Travel and Dry Eyes (Yes, You Can Even Go to Developing Countries and Survive!)

[RFREITAS]

Routine

Hello SAAG!

I hope you are having fun in Asia.

I would like to ask you what are your major sympthoms at the moment. It's possible to describe your current routine?
I am asking that because some of my sympthoms have changed a lot during this last year. Now I feel my eyes full... like if I touch them they will explode. Also I have pain around them... never had this before.

Also your nax drops are for which sympthom?

Sorry my poor english!!

SAAG,
He suggested to do cautery to that tear duct. I need your advise. I had double plugged on my worse eye 2+ weeks ago and throughout this period, that eye had overflow, say twice in an hour. Though I do not like the weeping feeling, I reckon more tears is better than less. Overall, it was more comfortable. Should I go for cautery?

Well, what I chose for myself, with no regrets, was cautery. Any overflow is well-worth it to me for the increase in comfort that I get from it.

Of course, I can't say for sure how YOU will feel about the trade-off. If it means you are suddenly able to be more productive (as I am), more comfortable (as I am), you may not care about the overflow since you'll see it as a small price to pay for the benefits you are getting.

Or you may be one of those people who despise the overflow so much that you end up feeling like you traded one problem for another that is just as bad. Prior to doing it (if that's what you choose), just be really sure of what YOU think is the lesser evil (overflow with cautery, or dryer eyes without cautery)

And keep in mind the possibility that your eyes will improve with time, in which case the weeping could get worse (and obviously your eye comfort should be better as well) - I'm fine with this possibility (it's the lesser evil as far as I'm concerned), you may feel differently.

Lastly, weigh the risk of serious complications from cautery (rare, if your doctor knows what he/she is doing) vs. the potential increase in ocular comfort and productivity from cautery vs. the inconvenience of overflow from cautery. Ultimately, all you can do is make an educated guess and play the odds, right?

Not unlike deciding to drive a car (risk of getting killed in an accident vs. the desire to get to your destination quickly and efficiently).

Not unlike choosing to eat solid food (risk of choking on your food any dying vs. the fact that a pureed diet would really suck).

Ok, so I get that those examples are far from a perfect comparison, but my point is, we make choices based on the likelihood of risk vs. benefit all the time, and the choice whether or not to have cautery is just one more of those, right?

What will happen if it reopens? Re-cautery?

Yes, as I understand it, re-cautery is the most common course of action if this occurs. My upper right puncta stayed shut after only one try. My upper left puncta took 3 tries. My bottom puncta each required 2 tries to stay shut.

I read in this forum that some people had cautery and after it re-opened, the tear duct was being probed to put in a plug. Is so confusing. Any advise please.

The impression I was given by the ophthamologists I've seen for this is that if it re-opens the best choice is to just re-cauterize it. I honestly don't know why someone would opt to have them dig around in there with a probe to insert a plug... maybe someone else here would know? I assume whoever needed to have it probed and whatever must have had an unusual situation? Or maybe they hated the cautery procedure so much that they didn't want to do it again??

[tealeaf]

SAAG,
This morning doctor removed 1 umbrella plug from my worse eye (which was double plugged) as that area becomes red and slightly inflammed. He said let the inflammation cool off then decide the next course. He suggested to do cautery to that tear duct. I need your advise. I had double plugged on my worse eye 2+ weeks ago and throughout this period, that eye had overflow, say twice in an hour. Though I do not like the weeping feeling, I reckon more tears is better than less. Overall, it was more comfortable. Should I go for cautery? What will happen if it reopens? Re-cautery? I read in this forum that some people had cautery and after it re-opened, the tear duct was being probed to put in a plug. Is so confusing. Any advise please.

[neilw]

SAAG,
good to hear you are still enjoying your time in Penang. Could I just ask you a couple of questions ?
Naltrexone drops
My wife has just started using these twice a day - a doctor here in Australia wrote a script for them and she got them compounded at a pharmacy in Sydney. We got the idea to try them as you had mentioned using them. So far they are going OK. They feel quite soothing when first put in but no other great benefit yet. It has only been a few days. Are you still using them ? Did you feel benefit for these fairly quickly or over a longer time ? There does not seem to be a lot on the internet about using Naltrexone as eye drops.

