a Pediatric Ophthalmologist/Working Mom/Administrator.

As a working Mom, I wear many hats, just as many of my colleagues do.  So, for today’s post, I decided to chart down what I did for a full day from the time I woke up to coming home.  People always ask me how I can manage working with 3 kids and it’s a juggling act.  We’re also super blessed with terrific babysitters who we can really depend upon when we have late days.

5:45 am: Arya is awake.  She likes to reach over from her crib and turn the light on and then calls to us “Mommeeee, Daddeeee”.  Her brother, Taj, who is a very light sleeper, will wake up then and run into her room “I’m coming Arya!”.  It’s very sweet.

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Then, get ready, make my bed (I read somewhere it’s part of starting the day right).  Man, I need some coffee.  I look longingly at my Nespresso.

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Since it’s a surgery day, I don’t drink caffeine, just to make sure I don’t have any jitters when operating.  But, I miss the routine of my coffee.  Gotta remember to buy some decaf pods.  Help get the kids ready for school, etc.  Show the nanny where the stuff for dinner is, so she can prepare it (tacos for kids tonight)

6:45 am: Leave the house.  

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Jeff usually drives and I take care of admin emails.  It gives me time to eat my yogurt.  It’s nice having a chauffeur !

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My chauffeur, Jeff, does not like being photographed.

 

7:05 am: Drop Jeff off at the office and I drive over to the Eye Surgery Center.

7:15 am:  Arrive at Eye Surgery Center, greeted by friendly smiling nurses.  I love this place.

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One of the pre-op nurses at the Surgical Center.

 

7:20 am: Say hello to my patient, mark above his eye with a large S (don’t want to operate on the wrong eye! – don’t worry, I always print a large photo of the patient and place it on the wall in the operating room to remind which muscles I am operating upon), and sign the necessary paperwork.

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Change into my scrubs  and head into the operating room.

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My scrub nurse, Jackie, enjoys 80’s Pop music in the OR just like I do!

 

8:45 am : Surgery is finished.  My second surgery canceled at the last minute, so there was no time to move up another patient.  So, now it’s coffee time! Yes!  I always go to Padovani’s.  It’s a cute little shop 2 doors down from the surgical center in Dole.  They have wonderful hand made gourmet chocolates, delicious cappuccinos and fresh muffins (my favorites are the pineapple and and mango)

Phillipe Padovani, owner and chef.

Phillipe Padovani, owner and chef.

Now, I usually wait about 45 minutes to an hour for the patient to be awake enough to perform suture adjustment on him.  So, I grab my usual bench and get to finalizing some charts on our electronic medical record system, EMA.  Paper charts are still way faster than electronic charting, but at least I don’t have to carry 25 charts with me in my bag.  It’s all on the iPad.  I am WAY behind, as usual

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9:45am-10: Perform suture adjustment.  I’ll do a separate post on this next month, but this is basically when I can fine tune the eye muscle surgery to make sure the eye is aligned exactly where I want it to be post-operatively.  My surgical coordinator in the office, Ronnie, is my scrub assistant in the OR when I operate at Eye Surgery Center and she is fantastic.  A real joy to work alongside.  And, the patients adore her as well.  She assists me with the suture adjustment as well.  I am lucky to have her as part of our team!

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Ronnie, surgical coordinator, scrub assistant and all around awesome girl!

I change and drive Ronnie and I back to the office.

10:30-12 pm.  All the fun, sexy stuff that goes into being a physician and administrator (that’s sarcasm, in case you can’t read into that).  Finish my charting, sign all the paperwork for the company 401K, talk to our financial adviser at Morgan Stanley about the conversion from Nationwide to Mass Mutual, decide upon profit sharing contributions.  Fun, fun, fun!

12-12:45 pm: Reconcile bank statement for July.  Try to locate a missing payroll report from that time period. Did I mention how much fun this stuff is?  Oops – forgot to bring leftovers from dinner to eat.  Thank goodness, one of my staff, Brandi, was kind enough to grab food for me so I can eat while at my desk.  I have the best staff.  But, quickbooks is still not working and syncing with my bank, even after spending 1 hour 38 minutes with them on the phone on my day off.  I’m not in a good mood.

Yes, this is my desk - 2 monitors, an iPad and tons of bank statements.  With a spicy poke!

Yes, this is my desk – 2 monitors, an iPad and tons of bank statements. With a spicy poke!

I’m a very neat person, but my desk at the office is always cluttered.  I think I’m just mid-project all the time.  I remember when they were filming the Hawaii National Bank commercial and they wanted to shoot an action shot of me working at my desk.  I started cleaning my desk and they said “No, no, keep it.  It’s more authentic”.  OK, so now, it’s out there, I have a messy desk.

12:45: First patient is ready for me to see. Steady stream of patients until 3:45.

