Nothing to Complain About

I’m writing this blog post from my ophthalmologist’s office – I’m sitting in a chair in an exam room, waiting for my eyes to dilate so my doctor can complete the exam.

Just before my eyes were dilated, I checked in for the appointment and went over my information with a nurse who works here. During the check-in, she asked me how my eyes fared in the last year.

The chair from which I wrote most of this blog post – on my phone, to boot! (It takes time for eyes to dilate, okay?!)

“I have nothing to complain about, all is well!” I said to her.

“That’s great to hear. After all, after a year like we’ve had, it’s nice when there’s no complaints about something.” She replied.

I sat here in this chair and smiled under my mask. Too true. It’s refreshing when there aren’t any complaints about any aspect of my health and well-being, considering diabetes can be such a pill.

And I’m happy to report (now from the comfort of my own desk chair) that I have “gorgeous retinas”, according to my ophthalmologist.

Nothing to complain about, indeed.

My Close Encounter with the Keto Diet

Remember that time that Oprah Winfrey did a Weight Watchers commercial and proclaimed loudly and proudly before the cameras that she loves bread? (If you don’t know what I’m talking about, here’s the link to the ad with a little doctoring done to it – it is worth a watch.)

Well, I can relate to Ms. Winfrey – except my obsession with carbs extends beyond bread. I love cake, candy, chocolate, pizza, pasta, sushi…and just about every other carbohydrate-laden food that exists. So while I think it’s awesome that many of my peers with T1D choose to follow low or close to no-carb diets, that’s not the kind of thing that works for a girl like me: I’m happy managing my diabetes in tandem with a moderate carb intake. But that’s not to say that I don’t eat lower carb sometimes or that I don’t have an interest in the principles of the keto diet, just because it’s so restrictive.

At least, that’s what I used to think about it.

Would my love of carbs prevent me from trying out aspects of the keto diet?

When my boyfriend decided to go on the keto diet back in May (he’s had experience with it before), I was simultaneously impressed with his dedication to it, but also a little worried. We have dinner together a few times each week and since I wanted to show him that I support him 100%, I knew that I’d have to change up my cooking so it adhered better with the dietary guidelines of keto.

So for the last two months, I’ve had a lot of exposure to the keto diet, and this is what I’ve learned about it:

  • It’s not as restrictive as I thought it would be. I figured that eating strictly keto meant that the only food groups we could eat were meats/proteins, fibrous vegetables, and cheese. That wasn’t 100% true. While we stuck to proteins and vegetables for most dinners, we also had plenty of snacks that kept things fun and interesting. I developed a mild addiction to cheese crisps and chicharrons (otherwise known as pork rinds). I also had a lot of fun trying different keto dessert options out there, including cookies, ice creams, and peanut butter cups (the latter being my absolute favorite).
  • Snacks can get expensive. One of the keto peanut butter cups that we ate cost $10 for a bag of 7. That’s an insane price. When you factor in the cost of other more expensive grocery items, like beef jerky or nuts, things add up quickly, which is definitely a downside to the keto diet.
  • My blood sugars tended to respond well when I ate keto…for the most part, anyways. Eating keto dinners was mostly great for my blood sugar and it stayed relatively steady more often than not. On the occasions it didn’t, it was because I was trying to bolus for the amount of protein or the negligible amount of carbs in the veggies I was consuming at dinner, and I would go low as a result. There’s an art to bolusing on the keto diet, for sure, but since I was half-assing it (really quarter-assing it) and not following it all the time, I never got a grip on how to account for minimal carbs.
  • Keto can inspire creativity in the kitchen. The best thing I made, ate, and loved throughout my experience with the keto diet was cauliflower crust pizza. I found the best recipe for it that was so easy to make and yielded delicious results. I always assumed that cauliflower pizza crust would be too difficult to make or not satisfying in the same way that pizza is, but that isn’t accurate at all. I grew to appreciate the challenge that keto presented me to come up with new things to eat that were tasty and filling, which I didn’t expect but liked.

T1D and “Inspired” Food Choices

There’s no doubt that T1D directly affects my relationship with food.

Sometimes, I eat whatever I want with zero guilt. Other times, I painstakingly count not just the carbs, but every single macro of any morsel that meets my mouth. And more often than not, I fall somewhere between those two extremes.

But no matter what, my relationship with food is exhausting and probably one of the most inconsistent relationships I’ve ever had in my entire life.

It’s also a relationship that causes me to make what I’m calling “inspired” food choices.

Diabetes certainly impacts my food choices…especially when it comes to blood-sugar spikers like pizza, pasta, waffles, cake, and more.

