Saturday, January 19, 2013

Four Years and Two Surgeries Later

I had the procedure in 2011, and the doctor told me, "It was actually just a build up of mucus." Gross, right? It made sense, though, since I'm pretty sure my multiple sinus infections caused the tear duct to get blocked in the first place.

The procedure was easy, and thankfully painless. I think he just stuck a tube down my tear duct and cleared out the blockage. The bad news: the tearing didn't stop. I thought the stent was preventing the tears from getting through the tear duct, but I was wrong. When I had the stent taken out, the tearing didn't get better. I carried a folded tissue with me at all times to stick in the corner of my eye. I avoided dealing with people face-to-face because I didn't want them to see me with tears welling up in my eye. My eye once again grew raw from rubbing the tears away.

And then in January 2012 a miracle happened:

I got the flu.

I was overdosing on Dayquill to stay functional at work, and one day while I was in the bathroom, I blew my nose and this green gunk came out of my eye. (I'm sorry this is so gross!) I was horrified and curious, and pinched my nose shut with my fingers and blew air into my sinuses.

More nasty gunk came out of my tear duct.

So I did it again.

And again.

And again.

Until the gunk stopped. And slowly, over a couple of days, the tearing did, too.

For all of 2012, I was amazingly tear free. And I'm not kidding when I say I was grateful every day for it. I kept a bottle of Dayquill at home and at work, because I'd get the occasional tearing, but a shot of Dayquill and blowing out my eye (I'm sorry it's nasty!) cured the first signs of tearing.

In December 2012, I decided to get bangs. A few weeks later, the tearing started again. And I thought back to the last time I started tearing, and realized that I'd gotten bangs then, too. And the time before that.

Coincidence? Maybe. Maybe not.

I tried my Dayquill trick, but to my horror, the tearing just seemed to get worse. I tried more Dayquill. Still worse. I downed Dayquill until I nearly passed out. Blew my eye.

Nothing. More tearing. Excessive tearing.

As I type this, my eye is more damp than teary, but it's been getting steadily worse. It could be a sinus infection (my sinuses do feel pretty full) or it could be the tear duct being blocked again.

Tomorrow I'm going to go buy some Mucinex and see if that helps, and on Monday, I'm calling the doctor. Hopefully it doesn't come to that.

Until next time.

Tuesday, May 24, 2011

CDCR - CDCR (Conjunctivodacryocystorhinostomy) - Block Tear Duct Surgery - Take Two!

It's been a year and a half since my DCR--the surgery for my blocked tear duct.

This is what I look like as of February 2011--remember, it was my right eye.


I was blissfully tear-free for all that time, though I'll admit, I waited almost a year to have the stent taken out. (WAAAYYY longer than I was supposed to.) The pain went away completely, the scar is barely visible--though it is still visible right under my eye--and I had no problems at all.

When I finally had the stent taken out, about nine-ten months ago, the doctor told me, "If it ever comes back, you just come back to see me and it's a really easy procedure to fix it."

Sweet, I thought, happily skipping on my merry little way. Procedures were easy. I'd had several "procedures" for the blocked tear duct before I'd finally had to undergo the knife. A lot of the comments I've gotten on this blog were people asking: "What did you do prior to the surgery?" (I'm sorry I never replied to any of you--for some reason, I never received an e-mail with your comments!)

The eye doctors pumped me full of drugs, then stuck a long needle in my eye and forced saline solution through my tear ducts to "clear the blockage." (How attractive does that sound? You can imagine how much I love having to tell people in real life about this...) I had it done at least twice with success, with the third time a failure resulting in me having to go in for surgery. Each time the tearing started up again, once about a year later, and once just a few months later. I was told at the time that in adults, that procedure is rarely a permanent solution, but it can work temporarily.


(Incidentally, another question I got a lot was, "What were your symptoms?" That's easy. My eye watered. Constantly. Sometimes it was just barely wet around my eyes. Some days my eye literally wouldn't stop pouring water, and I would soak through tissue after tissue, holding it against my eye to catch the tears. It came in waves. When I woke up some days, my eye had literally sealed itself shut and I had to pry it open from all the gunk. Gross, I know. Some days it was totally fine and it was just a little icky around the edges. Sometimes I would press against my tear duct--the area right on the skin outside of the inner corner of your eye--and all this STUFF would shoot out of my tear ducts in this horrifically repulsive manner and I would gag. My eye would get swollen from rubbing it to keep it dry. It was miserable.)

