-
AuthorPosts
-
When you said you had had your blood tested, and that your levels were "normal", I suspect you were talking about your thyroid levels. If that is correct, then what you need to know is that thyroid levels have absolutely nothing to do with whether or not our eye muscles are under antibody attack. They are two very separate issues. TED is a separate autoimmune problem closely associated with the autoimmune that caused our thyroids to go wonky. But the treatments for the thyroid disease do not treat the eyes. And your endocrinologist will probably be very little help to you on this issue. Ophthamologists are the doctors needed to treat the eye disease.
In addition, radiation to the eye muscles is a temporary fix — as you have seen. It can help for a while, but if the eye muscles are still under antibody attack, the symptoms can return. There is a "hot" phase to the eye disease, during which there is progressive worsening of the symptoms, and this phase typically lasts 18 months to 3 years. Then there is a period of time when the symptoms start to improve, followed by a long, perhaps permanent period when the eye condition has stabilized. This last phase is called the "cold" phase. ONce the cold phase has been established, our eye doctors can intervene surgically to correct issues caused by the TED. They are reluctant to use surgery (typically) until this phase, because there is a chance that a surgery done during the hot phase of the disease will prove to be too much once the cold phase establishes itself. (Remember, our symptoms typically abate once the hot phase stops.) The only time I’ve heard of surgery being used during the hot phase is when the optic nerve is in direct peril due to the swelling muscles. Typically our doctors use steroids and radiation during the hot phase to try to improve things.
I have no information about the safety of multiple eye orbit radiations, but perhaps some other faciliator here is more knowledgable about that than I am. And I have no answers for the dental question, either.
Hi
Went to my opthamologist yesterday, he confirmed my fears. Have swelling again in left eye and it likes to wander now (like a bad child) and he wants MRI again. I had radiation on eye orbits May 09, not something I’m looking forward to again. My blood work has been stable so I’m wondering why swelling would re-appear months later. Has anybody else had a second radiation on eye orbits. How much radiation is too much? I’m going to make appointment with endo to discuss what causes could be and will get second opinion before I go thru another radiation treatment. I had RAI in Oct 08. At this point it’s really frustrating, I feel like I’m doing the right thing for my body only to have more symptoms….also worried about osteoporosis, tried to have dental implant 4 months ago after drilling 2 mm-hit dead space and went to bottom of jaw bone-who do I discuss this with?Looking for answers..
MBThe osteoporosis/bone loss in your jaw may be due to the initial hyperthyroidism you experienced ~ as far as I know, there’s nothing thyroid-related that you could do to "solve" that at this point. The best thing to do is find a bone expert to figure out your overall bone density and the steps you can take to reclaim or rebuild bone.
As for the effect of additional doses of radiation ~ that’s something to discuss with the doctor. Radiation exposure is a cumulative thing, over a lifetime, and many factors can play into your decision to continue using radiation to relieve your symptoms. At this year’s conference, one of the doctors suggested that a combination of oral steroids and radiation treatments for the eyes can limit how much you need of either, thus limiting the exposure issues that come along with radiation and the side effects that come along with steroids. It’s a good time for that discussion with your ophthalmologist.
Either way, steroids and radiation are only temporary fixes, to get you through until you’ve reached the cold phase.
Thank you so much for the replies. My husband and i are surprised by your answers. Neither my endocrinologist or opthamologist told us that this was a temporary fix. In fact, I specifically asked my opthamologist repeatedly, if the eye bulging can happen again and was told more than likely not; and he had never seen it happen a second time. (While I have my left eye swelling again it is not bulging and he suggested another round of radiation). I am interested in getting to the "cause" of the swelling while I feel the opthamalogist is treating "symptoms".
I am obviously still in the hot stage so I’m surprised he would want me to move forward with the double vision and eyelid surgery-I sure don’t want to awaken and sleeping antibodies with surgery and have to go through another round of bulging eyes and radiation. There is only one opthamalogist in the city where I live who deals with TED, time to look outside my city for second opinions….Thanks again, your information; it has helped me make a better informed decision.
I just wanted you to be sure of something — the radiation that you had for your thyroid (RAI) probably IS a permanent "fix" for you (as your endocrinologist indicated). What makes us ill with the thyroid part of the disease is hyperthyroidism. RAI typically eliminates that possibility completely by removing enough thyroid tissue to render us hypOthyroid. The eye radiation is something completely different.
None of the treatments at this point in time affect the antibodies. For antibodies to be taken out of the equation, given the current level of knowledge among medical researchers, the only option is to suppress the entire immune system and this type of action poses severe dangers of its own. Some folks with life-threatening autoimmune diseases do take immunosuppressants, but in our case, with TED, that is not a typical option.
Thanks, I totally understand they are two different diseases but related. I had the RAI on my thyroid in Oct 08. Then was diagnosed with TED in April 09 and had radiation on eye orbits in May 09. Things had been stable up until last 2 months and we started noticing the left eye wandering on its own and some swelling. The opthamalogist confirmed the swelling this week – while it is bothersome it is definitely nowhere near the initial bulging hence; I am hesitant to anything at this point other than get a second or even a third opinion. I see opthamalogist every 3 months and endo every 6 months (although I have my blood work done every 6-8 weeks per instruction). I did make an apptmt with endo to discuss some of these issues and to get some clarity. I believe that along with the knowledge I’ve just gained from this forum will be helpful. I am grateful to have found this forum and for all of your input.
-
AuthorPosts
- You must be logged in to reply to this topic.