Choices like eating dessert before dinner because my blood sugar is low.

Choices like only eating low- or no-carb foods because my blood sugar is high.

Choices like timing my meals down to the minute because I know that my body functions best when I eat regularly.

Choices like keeping snacks in my purse, my overnight bags, my car, and miscellaneous other locations because I never know when I might need food on the fly.

Choices like restricting my eating because a low blood sugar made me binge on food one day, and the guilt carried over to the next day.

Maybe “inspired” isn’t the right word to describe my food choices here. There’s so many more that could apply: weird, strategic, healthy, unhealthy…the list is limitless.

Just like the number of “inspired” food choices that my diabetes triggers.

Good, bad, and everything in between, though, the first step in making changes to my relationship with food is acknowledging the flaws in it. While I admit that I’m not sure what the next step is, I do know that I’m feeling determined to finally establish a guilt-free relationship with food.

Diabetes already takes too much from me…I refuse to let it continue to make my relationship with food negative.

How My Diabetes and I Handled My Second COVID Vaccine

Last week, I received my second dose of the Moderna COVID-19 vaccine.

Dose number two was definitely different compared to dose number one.

Hanging out in CVS after my second dose. Don’t mind my cheeky shoe – from this angle, my footwear looks sassy, but it’s supposed to say “oh” (the other shoe says “hey”)

How so? Let me start by going over the fatigue I felt. It started to hit me around 9 P.M. on Tuesday evening, several hours after I received my shot. I just felt sleepier than I normally do at that time, and as a result, I went to bed as early as I could.

I woke up a few times in the middle of the night because of the pain that I felt radiating throughout my upper arm. I couldn’t believe how sore it felt! In fact, the site was so tender that sleeping on the left side of my body was a no-go – I didn’t want to do anything to increase the ache in my arm. Other than that, the only other disrupter to my sleep was feeling a little chillier than usual, though that was quickly fixed with the addition of another blanket.

So that was how I fared overnight. What about the morning? I slept later than usual, only rousing to turn off my alarm and drink a bottle of water (I’d heard that staying hydrated would help). I got out of bed around 10:15 A.M., only because I couldn’t sleep anymore and wanted to try to get some work done. But when I stood up for the first time, I recognized that my body was achy, like it was trying to recover from an intense workout I’d done the day before. It was nothing too terrible, but definitely noticeable.

I ate a small breakfast and logged onto my work computer, convinced that I could power through my soreness and grogginess and work the rest of the day. Boy, was I wrong. By the time I got out a meeting that went from 12:30-1:30, I was incredibly tired. Pressure had built in my head and behind my eyes to the point that they were very heavy, and I was so cold that two blankets and a cup of tea were doing nothing to warm me up. My mom (bless her) retrieved a heating pad for me which helped me get warm enough to comfortably fall asleep and take my first nap of the day.

The rest of the afternoon and evening was a cycle of waking up, trying to get out of bed, realizing I was too fatigued to do anything other than lay around, and either succumbing to more sleep or snuggling with my puppy and my parents’ dog. By the time I went to bed (for real) that night, I was starting to wonder whether I’d wake up feeling the same, or if my symptoms would subside come morning.

And guess what? I was 100% back to normal the next day! The moment I opened my eyes, I knew that I was back in commission. The only side effect I still felt was soreness in my upper arm, but even that went away about 48 hours or so after I got the shot.

The very best part (besides being fully vaccinated, of course) is that my blood sugars were not seemingly impacted by the vaccine. Maybe they ran slightly higher than usual, but I’d chalk that up to my lack of movement throughout the day rather than blame it on the shot (I wasn’t feeling well enough to go on my daily walk or do my exercise circuit; that, coupled with laying around all day, meant that I’d run a little high whether or not I’d just been vaccinated).

So yeah, I was mentally and physically tired the day after I got my vaccine, and my arm was a bit sore. Those side effects were more than worth it. Now that I’ve received both doses of the Moderna vaccine, I’ll continue to mask up and practice social distancing in public, but I’ll also now gather with fully vaccinated family members and friends to make up for lost time…and do so with far less anxiety and fear now that we’re all more protected.

How My T1D and I Handled My First COVID Vaccine

Imagine my surprise when I went to write about today’s new blog post on my Instagram account and swiftly realized…I didn’t have a new post! Life’s busy and as a result, I’ve fallen a bit behind my blogging schedule.

Luckily, I have the day off from work today, so I’m able to whip up a quick post on something that people might be wondering about: How did my diabetes and I fare after receiving dose 1 of 2 of a COVID vaccine?

I am officially halfway there on the vaccine front.