A couple of months ago, my eye started watering more than normal. I told myself, It's just your imagination. Don't worry about it. Then, as the watering got worse, I thought, It'll go away. Relax. But one night, as I stared at myself in the mirror of a dingy bathroom in a karaoke bar I was at with my friends, staring at my heavily made up left eye and my oddly bare right eye, wiped clean from the tears that had been leaking over the course of the night, I stared unhappily at my misshapen face and grimly realized, It's happening again.

I called the doctor and made an appointment to see him. My eye had stopped tearing as much over the course of the few days, and I thought, It's not so bad. It's just a procedure. In and out.

The doctor gently slid a freakishly long, blunt needle down my tear-duct (and let me tell you, there's nothing quite like having a long, flexible, freakishly long needle sticking out of you RIGHT NEXT TO YOUR EYE), and depressed on the syringe to squirt water into the duct.

It shot right back out at him.

"Okay," he said to me, rather cheerfully. He pulled the syringe out of my eye and tossed it away, going to his table to start scribbling in his folder. "Sometimes what happens is people heal too well after the DCR. The hole that we made in your nose closed up. So it's a really simple surgery--we do it downstairs--and we go in through your nose with a tiny little camera--it's very high tech--and a really little needle, and we open it back up. Then we put in some anti-scarring stuff, and you're good to go. It's called a CDCR."

I stared at him, sickened horror coming over me. Not a simple procedure. Back downstairs, where they do their surgeries. Not a quick in-and-out thing. They were going to put me under again. Knock me out.

Surgery.

But, I thought, resigned, at least they weren't going to cut me open again. So I nodded and headed out.

Over the next week, a dull, throbbing pain started to develop in the small space between my inner eye and my nose. Right over my tear duct. At first I thought I had been pressing it too much, but the pain increased every day.

Then the pain in my nose started.

When I had woken up from surgery after the DCR, I remember pressing my finger against the right side of my nose, a throbbing pressure concentrated in one tiny spot that seemed to bleed into the surrounding area making my entire face hurt. The nurse told me I was pressing right where they had drilled into my cartilage. (If you're reading this now, right after reading the previous post, then you'll know exactly where I'm talking about.) The pain had been intolerable, and I had gone back to the doctor for stronger medication because the painkillers I was on weren't cutting it.

And somehow, this was the exact same pain.

I wondered if I had ruptured something. If I had another tear stone. I wondered if somehow, the new canal he had made had gotten torn apart.

But as the days wore on and the pressure and pain became more intense, and just moving my eye or making facial gestures hurt, I realized it wasn't anything so simple. When I looked to the right, exposing the white part of my eye normally hidden by my tear duct, I could see that the white was blood shot and red, horribly irritated and inflamed. The pressure on my nose and on my eye was starting to become excrutiating.

I had an infection.

When I called the doctor to tell him about it, nearly in tears, I was dismayed to discover they weren't as surprised as I had hoped they would be by my symptoms. They called in a prescription of painkillers and antibiotic eyedrops (yes, they're putting eyedrops into an eye that won't stop pouring liquid--go figure) and my loving husband dutifully picked them up for me. I was told to apply the eyedrops three times a day, and to take the painkillers as needed.


As soon as I put the first drop in my eye, the pain almost instantly vanished.

I almost cried in relief. I still took the painkiller, sure it had to be a fluke, but over the course of four days, not only did the pain instantly disappear, but the tearing that had been a torrential downpour over the last week suddenly faded, too. When I went to see the doctor, astonished, he looked pleased.

"You may not even need surgery!" he told me cheerfully.

I gaped at him. "What?" I asked. "But... you mean... the drops... fixed it?"

He shrugged, nodding. "It's possible. If it comes back, we'll still get you scheduled. But if it doesn't, then there's no need for you to have the surgery."

I wanted to ask why he hadn't just given me the drops to begin with, instead of immediately scheduling me for surgery, but I was too grateful that everything in my eye looked good to care. "Do you know..." I began hesitantly, "what could have caused this? I mean... I was fine two when I saw you--what--two weeks ago?"

