[cathycnm]

#1072525

belldandy – Sounds like a good day for you. I see my opthamologist for a 6 mo follow-up (and for the #@#@ dry eye). Thanks for sharing your hopeful thoughts!

You are right – the glucocorticoid steriods are like the ones we make to deal with stress – and at higher doses, they help with inflamation. It is the androgens (male steriods) that athletes take and they are considered controlled substances like narcotics. Both are endocrine hormones but very different uses and actions.

[belldandy112]

#1019566

Well, I went to see the Graves eye specialist this morning. He also does a variety of cosmetic surgery on the eyes — did you know that eyelid lifts are done with laser surgery now? I came out with a $11 RX for Prednisone.

According to this particular doctor, I do have a bit of TED in that I have puffiness in the lids; but how much of that is due to allergies is unknown. There’s no pressure on the eyes that shouldn’t be going on. So I’ll do this treatment for six weeks. He says that I’ll see sufficient improvement. I’ve tolerated Prednisone well in the past (for hives), so hopefully, this won’t be horrid. AND … I might get my final 10 lbs. back and put it straight to muscle — if I can keep my mitts off the cupcakes. I eat healthy for the most part, but I don’t limit myself. That will probably change. This type of steroid is not the kind that athletes use to bulk up, which was a big concern. I’ve seen conditioned athletes at my boxing gym who use those type of steroids, and the women do not look very feminine! ” title=”Sad” />

All in all, it was a harmless experience. I know I’m overreacting — the doctor showed me pictures of what my eyes could look like, and I am nowhere near that level. I used to live with a two-pack-a-day smoker until very recently, and I’m wondering if that’s what bumped this along — the doctor did say TED is worse for smokers.

Hope everyone had a good day!

Melissa
Austin, TX

[belldandy112]

#1072526

You learn something new each day, don’t you? I was under the faulty assumption that steroids were all the same! Did you take them, and did they work for you?

As for that dry eye … there was a really nifty gel that I used when I had Lasix. They sent it home with me to use after the surgery. Worked like a charm, much better than the lubricating drops, although it does get a little messy.

[cathycnm]

#1072527

Yes – There are lots of kinds of steroids. It has to do with carbon and fat and how the molecule is made of these. Our own ovaries make steriods in the form of estrogen. Anabolic steroids are the male steroids or androgens we often think of as "steroids" that build muscle, cause women to masculanize, and are abused. We could not live without steroids in our body – so there is a big difference between that and the misuse of anabolic steroids.

I have some good drops and ointments I use. They are going to see if my insurance will pay for punctal plugs. With post graduate school and a full-time job – there is a lot of eye stress and stopping to put in drops every hour or two and waiting to be able to focus again adds several minutes to my study time each day. And I am virtually going 80 hours a week most weeks so it would be nice if this was less frequent and my eyes were less bothered by the reading.

We also talked about correction for the lower lid swelling eventually – he said if I did do it, he would advise going to Denver to someone who does this well. I don’t mind the bags in some ways – but I do look sadder and more tired – and I don’t like that image. I think it influences how people see my personality. I don’t know – it will wait a couple years either way – so I have time to decide.

[belldandy112]

#1072528

Cathy —

I know what you mean about how people perceive you. I wrote on another topic that my eyes make me look as though I’ve been either crying all night, hungover, or sleep-deprived. And in am employment situation, I cannot afford to have my employers have that perception. This position could evolve into one where I have much more public exposure. People say appearances don’t matter in job performance, but in some cases, they definitely do. Especially this one. I’ve been on the other side of the hiring desk, and yes — interviewers do say, after a candidate leaves, "Did you see how tired her eyes looked? I wonder if she’s a drinker/drug-user?"

On another note, I have tried every single concealer that I can think of for the "bags," and the only one that has worked is something called Touche Eclat by Yves St. Laurent — it’s very sheer and very liquidy, so I don’t have to push my eye skin around too much. The doc mentioned that if he did do surgery, it would be the laser surgery that they did in the office — your average lid lift, I suppose. He wants to wait a year to see what happens with my GD first. I think that’s a good idea — why waste money on a fix that’s only temporary?

[Ski]

#1072529

Absolutely ~ also not a good idea to mess with the skin now, in case you need it for other work later on. Wait until everything is resolved before looking into surgical corrections of any kind.

[belldandy112]

#1072530

Oh — another thing that this doctor mentioned was that he sometimes does radiation treatment of the eye — does anyone know anything more about this technique?

I took it that this is done for orbital decompression, as he explained it — not for cosmetic purposes.

[Ski]

#1072531

Orbital radiation can be effective during the "hot phase" of Thyroid Eye Disease, but has not been proven of any effect after the eye disease has run its course (once you’re in the "cold phase"). The doctors who spoke to us in October mentioned that some studies were done showing "no improvement," but the test subjects were all in the cold phase, so the results were of limited value. SOME patients do not show improvement from orbital radiation, even in the hot phase. Patients who had success controlling swelling with oral steroids in the hot phase were also likely to be successful with orbital radiation, so the idea is to use a little of each, limiting the risk of either. That’s only IF it’s necessary. Neither of these is necessary for most TED patients.

[belldandy112]

#1072532

Thanks for that info — I also read about direct injection into the eye. I would assume that this is for people who have really bad problems. It wasn’t mentioned to me as an option, and I wouldn’t want it. Ow-ow.

So I’ve discovered a little something … Prednisone — at least at this dosage — makes me queasy in a very strange way. Doc mentioned that I might want to get some Pepcid or another OTC medication. I think I might need to …

[cathycnm]

#1072533

belldandy – Yes, the corticosteriods can increase gastric acid so the best meds are like pepsid – the H2 receptor blockers are often suggested.

I found out my insurance does not need to preauth the punctal plugs – so going in in about two weeks for this.

[belldandy112]

#1072534

Cathy — congrats on your plugs! I keep seeing pretty long hair extensions, even thought I know that’s not what we’re talking about. ” title=”Smile” />

I’ll try the Pepcid … this is a really weird type of tummy upset. It feels like that doubled-over feeling I get whenever I run too long …

[Ski]

#1072535

The injections I’ve heard of are actually injections into the fluid behind the eye (they go in between the eye and the bone), and you’re right, again, not meant for any except those who are having the most problems. It’s a little less frightening than imagining an injection into the eye….

[belldandy112]

#1072536

Well, having had Lasix surgery with a tiny knife applied directly to my cornea, I doubt that would phase me too much, LOL!

It’s nice to know that all of these options exist now. That probably wasn’t the case for most patients with GD 20 years ago. And I was very cheered when I read about the laser surgery to cosmetically correct eyelid sag, which is done only with local anesthetic. I don’t know if I’ll ever be a candidate for this type of surgery, but the least invasive the procedure, the more comfortable I’d feel with it. I doubt that I would go under general anesthesia unless I had to save my vision, and it was not just for cosmetic purposes. I read stories in the news about people who die having simple cosmetic surgery procedures such as face lifts — what was the name of the popular female author who died during lipo? — and to me, it’s not worth it unless it is really needed, e.g., one’s quality of life has been compromised, such as in the case of serious burn victims or people who need gastric bypass to avoid having serious health complications in the future.

[belldandy112]

#1072537

Is it common for steroid treatment to start working after only three days –? Maybe it’s just wishful thinking, but my lower lid "poof" is going down, and I have less difficulty holding my eyelids up during the day. I dunno, it just seems like my lids have more mobility. (??)

[Ski]

#1072538

Oh yes, steroids should begin to work rapidly. Glad to hear you’re getting some relief!

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