I’m going to rapid-fire this one and sum it all up with some bullet points:

  • I got the Moderna vaccine
  • I felt 0 pain when I was injected – in fact, I didn’t feel anything and was surprised when the nurse told me I was all set
  • I had to wait 15 minutes after the dose was administered to make sure I didn’t experience any type of reaction
  • I had no reaction whatsoever
  • About 18 hours after I got the vaccine, I noticed some slight pain around the site
  • I could not see any marks around the site – no redness, no apparent injection location
  • The pain was only noticeable when I was changing my clothes
  • My blood sugar within the first 24 hours was mostly fine (I wasn’t eating super healthy so any high blood sugars can be blamed on my poor diet)
  • My blood sugar was fine 48 hours later, leading me to believe that the vaccine had 0 impact on my blood sugar levels (I had somewhat anticipated elevated blood sugar levels because my mother, who also got the Moderna vaccine, said her levels were higher 2-3 days later post-vaccine)
  • I felt absolutely normal! I got the vaccine three full days ago as of this writing and I can’t say that I’ve noticed anything different

That was my experience; remember, all people with diabetes (and without diabetes) are different and may experience different things. If you have any questions after reading this post, I highly recommend reading this post from Beyond Type 1 that tells you what you want to know about the vaccines. And here’s my little disclaimer to talk to your doctor about any concerns you have.

I’m glad that I got my first vaccine and that it was a hassle- and pain-free experience. I’m looking forward to getting dose number 2 at the end of April and will be sure to recap what it’s like then. In the meantime, I’m happy to continue masking up and practicing social distancing – after all, we’re in this together, and just because I got one vaccine doesn’t mean that I can’t do my part to help protect others.

How I Did My Part to Help Prioritize All Types of Diabetes as it Pertains to COVID-19 Vaccination Rollout in My State

Across social media, I keep seeing the same type of photo pop in my feeds that sparks jealousy, triumph, fear, confusion, and hope all at once: the COVID-19 vaccine selfie, fondly referred to as the “vaxxie”.

I’m beyond happy that dozens of family members and friends have received the vaccine. It makes me feel good to know that they’re doing their part to help protect themselves and others, and it’s wonderful to know that the vaccine is being distributed to some extent.

However, I take issue with part of the distribution plan in my state.

Using my voice to hopefully change/improve the rollout of the vaccine in MA felt good.

In Massachusetts, COVID-19 vaccine rollout has been chaotic, to put it mildly.

It’s probably similar in many states, but the part that I find most frustrating is the fact that people with type 1 diabetes (and seemingly no other co-morbidity) are being lumped together with the last group of individuals to be vaccinated.

My endocrinologist confirmed this for me the other day during my virtual appointment: “Why is it [presumably her computer system] showing you in phase 3? You should be in phase 2…” I nodded vigorously and we talked for a few minutes about how disconcerting the whole vaccine rollout plan is. I explained to her that the Massachusetts chapter of #insulin4all was coming up with language to email to local representatives to implore them to do everything possible to prioritize vaccination for all people with diabetes, and a couple days later, I got my chance to do just that.

I looked up my local and state representatives with a quick Google search and emailed three individuals who are in positions to revise public guidance regarding COVID vaccinations. As soon as I hit “send”, I felt this amazing sense of empowerment – it felt good to do something about an issue that I’m very passionate about.

While I wish that I could do more to ensure change, I do feel a sense of pride that I tried to do something by using my voice. It represented the first (but certainly not the last) time that I plan on contacting legislators to help improve diabetes care, management, and accessibility of supplies – not just for myself, but for all people living with diabetes.

My First Virtual Endocrinologist Appointment

My first-ever virtual endocrinologist appointment – and my first one of 2021 – took place last week. I’m going to sum it up list-style, because who doesn’t love a good bullet-point list?