He shrugged again. "It could be anything. It could have been a very small, slight infection. It could have been a tear stone. But the eyedrops should have cleared that all up. You can take them for a week at a time--don't take them for more than that, because they can cause cataracts--but if the drops work for the tearing, then you can use those instead of having the surgery."

I gaped at him. I remembered the pain in my eye and my nose. I remembered the gunk I had pushed out of my tear duct when the pain finally subsided enough for me to press on it again and gagging in disbelief as this disgusting stuff I don't even know how my body made shot out of the tiny little holes in my eyes. I thought of cataracts, and how I'm pretty sure they run in my family. I thought of putting those drops in my eyes, and how I can't wear a contact in one eye so I'm half-blind and unsteady on my feet. I thought of a lot of things in those few seconds.

"I think I'd prefer surgery," I told him weakly, offering an uneasy smile.

He nodded. "Sure. Sure. Well, the nurse will give you a call, and if it's still a problem, we can get you in, no problem."

I nodded, thanked him, and left.

I'm still waiting for the nurse to call me to schedule the CDCR, and it's been about two weeks now. But on the plus side, the tearing has slowed down to almost nothing, and the pain is gone. And I'm sure I'll have an update once I have the CDCR.

Until then, I hope this blog has been helpful to anyone who has, or is considering, or is going to have, this surgery. It was painful in the aftermath, yes, but it really was worth it. Having tears streaming down your face will drive you more crazy than a few days of pain. I guarantee it.

Monday, October 12, 2009

What it's like...

Here is a blog (pictures soon to follow) of my experience with the DCR surgery, aka, the "blocked tear duct" surgery. When I was told I'd have to have this surgery, I went searching for everything I could find on it. I found lots of medical journals, stating what they would do to my eye, but nothing about personal experience.

So, here you go... my personal experience with the DCR surgery... The pictures aren't pretty, but they're real. And trust me, it was embarrassing to take these, and to post these, but I thought maybe someone else could benefit from my experience.


Pre-Surgery

The day before the surgery, I was scared, but after the reassurances from my husband and everyone else, I was staying pretty calm. I scheduled my surgery for a Friday, as my doctor told me if I did it on a Friday, I could return to work on Monday, but if I did it Thursday, I wouldn't be able to return until Monday.

The scheduling nurse had told me I would need 4x4 guaze for after the surgery, an ice pack, and I couldn't take Advil or any type of aspirin 4 days prior to surgery. (As a migraine sufferer, this was horrible news.) But, I was still prepared when I went to the building.

I was told to arrive an hour prior to surgery, and that I'd have to stay an hour after surgery. (The surgery itself would only take 15 minutes, they said.) No jewelry from the neck up, and no makeup. Ugh. They also said to wear loose, comfortable clothing, and preferably something that I wouldn't have to pull over my head.

Check.

Me before surgery:










Day of Surgery:

I went with a velour lounge set I bought in Disneyland a few weeks earlier that had a zip-up hoodie. With no makeup on, Don and I drove by my dad as we pulled up to the building. He asked how I was doing, and I replied, "Scared."




I handed my dad my cross (which is an heirloom left from my grandmother), and asked him to hold it for me through the surgery. I had tried to figure out a way to wrap it around my wrist, but the necklace wasn't long enough and ultimately I decided not safe enough.

My husband and I in the waiting room... Nice without makeup, huh? =P:




I wasn't kept waiting long after I checked in, and I turned to my dad and husband and must have given them such a look of sheer terror that the nurse, when I approached her, told me they could come into the back with me. Relieved, I quickly beckoned them over, and they came.

We followed her to a back room, with a nurses station centered in the middle. Beds with curtains hanging around them and lots of monitors and tubes stuffed into the mini cubicles surrounded the beds.

The nurse (who was super nice and incredibly amazing) asked me a few questions, then told me how things would proceed. I was shown to a bathroom and given a key on a flexible cord, and they weighed me before asking me to give a urine sample. Then she asked me to put on the robe once I disrobed from above the waist.


