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why do some doctors not want to do cautery???

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  • why do some doctors not want to do cautery???

    does anyone else have a doctor whom they really like but will not or is hesitant to do cautery for them? i just want my upper left puncta cauterized as umbrella plugs rub and fall out, and the intracellular don't seem to help.. can anyone else relate?? what is the doc so afraid of?
    Jenny

  • #2
    I see 2 specialists and one of them is chomping at the bit to cauterize my ducts, the other one isn't such a fan. One of the reasons is because I, apparently, have extraordinarily small ducts so it's unlikely to make a difference (the plugs didn't) but the other reason is because ducts actually have a purpose besides draining excess tears. Dust, pollen, 'bad stuff' is flushed out of the eye through the ducts and cauterization prevents that. For me, since the plugs helped very little, if at all, the idea of doing something permanent seems extreme to me but if you noticed a big difference with the plugs, I can see why you'd want cautery. Have you asked your doctor specifically why he/she is so reluctant? I'd start there. He might have a good reason but may he doesn't feel capable, in which case, you could ask him for a referral.

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    • #3
      Most doctors don't have personal experience with the problems we face...only literature. Cautery is the only treatment that worked for me and I had to see many doctors in order to get relief from DES through cautery. They fear the procedure based on medical writings of others who haven't had the procedure themselves. I don't blame them. I'm just glad I found doctors who would go the extra mile and take on the risks to help me find relief from what we suffer!

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      • #4
        There are no brave doctors...

        Only brave patients.

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        • #5
          All the doctors I have seen over the past eight years have suggested it for me, so it must vary by the doctor and/or the patients symptoms. I've just been too scared to have cautery but may have to go for it in the Fall. (Doc mentioned it again last week and I see him again in Novemember.) If you have it done, please post about your experience and results.

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          • #6
            Hi Jenney, I have a doctor - a top specialist in Boston that keeps telling me I need to cauterize. I keep refusing and he keeps putting in plugs and telling me it is the last time he will do it. They keep falling out all the time and I already have the largest ones available. I hate the whole idea of something so painful and permanent. Personally I would not beg a doctor to do something he does not feel comfortable doing. It seems like a recipe for disaster. If you are really set on doing this, then I would find a doctor who does it all the time and has had a good success rate.

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            • #7
              Originally posted by djb View Post
              Most doctors don't have personal experience with the problems we face...only literature. Cautery is the only treatment that worked for me and I had to see many doctors in order to get relief from DES through cautery. They fear the procedure based on medical writings of others who haven't had the procedure themselves. I don't blame them. I'm just glad I found doctors who would go the extra mile and take on the risks to help me find relief from what we suffer!
              Can you elaborate on how much and what kind of dry eye you had prior to the cautery? I produce no perceivable tears, and cant cry a tear, I had punctal stenosis several years ago, had the surgery to open them, and now many years later am suffering from DES. The Doc wants to stitch closed first to see if it will even help me before considering cautery. Any input would be great...thanks

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              • #8
                Yes, I just had my top two cauterized this morning, so now i am fully cauterized. My doctor did not want to do it since im only 27, he did the bottom no problem but the top two was tough. I travel 2 hours to see him, and I had driven up a few times to do more trial runs with plugs. He looked back and realized its my 5th trial run with plugs which began in 2007.

                After trial run last month with the plugs it just bothered my eye, so I wrote him a note asking to please cauterize the top two. The plugs just bother me to much.

                So he finally agreed, but even this morning when I got there he tried to persuade me to only do one eye. Kind of head scratcher but i said i would rather get both.

                So he sealed them, but would not do it aggressively. I think that means that there sealed but could reopen.

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                • #9
                  Mawsky,

                  MG's 100% blocked. Very little water prior to cautery. Blurred vision with extreme dry eye pain prior to cautery. I am fully cauterized and the water is sufficient for vision and comfort most days. Epiphora is a pain sometimes but not as painful as dry eye.

                  Eyeproblems,

                  Cautery can reopen....when it does...you'll know it....then comes the hard part......convincing a doctor to cauterize it again......

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                  • #10
                    Im a little worried my one eye reopened already, either that or its just adjusting after a week, im not sure. Perhaps it opened a bit? Maybe i am just having a bad 2 days.

                    Since last week both eyes produced quite a bit of tear flow, the same amount, after the past two days my one eye still produces lots and the other still produces more then I recall, but now about half what the other one does.

                    I wish my doctor was not on holidays now and lived 2 hours away.

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