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For the purpose of preventing further harm to my wrist than has already occurred, I use a mousepad with my optical. The pillow puts my wrist in a comfortable position so it is not strained.
I bought a memory foam pad...it is better than the silicone ones.
As to the question of how often I change one out,,,well...I never thought of that. This one is new, so there will be no need to do so anytime soon,,,but the last one I had lasted five years.
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