28 July 2017

Now in Laser Vision!

I had Lasik nearly a decade ago. A brief cost-benefit analysis indicated I should do it regardless of price, I did it. As my astigmatism was carefully seared away, perfect vision emerged. In fact, it was even better than perfect! I was the proud owner of 20/15 vision! Note the "was."

About 8.5 years later, I noticed my vision was decreasing in precision. I wasn't happy, but my hefty Lasik fee included free enhancements for life*, which is just marketing-speak for doing the same procedure again. I went in for an eye exam. The good news? Sufficiently thick corneal tissue. The bad news? Waiting six months.

Dr. Lasik has the crazy notion that only those with stable vision should get their eyes lasered. Since my vision wasn't checked for longer than I care to admit, the only way to prove stability was waiting six months and getting another exam. In the mean time, I wore glasses.

I'm not known for patience. And yet, I survived for EIGHT months, due to some paperwork problems involving digging my old chart out of a sub-basement under a bridge. The last couple months were touch and go, but I digress.

You must have a valid driver/competent adult to take you home, and in return they get to watch everything on a large tv provided. Pictures are even allowed, so time for explicit eyeball surgery!

⚠️ Warning: Explicit eyeball surgery!

Step one is confirming that the  eyes do in fact exist. To keep things that way, 5 dots are drawn on each eye. Or maybe it was to carefully calibrate points on the cornea. Regardless, it was very reminiscent of the radiation tattoos for perfectly alignment.

You can't tell with the hairnets, but I'm the one in front.
Four little hooks hold the eye open. Very Clockwork Orange.

A femtosecond laser creates a thin flap in the cornea. Some low-cost surgeons still use a blade, which has higher risks. Do not recommend.

Say hi to Dr. Lasik!

The flap is carefully folded down with a tiny foam brush. The bottom isn't detached, so it can be reused later.


The main laser reshapes the cornea, turning it into a front lens that corrects for the deficiencies in the actual lens. In other words, pew pew!

The flap is dangling down from the bottom.

After sufficient zapping, the cornea flap is carefully replaced. No stitches, staples, or eye glue is necessary - the flap stays in place by itself. Unless you start rubbing your eye or or jabbing it with a fork. So don't do that.


Look into my eye. Look closer. Closer. Now you are under my control. Also, you can see the flap back in place.

The whole thing was repeated for the other eye, and I was ready to head home. Someone put goggles on me to prevent accidental touching, followed by sunglasses strong enough to prevent most screams due to bright light. Lastly, a generous dose of Valium prevented me from caring.

A checkup the next day confirmed I didn't knock the flap out of place. The goggles! They did something! More importantly, my vision was back to 20/15. I can see faerie dancing on the head of a pin. Assuming there was a faerie small enough to dance on a pin. Or a pin big enough. And within my line of sight.

Aside from some mild dry eyes for a couple weeks, everything went according to plan. Miraculously, I failed to find a new and interesting way to poke myself in the eyes! X-ray vision is yet to emerge and there are no signs of optic blasts anywhere, but I'm still happy with the results. 

*For those wondering why the original procedure including a lifetime of free enhancements, it's a numbers game that makes for good advertising The $4995 cost (now $5494) doesn't seem as bad when you start adding in a few do-overs. Most people over 30 never need one, and the technology is constantly improving. The only catch is no tech upgrades are included, but I was happy to pay $250/eye for a significantly faster healing time.

17 June 2017

The Fish Tank Compulsion

Many people associate hand washing with OCD. The person obsesses over hand cleanliness, so they create a ritual around washing their hands properly to alleviate the anxiety. Sometimes the ritual is scrubbing a certain number of times. Sometimes it is a certain manner of washing to get rid of all the dirt and germs. Regardless, continually washing ones hands all day does not actually accomplish anything positive. Even I have dealt with compulsions in the form of rituals to achieve the necessary level of cleanliness.