3:45 pm: My gorgeous girlfriend, Amelia, arrives for our cosmetic event we are having that, yikes, starts in 15 minutes!  We’re having a high tea party with stations for colored contact lenses, Botox, and hair/make-up by Amelia.  And, I have to help get everything set up pronto, though my office manager, Sara, has already done a ton.  I kind of fell into doing Botox about 7 years ago.  I was meeting with Thomas, the rep for Botox to ask about purchasing Botox for medical purposes (strabismus surgery) and he asked if I considered doing cosmetic Botox.  My training in cosmetic Botox was injecting my attendings with the leftover  Botox that we had used for medical reasons (since it has to be thrown away anyway).  And, I do enjoy it – I don’t ever want to be a primary cosmetic surgeon, but it does help people feel happier with how they look.  Most of my patients, are moms of the kids I examine for their eyes!

4-6 pm: Cosmetic event.  It’s a great turnout and all of the guests have a blast.

 

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My friend, Amelia, performing a mini-makeover. Who wouldn’t want to look like this girl?

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Our optician, Joel, doubles as a personal butler.

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Dr. Bossert explains the technology behind the new colored contact lenses

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My friend and I, with our hair styled by Amelia.

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6:10 pm:  Yowser, I was supposed to leave 10 minutes ago for my son’s 1st grade orientation, which got rescheduled at the last minute.  I stuff some sandwiches on a plate and eat while I drive.

6:30-7:10: 1st Grade Orientation.  I’m an hour late.  It started at 5:30, but at least my husband made it there on time.  The kids each drew a picture for us.  Here’s my son’s.

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“Do not feel bad if you come late ”  Uggh.  The guilt of being a working Mom!

7:30 pm: Back at home.  My oldest and youngest are asleep.  But, my middle child takes forever to fall asleep.  He comes out when we get home and asks for a massage.  He’s such a high energy boy, so I started doing nightly massages with essential oil to help calm him down.  Now, he expects it and chooses his scent.  Sorry, future daughter-in-law!

8:00 pm: All kids asleep! I settle in on the couch to do some Netflix binge watching while I do, what else?, finish charts!

 

 

 

I was trying to think of a good title for this blog post and I was reminded of FB posts I see and thought of : “This boy bought his Halloween contact lenses online and you wouldn’t believe what it did to his eyes!”  (He didn’t really, this is our Optician who purchased the lenses through our clinic).  But, that title was a bit too sensational for me, so I just thought a nice, simple title would suffice, though the dangers are very real.  I lived in Manhattan for 8 years and the Halloween parade down in the Village is legendary.  You see the best costumes and everyone gets dressed up.  That was the first time I saw someone in a costume contact lens – it was a cat eye and I thought it was cool.  I was an ophthalmology resident at the time, and I asked the girl where she got them “Oh, from the costume shop down on 14th Street”, she answered.  Yowser!  I couldn’t believe someone would put something in their eye that they bought at a pop up Halloween store!  That was about 8 years ago and now people can buy contact lenses online, which makes the dangers even more widespread.

Of course, we all want to have the best costumes for Halloween.  And, the cosmetic contacts add a little something extra – Walking Dead zombie with the crazy eyes; vampire with red rimmed iris, or cat eyes – all make for an exceptional outfit.

Our technician, Brandi, modeling our Halloween contacts

 The problem is that people do not realize that these kind of lenses require the same fitting and care as a regular contact lens.  People mistakenly believe that because it’s just for one night, that somehow these contacts do not need to be as safe, or fit as well, which is far from the truth.  Ten hours is more than enough time for bacteria to grow and for a serious, vision threatening infection to occur.  And, just because you can buy them online or in a novelty shop does not mean that they are.  Remember, all contact lenses are medical devices and should be approved by the FDA.  In fact, shops which sell non-FDA approved lenses or do so without requiring a prescription from your eye doctor are conducting business illegally can receive stiff fines, of up to $11,000.  Any place that sells contact lenses should ask you for a prescription.   The lenses pictured above are sold in our clinic and are FDA approved material.    The FDA has issued warnings in the past about the dangers of wearing Halloween contacts.

Dr. Jenifer Bossert, Director of Contact Lens Services at Honolulu Eye Clinic, offers this advice: “In our practice, I tell patients daily that contact lenses aren’t a “one size fits all”.  Just like everyone has a different size foot, everyone has a different size eye…and if your contact lenses aren’t fit to your eye, you run the risk of corneal ulcers, distortions, discomfort, and yes, even the potential for blindness as a result from a significant bacterial infection.  Halloween is such a fun time…and we want our costumes to be awesome…so think ahead, call your eye doctor early, and “treat” your eyes well!

 

Tips for a Safe Halloween with your costume lenses:

1.  Have your eyes examined by  a licensed eye care professional.  They can measure your eyes appropriately and discuss proper care of contacts.  This is especially important  for those of us (like me) who don’t wear glasses or contacts regularly.  We are just not as skilled at inserting or removing contact lenses and that is important at preventing scratches on the cornea.