My locker:


Me in an awesome hospital gown:

 

So I changed into the robe, stored my stuff in the locker she indicated, and made my way out to the bed. I handed my husband the key to my locker, and climbed onto the bed. They put this OH so lovely hair net on me, then strapped these little discs on cords to my chest to monitor my breathing and heart rate. She also stuck one of those little clamp things on my finger.




Note: Apparently taking in a deep breath through your nose and pursing your lips as you exhale really does slow your breathing and heart rate. By a lot. Who knew?

Eventually the guy with the IV came over and gave me a shot to numb the pain from the giant IV needle, and by the time the IV was going in, the area was so numb I thought he was still preparing for the IV when he said, "All done!" Then he taped it down to the back of my hand and to my arm so it wouldn't pull or get tangled, and he was gone.

A little bit later the anestheologist came over and stuck something in my IV, saying, "This is just an appetizer, to see how much you need."

I don't remember much after that, except everyone laughing at me when I started getting dazed.

Then I heard, "You're in recovery, and everything went perfectly with your surgery."

My throat hurt. My nose hurt REALLY bad. I opened my eye--the other one was blocked off by a heavy weight of guaze and tape--and smiled up at her, and said, "My throat hurts. Is that normal?"

"Yes," she assured me. "There was a tube in there."

I nodded, and pressed my finger against my nose. It REALLY, REALLY hurt. "My nose hurts," I told her. I sat up in the bed, tilting my head forward as the blinding pain struck again. "Really bad."

"Okay. Let's get something for that. On a scale of 1-10, how much does it hurt?"

"Like a six?"

"Okay."

A moment later, the anestheologist came over and poked something into my IV. The pain in my nose subsided a little, and when asked for the pain on a scale, I answered, "It's getting better... A four or so?"

Satisfied, they took out my IV, which I didn't even feel, and then put tape and guaze over the wound.

Another nurse came over and asked about my locker key. I told her my husband had it, and a few minutes later she came back with my purse and my clothes. She helped me get the robe off, and modestly I held it in front of myself while I changed into the zip-up hoodie I'd been wearing earlier that morning. I laughed at myself while I changed, "Look at me," I laughed, embarrassed, "trying to cover up in front of a nurse when I'm sure you see this all the time."

She laughed politely and assured me it was fine, then I was taken to a seat beside the bed, where the intense pain in my nose started to come back at an alarming rate. They offered me my choice of juice and I selected apple even though it upsets my stomach, and I sipped on it as I pressed my finger against my nose to try and hold it off. My dad and husband joined me in the back, and another nurse came over and asked how I was doing.

"My nose hurts," I told her, trying to stay calm.

"That's not really surprising. Actually, where you're pressing is right where they were working."

I laughed weakly. "So I probably shouldn't press there, huh?"

She smiled. "It's probably not a great idea. Hang on a sec and we'll get you something for the pain. Do you want one or two vicodin?"

"Two," I answered quickly, knowing full well that one never worked. (I used to take Vicodin for my migraines.)

Everyone laughed, and I was brought saltine crackers, which once consumed, was followed by a tiny cup of vicodin. I all-but gobbled them up.

The nurse gave us instructions for post-surgery with a print-out sheet of instructions, and then I was discharged.

"My nose hurts," I complained as we walked, trying not to press on it.

"Well you just had surgery," my dad returned.

"This sucks," I muttered, praying the vicodin would kick in soon.


We went home, and as part of my discharge instructions, I was told that I had to sleep sitting up, with about four pillows behind me to help stop the swelling. So I climbed into bed, stuffed four pillows behind my head (I usually sleep with two anyway), and promptly fell asleep while sitting up. For the rest of the day I dozed in and out of sleep. I was amazed I could sleep sitting up, but it actually worked better than I thought it would. At one point I woke up and tried to eat soup, as the instructions say to eat a light diet for twelve hours post-surgery, but I promptly threw it up, making me feel worse than I had before I'd eaten.

Lame.



Day Two: Day After Surgery

The pain was excrutiating. My stomach wouldn't stop churning. I could feel gunk sliding down my throat, and when I coughed/squeezed it up, it was all blood. The sight of it made me sick, but my husband was quick to remind me that they said this would probably happen. Still, hearing it would happen and seeing it happen were very different.

I was popping one-two vicodin every hour or two to keep the pain at bay, but that only made the nausea worse. It was absolutely miserable. I sat up in bed and moaned while clutching my stomach, trying not to press on my nose/eye (which felt like someone had blown air into my cheekbone), and just trying to stay calm.

