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A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
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Experience:  Board Certified NP, MS, RN. Private practice & hospitalist
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Hi, I have had dry eyes for 5 yrs (taking restasis), Ive had

Resolved Question:

Hi, I have had dry eyes for 5 yrs (taking restasis), I've had dry skin for 2 years (using cetaphil) and in the past year I've developed dry mouth which has caused a burst of cavities in the 6 months (now taking biotene and brushing with flurodex). I also have had poor sleep in the past 5 years (wake up at 2 - 4 am and wide awake - can't return to sleep for hours). In the past few months I've begun to notice fleeting pain in joints - annoying, but not bad. I am a celiac. What type of doc?
Submitted: 1 year ago.
Category: Health
Expert:  A. Schuyler, NP replied 1 year ago.

Hi, Jim,

Thanks for using Just Answer. My name is XXXXX XXXXX X will do whatever I can to answer your question.

 

What does your dentist and your ophthalmologist say about the dry eyes and dry mouth? Have they suggested seeing a rheumatologist?

 

Some of the symptoms may lead to a possible diagnosis of Sjögren's syndrome which is an autoimmune disorder. Rheumatologists are usually the most experienced with diagnosing and treating it.

 

I would not add back eggs and dairy before getting a definitive diagnosis. While Biotene contains the enzymes glucose oxidase, lactoferrin, lysozyme and lactoperoxidase, those may not be the enzymes in egg or dairy that you are allergic to.

 

 

Best regards,

 

Schuyler

 

Customer: replied 1 year ago.

Hi Schuyler, thanks for your quick reply. My last reply may have gone through. My fingers hit the wrong key. Anyway, if not, the simple answer to the eye doc and dentist is that neither was looking for a systemic answer to my body's dryness although both thought that there might be one. My eye doc agreed Sjogren's might be the cause but only because I asked about it. My GP said, some 3 years ago, that diagnosis of Sjogren's was very difficult and inconclusive. Perhaps things have changed.


 


Good point about the biotene. Had not thought of that. I'll get an appt with a rheumatologist. Thanks again, jim

Expert:  A. Schuyler, NP replied 1 year ago.

Hi, Jim,

 

They are entirely correct that Sjögren's syndrome is a more complicated diagnosis. A "syndrome" is a collection of symptoms, often not apparently related to one another. That's why a rheumatologist might be the best one to consult if your primary provider isn't prepared to go that extra mile. There are many body systems that can be affected, not just the eyes and mouth. Treatment is directed at allaying the symptoms (dry eyes, dry mouth, anti-inflammatories and pain relievers for painful joints, etc.). Immune system suppression may be required, since the problem originates with the immune system attacking the body. The cyclosporine in the Restasis is a mild immune modulator for the eyes, but there are also systemic drugs that work all over the body.

 

Good luck!

 

Schuyler

 

A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 14855
Experience: Board Certified NP, MS, RN. Private practice & hospitalist
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