A newbie with foamy tears and about zero patience left.

[Gil]

gil,

id be careful with eating a lot of soy. It is a GMO crop and additionally it can disrupt your hormones. Tomatoes are also in the nightshade family so if you have a possible autoimmune issue eating them can exacerbate problems by revving up your immune system. Also make sure you get B12. Most vegans/vegetarians are deficient in it and the kind you get from vegetarian sources isn't as active as animal based sources.

Gormz,

Thanks for the reminder about GMO soy. I just read that most soy and corn are GMO. I eat tortilla chips all the time. It's too bad that Prop 37 (mandatory GMO labeling) didn't pass in California. Doesn't soy contain estrogen? I thought the hormone disruption issue w/ soy only affects women, so I don't worry about it. I do try to avoid parabens, which I understand are hormone disrupters, too.

Tomatoes will be difficult to give up. It's a good thing I don't like eggplant.

I now take a sublingual B12 tablet daily. I also read that vegans/vegetarians are often deficient in D, so I take D2 (vegan source). Supposedly, D3 (animal source) is superior to D2, but the debate continues. I did recently find out that there's now a vegan version of D3 by Vitashine, but I can't seem to find it in the stores.

[gormz]

Gil,

Not just vegan/vegetarians but a large proportion of the population is deficient in D. Yeah D2 is definitely a suboptimal form to take.

I wont go on a rant about soy but they have phytoestrogens that are probably just as toxic (endocrine disrupter) to men as women. Do a quick pubmed search and you can find all kind of downsides to soy. Granted eating soy occasionally probably wont be harmful but id be cautious of eating it more than that.

[Gil]

gormz,

Actually, a large proportion of the population is deficient in most vitamins, not just D. I don't want to expose myself to the sun's UV rays (not as bad during the winter, though) to get my daily allowance of D3. I don't think I want to take D3 sourced from lanolin, either. I'd like to try Vitashine's vegan D3, but I want to be able to walk into a brick and mortar store to buy it. For now, D2 will have to do.

I'm going to try to limit my soy consumption.

[Nomad]

Shannon, does the site permit you to mention the brand of digestive enzymes that you are using? If not, can you at least say what should we look for in a digestive enzyme (like most imp. Ingredients) and how often and when you take them? Glad you are feeling better and thank you.

[shannon]

Hi Nomad,

I'm sorry it has taken me so long to get back to you. I think as long as I've been on here and I'm not shamelessly promoting some product then it's okay for me to share what's worked for me. That's what I got from reading the instructions for the forum. I've been drinking an Amazing Grass/Amazing Meal shake every day. It's full of good stuff, including dietary enzymes. I was also told I should use Source Naturals dietary enzymes so when I remember to take those before a meal, I take those before a meal. That's been a hard one for me to do on a regular basis. They say that the more enzymes the better (variety). What I was told was to start with a regular old dietary enzyme (with each meal) and couple it with probiotics (I take one a day after breakfast or lunch). It was also recommended that I take L-Glutamine on an empty stomach to repair the lining in my gut. I don't know if it's working and I don't do it with any regularity because I don't want to take a ton of supplements like that without really knowing what it's doing to me. Mostly what helps me is removing dairy and wheat from my diet and eating a ton of vegetables. The Amazing Grass/Amazing Meal is great. I have friends who have digestive issues and their health care practitioners (naturopaths, acupuncturists) have recommended Thorne MediClear. That contains enzymes and is a detoxy/liver kind of thing. It's expensive but I've heard really good things about it. I take Thorne's calcium/magnesium supplement and it's great. I hope that helps!

[shannon]

Oh, I also wanted to add that I don't eat yogurt (dairy) and I don't drink Kombucha or lots of fermented foods because I've been trying a lower histamine diet and the more fermented things are the more histamine they contain (that's what I've read). Anything to combat inflammation. But, those foods can be a good source of probiotics for the gut, just like Gormz mentioned above.

[shannon]

Okay, everyone. I went to see a new doctor in Oakland and I finally feel hopeful. She seems to know what she's doing. She has MGD. She writes and lectures on the subject. AND, she wears a ton of eye makeup! My kind of girl. I'm just happy to see that she has her MGD under control and she knows what to do with me. It was very reassuring. She definitively diagnosed me with MGD and said that based on the placement of the glands/openings she thinks I've had it for about 10 years. She has me on Azasite. She would have put me on Restasis I think but we're trying to have a baby. I apply Azasite to my lid margins once a day at night. I do lid scrubs/cleansing once a day before Azasite. The only weird thing is that she said I should stop my warm compresses. I'm going to call her Monday and ask her why. My hunch is that she thinks it's adding to the inflammation and she's preparing me for gland expression at the end of March (Mastrota paddle). Anyone ever been told to quit the warm compresses? That was the only thing that didn't make sense to me. I need to get better about asking questions when they come up...but I think I was just overwhelmed with joy that she knew what the heck she was doing and had the good sense to plan to express the glands. She says I have gland drop out and that likely some of my glands won't function anymore. But, I don't know, I think the body is flexible and my guess is that over time I may be able to rehab some. I'm hoping that the expression and Azasite give me a jump start and I can continue with hygiene and compresses to keep it under control. Any thoughts on the "no compress" thing? Thanks for your support and for listening and offering your experience. It's been so helpful.