2. Get a valid contact lens prescription which includes power, brand type, base curve measurements and expiration date

3.  Buy lenses from an eye care professional or vendor who requires a prescription.  We do offer the following contact lenses for sale.  The bottom ones are also available with prescription.  Today is the last day to order in time for Halloween.  Though, based upon their availability, there is a small chance that the lenses might not arrive in time since we live out in the middle of the ocean.  However, these lenses are available year round if you want to buy them early for next year for any upcoming  costume parties!

4.  Follow directions for proper cleaning and care of contact lenses.

5.  Never share your contact lenses.  This was the worst case I saw in NYC.  A 14 year old girl shared contacts with her friend and developed a terrible corneal ulcer and became blind in one eye from it.  It seems innocouus, but it is not just another part of your costume!

6.  Maintain proper follow-up appointments with your eye doctor.

Following these simple guidelines, should allow you to have a safe and fun Halloween!

 

 

 
Honolulu Eye Clinic is so so excited to be one of the first clinics on the island to carry the new AirOptix Colors Contact lenses.

I’ll admit it – when I was young, there was nothing I wanted more than green eyes.  There was an auntie I used to babysit for down the street.  She was Indian with these gorgeous silver/green eyes and I used to tell my parents – “When I’m 18, I’m going to get colored contact lenses” . I wanted to look like the famous Indian actress (and former Miss Universe), Aishwarya Rai.  That’s her real eye color.

Fast forward to 2008 when we took over Honolulu Eye Clinic.  Finally, I thought, colored contact lenses.  The only option was the Fresh Look colors and alas, try as hard as I could, I could not get those contacts on to my eyes.  I thought it was just my inexperience wearing contact lenses, since I don’t wear glasses and have never needed contacts.  But, even when I had our stellar staff put them on for me, they were incredibly uncomfortable and moved all over the place on my eye.  On top of that, they blurred my vision.  I finally checked my corneal measurements and realized that my corneas were too flat for the standard size that the Fresh Look colors come in.  So, I resigned myself to having brown eyes (OK, I’m being a bit melodramatic).

But, just last month, Alcon introduced AirOptix Colors and it’s a contact lens I can actually wear!  The fit is comfortable – much less movement and drying than the previous iterations.  The Dk constant (which is just a measurement of how much oxygen the lens transmits) for the AirOptix is 6 times more than the Fresh Look Colors.

And, the colors are so much more natural.  My husband does not care for the fake, artificial colors of Fresh Look and these new AirOptix ones just make your eyes pop but in a subtle manner.  They have a 3 in 1 color technology, which enhances your natural eye color (instead of just covering it).  The outer ring defines and intensifes your eyes.  The primary color enhances your eye color and the inner ring adds depth and natural richness.  The colors are are on both surfaces of the contact lenses, which makes the color more life-like.

Here a pic of me wearing the green (subtle).

Air Optix Colors in Green

 

 

AirOptix in Gray

 

I hate taking selfies.

And, last one of me wearing just one green contact lens.

Green contact in right eye and normal in left eye

Here’s some of my staff. Sam has beautiful blue eyes.  But, she likes to change it up,so she’s wearing a hazel contact lens in her right eye.

 

Sofie is wearing hazel on the left side.  Wouldn’t you just kill for those lashes?

And, last our optician, Becca who has beautiful brown eyes, but likes to play with the gray contact lenses.


The Air Optix website has a fun virtual studio, but nothing is as good as actually trying on the contacts on your eyes.  Please call us if you would like to try the new Air Optix colors.  They are monthly lenses and currently come in plano (no power in the lens) and minus powers (nearsighted).  The plus powers are supposed to come out by the end of the year, though they are not yet available.

 

We all do it – use make-up even when a nagging feeling tells you that you should probably toss it.  I know, it hurts to throw away your $30 tube of mascara, just because it’s been three months.  What’s the harm?  And, I’m pretty pake (that’s cheap for any readers who aren’t from Hawaii), so I think back in med school, I’d use the same mascara for a year.  But,now I know better.  Microbial organisms are present on your lashes and they can flourish in tubes and bottles when given the chance. Serious eye infections can occur, so I’m listing some guidelines to follow with eye make-up.

1. Toss your mascara every three months

You’ve probably read this in your beauty magazine or blog, but where did this magic 3 month number come from?  A study done almost 40 years ago in a very reputable ophthalmology journal showed that bacterial and fungal growth was found in 36% of mascara tubes after 3 months.  So, now ophthalmologists make the recommendation to discard your mascara after 3 months.

Like I said, I know this one is painful.  A little tube of Diorshow costs over $28 (I used to love this mascara) and I totally didn’t used to do what I knew in my heart was the right thing to do – throw it away after 3 months.  Think about it, you double dip your mascara wand and there are numerous normal bacteria on your lashes.  Once you apply your mascara, you’re putting that cespool of bacteria back into a liquid/gel bottle and sealing it tight.  That means staph and strep are growing and replicating inside your mascara tube.  Convinced now?  If not, here’s another great little fact – one study found that almost 80% of mascara samples contained Staph aureus and 13% contained Pseudomonas.  Pseudomonas is a terrible bacteria that is responsible for this below:

OK, so, I don’t think there’s ever been a reported case of Pseudomonas infection from mascara, however, that picture will probably convince you to dispose of your mascara in a timely fashion!

