Tuesday, November 11, 2008

My Eyes, My Eyes!

This title feels like a reference from somewhere, but it could be more ubiquitous or obscure than I could easily nail down with google. While I didn't get a hit that resonated with me a to source, google did send me to this fantastic link of Simpsons done as Anime which I consider a good omen.

I've got 10 more days to make the final decision on getting laser eye surgery this coming January or to put it off for a year. (Or, forever.) If your attention span is short, skip the following and take the poll at the end of the post. If your attention span can last, here's all the stuff rattling around in my head on the topic.

I checked it out. I was worried about the "reading glasses" thing that hits later. But it turns out to be the difference between reading glasses and bi- or trifocals, not glasses and no glasses. Simplistically, vision is controlled by the shape of the corneal lens and the eye muscles that change the shape of the eyeball to adjust the fine focus on the retina of the light coming through that lens. (Then the brain takes the signals from the retina and does all kinds of image processing.) The thing that laser surgery corrects is the lens shape. Glasses or contacts adjust the incoming light so that the wonky lens shape gets tailored light it can then resolve.

I've got a friend who has "cheaters" that work well for her. These are hard contacts you wear overnight that reshape your cornea. The work they do is not permanent which is a good and bad thing about them. I think this is a really interesting idea. But my goal is to have fewer daily maintenance tasks, and I'd like to wake up and be able to see - I think it makes a difference in my ability to be alert in the morning. So wearing contacts overnight is more work than I want to introduce to my bedtime and morning routine.

There's a laser surgery place in Beverly Hills that does work on celebrities and non-celebrites. I figure someone who makes their living correcting the vision of people who stand to lose multi-million dollar contracts if their eyesight goes wonky has to be pretty careful and a great track record. I've got an appointment there in January. They are expensive, but not out of line. It's a flat fee that covers everything including potential adjustments in the future. The places that say $300 per eye don't necessarily include follow up care and some say that worse vision will cost more. I don't want to go bargain basement with my eyes. I'd rather overpay then risk my vision.

The trick is that while I think $5000 is "reasonable" for the service, I still need to come up with $5K. I use the medical spending reimbursement account which has a $5K limit. This means I get the $5K tax free if I use it to fund the surgery, so it actually costs closer to $3300 of money I would see. My out of pocket medical expenses this year are nearing $2000 which I find astonishing because on the whole I'm really healthy. But I have allergies and chasing "non-restorative sleep" causes and symptom treatment is like throwing money down a black hole.

In the election brouhaha, I did some research and it turns out my salary is in the top 20% of salaries nationwide. But I live in one of the top 10 most expensive places in the country. My top 20% salary after 12 professional working years, 10 years of student loans, saving what I can, and the dot com bust back in the day meant I could buy one of the 10 cheapest condos in my county which was originally built as low income housing. Which is to say my disposable income isn't even close to being in the top 20%. I don't have kids and other such obligations, I can eat out at lunch (although that budget has been cut too), and I can afford gas and some treats. But living high on the hog I am not.

My job, for the most part, seems stable (go wireless!) although I have no illusions of big raises in this economy. I kept some money set aside to renovate the condo a bit and I'm chewing through that at pretty good clip. I'm running into deficit spending this year, so I'm actually using some of the savings for regular stuff as well. I got a pretty large income tax return last year, but I don't know if that was due to special circumstances (part of my relocation was costed out last year, and part the year before) since I'm new mortgage payments and their effect on taxes. If all goes well, the income tax return would cover most of the eye surgery.

If all doesn't go well, the income tax return might not exist or might cover only a fraction of the cost. And my cash reserves are not extensive. Currently they about cover my non-mortgage debt which I have not paid off so as to maintain a cash reserve on what used to be the outside chance that credit would not be easily available as I'm used to. These last thousand paragraphs can be summed up as if I get this surgery, I will be at risk of running out of money to the point where I will seriously have to cut back on food. Maybe.

On the "get the surgery now" side of the contract is I can get the reimbursement almost immediately so I won't be without the money right away, it's just that my paycheck will go down by a couple hundred dollars. Everyone I've talked to said it was the best thing they ever spent their money on and they'd do it again in a heartbeat and sooner than they did. Right now, I'm a very good candidate for the surgery and I should have a decade or more of glasses free living (although I do like my Kate Spades). I really think it will affect my ability to focus in the morning. If I go bust, they can't take my eyes back.

