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The good news and the bad news... - John [entries|archive|friends|userinfo]
John

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The good news and the bad news... [Oct. 18th, 2014|02:05 pm]
John
The good news: by staying on a strict ketogenic diet - < 30 grams of carbohydrate a day - I managed to avoid my worst symptoms for ten days.

The bad news: a side effect of a ketogenic diet can be dry eyes. Imagine waking up with your lids feeling glued to your eyes, and then feeling like your eyes are sandpapered all day - to the point that you have a hard time keeping your eyes open *or* closed. And staring at a computer monitor, checking log files and performance indicators? Forget it! Driving anywhere is a moderate risk - you can probably keep your eyes on the road, but you can't be sure....

I lost as much time to work last week as I ever lost to fatigue. And I was nearly as miserable due to the dry eyes.

So: I did some carb loading yesterday. And my eyes are significantly better today. But I'm also feeling the beginnings of my symptoms returning. Oh, it's not horrible - if this was the worst day ever, I'd be doing pretty good. But experience tells me this is more likely a "good" day.

So: Monday I see an eye doctor. And hopefully, we can do interventions to keep my eyes from injury. And in the beginning of November, I do my four day EEG and hopefully, we find something, and hopefully, we can fix it with something that doesn't dry the ever living (expletive) out of my eyes.
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Comments:
[User Picture]From: acelightning
2014-10-19 06:52 am (UTC)
Dry eyes are very easy to treat, usually with relatively inexpensive OTC drops - be sure to use the formulation your eye doctor recommends, because there are a bunch of different ones, and some of them aren't suitable for diabetics. But they make a HUGE difference in your quality-of-life!
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[User Picture]From: johnpalmer
2014-10-22 12:19 am (UTC)
Nod. It looks like I'm going to end up using the gross petrolatum/mineral oil ones, warmed up so I can get a gross quantity in. Once I'm not irritated, I'll take a chance with the others, but these are the only ones that seem to have the staying power I need overnight.
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[User Picture]From: acelightning
2014-10-23 10:33 am (UTC)
I guess there must be different degrees of dry eye, because I didn't even know there was a treatment involving petrolatum. I can't imagine how you'd get that to cover your cornea evenly. I'm supposed to use Systane Balance, which is just propylene glycol - the simplest dry-eye drops there are - four times a day, but sometimes I seem to need it quite a bit often than that, and other times I forget it completely.
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[User Picture]From: johnpalmer
2014-10-24 04:41 pm (UTC)
Yes, there is. My problem is at night - this isn't uncommon, because you don't blink at night, so you don't spread tears around as much.

Some people (including me) get a feeling like their eyelids are stuck to their eyes. This can be very painful and leave you with a bad "foreign object in eye" feeling for a long time, even if you thoroughly lubricate the eye, due to the tiny bits of damage.

It's also possible to get ones lids literally stuck to the eye, and cause more serious damage. This can even become vision threatening. That hasn't happened to me, but it scares the fuck out of me... I've had persistent imaginings/fears of losing my vision, and this scares me even more because it'd be one thing if I lost my vision through something heroic, through extreme stupidity, or through malicious actions - but losing my vision because of dry eyes seems like the ultimate insult to the injury.

There are goopier eye drops that tend to maintain lubrication longer, but petrolatum/mineral oil compounds (carefully sterilized, naturally!) exist as well. If you warm them to skin temperature, they tend to be soft enough to cover the eye, but there's (as I mentioned) a bit of an ick factor. But spending 2 days with "I can't keep it open... I can't keep it *closed* either!" makes one more ick tolerant.
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[User Picture]From: acelightning
2014-10-25 08:33 am (UTC)
Mine seems to be related to allergies. Even before I had cataract surgery on both eyes, I'd occasionally have a reaction to something - often as simple as a gust of wind, a sudden bright light, or a droplet of water in the shower - that would make one eye sting, itch, hurt, water uncontrollably, and swell. OTC anti-allergy eye drops, administered every ten minutes or so (instead of twice a day!) would help some, but not all the time. And when the cat affectionately licked my face, both eyes would swell shut, with similar itching and burning. After the cataract surgery (both eyes), this got somewhat worse. Last year, after ten years, one of the implanted lenses failed, and had to be removed and replaced. During the examinations before this surgery, the ophthalmologist told me, "Oh, by the way, you have 'dry eye' - try these drops," and handed me some samples. I need both antihistamine drops and lubricating drops, but fortunately I can get by with OTC versions of both - the first antihistamine he gave me would have cost close to $400/bottle, and a bottle would have lasted maybe two weeks!

When they did the original cataract surgeries, I dimly recall that after the second one, I had to use a gooey "ointment" in that eye; it came in a little tube, like cold-sore medicine, and it was horribly difficult to use. At the time, the ophthalmologist said, "You moved, and messed up the operation. Now it's going to take longer to heal, and you have to keep this stuff on it for a week." That was the surgery that eventually failed - the plastic implant tore free, and could have fallen inside my eyeball, which would have been very bad, but they removed it and put in a new one. Apparently the ophthalmologist(*) who did those earlier surgeries has a reputation among his peers as being basically a barely competent money-hungry quack.

(*) Yes, I'm showing off that I know how to spell "ophthalmologist" :-)

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[User Picture]From: johnpalmer
2014-10-27 06:18 pm (UTC)
I remembered *almost* how to spell ophthalmologist from old Peanuts cartoons - Linus had long discussions with his! - but my last spelling challenge was bemoaning that I don't know how to spell "sphygnomanometer" (it's sphyg*mo*...") on Usenet. Upon correction, I quoted the old saw about the best way to get information online is not to ask a question, but to post something incorrect.
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[User Picture]From: acelightning
2014-10-28 04:54 am (UTC)
When I had my cancer surgeries, they kept insisting that I had high blood pressure. But they always used one of the automatic devices, and I have the kind of fat, fleshy upper arm on which those gizmos produce completely bogus readings (e.g., 187/52). I had to keep insisting that they use a manual sphygmomanometer, which meant I had to be able to both spell it and pronounce it. (Alas, they often don't even have one, or they give me excuses such as "Nobody here knows how to use one", or "We don't have one here", or "We had one, but it's broken".)

Then my old cataract implant failed, and I had to reactivate my knowledge of how to spell and pronounce "ophthalmologist" :-D

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