ophthalmologist

Just Ask

It’s the 4th Annual Diabetes Blog Week! If you want to participate, or if you want to see what other diabetes bloggers have to say about the daily topics over the next seven days, head over to Karen’s blog at Bitter~Sweet and jump in.

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Today’s blog prompt comes from Melissa over at Sweetly Voiced.

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?

Unless I’m traveling or just too busy to stop what I’m doing (or in denial…yes, that happens), I see my endocrinologist (endo) and CDE every three months, my ophthalmologist (eye doctor) every year, and my dentist twice a year. That amounts to, at the very least, four hours a year in the office of my healthcare team with my pancreas hanging out, my pupils dilated, or my mouth wide open. Sometimes at the same time.

Considering that there are 8760 hours in a year, I spend about .5% of my year in doctors offices in various compromising positions (not counting labs, time on the phone with insurance, time spent hooking so that I can afford my copays, etc.), which begs the question… How the heck am I still alive?

There are plenty of other doctors that I could spend time with too. Presently on my list of docs to find include a dermatologist, a podiatrist, and a psychologist. That last one will likely make my doctor time (and spend) increase exponentially, but that’s a conversation for another day. When I’m less crazy. Because that happens too.

Bank - Saving Up For Therapy

The thing is, I need all of the services and advice of all of these doctors in order for me to stay at my optimal health status and achieve my health goals. Yet, I struggle. What little bit of time I have with each of these doctors, we don’t have a chance to talk about some of the things that they could really help me with probably better than anyone.

At my endo, we talk about diabetes, pump settings, high and low blood sugar trends, A1C’s, prescriptions, and sometimes even new diabetes research and technology. We don’t talk about my struggle with my weight, and how it affects me both physically and mentally. We don’t talk about my depression, and how sometimes I’m smiling on the outside and absolutely falling apart on the inside, and nobody ever truly knows the extent of it. We don’t talk about stress, and ways to manage being overloaded, and strategies to cut it down so that I don’t have to add hypertension and heart disease to my laundry list of sh–stuff to deal with on a daily basis.

At the eye doctor, we talk about diabetes, A1C’s, and the importance of keeping and EYE on things (see what I did there?) in the back of my eyeballs. We don’t talk about how prescription glasses are expensive, especially when you need multiple pairs (stylish regular glasses, plus sunglasses that make you think you look stylish, plus sport sunglasses for when you play volleyball on the beach with no shirt on all Top Gun style). We don’t talk about how much time I spend staring at a computer screen, and whether or not that is good or bad. We don’t talk about anything to allay my fears and anxiety from potential and, in reality, way over-exaggerated diabetes complications. We don’t even differentiate between Type 1 and Type 2 diabetes, but rather treat it as just this overarching definition of diabetes that sucks and makes you go blind, your feet fall off, and your wenis not work properly. And I need my wenis to continue to work properly dangit! (I don’t even know how I got from eyeballs to wenis, but I’m mildly impressed and entertained with myself right now.)

I want my healthcare team to know that, just because it isn’t their area of expertise, all of these various other things in Martin World impact me, and are related in some way, and have the potential to impact my health in both positive and negative ways. Because I’m stressed out that my BG’s are running higher than normal may mean that I don’t check my BG as often because I don’t want to deal with the stress that I feel when I see that high number on my meter. So then I go get something awful to eat to feed the stress with, and then my pants start fitting a little tighter, and I feel like I’m the size of a whale and the idea of an 19th century style corset sounds like a pretty great idea if it will make my pants fit better. Then my pants get too tight and the pressure makes my eyeballs fall out and my teeth point forward.

What I also want my healthcare team to know is that I have absolutely no clue how to bring these things up and talk about them in the time limit and in a way that makes sense to them before they have to run off and see the next patient. I’m doing good to remember to even show up for the appointment most days. If it’s not on my Outlook calendar with an alarm, don’t expect me to be there. If there was one thing I wish they would all ask, it might be, “So all of these numbers aside, how are YOU doing? Feeling okay? Any particular issue not related to insulin, BG test strips, and pump supplies that I can help with?”

Just ask. The answer might be no most of the time. But sometimes it might be yes. And that’s when it is most important that you asked, and that you are there to listen.

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Seeing Things

I’m finally learning to accept some things. Not everything, but some things.

For example, I’ve learned to accept that cooked carrots and mushrooms are disgusting and have no place on the food pyramid. Except maybe underneath the pyramid, as compost, to grow delicious things. Like fried chicken strip trees.

I’ve learned that my dog doesn’t really detect low blood sugars like I imagine he does in my low-brained head. He just likes spoonfuls of peanut butter at 3:30 in the morning. And who doesn’t love that?

A big thing that I’ve learned to accept (sort of…okay, not really) is that I get nervous when it comes to tests. Or things that I perceive as tests, like doctor visits. I don’t know why, but I always dread these appointments. In my head, they are the worst, even though 99% of the time they turn out just fine. It defies explanation.

As well as my life has been with diabetes, my imagination has a tendency to run wild and make things up that don’t necessarily reflect the reality of what I do everyday with diabetes. I think my anxiety is because diabetes is like a really crappy retirement plan: You make decisions based on data every single day in hopes that your annual account statement doesn’t show that you’ve invested all your efforts into a poop factory.

Earlier this week I went to the eye doctor, or more specifically, the ophthalmologist. This is where they check my eyeballs and retinas and all the tiny little veins and capillaries and doohickeys that keep them working to make sure that I have my diabetes in good control and that complications aren’t running rampant in my eyeball holes and causing irreparable damage to my vision and kidneys (which are connected to my eyeballs, somehow). I’m sure it’s a little more complicated than that, but that’s basically the big idea.

