Dry Eyes

eye drops 014One can spend a small fortune on eye drops.  Who knew there were so many options?

It turns out that there are (at least) two factors affecting eye lubrication.  First is tear production volume.  Eyes need to produce tears to moisten the eye.  If few tears are produced, then there isn’t enough moisture and the eyes will feel dry.  The second factor is evaporation rate.  If tears evaporate quickly, the eyes will be dryer than if tears evaporate slowly.

Regardless of the cause, when eyes are dry, they need to be moistened.

Artificial tears are available over the counter (OTC).  These liquid eye drops come in many brands, with different types available within each brand.  Plain artificial tears are what you want.  Drops for relief of red eyes usually contain an antihistamine, which is great for allergy sufferers but bad for dry eyes.  Note that bottles of eye drops contain preservatives.  In general, the recommendation is that if you use drops more than four times a day, switch to drops without preservatives.  Drops without preservatives come in tiny single-use applicators.  Whether it’s single-use tubes or full-size bottles, carrying them in your pants pocket all day 1) keeps them conveniently close at hand, and 2) keeps the drops warm, making them much more comfortable to put in.

Gels are also available OTC.  These are thicker than drops.  The advantage is that they don’t evaporate as quickly, so don’t need to be used as frequently as artificial tears.  One disadvantage is that they’re goopy, so cloud the vision for a short time after application.  For this reason, gels are usually used at bedtime.  Or, if you’re like me, you don’t mind enduring ten minutes of cloudy vision so that you don’t need to use drops quite so often.

Ointments are basically sterile Vaseline in a small eye-applicator tube.  These, too, are available OTC, and cost about $16 if you take one of the brands off the shelf.  My pharmacist has a $4 brand behind the counter.  Horrible as it might sound to put Vaseline in your eye, when your eyes are dry enough and you’re waking multiple times a night to use drops, you’ll try anything.  Ointments cloud your vision significantly more than gels, so if you try these, have everything ready so that  you can close your eyes and hop into bed immediately once the ointment is in.  You won’t even be able to see to find your way to bed, so if you can’t find your bed with your eyes closed, consider getting a mirror for your bedstand so that you can already be in bed when you put the ointment into your eyes.

Regardless of the amount of tears produced, sometimes those tears evaporate too quickly.  If the meibomian glands don’t work properly, the tears won’t contain enough oil to keep them from evaporating.  Sometimes these glands get clogged.  Applying a warm compress twice a day can help.  Although a hot washcloth can feel nice and relaxing, it won’t stay hot long enough.  One good option is a flexible microwavable heat pad.  This goes into the microwave for 25 seconds (approximately), and then will be the perfect temperature to place gently over the eyes for 10-15 minutes.  After this time is up, gently wash the eyes with warm soapy water.

TheraPearls

A few other options for self-treating dry eyes:

  • Avoid antihistamines.  During the height of allergy season, this can be hard.  Allergy medicines are drying, though, so they will make dry eyes worse.
  • Avoid drafty air, fans, and air conditioners.  These tend to dry the air — and the eyes.
  • Seek out humid air.  Moist air can help the eyes retain their moisture.

If dry eyes persist, despite the best efforts of eye-drop manufacturers, make an appointment with your eye doctor.  This is not an appointment to have your vision checked to see if you need new glasses.  It will not be billed to your vision insurance, but to your medical insurance.  When you call, tell them that the reason for the appointment is “dry eyes.”  Take all your drops with you so that the doctor can see what you’ve tried.

When I saw my eye doctor, I led with, “My dermatologist says that my skin is dry. My dentist says that my mouth is dry. My eyes are so dry that I’m buying eye drops at Costco and emptying the bottles before they expire or get lost.  Can you tell me if this is Sjögren’s Syndrome, or something else that’s making my eyes so dry?”  Nope.  He couldn’t tell, but he could tell that I am both 1) not producing many tears, and 2) not producing much oil. Sometimes low tear production is due to inflammation, so I have $500 prescription eye drops that will take 6-8 weeks to take effect.  These are used every twelve hours, and are in addition to the preservative-free drops I need during the day and the ointment that I use at bedtime.

Wishing you pain-free days and nice, moist eyes.

Keeping Busy Despite RA

RA meds work!  True, they don’t cure the disease, but they’re designed to slow down progression and make it possible to have a life.  I’d have to say that my life is a testament to how well my meds are working.

rheumatoid arthritis best blogs badgeA big thank-you to Health Line for honoring my blog while I was busy proving that RA meds can be effective, and congratulations to my fellow-bloggers also named.

 Before diagnosis, I remember having to limit myself to three errands a day. Two was even better.  Best was to stay home and not do anything.  Everything hurt, and I was just too exhausted to do anything.  Nothing could be done before 8 a.m., and I had to be back home by noon because my energy for the day was gone by then.

In contrast, now I’m able to go out and do things  — many things.  For example, between them, my two boys have had ten baseball games and two track meets in the past week.  After schoolwork in the mornings, we leave the house around 1:30 (way past noon), drop one son off for practice, drop the other off for his practice, stop at the store if needed, go home and make/pack dinner, then go back to pick up boys from afternoon practice (or watch & cheer if it’s a game/meet day). On baseball game days (most days, it seems), drive to evening games, some of which are an hour away, and cheer some more.  Thanks to RA meds, I can do more than three things in one day, and can be gone from the house past noon.  Honestly, my entire family’s life would be very different without biologics, because that’s what it took to get me to this point.