  • It was strange. I didn’t think I would be weirded out by having my endocrinologist “in” my home, but it was freakin’ bizarre to see her face show up on the monitor that I do my day job from, that happens to live on a desk in my bedroom.
  • I had to wait to see my doctor. It took almost 10 minutes for me to receive my pre-appointment check-in call, and another five before my doctor actually joined. That felt normal.
  • We made a single change to my pump settings in the whole appointment. She suggested a solitary tweak to my correction factor. I’m not sure I agree with said change, but we’ll see how I feel about it over time.
Look, it’s actually me in the virtual waiting room! Smirking at the camera and everything! Thank goodness my doctor didn’t join at this moment…
  • My lab results were barely discussed. My doc mentioned that my cholesterol was a little higher than it was last time, and I unabashedly told her that this was probably because I hit the drink somewhat harder than I used to in the past (sorry not sorry, I like wine). I brought up my A1c and I said I was proud of myself for achieving it, and she just nodded, otherwise disregarding this data point.
  • We figured out which prescriptions I needed. When she asked about my supplies, I explained to her that Dexcom is no longer shipping sensors and transmitters to me directly and they want me to use another supplier called Byram (more on that in a future post). I asked if she could send my prescription to my regular mail-order pharmacy instead, and she obliged, telling me to double-check on the script in a few days to make sure it would go through properly.
  • It was just as short as they typically are. The whole damn appointment lasted only 15 minutes and 2 seconds…and we talked about me/my diabetes, specifically, for fewer than 5 minutes. We spent the rest of the time discussing our collective confusion over my COVID vaccine eligibility and my frustration over my postponed physical. It was both gratifying and dismaying to discover that she couldn’t understand why the state of Massachusetts considers me ineligible to receive the vaccine until the third (final) distribution phase, but I’m hoping that will change soon.
  • She wants to see me again in 6-7 months. My doctor ended the appointment by asking me to schedule an appointment in the August/September range, which seems so far away. I let her know I’d schedule it at a later date for a couple of reasons, one being that I have no clue whether I’ll want to go in person or do it virtually again, and another being that I really don’t know that I want to keep her as my endo.

That just about covers it. I’m not the happiest patient in the world – I’ve been uncertain about this doctor since I started seeing her – but for realsies, I’m glad that I trusted my instincts and requested a virtual appointment instead of an in-person one.

The drive would’ve been longer than the visit, and for me, that just doesn’t make it worth it.

A Postponed Physical and the Resulting Questions

“Molly, we’re calling to inform you that your 10 A.M. appointment for this Thursday has been canceled. We still aren’t taking patients in the office and we won’t be rescheduling you until April. Please give us a call back so we can set up a new appointment time.”

I listened to the voicemail twice before it sank in that my primary care doctor’s office was calling me to postpone my annual physical.

Why, exactly, did it get postponed? And how do I feel about it?

My doctor’s office called me two days before I was scheduled to come in…leaving me to also wonder why such short notice of the cancellation?

Well, I can only theorize the answer to the first question. I’m certain that my doctor’s office is absolutely overwhelmed with phone calls and appointments…and they’ve probably been like that for the past year or so. I’m guessing that they’re only keeping appointments with higher-priority patients that absolutely need to be seen…someone like me, a pretty healthy (discounting my diabetes) and younger individual, is likely not very high on the list of patients they want to see. Plus, even though I know they’re doing virtual appointments for medical questions as they come up, there probably is no purpose in doing a virtual physical because there’s only so much they can do via video call. So I get the postponement, but that doesn’t mean I’m happy about it.

My annual physical is the doctor’s appointment for me, the one that I have each year that I know won’t be a total waste of time. Each year, I get my blood work and urinalysis completed at this appointment, as well as an EKG to monitor my heart. I also get to go over any general health concerns I have with my PCP, who is very thorough when explaining things to me. During this particular visit, I’d hoped to talk about (what I believe to be) the stress-induced hives I’ve experienced in the last month, but now it sounds like I won’t have the chance to do that until April.

But I’m also wondering…when I go to the appointment in April, will I receive my COVID vaccine then, too?

I messaged the doctor’s office to find out and learned…nothing helpful:

I believe by that time you should qualify for the vaccine so you should be able to get it. This of course depends on if the state has given us the vaccine. We will know soon about that and will be sending information to all our patients. 

Uhh…according to the multi-phase vaccine plan outlined by the state of Massachusetts, I should be eligible for the vaccine prior to April. (But quite frankly, the whole phase plan has been a bit of a hot mess. I’m just glad to have 2 out of 4 immediate family members vaccinated at this point.) And the “if” there? Definitely unsettling.

I have so many questions: Can they postpone again in April? When will they be able to tell us more information about the vaccine? Do they think that it’s safer to wait in April because there will hopefully be more vaccinated individuals overall then? Or are they actually worried about vaccine distribution and don’t want to clue anyone into that?

So I feel not-so-awesome about having to wait three more months to check in with my PCP. I take my overall health very seriously, not just my diabetes. One thing has everything to do with the other. However, I do have a virtual appointment with my endocrinologist in a few weeks…maybe that will be the health check-in that I’m desiring?

I’m not banking on it, but I’m hopeful.

The Impact of Diabetes on My Relationship with Food

There’s no cutesy lead-in to this post…I’m going with a very straightforward statement here:

Diabetes has caused me to have a very weird and strained relationship with food.

