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.


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.