Once the mascara starts to smell funny, change in consistency and become clumpy or dry, then you know it’s time to dispose of it.  There are a lot of less expensive mascaras out there which work really well.  And, then you won’t feel so bad to throw it away.  Also, be conscious of the expiration date.  Before I wrote this blog post, I didn’t even realize mascaras had expiration dates – but here it is.  This is from the back of my Fiberwig mascara.

If you look closely, it actually states 6 months, but don’t do it – stick to the 3 month guideline to be safe.

 

2.  Don’t share mascara or eyeliner

Anything that it’s in gel/liquid form can harbor bacteria more than powder form.  Therefore, don’t share!  If I get my make-up done by a make-up artist, I always bring my own gel liner and mascara.  Perhaps that’s being too careful, but I have no idea how long that tube has been open, even if they use a clean, disposable applicator each time.   Honestly, probably the best thing to do is to avoid the samples at make-up counters all together.

3.  Dispose of eye make-up after an eye infection

If you get conjunctivitis (pink eye), even if it resolves with antibiotic drops, you must throw away your eye make-up, at the very least your mascara.  Adenovirus particles can live on the surfaces of inanimate objects for upwards of one month .  And, you likely had the infection even before you started manifesting symptoms.  So it’s not good enough to just stop using the products when you have the conjunctivitis and the resume use once the pink eye improves.

One question I get asked often is if a patient can wear make-up if they have blepharitis.  Blepharitis is not an eye infection.  It’s inflammation of the eyelids, so technically, you can continue using your make-up with blepharitis.  However, there are certain types of make-up which are non-clogging and may be better tolerated by people with blepharitis.   Cosmetics may say “non-comedogenic” but that doesn’t necessarily mean they are oil-free.   AND, blepharitis can be caused by staph – remember, there’s a lot of staph just hanging out on your skin and lashes.   So, if you have the severe form of blepharitis – staph marginal disease – then check with your ophthalmologist regarding make-up use.

4.  Eye shadows (powder form) are good for 1-2 years, but don’t forget to clean your brushes

I have a bit of an eyeshadow addiction.  It started when I moved here to Hawaii.  I would get my make-up done at the MAC counter before our photos for our Honolulu magazine ad and have to buy $50 worth of makeup.  There’s just something so pretty about all the colors.  Anyway, here is the embarassing picture of the contents of my make-up drawer.  I own one eyeliner, one blush and a million pots of shadow.

Thankfully, since most eye shadows are powders, they carry much less risk of bacterial infection.  So, I’m safe to indulge my eye shadow addiction.  Though, now that I pulled out all my eye shadows, I see some in this pile from my days in NYC, which was 8 years ago!  Guess those are going in the trash now.  Another thing is even if eye shadow is safe for 2 years,  people often neglect to clean their make-up brushes and these can harbor bacteria.  I clean my brushes with MAC cleaner.  I’ll also use baby shampoo for a real deep clean as well.

5.  Remove make-up before sleeping (even if you have lash extensions).

This is a great time to review some standard eyelid cleaning techniques.  I see a lot of blepharitis in my adult patients, especially in women who wear lash extensions.  They have the extensions and then wear make-up, but they are so worried about losing their precious extensions, that they don’t clean their eyelids properly.  This almost always results in blepharitis.  Washing your eyebrows and eyelids with antibacterial shampoo (Johnson & Johnson’s baby shampoo is what I prefer) can help control blepharitis.  Put a small bit of dilute baby shampoo on your ring finger and suds right on to the lid margin for 30 seconds on each eye.

 

 

Many of you remember when I wanted to take “The Latisse Challenge” last year.  I was planning on using Latisse and taking weekly photographs of my lash growth.  But, since I was breast feeding my second son, I decided against doing it (Latisse is not FDA approved in pregnant or nursing moms).  And, since I got very quickly pregnant with Arya after ceasing nursing Taj, I really have never had the chance to try Latisse.  I have been jealously checking out  all of the people around me with their gorgeous eyelashes.  Even both my boys have lashes that Kim Kardashian would covet.

 

My Boys

To top it off, I have suffered from madarosis with pregnancy.  Madarosis is the medical term for loss of eyelashes and eyebrows.

There can be many different reasons for it – inflammation such as caused by infections, blepharitis, or even allergy.  Or it can be a sign of a systemic disease or condition, toxicity from medications, nutritional disorders, autoimmune disorder (lupus), tumors, hyperthyroidism or hypothyroidism, or traction (did you know that a lash curler can cause lash loss??).  For me, I think it’s been a combination of hormones and my lash curler.  The skimpier my lashes got, the more I tried to make every lash count – so I started curling them which really made things worse.  Oh, and I’m a notorious eye rubber.  I get bad allergies and I never remember to take my Pataday drops and just end up pulling and stretching my eyelid skin, which is never a good thing.