Malaysia and Thaliand
Just wondering if you have considered other parts of these 2 countries ? In particular, we have just read the book on retiring there that I mentioned earlier. Places that are given a good recommendation (apart from Penang) are Ipoh, Phuket and also Chiang Mai. Kathy in particular is very sensitive to wind, so we are thinking of places that have low wind as well as humidity. Also, to be close to the very good medical facilities in Singapore, Johor could be a possibility. It seems Singapore itself would not be a possibility for us as getting a long term visa is very difficult.

Thanks for any info.
Neil

And for sure, a penlight will make it a LOT easier to see your MG's, especially if the mirror you bought did not come with a decent built-in LED light.

For me, overflow is always the most for the first week or two (sometimes 4) after cautery, then things seem to settle down to what I'll experience long-term. Also, sometimes as the cautery heals, it pops open again (may open completely, or just a bit, you never know)... so that's another reason to wait it out for a month or more before deciding if the overflow is going to be permanently annoying, or something you can live with.

Also, you may find that the overflow option is preferable since it allows you to do things that you otherwise would not be able to do (for example, tolerate taking off your moisture chambers in a restaurant despite the fans blowing the air around, and then doing that, you won't have overflow during that time since the moving air will evaporate the excess tears before they overflow). And in the meantime, just carry some clean tissues with you all the time, that way you can dab at your eyes as needed.

Glad you're tolerating Restasis - nice to hear some happy stories with that one!

[tealeaf]

SAAG,
Are your children studying in any school in Penang or doing home-schooling?

I think I need the penlight to see the MG's clearly.

Regarding overflow, do you dab with tissue many times a day? When you first plugged/cauterised all the 4 ducts, was the overflow more? and does it regulate/reduce over time?
It's a dilemma, I am dabbing my eyes rather often. Is comfortable to have more tears, but it will be perfect if a tiny bit of the tears could flow through. I don't think my eye doctor has flow control plug. He did mention that for patients who cauterised completely and overflow quite a fair bit, he can make a teenie tiny hole to allow tears to flow through.

I am also using restasis, seems like my eyes love them

I am still using those treatments and finding them helpful.

[tealeaf]

Hi SAAG,
How have you been? Are you still in Penang? Is it windy now? It's extremely windy in Singapore!

I have bought the 15x magnifying mirror. Still trying to figure out if my MG is healthy. I went to see eye specialist yesterday, he insisted mine look alrignt. Thus, am wondering should I continue to wash my eyes with Sterilid to reduce the use of chemicals around my eyes. Are you still washing your eye lids?

By the way, I have double plugged my worse eye since 4 days ago, thus it has 2 umbrella plugs now. The new upper plug did not irritate my eye at all. Now my eye is weeping. Did you experience overflow? My eye doctor said the weeping will reduce after the body adjusts itself. How long did your overflow last? He mentioned that all who use umbrella plugs will ultimately have infection as mucus and dirt built around the plug area, hmm ... but you did not have any such problem, right?
He said till then, may consider cautery, which is better since there is no foreign object in the eye.

How's cautery for your upper tear ducts so far for you? One more question, since the eyes are feeling fine, must continue with restasis?

Hi SAAG,
Thanks for your reply. I am in the midst of recovering from an operation, thus late reply.

Hope it goes ok - so not fun to go through that stuff!

By the way, can share where did you get your 15x magnifying mirror from? Via online?

I bought it off Amazon.com It was quite a while ago now though, but if you do a search, you'll see what they've got.

I agree with Peppermint with regard to your upbeat spirit, hope 1 day I can get to the point where you are.

You will... just keep at it!!!

[tealeaf]

Hi SAAG,
Thanks for your reply. I am in the midst of recovering from an operation, thus late reply.

Yes, I am seriously considering having all 4 puncta plugged. Am going to discuss with my eye specialist on this the next round. Currently, the temporary upper plugs and lower puncta plugs are still holding my tears but the worse eye not doing good and the better eye has some over-tearing.

By the way, can share where did you get your 15x magnifying mirror from? Via online?

I agree with Peppermint with regard to your upbeat spirit, hope 1 day I can get to the point where you are.

[Peppermint]

You're awesome, SAAG! I can't thank you enough. I feel so much better reading your inspiring words. It is so hard to not wallow in self pity. I definitely need to work on that. And you are right, if I got to that level of peak performance, I can get back there again. Patience is key and it's such a huge part of dealing with this eye condition. One major thing I learned from this set back is, if things are going well, don't do anything!!

You should do a Ted talk on dry eyes

I wanted to reach out to you because you are so positive and anytime I am feeling depressed about this eye condition, I manage to read a comment of yours on any given thread and I feel so much better. You have such a positive spirit and I wanted to thank you for being such a shining light.