Before college, I had a fish tank. Cleaning that fish tank brought up a lot of contamination issues. I put towels down everywhere so no stray drop could get through. Once the dirty water was out and the clean water in, it was time for decontamination. Everything had to be done in a very specific order to prevent contaminating anything. First my clothes went into a pile in the bathroom. I carefully piled them such that no wet spots touched the floor. Then I washed my hands and arms three times, as three was number necessary to get rid of any yucky fish water. If I didn't feel like I sufficiently scrubbed myself, it become four or five times. Next, I wrapped myself in a clean towel and went back to my room to change. All the towels and clothes were carefully carried downstairs and straight into the washer. Just in care, I washed my hands again between carrying the pile and turning on the washer. No sense in getting fish water on the washer controls. Finally, I sprayed down everything with antibacterial cleaner. The outside of the fish tank, all nearby hard surfaces, the bathroom sink. Everything. After waiting a few minutes for the cleaner to work, all the surfaces were wiped down with paper towels. The paper towels went straight into the trash. Finally, I washed my hands another three times. Contamination from the fish water was my obsession and this ridiculous cleaning strategy was my compulsion.

What happened if something went awry in my plan? Disaster. One time I ran out of antibacterial cleaner. I needed a new bottle from under the kitchen sink. I tried to open the door with my foot, but the childproof lock kept me out. I asked my dad to open the cabinet for me. He refused, saying I should open it myself. In desperation to finish my cleaning, I eventually opened it myself while in a teary mess. My life-preserving decontaminating ritual was ruined.

For years, I refused to touch that part of the cabinet. No amount of scrubbing or chemicals could disinfect that area sufficiently, as the fish water penetrated the wood. In fact, I never touched it again. It wasn't until the cabinet was replaced that I opened the door under the sink normally.

Such a rigorous cleaning regiment is clearly not necessary to prevent fish water from ruining my life. Fish water isn't even that horrible compared to other possible contaminants. Somewhere in my brain I always knew this wasn't logical. And yet I continued for years, as performing the compulsion was infinitely better than not doing it.

After years of cognitive behavioral therapy, I now know how harmful it is to keep performing the compulsion. Instead, through countless hours of exposure and response prevention (ERP), it is possible to overcome the compulsion. Exposing yourself to an obsession and sitting through the anxiety instead of performing the compulsion is incredibly hard by itself. A therapist or ERP coach makes it mind-numbingly painful by constantly reminding you about how horrible the situation is and not letting you cheat. Eventually, the ERP makes it possible to function without performing the specific compulsion. Sometimes the compulsion goes away completely. Other times, the desire to compulse remains, but is bearable. Either way, it's better than living with horrible, time-consuming ritual.

01 May 2017

Combating OCD

It is a common trope to declare oneself as OCD due to some specific desire of orderliness. Shockingly, keeping the house clean or carefully ordering books doesn't qualify as a symptom of OCD by itself. Some people with OCD are complete slobs. Others just shove all the books on the shelf where ever they fit. Merely preferring something a particular way is normal. Having it completely take over everyday life is when it becomes an obsession.

Obsessive-compulsive Disorder consists of two parts. As described above, the obsession can be nearly anything. Many of my obsessions are around what I consider perfection. The compulsion is something that eases the mind and makes the obsession go away. Mine are often fixing things to make them perfect. Even that last sentence needed to be perfect, so I rewrote it three times before convincing myself to move on.

Rewriting a sentence a few times doesn't seem like a big deal, but it is part of a much larger problem. If my blog posts aren't perfect, readers will see these imperfections and think I'm an idiot or incapable of properly editing my writing. In reality, these responses aren't actually likely. In my mind, I need to prevent people from thinking poorly of me. And therein lies the problem, causing me to rewrite sentences and even paragraphs over and over.

The only proven method of combating OCD is through exposures. Exposures have absolutely nothing to do with streaking. An exposure is purposely creating an appropriate obsessive situation and not performing the compulsion to make the anxiety go away. It often takes weeks or months of daily exposures to combat just one obsession.