All of this lead me to try lash extensions.  Several of my friends have them and they are super popular here in Hawaii.  Many of my patients ask me about them and I wanted to try it out.  The licensing for lash extensions varies state to state.  In Hawaii, an aesthetician or cosmetologist can be licensed to apply lash extensions, even currently no classes or lectures are taught about lashes in these two fields.  Therefore, anyone can do lashes and you should make sure that the person you choose for your lash extensions does not skimp on the type glue, types of lashes and is diligent with their application.  After all, this is a non-surgeon using crazy glue and sharp instruments approximately 1 mm from your eye!  The American Academy of Ophthalmology cautions about the dangers of lash extensions.  They warn about:

  • Infection of the cornea
  • Infection or swelling of the eyelid
  • Permanent or temporary loss of lashes

I went to a lady who was highly recommended.  The process of lash extensions involves gluing, with cyanoacrylate glue (Dermabond – the same type of skin glue doctors sometimes use instead of stitches), lashes on to the base of your natural lashes.  I have since learned that there are a few different types of lashes – synthetic, silk and mink.  For mink lashes, think the Kardashians or Beyonce.

The adhesive should not be adherent to your eyelid skin.  The first time I had the lashes done, I liked their look and did not have difficulty with them.

The typical lash cycle consists of 4 different phases, and most women have between 100-200 upper lashes on each eye.

 

Therefore, even though it takes a full 3 months to cycle through your lashes, most women will want to get their lash extensions filled in every 3-4 weeks.  I went back for my fill=in and asked for more noticeable lashes.  One thing to note is that I had my baby 3 months ago.  This is important because, as many of you mamas out there know, like clockwork, right around the 3-4 month mark, all that luscious hair on your head that the baby hormones were promoting starts to fall out.  Same is true for your lashes.  Unfortunately, the lash lady saw that I had baby fine lashes, since I was shedding a lot of lashes due to the hormones, and applied extra glue to make the lashes stick better.  The fumes from the glue caused my eyes to tear throughout the entire process. The end result was that the lashes were too heavy and caused most of my real lashes to fall out.  Even though I’m an ophthalmologist, it didn’t occur to me to check the ingredients of the glue used.

 

Lash extensions glued to multiple of my lashes with excess glue at base

I looked online for studies regarding lash growth and lash extensions.  You might be scared yourself to try lash extensions because you’ve heard “it causes your lashes to fall out”.  In reality, no study has actually been performed to support or deny this assertion.  But, there are risks associated with lash extensions – irritation, inflammation, infection, allergic reaction and even madarosis.  Some of you may remember Kristin Chenowith showing up on David Leterman wearing huge sunglasses because of an allergic reaction from her lash extensions.

 

Long and short of it, I started developing irritation and redness of my upper eyelid skin from the lash extensions – I wanted them off.  I almost attempted to pull them off myself, but I knew that would result in more missing lashes.

So, I tried another lash stylist (is that what they are called?) who had been highly recommended by another friend.  Kristin Wood of the Kristin Wood salon.  She spent an hour and a half carefully removing all of the excess glue at the base of my lashes and the few errant lashes remaining.  At the conclusion, my upper lids were swollen and red and she advised me to wait  to get new lash extensions until my eyelids had healed.

Redness and swelling at base of lashes after lash removal

I knew that was the right call, so I came back in two weeks and she worked her magic.

New lashes!

 

One week later, only two of my lashes have fallen out.  The lashes are longer and feel much lighter than my previous ones.  When I touch them, they don’t feel stiff, but soft like my own lashes.  However, most people in the lash industry will admit that lash extensions do cause your natural lashes to fall out more quickly.  So, what should you do to avoid complications from lash extensions?  The FDA and American Academy of Ophthalmology offers the following advice:

  • Check the ingredients of the glue to make sure you are not allergic to it
  • If you have an eye infection or the skin around the eyes is inflamed, avoid lash extensions (as I did initially)
  • Make sure that the technician applying your lashes wears gloves and practices proper hygiene
  • Ensure that the aesthetician is properly certified and working at a reputable place.

If you develop an infection from the lash extensions, resist the urge to pull them out yourself.  Go to an ophthalmologist for treatment. An ophthalmologist can prescribe an antibiotic or antiobiotic/steroid ointment.  The lashes will fall out over the period of about six weeks and with it, the glue should also fall out in that time.

Also, beware of a lash stylist who tells you not to get your lashes wet at all.  Usually, you shouldn’t get them wet the first 24 hours, but after this, you should clean your lashes and remove make-up with an oil-free make-up remover.  Kristin advised to perform the same baby shampoo lid scrubs that I recommend to my patients with blepharitis to prevent build-up of protein and oil (and this was before she knew I was an ophthalmologist!)