On the "delay a year" side is that I already have new glasses and a year's worth of contacts so I shouldn't incur more expenses on that front for a year. I don't know how my medical expenses will shake out. If I have to shell out another $2K next year in addition to the $5K for my eyes, I don't know where that money will come from. I don't know how the economy will treat my paltry remaining few non-retirement investment dollars outside the cash/money market condo/emergency fund which are down almost 50% from last year and what I had thought to use on the surgery but didn't move to a money market and now it's hardly worth cashing them out. I don't have any family backup money. I won't starve, but I won't be able to do anything fun either, if the tax refund is off or anything else unexpected comes up.

I've assessed it before. While I like to think I take risks, I don't really. I have a low risk tolerance for my basic needs. Once I have enough money to meet my basic needs, I have lots of risk tolerance because I don't care about money for its own sake or power or anything. This also means I tend not to put myself out to build up reserves once I'm comfortable. Which makes me a bad candidate for commission sales - that's my brother's thing.

I have to decide in the next 10 days or so whether to set aside $2K for medical expenses next year or $5K. And I'm completely torn. One part of me thinks, "just do it and worry about paying for it later, like college, it's a quality of life investment." The other side of me thinks that $5K is a lot of money in these trying times that could be better utilized as a mattress pad until signs become clearer. Or I get a better raise.

What's the opinion from out in blogland?


azteclady said...

I did it, on March 19, 1996. To this day, I have the same vision as four weeks after the surgery.

I don't know whether I'm a typical patient or not, though--had it done in Caracas, and was one of the first hundred patients who had the surgery with the ONE lasik machine in the country at the time.

My vote, obviously, would be do it now or earlier if possible.

Anonymous said...

where's the "flip a coin" choice??


gail said...

I'm sticking to my opinion that lasers and eyeballs should never mix.

I'll stay with my CRT contacts --- they soak and clean themselves all day and are ready to be popped into my eyes each night --- in the morning out they come and into their self cleaning solution for another cycle.

HOWEVER! No one knows better than me that one solution is not right for all people.

It's just that I've personally seen what happens when things don't go so well with these surgeries --- and I'm always looking for methods that will allow me to change my mind or move with the new technologies when they come along in the future.

Good luck with whatever you decide!

CrankyOtter said...

Dang, one each in the comments even! And I need to remember to take out my Yes vote in the final tallies or it won't be representative.

Junior said...

Meowm has a friend who had hers done several years ago and it went really well. Then she has a friend who had hers done not so long ago and hers went back to almost where they were before the surgery. The first friend had hers done in California and the second here in Utah.

It's a hard choice. If you are only looking at having to brown bag it to cut back if things go bad, then get the surgery. But if you will stand to lose more...then wait.

S said...

I'm going to be really picky and say that, given that it's mid-November, you should be able to sit down with your current pay stubs and last year's tax return, spend an hour or two doing some calculations, and come up with a pretty accurate idea of what your tax return will look like. That might give you the confidence to go ahead, or a darn good reason not to.

As far as alertness being related to being able to see first thing in the morning, do you keep your glasses right by your bed, ready to put on first thing when you get up? Or are you puttering around half-blind until you find the glasses, or until you find and clean them, or until you put contacts in?

CrankyOtter said...

S: I usually have to make it out of bed before I get glasses on. Even if I keep them by my bed.

As to the taxes, the withholding was different on the relocation expenses than regular salary and I cashed in some stock options last year that had over-withholding as well. And the year before that was the condo buy and the two state-two salary +half relocation and some other stuff. So maybe I can figure it out, but I don't have high hopes. I'll see if my tax guy can give me an estimate.

AAAAHHHHHGGGGHHHH. Still flipping out. I kind of want to just go for it and hope things work out for the best. And maybe the gov't will let me throw out the HELOC while I'm wishing on stars.

Beki said...

I voted that lasers and eyeballs should never mix because if anything can go wrong it usually does for me.

My sister had it done and she can see well but is experiencing really bad dry eyes. I already have severe dry eyes which is why I can't wear contacts. Plus I have retina issues in my right eye so I am afraid to mess with my eyes given that I already see more spots than words when reading.

And although my eye care clinic does Lasik they have never even once mentioned it to me---made me think I probably wasn't a good candidate for it.

However, if it goes well it should be great! I guess only you can decide if it is worth any risk involved.

Amy in sunny CA said...

My dh had it done 10 years ago and he swears by it! My biggie . . . TRUST your doctor!

You mentioned we live in the top 10 most expensive states - I can only think of NY and (maybe) FL to be higher than us - which are the other states? Just curious. I have ALWAYS maintained that region/home prices/gas prices/state sales tax etc. should be added to the equation when figuring out taxes. IMO