Health for life

Showing posts with label diabetic. Show all posts

Diabetic Retinopathy Vs Macular Degeneration

Thursday, April 17, 2014

Many people with diabetes wonder if their blurred vision signals the beginning of diabetic retinopathy or perhaps another common cause of vision loss, macular degeneration.

While blurred vision occurs with both conditions, there are distinct differences between diabetic retinopathy and macular degeneration.

First, macular degeneration generally results in central vision loss while diabetic retinopathy results in dispersed areas of vision loss.

Heres a normal view:

Heres that same view through the eyes of someone with macular degeneration:

Heres that same view through the eyes of someone with diabetic retinopathy:

You may be able to turn your head to compensate for central vision loss. Compensation for dispersed loss from retinopathy is more challenging.

Another difference between the two is the age at which they develop.

Where age-related macular degeneration usually occurs in an older age group (60 years and older), diabetic retinopathy can and does strike a younger population.

The ADA states:

"After 20 years of diabetes, nearly all patients with type 1 diabetes and >60% of patients with type 2 diabetes have some degree of retinopathy."
- American Diabetes Association: Diabetic Retinopathy

The average age for diagnosis of type 2 diabetes has shifted from the 40s and 50s in recent years towards a younger population, occurring with troubling frequency in adolescents. Type 1 diabetes can occur in children as young as 2 years old.

Twenty years on from childhood or the teen years places someone with diabetes at risk of losing their eyesight at the height of midlife. The ADA says:

"Diabetic retinopathy is estimated to be the most frequent cause of new cases of blindness among adults aged 20–74 years."

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Photos of vision loss from NIH National Eye Institute via Wikipedia.

A Diabetic Manifesto

Tuesday, March 18, 2014

I love my Christmas tree... I light it. I enjoy its silent cheer; its proud glow. Perhaps, a memory of a perfect childhood, at least, in my own imagination. The room is messy, but the tree makes it come to life. It brings a certain peace to my heart. It makes everything... perfect. I probably wont take it down for a few more weeks.

Peace is a little hard to come by, these days... The worries of adulthood, and the insecurities of employment and finances, really take their toll... on ones joy, ones dreams, ones relationships, ones family, you name it. Still, I sit, and wonder... at the magic of it all. When folks sort of stop paying attention to the "mess" in their lives, for a moment, and just stop for some peace.

And peace, hope, growth, and prosperity is what I wish for all of you, this holiday season. I wish all of you to be BLESSED in one way, or another... And to make NO resolutions.

NO RESOLUTIONS. Instead, look back upon the year, with bittersweetness; say goodbye to friendships that are parted, and welcome new ones... Say thanks for all the hardships, lessons, and opportunities life has awarded you, and for all the mistakes you have made. Especially, for all the mistakes you have made. Cheer on the challenge a new year will present, and be hopeful for whats to come.

Be hopeful...

That friends and family will embrace, love, and support their fellow diabetics through this hard and challenging journey, without recrimination, and judgment, but with education, and a listening ear.
That diabetic patients receive the respect and dignity every person with a chronic illness DESERVES to be afforded, without gimmicks, media misinformation, doctors selling their profession for fame and a quick buck, and discrimination.
That government, and employers, strive to learn, educate themselves, and accommodate diabetics and their needs, and realize that we are just as capable, and just as willing to do a good, and proper job. That we can be just as productive, and caul good citizens, as anyone else.
That doctors will EDUCATE themselves, and not make insensitive comments or unfair comparisons, uneducated assessments, guilt trip patients with the blame game, give uneducated guidelines, and endanger patients lives. That they become aware of the HUMAN EQUATION, and grow some bedside manners.
That patients presenting diabetic symptoms will NOT be ignored until its dangerously late, and they have developed irreversible complications.
That patients will be properly educated at diagnosis time about their disease, and ALL their treatment options, and not left wondering in the dark about what to do, or how to make adjustments, and NOT DENIED access to proper specialists, such as endocrinologists, certified diabetes educators, or dietitians, but be left with only limited options such gastric bypass for those who are overweight... either because of professional ego, or because of insurance restrictions.
That patients will not be diagnosed based on biases -- but that every person out there presenting diabetic symptoms be given COMPLETE testing to determine not just whether they have diabetes, but where their insulin production stands, and their type of diabetes, REGARDLESS of their age, or their weight, so that they can receive the PROPER CARE they need to manage their condition, and educate themselves without much danger, second guessing, grief, and confusion.
That patients will receive proper access to medicines, and NOT DENIED access to insulin, needles, or test strips. That patients be allowed to test as often as THEY deem necessary. It is THEIR right to be vigilant, and it is THEIR right to stay alive. Test strips might seem expensive, but they are not, in comparison to the costs of the complications of poorly controlled blood glucose levels.
That patients will receive proper access to any care they need, and any tools to management they need, including pumps and CGMs, and diabetes alert dogs, without exorbitant expenses, or insurance games; in fact, that insurance companies will one day not be necessary.
That diabetic research organizations devote enough resources and work into finding a true CURE, because we are not a lost cause once we have gotten diabetes... We are just as important as those they hope to help avoid the risk of getting diabetes. ALL of us deserve a TRUE cure. Not gimmicks.
That together, we can tackle the challenges we face because of our many health concerns, and realize that we are all the same... Just folks wanting to be acknowledged, and heard; folks wanting to be UNDERSTOOD.

This is what I long for, hope for, and work for... in the year 2012... It is my Diabetic Manifesto. If we work together, we can slowly turn the tide... Wont you join me?

(I am sure glad that, in my culture, the holidays last a little longer... At least for now, Ill have a little more hope, and a little less mess.)