So, what do I think of lash extensions?  I had one experience which seems to echo everything that the Academy of Ophthalmology warns about – glue on the base of the eyelid skin, allergic reaction and lashes that were too heavy for my natural lash to sustain, thus causing traction madarosis.  And, I had a great experience with another lash stylish with no complications.  So, the choice is yours – lashes, Latisse, good old fashioned mascara, whatever you choose, be safe and make your eye health your top priority, don’t just look for a good deal.

 

We had a wonderfully successful cosmetic event a few weeks ago at Honolulu Eye Clinic.   Our theme was ‘Mommy Makeovers” to provide an opportunity to tired, overworked mothers to have some time to themselves.

My good friend, Shandis Ching, helped me create a beautiful tablescape for our guests and gift bags as well.  I love throwing parties, click here to see a post about my son’s third birthday party and I especially enjoy doing signage, paper aspects of a party.  Shandis is brilliantly creative and has lots of wonderful ideas.  We always say we should start a party planning business together.

Shandis tied sand dollars and raffia to white towels for each guest to take home.  

 

 

I packaged turquoise bath salts in little jars and made cute Honolulu Eye Clinic water bottle labels.

And, each guest received their own tote bag, which Shandis hand stamped!

Childcare was provided  and all the kids had a great time back in our pediatric waiting room, painting and drawing and eating!

 

 

 

Guests learned about beauty products like Skinceuticals (recently named to Allure and In Style magazine’s Best Skin Products list)  and were each treated to a complimentary skin analysis.

They also witnessed a live injection demonstration of  Dysport and fillers and enjoyed hand rolled sushi.

 

A big mahalo to David from Medicis for helping sponsor this event and sharing the latest news about Dysport and Restylane. Restylane is terrific for rejuvenation of the eyes.  And, another huge MAHALO to Shandis Ching and to all of the gorgeous moms who came out for this event.

If you missed this event, don’t worry, we’ll have another in a few months.  Keep checking my cosmetic website: www.drrupawong.com or our facebook page.

 

Latisse Update

So, after much deliberation, I have decided not to do the Latisse challenge.  The reason is because I’m still nursing and Latisse is not FDA approved to be used in pregnant or nursing mothers.  I knew that beforehand and I’ve never prescribed it to a patient who is pregnant or nursing, but my overzealousness to have nice lashes almost got the better of me.  I figured that the amount of Latisse that is systemically absorbed is quite small.  But, when I sat down and really considered it, I realized it just wasn’t worth the risk.  Though I’m not a patient person, I would rather wait 6 months and know for sure that I am not harming my baby.  The only time I used it was when I posted the video.  So, instead I’ve put one of my staff on Latisse and I’ll be posting pics of her every 2 weeksThis is obviously not a picture of my employee’s lashes, but my son, Nikhil has the best lashes, so I just decided to post a pic of him until I get the staff pics uploaded.

 

Tear Duct Update

On a happy note, Taj’s nasolacrimal duct obstruction has completely resolved.  It’s interesting, it appeared to be worsening one day and then all of a sudden there was no discharge, no tearing.  So, parents out there – continue the massage, it really does work.  I did the Crigler massage much more consistently than the antibiotic ointment or warm compresses.

No more tearing or discharge!

 

 

Many of you have probably seen the commercials for Latisse.  They originally featured Brooke Shields and now Claire Danes and looks like this:

So, what exactly is Latisse, how does it work and does it actually work?

Latisse is the only FDA approved medication proven to grow lashes longer, thicker and darker.  Quite a statement, right?  Well, how did they come up with Latisse.  Latisse is the brand name for bimatoprost ophthalmic solution 0.03%.  And, what exactly is that?  Well, it’s the same medicine as Lumigan, a glaucoma drop.  And, it’s similar to Xalatan (latanoprost ophthalmic solution) and Travatan (travaprost ophthalmic solution).  All three are known as prostaglandin analogues, and are a specific type of glaucoma medicine.  Each differs slightly and is made by different manufacturers.  Well, we ophthalmologists began prescribing these medicines for glaucoma, we noticed that patients reported that their eyelashes got longer.  For men, this was an unwanted side effect.  But, someone had the bright idea of repackaging Lumigan (which you can still buy for glaucoma) and selling it as Latisse.  Instead of placing the drop in the eye as you would for glaucoma, you place it on the lashes (I’ll get to that later).

So, how does Latisse promote your lashes to grow?  Well, that’s kind of unknown.  If you go to the Latisse website, you’ll find this diagram.  All this tells you is that each hair follicle undergoes a cycle of growth and death.  For some reason, Latisse makes the growth phase of lashes longer, but it isn’t known why.

So, on to the third and final, and most important question.

Does Latisse work?

The FDA clinical trials actually proved that lashes did grow significantly with the use of Latisse, after 16 weeks of use.  Here are the pics from the clinical trial.

But, I think it’s more impressive when you see pics of real people using Latisse.