It was also the day I could take off the patch they'd put over my eye. Eagerly I went to the mirror, and made my husband sit with me while I peeled the tape off.


The horror that looked back at me in the mirror would have made me thrown up if I'd had anything in my stomach.

I was grotesque. Under my eye was black and blue with deep shades of red, there was a nasty, jagged line of stitches about an inch long (so much for a centimeter-long incision!), and my eye looked mis-shapen from the swelling. I was a monster.

I actually swallowed a scream. I held back my tears (can't get the stitches wet for 36 hours). I tried to speak, but nothing came out until, "...I'm hideous."

"It's healing," my husband assured me quickly. "You're healing. It's okay. The swelling will go down."

I took the 4x4 guaze the doctor's office had given us and taped it over my eye so neither my husband nor I would have to look at me. I laid in bed and stared emptily at the TV. I've always maintained that I am not pretty enough to have a scar or anything seriously wrong with me. This was my worst nightmare come true.

My mom came over and brought some food. I went down to greet her and showed her my eye, and she gave me a sympathetic look but reassured me, "That's going to heal so well. There's not going to be a scar at all. It looks really good."

Ha, I thought. I'll be disfigured forever.

The intense pain went long-into the night, and I was overdosing on Vicodin so much that even I was concerned. (And I'm a migraine sufferer, so overdosing on meds is pretty standard for me.) But I just kept popping pills and tried to sleep a bit (all the while sitting up) so the time would pass faster. I also started using the ice pack the doctor told me to use, applying it to my eye every hour for 15-20 minutes. The ice pack helped more than I can possibly express. The coldness was soothing on the pain in my head and the swelled flesh under my eye. But nothing could help the nausea, except for a couple of pretzels, and even that didn't last long.



Day Three

My eye was still pretty gross-looking, still pretty swollen, but I was starting to feel better. The nausea wasn't as severe, and even though when I took the guaze off to apply the cream to my stitches and in the corner of my eye over my tear ducts it was really hard and uncomfortable to blink, there wasn't as much pain as there had been the day before.

Or so I thought.

Soon enough, the pain was back, and all of Sunday, day three, passed with me trying to get as much Vicodin into my system as I could handle to manage the pain. I still couldn't eat much, but at least food was staying down. I think I had two handfuls of pretzels all day.

At one point a drop of water fell from under the guaze, and I bolted up from the bed and dashed to the mirror, thinking something had broken or popped or something. But no, it was just a tear that had welled up and not been caught by the guaze. The doctor also said that I might continue to tear up until the stent came out (that's the little tube connecting your tear ducts that they put in and put down your nose to open up your tear ducts) in three months. So after breathing a sigh of relief that my eye was still there and my cheek sadly still puffy, I went back to bed.



Day Four: Monday

Same as Sunday, only the swelling was starting to look better. It was still hard to blink and my right cheek still felt like it was twice the size of my other cheek, but mostly better. I was running out of vicodin to keep the pain at bay. I was supposed to switch to warm compresses, but I continued with the ice to keep trying to reduce swelling, and because it helped the pain.

I worked on Monday, though if I hadn't been able to work from home, I probably wouldn't have gone in.



Day Five: Tuesday

Excrutiating pain. Swelling. Running out of vicodin. I'd taken at least ten by Tuesday at 1:00 P.M. I'd called the doctor and begged for an appointment to make sure nothing was wrong. They scheduled me for a 2:30 appointment, where I was kept in the waiting room for a half-hour.

When the doctor finally came into the room, I opened my mouth to talk and tell him what was wrong, and all that came out were tears and sobs.

"I'm in pain," I told him tearfully. "Please, help me."

Through my tears I explained that I was a migraine sufferer, and this could just be a very intense migraine, but the pain was all coming from pressure around my right eye--the right cheekbone, the right temple, even on the right side of my forehead. I apologized profusely for crying, but the pain was just too overwhelming. I couldn't function or focus on anything but it.

He quickly went into action, writing out perscriptions for Percocet and anti-nausea medication while telling me that my eye looked really good and was definitely not infected. I was relieved that he had asked if I was nauseous and didn't have to bring it up, because at that point all I could really do was cry.

