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13 March 2012

Auto-Immune Disease Cheat Codes

I'm pretty terrible at managing my Crohn's Disease. I continue eating spicy food, skipping meals, occasionally overeating, not managing stress properly, and not getting enough rest. Somehow it mostly stays in remission unless the stress in my life gets out of control (there are times when I don't consciously process stress factors on a mental or emotional level; I realize I'm overstressed when the Crohn's symptoms set in, and then I have to stop and think about why). I've been pretty lucky with that.

Iritis, it turns out, is a little harder to just ignore. I have to actually behave myself in order to manage this nonsense, which apparently means that the days when I could stay up until 0300 playing video games and then wake up in the morning ready to kick some journalistic butt are pretty much over. By the time I went to bed Sunday night, my eye was scratchy and achy, and when I woke up yesterday morning, I was miserable.

Needless to say, yesterday was a total waste in terms of getting any work done.

If you're managing this condition yourself, you already know what a nuisance the prescription eyedrops are.
There are actually two medications - a steroid and an anti-inflammatory- which is pretty common approach to treating autoimmune issues (if my experience with Crohn's Disease is any indication). The basic goal in treating either condition is reduction of the inflammation caused by the immune system deciding you're actually enemy.

The steroid, in my case, is usually prednisolone (the oral version of which this article says is used in treating Crohn's Disease, go figure). It really isn't so bad except for the every-six-hour dosing, but since iritis usually disrupts my already screwy sleep cycle anyway, it's pretty easy to just go with it. This article notes that it's an immuno-suppressant (which makes sense for a drug that's supposed to be combating a misbehaving immune system), but I have personally never had any problems in that regard.

Strangely, I find that flare-ups of either irits or Crohn's tend to make me less prone to getting other illnesses, and being sick with something else tends to make me less prone to auto-immune flare-ups. The latter part of that makes sense, given that an immune system already occupied with an actual invader is less likely to get bored enough to turn on itself (yes, I know that's not actually how it works), but the first part is still perplexing, especially given the immuno-suppressant nature of some of the drugs involved. Is that all in my head, or has someone else out there figured it out?

The anti-inflammatory I'm usually stuck with is a hydrochloride formulation of some sort (I can't remember now and the bottle is still packed away someplace, where it can darn well stay as far as I'm concerned). The drops reduce the swelling in the iris, so they prevent the iris from sticking to the cornea - which gets rid of that awful sticky feeling, as well as most of the painful scratchy irritation. Unfortunately, in order to do that, they dilate the pupil (this makes sense, since the iris is the muscle that dilates and contracts the pupil). The end result, at least for me, is a week or two of excruciating photo-sensitivity that is, in some ways, worse than the original problem (especially since my work mostly involves staring at a glowing screen). Am I the only one out there who has that particular difficulty? After the first couple of days of use, the mild stinging of application turns into a painful burning, too. I end up being totally useless and obnoxiously whiny for 7-14 days.

Last fall, while we were in the process of migrating out west, I figured that Visine's original formula seems to work something like a really low dose of the prescription anti-inflammatory, so if you apply it early enough while the symptoms are still relatively mild, you actually get some relief and can usually avoid a full flare-up. Since this also means avoiding the prescription pupil-dilating anti-inflammatory drops, I'm all for it. Generally there is still some discomfort, but the OTC remedy seems to keep the problem from escalating to a level that actually impairs normal activities. That's kind of important for me, because I don't get paid sick days anymore.

Initially, I tried using the corticosteroid drops alone, since their side effects are barely noticeable. That does give some relief, but it doesn't tend to last. The Visine drops (I'm guessing a generic version will work just as well) alone work much better than the steroid drops alone, so if you can only manage one bottle of eyedrops, my recommendation is that you go with the Visine. If you have your prescription meds on hand, though, I find that using the steroid drops with the Visine is remarkably effective and a good way to manage the condition and stave off a flare-up without the more drastic side effects.

So there you go, folks: Autoimmune Disease Cheat Code of the Day.

Questions for you:
  • Does anyone else have this photo-sensitivity problem with the drops, or am I just extra-screwy?
  • Does anyone notice that flare-ups make you less likely to get "normal" kinds of sick?

1 comment:

  1. Well, if you want to look totally bitchin' while having to deal with photo-sensitivity, check these sunglasses out. ^_^

    When I am having a migraine, my eyes get super sensitive to light. I have several cheap shades laying around just in case.


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