[sunshinelover]

Okay, everyone. I went to see a new doctor in Oakland and I finally feel hopeful. She seems to know what she's doing. She has MGD. She writes and lectures on the subject. AND, she wears a ton of eye makeup! My kind of girl. I'm just happy to see that she has her MGD under control and she knows what to do with me. It was very reassuring. She definitively diagnosed me with MGD and said that based on the placement of the glands/openings she thinks I've had it for about 10 years. She has me on Azasite. She would have put me on Restasis I think but we're trying to have a baby. I apply Azasite to my lid margins once a day at night. I do lid scrubs/cleansing once a day before Azasite. The only weird thing is that she said I should stop my warm compresses. I'm going to call her Monday and ask her why. My hunch is that she thinks it's adding to the inflammation and she's preparing me for gland expression at the end of March (Mastrota paddle). Anyone ever been told to quit the warm compresses? That was the only thing that didn't make sense to me. I need to get better about asking questions when they come up...but I think I was just overwhelmed with joy that she knew what the heck she was doing and had the good sense to plan to express the glands. She says I have gland drop out and that likely some of my glands won't function anymore. But, I don't know, I think the body is flexible and my guess is that over time I may be able to rehab some. I'm hoping that the expression and Azasite give me a jump start and I can continue with hygiene and compresses to keep it under control. Any thoughts on the "no compress" thing? Thanks for your support and for listening and offering your experience. It's been so helpful.

Hi Shannon,
Interesting to read.your story. Did you get any diagnose as to the cause of the mgd? I also3 have an3 excema o n the other corner of3 one eye and it is itchy. Wonder if it is related to the dryness and mgd. Also have seborroic skin, and had acne in my twenties but fine now. Nice to have found a doctor who has her own experience, and good to hear about the makeup!

[littlemermaid]

Useful on what's happening with foamy tears - Dr Eric Donnenfeld, Dr Christopher Rapuano and Dr Marguerite McDonald, 'Physicians examine treatment options for patients with blepharitis', Healio.com 2008 http://www.healio.com/ophthalmology/...th-blepharitis

[Gil]

Useful on what's happening with foamy tears - Dr Eric Donnenfeld, Dr Christopher Rapuano and Dr Marguerite McDonald, 'Physicians examine treatment options for patients with blepharitis', Healio.com 2008 http://www.healio.com/ophthalmology/...th-blepharitis

Thanks for the heads up, lm.

[shannon]

Hi All,

I wanted to update you about my appointment to have my glands expressed (or extracted, however you want to look at it). I went to see Dr. Gill and she gave me a numbing drop and showed me the Mastrota paddle and then she went to work expressing my glands. It was not painful at all for me. She did say at one point that I have a high tolerance for discomfort. I have to credit my meditation practice because it really helps me stay grounded and attuned to my body on a moment to moment basis. Plus, I think I could rest in the comfort of knowing that this was a good step in the direction of healing my eyes. I, like you, have done a ton of research and I could rest in the decision that I made with some confidence. So, for some people I guess it would be more uncomfortable but I didn't really feel much. I went home afterward and my eyes did not swell or hurt. There was some seeping (I was prepared for this) because they glands continued to express oil.

Some of my glands are really blocked. She exfoliated the lid margins because I had keratinization and that's what was blocking the gland orifices. Once she exfoliated she could get a bunch more stuff out. Exfoliation was not a mystery...she just rubbed a q-tip along the margin, sort of how you'd scrub your face with a washcloth. Anyway, I had high hopes for the procedure and while it wasn't a cure I do feel that it was a good first step. I'm going back in 6 weeks or so and having the expression done again. Still putting Azasite on lid margins once a day before bed. Lid scrubs before Azasite. I've brought back the warm compresses because I think they help. I'm going to do them once a day or every other day depending on how my eyes feel. Dr. Gill was not sure warm compresses would help due to the keratinization and gland blockage but since the lid margins (epithelium?) have been exfoliated I've seen that more and more gland orifices are opened and working. My eyes feel better when I do warm compresses so I'll keep it up.

As of now, my eyes are still foaming. Not a ton and sometimes the tears are actually clear. I think some progress has been made. There is still more work to do!

Stay tuned...

[Gil]

Thanks for the update, Shannon. How does Dr. Gill use the Mastrota paddle? Does she put it between your eye and lid, then press on the glands against the paddle w/ her fingers? Are only the lower lid glands expressed?

Did the cotton swab have a cleanser or something similar on it before she rubbed along your lid margins? I found that using lid scrubs irritated my eyes.

[shannon]

Hi Gil,

Dr. Gill puts the paddle between the eye and lid and presses with a q-tip on the outside of the lid (against the paddle). She expressed my upper and lower lids. The upper lids were much easier to express (gravity helps and they tend not to get as clogged). When she exfoliated my lid margins she did put something on the q-tip. I can't remember what it was but I think it was either saline or Ocusoft lid scrub. They use Ocusoft foam a lot there. I don't use a lot of chemicals. I've been using blephasol to clean my lids/lashes once a day. I've been following Dr. Latkany's directions when it comes to lid compresses and hygiene (q-tip dipped in warm water along the lid margin). I've found that putting any chemical on the lid margin is not great for me. The only thing that has not been irritating is blephasol and blephaclean...but I still don't use those on margins. Blephaclean is nice because it has hyaluronic acid in it and I think that this helps with keratinization. The whole process with Dr. Gill took about 20-30 minutes. She doesn't overdo it. She told me that she was tempted to keep expressing my glands because she started to get some good gunk out of there but she stopped herself, which I thought showed a healthy restraint. She had another patient to attend to otherwise I would have encouraged her to go for it.

[Gil]

Thanks for the info, Shannon. Keep us posted on your progress.