Surgery: Saudi Style

 Long delay in posting. I had eye surgery and have had very limited vision for the past week. I am slowly regaining it but am still struggling with the computer.  Some fun things have happened in the meantime and I have a host of photos so will hopefully be getting caught up on sharing sooner than later.  I want to start with my surgery experience here. It is something that I imagine many western people will never get the opportunity (if that is what one would term it!) to experience here.A little background. I got my first pair of glasses about age 10. I was in the fifth grade and not overly thrilled with them. I haven;t gotten any more enamored of them as time has passed and my eyesight has continued the slow creep downward.  I started with contact lenses just before high school and they have been a godsend.  For the most part I put them in upon awaking and forget about them for the rest of the day. Other than the occasional difficulty such as dry eyes or losing one while kiting I have experienced great success with them. It is for this reason that I have held off on laser surgery. I have looked into it on occasion but am not a huge fan of elective surgeries and really had few complaints about my contacts.KSA is an altogether different animal, though. The combination of extremely dry air (average humidity is about 7%) and sand/dust has made for a long few months. I have found myself taking my contacts out earlier and earlier in the day and not wanting to wear them at all some days. As my vision is not as good with glasses, this caused headaches by the end of the day. Additionally, not being able to wear my sunglasses wasn’t much fun.  So, I got a recommendation for a doctor and went in for a consult.

The man who hired me to work in KSA has a degree in healthcare administration and he staffed a few new hospitals here before deciding to work privately for a family.  Additionally, his son and daughter both had laser surgery done by this doctor so I felt that this was a strong recommendation. Upon getting a consult, I found that I was not a candidate for LASIK and would have to under PRK if I wanted laser correction. Biggest difference to the layperson is that PRK has pain and discomfort associated with it and much longer recovery until full visual acuity.  I came home to think on it and do a bit more research.  First off, I sent a message to one of the eye doctors at the practice I used while living in CT. He happens to be the father of a good friend and I knew I would get sound advice from him. Additionally, I did the now ubiquitous google search.  I discovered that PRK (over LASIK) has better long term outcomes, better visual acuity and no chance of getting bumped or dislodged down the road. I wasn’t overly concerned with the pain aspect as I have a high pain threshold and it was only for a few days, anyway.

But, enough background. The story starts with the consult. I called and made an appointment and arrived on the correct day, approximately ten minutes before my 2 pm appointment. My doctor is located in one of the outpatient buildings and they have their own registrar. I went to the counter and asked for Dr. Al-Shuaibi. The man at the counter said “Dr.Moteb doesn’t arrive until 5.” I said “Dr. Al-Shuabi?” He said “Dr. Moteb arrives at 5.” I decided to assume we were speaking about the same doctor and said that I was sure I had an appointment at 2. He
points to a room on the other side of the waiting room and says to go in there. I walk into the room and find quite a few nurses.  I explain who I am and that I believe I have a 2 pm appointment. One of them “oh yes” and uses a stamp on a post-it pad.  She then hands me the post-it and says “take this to the registrar.”

My official appointment slip!

So, I walk back across the waiting area and hand the post-it to the same guy from before. He then says “oh, you have an appointment” and proceeds to ask me if I have a file.  I said I have no idea and handed him my Iqama (residency permit.) He proceeds to make a file for me. He asked if I was married and what my phone number was. That is all. Then he sends me around to the other side of the counter to the cashier. The consult cost 100 riyals. This is the equivalent of just under 27 USD.

Finished with the paperwork, I sit to wait. Hopefully not for 3 hours but not actually knowing! Fortunately, I get called in shortly thereafter and have my consult. The doctor is great and does a nice job explaining why I am not a LASIK candidate and I tell him I want to think about this and will call him. Additionally, I ask the cost.  It is 7000 SAR, about 1,800 USD. For reference, it costs about $5,500 in the states.

Short story, I booked the surgery and am recovering fairly well. One eye is a little slower than expected but the doctor doesn’t seem concerned yet. Longer and funnier story is my day at the hospital. I call the day before to confirm my 2 pm appointment and am told that it is at 4, I am pretty certain I had it correct but say ok.  I ask if I need to come early or purchase any prescriptions. I am told no so I arrive approximately 10 minutes prior to surgery. I check in at the counter and am pointed to the Dr’s office. I do the post-it routine again and then go back and get checked in.

I have been told that the surgery only takes about 10 minutes so my driver settles in to wait. At just past 4:30 a nurse finally comes out and gives me eyedrops (never asked if I was the right person) in the waiting area. She then gives them to the woman next to me.