"You were an interesting case," he told me. "You actually had a tear STONE in your eye, which was why the problem kept repeating. But we took it out, and the surgery went really well. Your eye looks really good."

He explained what a tear stone was, but I was in so much pain I missed it.

My husband and I dropped off my new perscriptions, then I went home and just sat in bed while we waited for the medicine to be ready. An hour later my husband returned, I popped the pills, and immediately got sick to my stomach... Again. Despite the anti-nausea meds.

It was awesome.

I went to bed early. I think the Percocet knocked me out.



Day Six: Wednesday

By far the worst morning I've had so far. I woke up at 6 when my alarm went off with the worst, most excrutiating, most painful migraine I've ever had in my life. I couldn't move my head or a BLINDING pain hit me. I took a Percocet and for the first time in days laid down in bed and tried not to cry as I tried to sleep again.

I woke up at 7:00 when my alarm went off again, still in horrible pain, and after shutting it off, took another Percocet and tried to fall asleep again.

I woke up on my own around 8:30, still with a dull pain in the back of my head, but better than it had been earlier, when I'd been prepared to go to the ER. I signed into work, and every couple hours, in fear that the pain would return, popped another Percocet.

Yesterday I took the guaze off of my eye (I'd been keeping it taped over my eye since I'd unveiled the hideousness of myself earlier) and I've left it off since then except to sleep. I'm horribly blind without my contacts, so I have one contact in (glasses would press against the stitches) and so I have lovely double-vision of everything.

My eye feels much more swollen than it did yesterday, probably because I laid down this morning. I also finally switched to the warm compresses.

My husband told me that he asked the doctor yesterday (during my blindness caused by pain) about whether I could fly on Friday night (yes), and whether I could sleep laying down yet (not for another few days to decrease the chance of swelling).

So that brings me to today, where the blinding pain has subsided due to Percocet, but is definitely still there, and where unfortunately, the swelling appears to be returning. My eye still leaks/tears up occasionally, so I always have tissues with me. And I'm still putting that ointment on my stitches and in my tear ducts to prevent infection.

Yay...

One thing I will say for Percocet... Everyone makes it sound like you can't work or function while on it, but it's not true. You can. It just makes the pain go away. So that was a huge relief.




Day Seven: Thursday

Last night I was finally able to eat some food that wasn't pretzels or straight bread without feeling nauseous. I actually ate pepperoni pizza and pizza bites. It was amazing.

Before bed I took two Percocet, hoping I wouldn't wake up with a killer headache.

It didn't work.

The pain wasn't as bad as it was yesterday, but it was still pretty horrible. I took two Percocet when I woke up.
 
 
Two weeks later:
 
Reading this is crazy. I was in so much pain; I almost forgot.
 
My husband and I were vacation for a week, and while we were gone, the swelling in my eye went down completely. My stitches started coming out, which happened when I noticed that it looked like skin or something was around my stitches. (Sounds gross, I know...) I scratched it, and the stitch came out! Dissolvable stiches are awesome.
 
I started scratching a little more over the next couple of days, but it just hurts. LOL! Guess the stitches aren't all ready to come out. But they are coming out, and they're far, far less noticable now. Most of the darkness around the stitches is gone, and while you can still see it close-up and far-away, it's almost non-existent.
 
While we were on vacation, our waiter asked me if I had stitches (it was a dark place), and I said yes, and he said that he'd had stitches twice on his face, and that my surgeon had done an awesome job. I agreed. It really does look good. My surgeon was amazing. I was lucky. <3
 
You still can't really see the stent in my eye (the tube that is running in my tear ducts), which is really cool. I thought it would be much more noticable based on the picture I saw online. I can't see it unless I'm pressed up against the mirror and looking for it.
 
The headaches unfortunately still come and go, but they're manageable with Advil now. So that's good, too. <3
 
All-in-all, I'm almost completely back to normal except for a little pain. So, YAY!!!
 
Now, enjoy some pictures of what I look like now, post surgery (and having a fantastic time in Disneyland!). Through the days, you can see the stitches getting lighter, and me finally being able to wear makeup again!
 
 


 


 
So it will pass... The pain and the stitches, and soon the scar. <3