Exposures suck. Really really suck. Even minor ones. You can't just do it for five minutes and declare it finished. The entire point is to sit with the horrible anxiety until it decreases. A typical exposure lasts forty-five minutes to an hour. The anxiety may not decrease at all for awhile. For it to work, you have to keep at it, repeating the same exposure daily until the anxiety decreases or disappears entirely for an obsession.

Any exposure worth its salt is mentally draining. Two a day, plus an hour of regular therapy and an hour of group is also physically draining. Just this half day routine is enough to leave me useless all afternoon.

Most people with OCD have a large pile of obsessions. That means each of these obsessions needs to be treated individually. The obsessions are usually ranked into a hierarchy, from least horrible to completely life-destroying. As the lower obsessions are conquered, the higher ones become relatively easier to experience.

Even with countless exposures, some obsessions and compulsions never go away entirely. You just have to be diligent about not falling back into old patterns. It's a lifelong struggle. And on that note, I'm going to hit "Publish", without checking for spelling and grammatical mistakes.

31 March 2017

The High Cost of Perfection

Everything must be perfect. Me, the world around me, even this blog post. What constitutes perfection depends whatever exemplar I create for the thing in question. A major example is my notebook. If I make a mistake and need to cross out or write over something, it is no longer perfect. And when something is no longer perfect, it is ruined. While other people may not even notice such a slight flaw, I need to fix it somehow. Continuing the notebook example, I tear out the page and rewrite it until there are no mistakes. If tearing out the page is not possible, well, the notebook is a complete wash. I need a new one. In the new one, I must rewrite everything exactly as it was the first time. Even the same pen(s) used the first time. Clearly this is no way to live.

The level of imperfection, and therefore damage, varies from situation to situation. Some things can easily be fixed and once fixed are of little consequence. If something is impossible to fix, such as a past action of mine, I experience high levels of anxiety. My brain can't handle it, so it ruminates on the imperfection for hours, days, even weeks. I only dwell on the perceived problem. Rationally, I know this is completely inane. Nothing in life is perfect. Things get scratched. I make mistakes. Normal wear and tear occurs. And yet it is still the end of the world when these things happen.

One detrimental way to get around imperfections is to ask for reassurance. Just hearing from someone else that something is not a problem gives me temporary relief. But temporary relief is temporary. It becomes an addiction, with my brain always needing another fix of "it's fine." As with any other addiction, I can't ever get past the problem myself when I keep getting further reassurance.

Matt used to constantly provide reassurance until he found out that it's actually detrimental in the long run. Even after years of him denying me, I continue to ask. I still crave that quantum of relief.

My inability to make seemingly simple decisions arises from this perfection problem. I need to make the perfect decision every time, so I continually mull over every option, looking for possible benefits and flaws for every option. I even ask other people for opinions. I get so wrapped up with trying to make the perfect selection that I never actually make one.

After selling my beloved car, my therapist suggested that I use a bit of the money to get myself something something nice. Nothing that I need, merely something to enjoy. I narrowed my search down to a necklace, a nice pen, and a camera lens. I was able to remove the lens from consideration as it would be slightly superfluous, but there isn't a right or wrong answer for the other two options. It's been two weeks and I've successfully accomplished is looking at both in person. The longer I take to decide, the more energy I waste ruminating on the options.

I really wish I could see the world like most people. Imperfections are okay, and things are still completely usable. I just need to convince my brain of that.

27 March 2017

Review: restaurant delivery

grubhub
-

doordash
- multiple problems, but always resolved it easily
- wider selection

caviar
- never had a problem with the delivery
- set delivery price + service charge
- smaller selection, but "curated"

postmates
- service fee + delivery fee + tip
- doesn't know what customer service is

uber eats
- don't come to the door
- cheap delivery if no surge
- owned by the uber asshats