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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Ive been sick since I was 14 years old. I am a female now 29 years old. When I was 2

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I've been sick since I was 14 years old. I am a female now 29 years old. When I was 20 I lost most of my hair, had seizures,headaches, muscle and joint pain. I was diagnosed with lupus as well as sjogrens and Gastroparesis. I just got back from the mayo clinic & will be returning.They said I also have pots syndrome and sinus tachycardia.They believe all my diagnoses are secondary and there is a primary condition causing my body to go haywire.Symptoms that I am currently having are extreme fatigue, muscle & joint pain, migraines, dilated pupils, swollen lymph nodes(just had one removed),shortness of breath, unable to do anything physical, can't work, dark circles under eyes,stomach pain, dry eyes and mouth, diarrhea, leg numbness & hand numbness. Recent blood work was low neutrophils,high am cortisol,high c4 complement. I'm out of work and need a life.What do you suggestThank u so much for taking the time to read this. Oh I had a heart monitor on,heart rate was 180 walking 110 sleeping.
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

I'm sorry to hear about all the difficulty you are having. Let me go over your issues one at a time and see what I can do to help you :)

Dr. Rick :

As far as the dryness of your eyes, I believe you can do some simple home therapy to help with this issue. Here is what you can do:

Dr. Rick :

Dry eyes can be due to many different factors. Different medicines such as psychiatric medicines, antihistamines, cold medicines and others can contribute to dry eyes. Allergies in the eyes can also contribute (make dry eyes worse). Some people have an innate deficiency in making their own tears (these people may also have other dry mucus membranes, such as their mouth, nasal passages, or genitalia). Many people have an inflammation in the eyelids called blepharitis which causes the tear film that is supposed to coat the front of the eye to not function as well, and then the eyes dry out. People with blepharitis have morning tearing, burning, and often eyelash mattering. Their symptoms get better as the day progresses, but then they get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving.


Because blepharitis is so under-diagnosed and the treatment for it is relatively benign, you might consider starting this treatment, while concurrently continuing artificial tears. In order to treat blepharitis, everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are called Ocusoft or Sterilid which are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water), you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done.


It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working. Also the eyes are still significantly dry during this 3-4 weeks so use the artificial tears you bought 4x/day in both eyes (one drop per application). After 4 weeks you should be able to start tapering off of the tears to as you need them.


Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working.


If you are a person that doesn't make their own tears very well, then you may also benefit from a prescription drop called Restasis, which actually modulates a person's immune system to help them make more of their own tears. This drop actually requires constant usage on a daily basis for up to 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body).

Dr. Rick :

Now, as far as your POTS syndrome, lupus etc, I have to admit that you are already being treated at on of the best University Teaching Hospitals in the USA. I, personally, have been to Rochester Mn and the doctors at the Mayo Clinic figured out what was going on when many other doctors couldn't and had me feeling better in a week after months of suffering.

Dr. Rick :

As such, I suggest you continue in their care and, if it is humanly possible, they will get you back on your feet. You will not find any better medical experts anywhere in the USA or, quite possibly, the world.

Dr. Rick :

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?


 


I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick :

I see that you are offline. I will switch to Q&A format. This format works a lot like 'text messaging' but an email is sent to each of us anytime something is posted to this thread. We can continue to work on your question there..... :)

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7750
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Rick replied 1 year ago.
We have been experiencing technical difficulties with the chat system. Please allow me to retype my chat here for your review:


Dr. Rick : Hi. I'm online and happy to answer your question today.
Dr. Rick : I'm sorry to hear about all the difficulty you are having. Let me go over your issues one at a time and see what I can do to help you :)
Dr. Rick : As far as the dryness of your eyes, I believe you can do some simple home therapy to help with this issue. Here is what you can do:
Dr. Rick : Dry eyes can be due to many different factors. Different medicines such as psychiatric medicines, antihistamines, cold medicines and others can contribute to dry eyes. Allergies in the eyes can also contribute (make dry eyes worse). Some people have an innate deficiency in making their own tears (these people may also have other dry mucus membranes, such as their mouth, nasal passages, or genitalia). Many people have an inflammation in the eyelids called blepharitis which causes the tear film that is supposed to coat the front of the eye to not function as well, and then the eyes dry out. People with blepharitis have morning tearing, burning, and often eyelash mattering. Their symptoms get better as the day progresses, but then they get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving.
Because blepharitis is so under-diagnosed and the treatment for it is relatively benign, you might consider starting this treatment, while concurrently continuing artificial tears. In order to treat blepharitis, everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are called Ocusoft or Sterilid which are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water), you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done.
It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working. Also the eyes are still significantly dry during this 3-4 weeks so use the artificial tears you bought 4x/day in both eyes (one drop per application). After 4 weeks you should be able to start tapering off of the tears to as you need them.
Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working.
If you are a person that doesn't make their own tears very well, then you may also benefit from a prescription drop called Restasis, which actually modulates a person's immune system to help them make more of their own tears. This drop actually requires constant usage on a daily basis for up to 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body).
Dr. Rick : Now, as far as your POTS syndrome, lupus etc, I have to admit that you are already being treated at on of the best University Teaching Hospitals in the USA. I, personally, have been to Rochester Mn and the doctors at the Mayo Clinic figured out what was going on when many other doctors couldn't and had me feeling better in a week after months of suffering.
Dr. Rick : As such, I suggest you continue in their care and, if it is humanly possible, they will get you back on your feet. You will not find any better medical experts anywhere in the USA or, quite possibly, the world.
Dr. Rick : Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick MD FACS

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