. Newer procedure, so less information about risks. All of the above surgeries have risks, many of them similar risks. All of them can potentially cause permanent vision loss not correctable with glasses or contacts. All of them have very specific criteria for patients to be candidates, and those criteria differ from one procedure to the next. All of them take a very long time to heal due to the avascularity of the cornea. Perfection is not a realistic goal. At the very least, reading glasses will be needed past 40ish due to the natural aging of the lens inside the eye. Virtually all patients lose some degree of contrast sensitivity after refractive surgery, which is more noticable in older patients. Many have increased glare at night, most notice an increase in dryness. Whether or not refractive surgery is right for you is between you and your doc. Ask a million questions before having any surgery so you can make an educated decision knowing what to expect and what potentially can happen. Ok, my fingers are tired of typing now Ask me shorter questions next time Do or do not, there is no try -Yoda

There is no 'flap' as done with lasik, but the epithelium (top surface) of the cornea is still removed from the underlying layer, the middle layer reshaped, and the epithelium replaced. Yes, less invasive than LASIK, but definitely still involves separation of corneal layers. Do or do not, there is no try -Yoda

The problem is that your cornea is avascular. It literally takes years to heal to it's original strength since there is no blood supply there to deliver raw materials to the cornea. Do or do not, there is no try -Yoda

Do a search, there are already a lot of posts on this. I'm an eye doc and posted quite a bit here on the topic, just don't feel like re-typing everything. I'm lazy. Personally, I won't do it. There are risks to any surgical procedure. I don't think that the benefits make the risk worth it for me. That does not mean no one should do it, I work with pre and post op lasik patients quite a bit, and for those that are good candidates, it's an appropriate option. Jen Do or do not, there is no try -Yoda

I don't know of any whiplash induced injuries from refractive surgery. I suppose it could happen, but isn't really likely. The eyeball guts are held back by the natural lens of the eye, so I doubt the innards will come flying out of there Do or do not, there is no try -Yoda

It doesn't matter. If it is the right person for you, skygoddess or whuffo won't matter since the relationship is good and something that you have mutual respect and appreciation for. I think it's a little unfair to write off the entire whuffo population based on a question posed to DZ.commers Jen (former whuffo dating/married to a jumper) Do or do not, there is no try -Yoda

Every surgery has risks/side effects. This is one of them. The cornea has no blood supply, so it takes years to heal back to the strength it was prior to surgery. 30 days definitely gets things tacked down and healed to a fairly safe degree, but deeper corneal injury to the stroma (middle layer of the cornea) from surgery or from prior eye injury tends to be a bit weaker at the location of the trauma. This doesn't mean not to have surgery, just be aware of what can happen as a result, make an educated decision, and take as many precautions as possible to prevent problems down the road. Hope you are doing better quickly though!! Jen Do or do not, there is no try -Yoda

I work every other Saturday until 3. Although that location is 1.5 hr from my house, it is 15min from the DZ, so by 3:15, I'm at the DZ Do or do not, there is no try -Yoda

Although I'm a packer, I don't understand why people pay to pack. Plus several give tips with every pack job. A couple others with brand new canopies often leave 2 pack tickets on the rig. Maybe I'm just cheap, but I can't see myself paying someone else to do something I'm perfectly capable of doing myself. But keep paying us packers anyway, it keeps us in the air!! Do or do not, there is no try -Yoda