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Thursday, February 5, 2015

Meets the eye

I did it! After about 23 months I went in for a dilated eye exam. By went in I mean went down two flights from my office. Really- I had no excuse for prolonging the inevitable other than being terrified. Yup (see previous post). I think after being traumatized by a terribly judgemental eye doctor two years ago I was really dreading this - that's the thing - I wish more docs understood that blame games and scare tactics make me want to run far away and never come back!

It was better this time. I was seen by a 4th year student and then also by the attending - essentially my eyes were double-checked. In fact, I believe that happened because of diabetes. I though I was all done but them more flashing lights (just to be sure). As he examined me he routinely quizzed the student on random shit like "what is the most likely primary location of developing NPDR?" At which point I was like "please stop saying NPDR! You're freaking me out!" He laughed - "don't worry"

The thing is I did worry - from the moment I sat in that chair and the student collected all my info. "Do you have any eye disease?" "Not yet" I replied in my best humorous voice. "Why are you so worried, don't worry" they kept saying (so worried in fact that my bp clocked in a systolic of over 140 with a pulse in the 90s - I assired them that I have a bp monitor at home and it's normally fine -all true). Here's the thing: I realized I feel like my poorish diabetes control especially recently (while not extremely terrible but definitely not great) would definitely warrant complications. I thought the time was now. I fully expected to be told that diabetes fucked up my eyes. Being that the blood vessels are soooo teeny tiny there we all know that that's where the first signs will show up typically. So after 8 years (of which about half I would consider subpar management) I fully expected to be handed a new diagnosis and join the complicated club. I went in prepared for the worst: telling myself that I would not be alone in this and that information is power.

Between the two of them, they found no eye issues related in any way to diabetes at all. I think everyone could sense my sense of relief in a profound way that day. Knowledge is power and I felt very empowered in knowing that at this particular moment my eyes are very healthy. And I'm grateful for that fact. The thing is I feel I dont deserve it and yea I know how fucked up that sounds. I know that ydmv and that people who are well-controlled experience complications and that sometimes people with worse control do not. Genetics, epigenetics,etc. In any case - I felt guilt for having healthy eyes with not great control. Based on my last reported a1c from last spring! (6.8) the docs congratulated me on good control and told me to keep up the good work. I could not bring myself to tell them that my current a1c is definitely higher and that during the appointment my bg shot up into the high 200s. He left me with "there are two things with eyes and diabetes. There's time and there's high blood sugar that contribute to disease." I thought it was interesting that he aknowledges that even with good control time can still influence things. I laughingly dropped a line about well controlled diabetes being the leading cause of nothing whilst knowing perfectly well in my head that perfectly controlled diabetes is impossible.

Ok- lets go back to the fact that my eyes are healthy. That the poor control I experience form time to time (while a consequence of my actions or inactions) is no reason to blame myself for being human and far from perfect. Between the 6.8 and now a lot has happened. There was my dissertation and phd defense in July, coupled with a move and starting a new job in the same month. There were months of     not having health insurance. There was the fuck it I'm out of grad school parties, and Christmas and travel. I am quick to blame myself. It's important to remember that I have a life that isn't all about diabetes management! I should be proud of my accomplishments, proud that I've managed to care enough to test often even if I'm running high a lot. Proud that I haven't experienced debilitating lows. Proud that I'm very motivated to get better control and at this particular moment things are better and I couldn't be happier about that!

Yep, there is much much more to diabetes than meets the eye. Here is my dilated eyeball. Please ignore the incoming  wrinkles that graduate school has induced - love you guys!!!
<3 MM ;)

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