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Hi all... for what it's worth, I'm going to put this out there.
So as many of you know, I have my upper puncta cauterized. The upper right has stayed shut ever since day 1 - awesome. The upper left has not been nearly as cooperative and re-opens within a few weeks (5 weeks was my record for it staying shut, up until this last time where it has now been shut for almost 2.5 mo. and no signs of re-opening) I've been wondering if the exact way that that the dr. performs the cautery makes a difference... here's why.
When my dr. did my upper right puncta (the one that has stayed shut for over 3 years now), he put the cautery device in the puncta, and kept it in there for a fair bit, then took it out. When he did my upper left, he started off the same way, but then I could feel some heat and I when I let him know, he took out the cautery device, added more freezing, then re-inserted the cautery device for a bit more time. (Between the 2 insertions, the total time was about equal to how long it was in the upper right... except for the upper right, it was in there all at once with no break in between) Anyhow, within a month, that upper left puncta re-opened.
2nd attempt for upper left: dr. put in the cautery device once for a few seconds, took it out, then re-inserted it for a few more seconds. Within 5 weeks, the puncta re-opened.
3rd attempt for upper left: I mentioned to the dr. my observations from the first few couple of attempts, and asked him if the length of time the cautery device was inserted all in a row could make a difference. He said when they are learning cautery, it's basically like "just stick it in for a few seconds" and the texts don't really go into detail... I guess when they are learning it for practice too, maybe the dr's training them don't go into much detail either? Point being, there apparently isn't much in the way of details regarding technique that is taught. ie. do you stick it in once for say, 3 seconds, and that's it? do you stick it in deeper for say 3 seconds, take it out, then stick it in one last time to cauterize another 3 seconds but a bit less deep that time? do you stick it in deep for 6 seconds and that's it? Do you cauterize for a total of 3 seconds and that's it? how long?
Anyhow, it was an interesting conversation, and kind of cool to hear from their side of things how they know, or don't know, how long to stick it in there etc. I assume with experience, they maybe get a feel for it, but then again, there aren't many people like us who need cautery, so maybe they don't end up doing it all that much? who knows...
Bottom line though, is for the last attempt, the dr. did it more like it was done the first time on my upper right (the one that has stayed shut for over 3 years now) - he put in the cautery device, and left it there for a longer time (relatively speaking haha... not like it was in there for 5 minutes or anything like that)... he kept it in there long enough for me to feel the heat for a few seconds (at first, you feel nothing... but after a few seconds, you can feel heat). So 1 insertion, and "longer" one at that. And lo and behold, that puncta appears to be staying shut this time.
Thought this might be of interest to any fellow patients getting cautery done... and maybe a doc or two might find this interesting also (or maybe not? who knows... just putting it out there)
Have a good day all!
So as many of you know, I have my upper puncta cauterized. The upper right has stayed shut ever since day 1 - awesome. The upper left has not been nearly as cooperative and re-opens within a few weeks (5 weeks was my record for it staying shut, up until this last time where it has now been shut for almost 2.5 mo. and no signs of re-opening) I've been wondering if the exact way that that the dr. performs the cautery makes a difference... here's why.
When my dr. did my upper right puncta (the one that has stayed shut for over 3 years now), he put the cautery device in the puncta, and kept it in there for a fair bit, then took it out. When he did my upper left, he started off the same way, but then I could feel some heat and I when I let him know, he took out the cautery device, added more freezing, then re-inserted the cautery device for a bit more time. (Between the 2 insertions, the total time was about equal to how long it was in the upper right... except for the upper right, it was in there all at once with no break in between) Anyhow, within a month, that upper left puncta re-opened.
2nd attempt for upper left: dr. put in the cautery device once for a few seconds, took it out, then re-inserted it for a few more seconds. Within 5 weeks, the puncta re-opened.
3rd attempt for upper left: I mentioned to the dr. my observations from the first few couple of attempts, and asked him if the length of time the cautery device was inserted all in a row could make a difference. He said when they are learning cautery, it's basically like "just stick it in for a few seconds" and the texts don't really go into detail... I guess when they are learning it for practice too, maybe the dr's training them don't go into much detail either? Point being, there apparently isn't much in the way of details regarding technique that is taught. ie. do you stick it in once for say, 3 seconds, and that's it? do you stick it in deeper for say 3 seconds, take it out, then stick it in one last time to cauterize another 3 seconds but a bit less deep that time? do you stick it in deep for 6 seconds and that's it? Do you cauterize for a total of 3 seconds and that's it? how long?
Anyhow, it was an interesting conversation, and kind of cool to hear from their side of things how they know, or don't know, how long to stick it in there etc. I assume with experience, they maybe get a feel for it, but then again, there aren't many people like us who need cautery, so maybe they don't end up doing it all that much? who knows...
Bottom line though, is for the last attempt, the dr. did it more like it was done the first time on my upper right (the one that has stayed shut for over 3 years now) - he put in the cautery device, and left it there for a longer time (relatively speaking haha... not like it was in there for 5 minutes or anything like that)... he kept it in there long enough for me to feel the heat for a few seconds (at first, you feel nothing... but after a few seconds, you can feel heat). So 1 insertion, and "longer" one at that. And lo and behold, that puncta appears to be staying shut this time.
Thought this might be of interest to any fellow patients getting cautery done... and maybe a doc or two might find this interesting also (or maybe not? who knows... just putting it out there)
Have a good day all!
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