This is Christina, my receptionist.

And, here’s Kelley, one of our technicians.

 

 

 

 

 

 

This is what she says about Latisse:

” I started using Latisse about a year ago and have definitely noticed an improvement in the length and fullness of my lashes.  I have noticed a slight darkening of the skin on my lash line, but I don’t mind.  It looks like I have on a little eye shadow, or perhaps eyeliner, without the hassle of putting it on!  I am using less mascara and can even go without it now and still have long, lush looking lashes!  I am not the kind of person w ho does anything regularly with my hectic schedule, so it’s difficult for me to remember to use it every day, but I have still gotten excellent results.  People compliment me on their beauty when I’m in stores and I always have the same reply, “Thanks, I use Latisse” 

And, last, another employee – Shawna.  She uses Latisse two to three times a week and these are her lashes.

My mother uses Latisse and she barely uses any cosmetics.  She noticed during my wedding when the make-up artist was putting false eyelashes on her that it made her eyes look the way they did when she was young.  She commented that the loss of eyelashes as you age is so gradual, you don’t notice it at first.  Once she started using Latisse, she saw a dramatic difference within 4 weeks (the label on the box says you’ll see a change in 16 weeks, though most of my patients report seeing an increase in lash growth and thickness even within the first month) and it restored a youthful appearance to her eyes.

Before we discuss how to apply Latisse, I want to briefly review the potential adverse effects of it.  It is a medication, which is why only a doctor can prescribe Latisse.  And, I do recommend purchasing Latisse from your eye doctor so that they can perform an eye exam on you before and during Latisse use.

Side Effects

  • Change iris color – this is what most people really worry about and it actually wasn’t shown to happen in the FDA trial at all.  But, the glaucoma medicine (when you put the drop in your eye instead of on the lashes) can cause hazel eyes to turn darker brown.  Blue eyes remain blue and brown eyes remain brown
  • Skin pigmentation – if you don’t apply Latisse correctly or put it on the lower lashes (not supposed to), then you may get darkening of the skin of the lower lid.  This happened in about 4% of patients
  • Uveitis – this is inflammation of the eye.  This is why I like to do an eye exam on anyone who requests a prescription for Latisse.  Many doctors may not and since there are many non-ophthalmologists prescribing Latisse (internists, OB/Gyn, etc, they wouldn’t know how to check for uveitis anyway), it may get missed.  However, I like to be careful
  • Skin irritation or redness
  • Macular edema – this is swelling of the retina of the eye.  Again, this can only be detected by an ophthalmologist or optometrist

 

How to Apply Latisse

The above is what you’ll find on the Latisse website, but I’ve made a little video to make it easier.  Sorry if I seem a bit serious in here, it’s weird talking to yourself in the bathroom.

The video cannot be shown at the moment. Please try again later.


So, I’m starting the Latisse challenge.  Yes, I know it’s not like a marathon challenge or anything really important, but still…For years, I’ve wanted to try Latisse.  Honolulu Eye Clinic was one of the first clinics in Hawaii to dispense Latisse, but because I was pregnant with my first son at the time, I was never able to try it (it is contraindicated in pregnant and nursing mothers).  But, I will no longer have lash envy of the other women in my office.  I’m going to start using Latisse and will post weekly pictures on the blog and you can follow along.

I almost forgot, right now we have a

Buy one box of Latisse, get one free

So, if you’ve ever wanted to try Latisse, hurry on over to Honolulu Eye Clinic, while supplies last.  Once we run out of the special, we still offer $25 off each box of Latisse.  Yes, Latisse is expensive – $125/ box full price.  But, unlike lash extensions, these are your own lashes and they never look artificial.  I’ve had many patients tell me that once they reach the length they desire, they are able to taper down to using Latisse a couple times a week instead of daily (again, this is not the FDA recommended use of the product).

 

So, one more quick Taj related post.  I had to share the amazingness of the new SkinCeutical AOX eye gel. I’m usually pretty hesitant to endorse one product over another, but I’ve been so happy with this eye gel, that I had to share it with you all.  Everyone has one particular area of their face and body which they wish they could improve.  For me, it’s the area under my eyes.  I hate when they get swollen and dark…It’s very easy to tell when I’ve had a good night’s sleep (and since I have a newborn, I’m usually not getting too much sleep!).   I think it’s all the more obvious since my eyes are large and I feel that the puffiness is even more noticeable.  I also get a lot of questions from patients about how best to combat signs of puffiness and dark circles under they eyes.

First, a little bit about the SkinCeuticals line.  I like the Skinceuticals products, and they are the only cosmetic products we carry in our clinic, because of the evidence based medicine which supports their claims.  There is real science behind their products, published in peer reviewed journals.  You may have seen the product in Allure magazine when the Phlorotein CF serum  was named “Best of Beauty”.  The line really stresses the importance of prevention, prevention, prevention.  I now use the phlorotein CF serum (named one of Allure magazine’s top beauty products) which has anti-oxidants (Vitamin C, E and ferrulic acid) that help prevent UV damage and a daily sunscreen.  Photoaging is what causes all of the signs we associate with aging and if you minimize the oxidative and free radical damage caused by the sun, then it stands to reason, that you will look better too (in addition to preventing skin cancer).