I was extremely nervous. Anxious. Full on shakytown while waiting to sign in. It didn’t help that the receptionist had a look on her face like she had just bitten into a piece of cat litter in her sandwich. She wasn’t rude by any means, just not exceptionally welcoming. In her defense, my appointment was at 1:00pm, and she was probably hungry. Plus, cat litter in your sandwich isn’t pleasant no matter how famished you are.

After I signed in, I barely had time to do a quick BG check before they called me back (it was 89, by the way…perfection). The nurse was super nice, but I could tell she hadn’t really been exposed to too many people with Type 1 diabetes before. We went through the standard form field questions for an eye doctor appointment: Height, weight, do you wear glasses, do you have any health problems, what kind of insulin do you use, what book are you going to try to read after we dilate your eyes, will you please put your phone away, did you just roll your eyes at me? You know, the usual.

I told her that my blood pressure was probably a little high because I was very nervous. It was, and wasn’t a big deal at all. She said, very friendly-like, “You should be used to this for as long as you have had diabetes.” I just smiled and laughed. Truth is, I’ve never gotten used to it. I don’t think I ever will.

The biggest disconnect was when she asked, “What was your blood sugar this morning?” I fumbled for an answer. That was at least three checks ago. I don’t remember that kind of information. That’s what BG meters and insulin pumps are for. I have more important questions to answer from my short term memory. Like, where did I park my car? What pocket is my cell phone in? How did I think these clothes matched this morning when I got dressed? I told her what my last BG was, and just went with that. One BG on my patient chart out of all the data points that I depend on every day to keep myself alive really makes zero difference in the grand scheme of things.

So we got through the formalities, and then I met with my ophthalmologist. Through all of the anxiety and nervousness, the experience was rather uneventful, which is a good thing. Bottom line, my eyes look the same as they did when I saw my ophthalmologist two years ago. Very microscopic evidence of having had Type 1 diabetes for almost 32 years, but nothing at all to be worried about. No blood vessels bleeding into the back of my eyes. No kidneys waving white flags of surrender. All in all, a clean bill of health, and a free joke about me being the oldest “kid” that my pediatric endocrinologist still sees on a regular basis.

I’ll take it. Growing up is overrated anyway.

Bindi Glasses

Livestrong Glasses

I Thought I Thaw an Ophthalmologist

I did, I did, I did thee an ophthalmologist!

I went to the ophthalmologist for the first time in three years today. I’m so good about keeping my appointments with my endo, but the other appointments just seem to get neglected more than respected. Maybe it’s because they aren’t prescribing me insulin. In any case…

It wasn’t without reason that I haven’t been to the ophthalmologist in three years. After a few visits, my last eye doctor and I were no longer able to see…um, eye to eye. I remember the day well. It was a sunny day in south Florida (like so many of them), and I had left work early to go to my annual eye exam. I went through the usual steps of signing in, getting my vision screening, eyes dilated, and squinting at the TV to try and read the news ticker with blurry vision. Always a fun game in the eye doctor waiting room. Finally, I went back to see the doctor, and he proceeded to look in my eyes with his little bright lights and explain to me how us people with diabetes just don’t take care of ourselves and it’s our fault for being in the shape we’re in. He continued to tell me that I had spots on the backs of my eyes from diabetes retinopathy that were leaking and cataracts. I was 28 years old, and had lived with diabetes for 26 of them.

Unlike John Boehner, it’s hard to make me cry. I have a tendency to throw up walls and block things out. But that appointment managed to get inside my walls, and I broke down. The technician couldn’t get a picture of my eyeball to put in my file because of the tears. That visit was a disaster, I was a failure, and I had just been told that my failure was nobody’s fault but my own. No wonder PWD’s struggle with guilt.

The sun was bright that day, so I sat down in the lobby after my appointment to wait for the sun to go down a bit more before driving home with my eyes dilated. That’s when I got to thinking. My A1C was in the 6 percentile. I was 175 pounds and put over 200 miles a week on my bicycle. I didn’t smoke, and only drank on rare occasions. I kept regular appointments with my endo, and wore my lab numbers with pride. How dare that doctor blame me for my diabetes! Which was about the time I marched back to the exam rooms and set the record straight for him in front of his staff.

So three years passed without my going to another eye doctor appointment.

At a recent diabetes meet-up, a friend recommended me to her eye doctor. Seeing as how my good glasses are broken now and I’m wandering around in my backups with their scratched lenses and all their glory, it was time to try it again, so I bit the bullet and made the appointment.

Today was a completely different experience, and for that I am so thankful. My vision screening went well (20/50 in both eyes without glasses, 20/20 with). Everyone I met at the doctor’s office was very polite, patient, and respectful. They answered my librarian brain fueled list of questions without showing any signs of annoyance or judgment. My new eye doctor understood the differences between the various types of diabetes, and was very encouraging. He did find a couple very minor spots on both eyes, but no leaks and no cataracts, and he said that I have nothing at all to be concerned about, especially not for someone who has had diabetes for 29 years and taken care of it like I have.

Sometimes it feels damn good to have someone pat you on the back and say, “Good job!”

Plus, I got a prescription for new glasses now, and I’m going to save my pennies and reward myself with a pair of these…

Livestrong Glasses

Oakley Black Livestrong glasses...yes please!