Awww, you're very sweet! Thanks so much!

My question to you is, how do you manage to get over setbacks? ...How do you manage to not beat yourself up and just stay positive, upbeat and not feel defeated.

It's totally a mental game, isn't it!

For me, this is what I do:

1. Remind myself that if I reached that peak of performance (for lack of a better word) then it's highly likely I'll get back there again - at least I now know what's possible, right?

2. Try to at least learn from the setback - what is it that tipped me over the edge into a decline? Knowledge is power, and the more you know, the less the odds of your making a mistake and setting yourself back again in future. So don't focus on the fact that you've been set back, focus on what you LEARNED from it, and focus on strategies that will help you avoid that scenario from repeating itself in future.

3. Refuse to wallow in self pity. It's hard at first, but the longer you do it, the easier it becomes. And eventually, you don't even have to try very hard - you just naturally avoid wallowing. Do not compare yourself to people that are better off than you - only compare yourself to people that are worse off (that'll make you feel lucky, as opposed to the other way around)

4. Get enough sleep. I don't know about you, but when I'm overtired, I turn into a cranky, teary child in a grown woman's body.

I see this as an ongoing war with my eyes, I win some battles and lose others - but overall, I have to try to win more than I lose. Setbacks are part of it - they totally suck, but such is life.

Hang in there!!

[Peppermint]

Hi SAAG-

I wanted to reach out to you because you are so positive and anytime I am feeling depressed about this eye condition, I manage to read a comment of yours on any given thread and I feel so much better. You have such a positive spirit and I wanted to thank you for being such a shining light.

My question to you is, how do you manage to get over setbacks? Just when I think I've turned the corner and I'm feeling better than ever, something happens. Specifically, I had been doing so good...I was able to read again (finished a 700 page book!), my lid margins were light pink/beige again, I had minimal swelling....I felt like a "normal" person almost. In my quest to improve even further, I got greedy and I decided I should get a manual expression and that might push me over the edge into real "normalcy." Well the opposite happened! I experienced so much swelling that it set me back! Without getting into more details, I went to my regular dry eye specialist (another dr did the expression) and I'm back on steroids (which I was off), and doxy 2x a day (i had been on it 1x/day only). I am still not back to where I was before the expression, but definitely improving. How do you manage to not beat yourself up and just stay positive, upbeat and not feel defeated.

Thanks for your input! (I know this has nothing to do with travel but I couldn't PM you)Hope you are enjoying a great vacation!!

Is there a difference with your eyes wearing moisture chamber glasses with fan on in Penang versus in cold Canada winter? If seal is tight, eyes should feel the same?

My eyes feel much better here compared to cold Canadian winter - the humidity levels are soooo gloriously high here, that it's like putting my eyes in a soothing bath. So it's not necessarily due to the moisture chambers being any better here compared to home... but for sure, I still wear them because they improve my eyes compared to not wearing them.

How I desire to travel with my kids for holiday but with no moisture chamber glasses or scleral lens, I have phobia of taking the plane and at the same time, wonder if my eyes can take the dry winter air overseas ..

If traveling to a place with cold winters, just avoid it and go in spring, summer, or fall. The air holds more moisture at those times of year. And if you do have to go in winter, it's not the end of the world, but plan on being far less able to handle reading, computer use, watching TV etc., and plan on your eyes being less able to tolerate air movement (moisture chambers are a must if your eyes are very sensitive, as mine are). It is possible to keep one's eyes comfortable, as long as you're willing to limit, or eliminate, drying activities like reading for example.

As for planes, just do it - baby the heck out of your eyes, wear moisture chambers the entire way (if you can get a good fitting pair, but even a poorly fitting pair is probably better than nothing), and rest your eyes as much as possible during the journey. Doing that, odds are your eyes may flare up a bit, but hopefully a couple days of babying them afterwards will be enough and they'll bounce back to normal. Works for me, hopefully for you too!!

[tealeaf]

Saag,
Glad that the haze is gone, same here in Singapore.
Is there a difference with your eyes wearing moisture chamber glasses with fan on in Penang versus in cold Canada winter? If seal is tight, eyes should feel the same?
How I desire to travel with my kids for holiday but with no moisture chamber glasses or scleral lens, I have phobia of taking the plane and at the same time, wonder if my eyes can take the dry winter air overseas ..