Burnt Out on Judgment The Not So Simple Motions of Diabetic Living

Sunday, March 16, 2014

This might seem silly... I know. I know I dont have to try hard, or go far, to ask my readers to imagine for a moment being a person with diabetes. (Naw... You dont say!) ☺

But still...! Imagine, for a moment that youre a person living with diabetes, and have lived with it for many, many years... Imagine its been challenging. Youve gone through many phases of burn out, and phases of challenge. Its been a deep struggle, for various reasons:

Managing this crap every day is a roller coaster, and well, it seldom likes to actually do what we expect it to do. Einstein once said that "doing the same thing over and over again and expecting different results" was the definition of insanity. I like to call it... Diabetes.
You have some white coat person always reminding you if you dont take care of yourself, youre going to die. And NOT in uncertain terms, either.

Youll get retinopathy...
Youll get nephropathy...
Youll get neuropathy...
All the opathies...
Youll get your limbs amputated...
Youll lose bladder function...
Youll be impotent...
Youll have congestive heart failure, or a stroke...
Youll go into DKA, or insulin shock...
Youll DIE.

You may not necessarily have many close friendships, in your immediate circle of acquaintances, that can actually understand you.
You have some family members constantly reminding you of the things the white coat person was reminding you...
You have friends, coworkers, and other relatives, wanting you to FORGET about what the white coats, and the other family members, keep reminding you, and then just go live life with them... "just live a little." (And its always living thats centered around food, or alcohol.)
You have your own deep desires to want to just be NORMAL, or as close to normal as you can be... and "just live a little."
Youve carried the heavy load of discipline, and care, however individualized your load might be, for a long, long time. You are very AWARE of how serious it is if you dont carry the load.
You get tired... You burn out. You drop the load.

Now... most of us understand this circle. We understand that it gets OLD carrying the load, and we get burnout. We stop... we go through the motions. Often, we even get eating disorders, etc.

So we crusade long and hard for our folks, because, we dont want people to think we gave ourselves complications, when they happen. No one consciously says "Im going to chug donuts! I want retinopathy!" -- Burnout IS a part of chronic illness. It is NOT a character flaw. It is not simply "people not doing their part," or not taking responsibility. It is simply... people being TIRED from taking on so much responsibility.

By contrast, we may have well been doing our part, and were just genetically predisposed to complications... But the world outside of us does not understand "genetically predisposed." The media doesnt tell ANYONE about "genetically predisposed" -- only about you can prevent and avoid complications, if you just take care of yourself. Why? Because the media is not interested in shades of gray -- the media has a job, and that job is to gain viewership, and ratings. The only way you get viewership, readership, and ratings... is by generating controversy... And the only way you get controversy is by getting folks to think in the inflexible lanes of black and white. And when you scare people about the rising cost of diabetes (uncontrolled diabetes, mind you), and then show them articles about "My aunt Bonnie, who didnt take care of her diabetes, and was irresponsible, etc, etc..." people get MAD. Angry. Unsupportive. Unsympathetic.

Does that make sense? Im sure it does.

Now, imagine a non-diabetic person... living their life as usual. They want to be normal, and keep living, just like anyone else... and as usual. They have the same family members, coworkers, and friends pressuring them to "just live a little."

They go to their doctor, and hear:

"Meh, you could lose a couple of pounds, but youre fine."
"You maaaaaay, or maaaaaaay not get diabetes down the long road... Its just not easy to say. But dont worry about it. Youll be fine. Just walk it off."
"Meh, youre blood sugar is a little high, but youre fine! Theres no way you have any issues... Just walk it off..."
"Nah, I dont think we need to test anything, youre fine... Just walk it off..."

Now... If it is hard for us to get our minds wrapped around the realities and burdens of illness, when we HAVE illness... Imagine how hard it is for an illness-free person to get their minds wrapped around the POTENTIALS of illness, and some "boogieman" of illness, out there, somewhere, over the hill... that may come, or not come... but they cant really say for sure... Its just some hazy smoke and mirrors thing. Imagine being "genetically predisposed", but only if you trip! "Dont you ever TRIP!" (Of course, they dont ever mention the trip can also be almost anything, besides weight and diet...)

Sure, hindsight is 20/20. Id love to go back in a time machine, and slap the crap out of Liz, and tell her "hey, start carrying the load a little sooner!" (Not that itd be of much help, with all my other health conditions, medications, and predispositions... They are, together, a much stronger trigger than lifestyle...) Some might say I was damned if I didnt, and damned if I did... But Im not quite sure what Id be avoiding, frankly...

"Live sternly, as a diabetic, so that you dont become a diabetic."

Seems a bit off putting... It might be hard to convince Liz. Especially if no ones serious about the boogieman... Its never around, and just some foggy illusion thing... And EVERYONE says you can get rid of it, if you do get it... (snark, snark) I mean, yeah, we should ALL do our best to be healthy, and everything... but Liz might want to enjoy a burden free life for a little longer -- at least, as long as she can. I mean, isnt that what we long for when were burnt out? A bit of freedom? Choices? Splurging without going into some diabetic hell episode? Having a little more than a 1/2 cup of moderation?

Yeah, I thought so... What burnt out people want is not that different than what illness free people want. A little freedom, a little empathy, a little break, a little life.

So we should crusade long and hard for folks, because, people should not think we gave ourselves diseases, when they happen. Chronic illness is NOT easy to manage, but neither is it exactly so easy to avoid... No one consciously says "Im going to chug donuts! I want diabetes!," and most people arent binge eating disordered individuals... (And so what if some are... People have demons. People fight them as they can... or struggle, as they tire of their loads... Life is hard.) They are just people living... and illness IS a part of living. Illness doesnt really care if you gave it to yourself, or not. It is NOT a character flaw. It just is... It is simply... people going through the motions of LIVING...