That doesn’t mean that I’m pain-free, or that there aren’t rough days, but things are manageable.

High school basketball begins in early November, as do practices and tournaments for my younger son’s select basketball team. Middle school basketball begins the first week in February, so the select team ends their season (thankfully we stop – some teams go year-round).  Then high school basketball ends a week later.  High schoolers have a week off before baseball turnouts, then games start the first week of March. Youth league baseball practices also start practicing in mid-February, so kids are doing both basketball and baseball.  Basketball season is over at the end of March, then track begins in April (right after school), as do youth baseball games (in the evenings and on weekends). The high school baseball season ends the first week of May, then American Legion teams start the next day. Unless the high school team makes playoffs, in which case kids are playing on two teams. Track ends the first week of June, but high school’s summer basketball program starts, so we’re still juggling three teams.  Baseball runs into July, but this year the coaches are trying to ensure that people have a break, so we’ll get most of a month off between the end of summer ball and the start of fall ball.  Fall baseball practices for both boys begin in August, with games running through October.  Then it starts all over again.

SportsCalendar

Sports weren’t like this when I was a kid (back when dinosaurs roamed the earth). Sports had distinct seasons, and coaches didn’t make kids feel like they couldn’t make the regular season team if they didn’t also participate in extended stuff.  The best I can do is juggle, try to teach about having some balance, and support my kids in pursuing their dreams.

But I can!  The way I felt before starting on a biologic, there is no way my sons would be able to play sports because I wouldn’t be able to transport them.  I can only imagine what family life must have been like for RA patients before biologics came out.

Plus, we still have cows, horses, alpacas, and ducks to feed.  Meals need to be cooked, laundry needs to be washed, and it’s nice to vacuum the floor every now and again.

My two sports-minded sons aren’t the only kids in this family.

  • My oldest just completed his junior year of college. He is currently in Greece.  A group of students have spent the past year studying Greek history (3 history credits), as well as physical setting of the Bible (3 Biblical Literature credits), and are now travelling in Greece to see the places they’ve been learning about.  Once he returns, he has an internship set up (same place he worked last summer).
  • My older daughter is a college sophomore, and is taking time for some real-world experience before finishing her degree.  She is fundraising, and leaves soon for a six-month trip that begins with 12-weeks of training, followed by hands-on medical missions work.  They’ll start out at a clinic in Kolkata, then head either to southeast Asia, Africa, or Nepal (depending on needs at the time).  In addition to earning money for her trip, she’s doing all the pre-trip things one needs to do like get travel vaccines, find a good-quality backpack she can live out of while she’s gone, learn about the places she’ll be going, renew her passport, apply for visas…
  • My younger daughter is nearly done with her high school work and took two dual-credit courses this year.  She just registered for classes at her first-choice college, so is doing all the college prep activities that 18 year olds do.

Life is busy!  I am so thankful that I have been able to keep up with my kids’ activities!

In the Kitchen

Wouldn’t it be nice to have hands that worked without aching?  Unfortunately, meds to treat autoimmune arthritis only slow the disease; they don’t halt progression or provide a cure.  In the kitchen, achy hands make meal prep a challenge.

CanOpenerAlthough I try to cook with fresh ingredients, sometimes it is necessary to open cans.  My preferred method of opening a can has been to hand the can and opener to someone and raise my eyebrows in a silent plea for help.  Unfortunately, my kids are growing up and either playing sports or heading to college, which throws a wrench in my can-opening options.  Everyone in the house recognized the problem, so my kids did some research in an attempt to find me the best electric can opener on the market.  I have great kids!  They gave me a Hamilton Beach 76606Z for Christmas, which means I’ve had it long enough to know that it is a very good can opener.  I can now open cans even if there’s nobody else in the house and my hands and wrists prevent use of a traditional-style can opener.

MandolineThe other kitchen acquisition that has helped tremendously is a good-quality mandoline.  Note the “good quality” modifier. I used to have an inexpensive model, and cutting things with it was an exercise in frustration.  The one I replaced it with is fabulous.  I first saw it demonstrated at a fair, then did some research before buying.  The price on Amazon has come down in the past year and beats the fair price by a good bit.  This mandoline will slice tomatoes, pickles, mushrooms, potatoes, and probably anything else you might want to slice (except avocados — it gets jammed on the pit when slicing so effortlessly you don’t realize you’re already that far into the fruit).  I like the fact that the slice thickness is determined by a fixed bed.  You choose the thickness you want and easily insert the appropriate cutting bed. My old mandoline had a knob that I turned to adjust the cut-depth and it had a tendency to slip while in use.  With this setup, there is nothing that can slip and inadvertently change the slice-size.  I also like the V-blade, because it will slice soft things like tomatoes just as perfectly as it slices firm foods like potatoes.  I also like that it’s mostly stainless steel instead of plastic. The Borner V6 comes with a holder that can be mounted on the kitchen wall.  Since there’s no space on my walls to mount anything, I just leave it sitting on the counter beside my KA.

My favorite cooking tool is a crockpot.  Any kind, every kind.  Start oatmeal at bedtime and it’s ready in the morning when you get up.  Start supper in the morning, and it will be ready to eat when you get home in the evening.  Everyone should own at least one crockpot (IMHO).

If your budget is like mine, you can’t afford a personal chef. A few good kitchen tools will make a world of difference.

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Disclaimer:  while I’m not opposed to people sending me gadgets or money, that didn’t happen here.  I bought my mandoline and crockpots, and my kids bought my can opener.