She then comes back every fifteen minutes administering more drops.  At this point I tell my driver he may as well go and I’ll call him when its over. At one point a nurse asks me how many times I have gotten drops…starting to be a little concerned. I say four and she says “ok, good.” In the meantime, I watch the live entertainment in the zoo that is the waiting area.  It appears that everyone brings the entire family when coming to hospital here. Mom, dad and all the kids. There are at least 5 full families in the waiting area. Additionally, the kids are not terrifically well corralled or even paid attention to. And plunking them up on the counter seems to be the standard place for them!

Waiting area boredom


Eyedrops in the waiting area.



Labyrinth boys. There were three of these little brothers
but one was too slow to capture with the others!
This little dude was trying to touch the sign hanging from the ceiling. What is difficult to see in the photo and makes this even scarier is that the sign isn’t directly above the counter!
It is now about 5:30 and I finally head into the surgery area.  The nurse leads me to a cubby in the front of the room that is draped off with a curtain and tells me to take off my abaya. She then puts a johnny on over my clothes and a hair net on my head. Next is a mask and then she points to the five pairs of clogs on the floor and tells me to choose a pair that fits…no socks, eeww! Suitably geared up I leave the cubby and go lay on the table in the laser room. The nurse puts on gloves, hat, booties and a gown, all from sterile packages. She then says, “oops, I forgot to have you sign this” and hands me the release form. Mind you, no one has ever asked for an emergency contact for me or even the name and number of my driver. I put the release about an inch from my nose to read it as I had to leave my glasses in the cubby and then I sign it.  Shortly after a man in street clothes comes in and starts banging around by my head. He tries to put some items on the cart with the nurses tools (that she just ripped out of sterile packaging) and she tells him no. It bothers me having this non doctor or nurse and non sterile wearing dude banging around and putting tools everywhere. I ask who he is. The nurse says, “oh, hes the technician getting the laser ready for the next patient, she has a different type of surgery from you.” Great! He is now literally leaning on my legs to reach over me on the table to adjust something. I ask if he can do this on that patient’s time since it is for her, rather than me. I am told no, he has time now. Clearly a dumb question on my part. 
The nasty clogs

Cross eyed because I’m too blind to even see myself in the iPhone screen w/out glasses!

My cubby

The view from my cubby

This is how the technician kept the surgery room door open so he could traipse in and out w/his tools
The tech finally finishes and leaves and the doctor comes in and the surgery is very quick and uneventful except the laser burning my eyeballs smells like burning hair and I worry briefly about throwing up and messing the whole thing up.  I get through it and can see the doctors face more clearly than I have seen anything without glasses in years! It is pretty exciting. He puts a clear contact in each eye and says these will act as bandages. Keep them in until you come back to see me.  I leave and call my driver to meet me at the pharmacy (pharmacy is in the hospital, nice feature) to pick up my prescriptions. I get to the pharmacy and vision is starting to go downhill. They have the take a number system and I can’t see mine or the big red ones over the counter. Plus one of the contacts has fallen out and is on my finger. I leave my driver to fill my prescriptions and manage to find my way back to the doctor’s office. He is in surgery number two so the nurse walks me into the surgery room and puts me in the cubby with this other lady’s abaya and purse. After she comes out, I leave the cubby so she can enter and the doctor tries a new set of contacts on me. At this point I had blinked out the other one, as well. As he is putting the second one in, the first is falling out. He tries one more set and I lose one immediately. He tells me to go back to the pharmacy and pick up a gel that will help protect my eyes. I can see virtually nothing at this point so I call my driver to come get me. He walks me back to the pharmacy, fills this second prescription and then takes my arm to walk me to the car. 
The last contact falls out on the way home. In my prescription bag they included the most ludicrous night time eye protection things. They are so I don’t rub my eyes while sleeping. I put them on when I went to bed and, after about five minutes, decided I would take my chances. My eyes hurt so badly that rubbing them was going to be the last thing I did! That first night was awful and at a few points I thought “I can’t do this, it hurts too much.” Seeing as I didn’t have any option but to do it, I just lay in bed all night, counting the seconds between needing to blink, as that increased the agony. Thank goodness it was significantly less painful by morning. Still terrifically not nice but manageable. I have read many articles online about PRK and they all mention some form of pain meds for the first few days. My doctor told me to take acetaminophen…
Photo Oct 02, 8 22 21 PM

Unrealistic night gear and very swollen eyes the first night

Photo Oct 04, 1 22 35 PM
Swelling going down the second day
Long story short, the giant text options on the iPhone and kindle were a godsend and I am finally healing up nicely.  I have made the text smaller twice and hoping to be able to go down again tomorrow.  
Photo Oct 02, 7 22 38 PM

Not only did this not look huge, I couldn’t even read it for the first four days! I think that the page turner button would get worn out very quickly reading at this size




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