Before I met the Skinceuticals rep, I pretty much had zero skincare routine.  I used Cetaphil moisturizing lotion from Long’s  and that was it.  My skin was OK, but not amazing.  But, living in Hawaii, it is really important to care for your skin and protect it from the UV damage which occurs daily.  My mother is 61 years old and looks amazing, so I’m hoping with proper skin care, I can age as amazingly as she has.

My mom and dad with my son, Nikhil

So, back to the AOX Eye Gel.  I had just given birth, having been in labor from midnight to 6 am.  Obviously, I wasn’t looking my best, which wasn’t really all that important to me on the first day.  You’re exhausted, your body aches, and you have a newborn.  But, I took a look in the mirror a few hours later and almost didn’t recognize myself.  I had HUGE bags under my eyes, the likes of which I have never seen before.  The ophthalmologic term is festoons.  You can see how swollen my lower eyelids are.  I look like I can barely keep my eyes open – I barely could, it had been a hard labor!  I can’t believe I am actually posting this picture (note the all important headband – pregnant mothers, don’t forget the headband!).

After labor with my wonderful OB and nurse

Since I work at Queen’s and delivered there, I knew people would be stopping by to offer their congratulations and I needed to improve my appearance slightly (Thanks so much to the Same Day Surgery nurses for the beautiful flowers and to my friends who dropped by).  Let’s be real.  Of course, it’s about the baby, but I knew there were going to be a lot of pictures taken.  And who wants to look back at photos of one of the happiest days in their lives and cringe at the way you look? Jeff was operating the next morning, so I told him to go home to get good rest and not spend the night in the hospital with me and the baby.  The plus side of that was that he could bring me my eye gel which I had left at home.

AOX Eye Gel

The skin around your eyes is the thinnest skin in your body.  Therefore, it shows signs of accelerated aging and stress more than other areas of your face.  In addition, the fat that normally supports your eyes, can prolapse forward causing the eyelids to appear puffy.

AOX Eye Gel:

  •  Prevents signs of aging with a high concentration of pure L-Ascorbic Acid, Ferulic Acid and Phloretin antioxidants
  • Antioxidants also corrects signs of photodamage including fine lines, wrinkles and improved skin tone
  • Ruscus Aculeatus (type of plant) supports under-eye circulation to help reduce the appearance of puffiness caused by swelling.  It actually causes the blood vessels to become smaller or vasoconstrict.
  • Caffeine helps improve drainage and congestion of fluids which cause under eye bags

I really think the caffeine and ruscus aculeatus are what you notice immediately when you use it and the antioxidants help prevent future damage. I used it in the morning (I was still in the hospital), put on my headband (a very necessary accessory and should be packed in every pregnant woman’s hospital bag) and slapped on a bit of lipstick.  I kid you not, the nurse who came to check on me, right after this picture was taken, gave me a strange look and said “Are you the patient?”  That was great!

So, the new eye gel is added to my serum and sunscreen as my skincare regimen.  It has become extremely necessary to combat the sleepless nights which accompany a newborn.

Some patients will ask me specifically what I use for my skincare regimen.  Everyone’s skin is different, so what is right for me, may not be right for you.  My skin tends to be slightly dry and sensitive.  So, here’s what I use.  And, remember, I am slightly lazy when it comes to my skincare routine.

Cleanser:

I tend to alternate between the Foaming Cleanser and my old stand by of Cetaphil.  My mother-in-law gave me the Clarisonic for my birthday, and I love it, but I remember to use it only once a week.

In the mornings, I use:

I use all three of these daily.  I love the SkinCeuticals sunscreen, especially the Physical fusion.  It has Titanium dioxide and zinc oxide, which area wonderful sunscreens (they’re what lifeguards use on their noses to make them white).  I only use sunscreen on my kids with these 2 ingredients because they are what is termed “Physical” sunscreens and have been proven to be the most effective.  Obviously, those of you who have seen me in the clinic know that I don’t show up with a completely white face like kabuki make-up and the reason is because the Skinceuticals sunscreen is emulsified and tinted.  It isn’t oily feeling and the tint is quite nice.  I use this and it looks like I’m wearing powder or foundation, so I can skip that make-up step.

So, there it is.  Everything that you wanted to know and more about SkinCeuticals, my vanity after labor and the importance of sun protection.  And, if used properly, you may even be able to combat the signs of sleeplessness that come with a baby (or just wake your hubby to do some diaper changes, which Jeff happily does).  Have any of you tried any of the SkinCeuticals products?  Or do you have your own remedy for sleepless nights and dark, puffy circles under your eyes?

**I do not receive any type of commission or perk for blogging about SkinCeuticals**

 

 

 

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