Treatment at Bumrungrad is with the VISX-Star S4 laser system - the latest laser available and treatment for both eyes cost 48,000 bhat - about 650 pounds Sterling. I chose it because of its high reputation. Even foreign doctors from countries with renowned health care systems would fly into Bangkok to have their eyes treated here. Equivalent surgery at such a high class hospital would cost at least double in the West. Bumrungrad kept costs low due to the cheap overheads of building costs and labour that come naturally here plus the pure numbers of patients who undergo this procedure there. Tests were ran through: my pupils were dilated; lights were shone into my eyes; my head was placed in the headrests of countless instruments; I read off wall-charts; I had my blood pressure taken; my pulse was tallied; and my weight measured; nurses came round waiting rooms offering drinks. I spoke to the doctor, asked all the questions I could think of and agreed to go ahead.
On the days before the surgery I did all the usual things (I avoided wearing contact lenses and abstained from alcohol, caffeine and anything else that might be construed as a narcotic), but in my mind I was telling myself "this is the last time you will shave wearing glasses", this is the last TV you will see in glasses", "this is the last shower you will take when the world's a blur" and so on. I arrived at the hospital a good two hours before surgery. I was immediately given hospital pyjamas - decorated with elephants and the Bumrungrad Hospital logo - to wear and put in a bed. More tests were taken - my blood pressure and pulse were measured for about the tenth time in a week. Pills were distributed to my mouth and I popped my glasses - wretched things - into a sealable plastic bag, the sort drug dealers distribute their weed in... I think it was a new one though.
I was wheeled towards the operating theatre, head laid back against my pillow. Lights on the ceiling, blurred to my eyes, passed overhead. It felt like a much overused shot from a film - it was a much overused shot in films. I wondered whether it was used so much because it was such a striking image or if it was such a striking image because it had been used so much by directors. Doors swung open automatically as my bed neared them before I was finally turned into a modern-looking operating theatre. From the top of my vision, and upside down to my eyes, a middle-aged Thai woman dressed for surgery looked at me, smiled, and said "No pain." She was wearing glasses.
Why was she wearing glasses? Did she not trust the procedure. I put it out of my mind. She gave me a dose of anesthetic eye drops. I lay there for ten minutes before Dr. Narurmol came in. "The traffic was terrible" she said.
"That's Bangkok for you" I countered, already beginning to sweat.
For some reason I had a thick blanket over me underneath the green surgical cloth that covered all but my eyes. I maneuvered it downwards. "No pain", the woman with glasses repeated.
More pleasantries were exchanged. If they weren't competent at least they were incredibly friendly. Smiles and laughter were present probably in part to put everybody at ease. In the event they all seemed very competent, and I wouldn't have been there if I thought any differently. I have previously criticised the quality of Thai nursing in chemists on Ko Pangan, however this was a plush hospital and all were highly trained.
I was put under the laser. It would vapourize the middle part of my cornea by tiny amounts at a time until the relevant part of my eye effectively presented a perfect sphere allowing light to focus perfectly onto the back of my eye. At least that was the theory. To do this, the top part of my cornea would have to be lifted up - it cut almost all the way round in a circle and lifted up like a flap. Dr. Narurmol turned on the laser so I could hear what it would sound like. A circular metal instrument was pushed over my eye ball both forcing my skin back so as not to obstruct the eye and keeping my eye still. My eyes were numb but I was fully conscious and able to see.
Looking up at where the laser would be emitted I could see a distinct red dot. The instrument that was to cut my cornea was placed over my right eye. I could only see the bottom of it but I imagined it to be shaped something like a jeweller's eye piece. It was a machine that made the necessary incision. I didn't feel it, but I knew exactly what was happening. My body's sweat glands would have opened at this point I imagine. It took a few seconds to cut and my cornea was lifted. This was indicated to me as the vision in my right eye swung quickly in the same direction before the cornea cleared my line of sight and the red dot became very blurred almost filling my entire field of view. A minute or so passed presumably as the surgeons checked all was fine before the laser was started. I cannot remember if I was given any warning - I was too busy sweating, worrying, and attempting not to move my eye at all.
Not that it mattered - the metal clamp thingy would have prevented that and the laser supposedly performs several checks of the position of the eye before committing itself to a burst of zapping light. And I had read somewhere that the laser captures 99.8% of all the eyes movement and corrects the position of the laser accordingly. The 'putt putt' sound continued for what seemed like about fifteen seconds - although could have been anything up to thirty or forty seconds. I was hardly in a calm second-counting mood. The cornea was replaced and my eyes was cleaned with the first hand tool I had encountered - a small swab.
Once my left eye was completed (it seemed the laser took longer than for my right eye), the surgeons seemed to take an eternity to bring me out from under the now redundant laser. Probably they were checking the condition of my eyes very closely. Next two plastic gauzes were placed over my eyes with only small holes with which to see through. I was helped out of the operating chair - my Bumrungrad pyjamas were soaked through with my cold sweat. I asked and was told that, yes, I had sweated more than any other previous patient. I suspected they were humouring me with news of such an honour. Outside of the operating theatre then and I attempted to glance through the holes in my eye shields. I knew my vision certainly would still be blurry, but I could perceive... Yes! A definite improvement. I could see things clearly in the distance!
Four days have passed now. The irritation in my eyes was much less than I expected, and every day my vision has stabilised a little bit more. My eyesight is at least as good as with my glasses on, although glare off lights will remain for a few weeks yet. I am being careful with what I do, and I'm not venturing out into the Bangkok fumes, but I am functional and vision is good. Eye drops and antibiotics in my pockets I stalk through the world without a form of crafted lens between my eyes and the world. And it should be bloody marvelous as I venture further afield.
Despite the lack of hex vision...
Now use your eyes to espy some pictures of my group on Fraser Island, Australia via Tibo's website.
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