How? Oh, let me count the ways…

Diabetes has positively impacted my relationship with food because it has helped me understand the importance of nutrition. I’ve had to learn how carbohydrates, proteins, and fats affect my levels, as well as the role that the glycemic index of foods play into the picture. I’m also grateful that diabetes has caused me to realize there are limits – I can’t mindlessly eat huge quantities of food (though on occasion I do, more on that in a minute). I must measure everything out, and I believe that this forced sense of portion control has helped me maintain a (mostly) healthy weight.

But diabetes has also, absolutely, negatively impacted my relationship with food.

Here’s pretend cartoon me, being absolutely adorable as she calmly whips up a feast in the kitchen (LOL there’s so much wrong about that sentence)!!!

For starters, I can get so fed-up with having to account for every single morsel I consume in a given day – I resent having to take insulin for foods I’d otherwise find enjoyable. Plus, there’s a lot of guilt associated with my regular food consumption. “Should you eat that?” is question I hear not just from others, but from myself as I have to think about whether certain foods are worth not just the calories, but also the amount of insulin that I have to dose for it. And don’t even get me started on how literally unsavory it is to have to eat food when I’m already full but dealing with a low blood sugar…

In a word, my relationship with food is complicated…and I don’t hesitate to blame my diabetes for that. Don’t get me wrong: At the end of the day, I loooooooove food. Really, there’s very few things that I don’t (or won’t) eat or at least try. I enjoy consuming a large variety of foods and I like to eat veggies almost as much as I like eating chocolate (that may be a bit of a stretch, but I think you get my point).

It’s just unfortunate that my diabetes forces me to overthink every food choice that I make. So I’m that much more hopeful for the day which I can eat food without having to think twice about it, without having to feel guilt, shame, doubt, anger, sadness…nothing but pure enjoyment.

An Enjoyable Eye Exam

I think I just had the best doctor’s appointment of my life (so far).

And the most incredible part about that statement? This was my very first appointment with this particular doctor and she absolutely nailed it. I’m almost bummed that I only have to see her annually…

Let me back up a bit. This doctor is my new ophthalmologist (eye care specialist). I switched to her because I’d seen my previous one for just about my entire life, and while he was unquestionably an excellent and knowledgeable doctor, we had some…personality clashes that made my yearly visits with him not so great. It wasn’t like we had a breaking point or anything during my last appointment with him, I just decided that now was the time to make the switch to someone else.

So I did. In August, I contacted the new doctor’s office and set up an appointment. I also wrote to my old doctor and requested the last few years’ worth of notes to be faxed to the new doctor. I’d never written a formal letter like that before, but I kept it short, sweet, and professional by informing him that I’d be seeing a new doctor, providing him with her location and fax number, and thanking him for taking great care of me over the years.

An Enjoyable eye exam
I totally snagged this picture of the exam equipment during the few minutes I was in the room alone. 

Making the switch was as simple as those steps – I had nothing else to do but show up for my appointment on September 1.

When I arrived to the office, I took note of all the social distancing protocol in place. There were only a dozen or so chairs spread out throughout the waiting room. There were dividers in place and stickers on the floor to mark six or more feet apart from the next person in line. The receptionist took my temperature with a contact-less thermometer and of course, nobody was allowed into the area without a mask.

Pleased with the careful measurements the office had taken, I waited for a few minutes before being called into an exam room. A nurse gave me a brief exam and had me read an eye chart using my current glasses prescription, then she dilated my eyes before leaving to go get the doctor.

Within a couple minutes, the doctor entered…and it was nonstop chatter from the moment she came in to the moment I left the practice. Her bubbly energy was infectious and it was obvious I was speaking to someone who truly loves her job. She let me know straightaway that her son is also a T1D right around my age, so she’s more than familiar with every facet of caring for it (with, of course, a special focus on eye health).

We talked a little about everything from insulin pumps, careers, CGMs, my broken bone (she was rocking a brace on her foot, so we shared a laugh over our injuries), and our studies in college. And yes, eventually we did get to the eye exam component, which took barely 60 seconds. She exclaimed with enthusiasm over my “gorgeous” eye health and told me that she is a T1D cheerleader, meaning she recognizes how hard we work to take the best possible care of ourselves.

Absolutely amazing, right?!

The appointment ended with me mentioning my appearance in Dexcom G6 advertisements, and she requested that I send her a clip via email. I did so shortly after I got home, and received the loveliest response back:

“You are spectacular. See you next year!”

I swear, I’ve never left a doctor’s appointment feeling so wonderful about myself. It’s a credit to all physicians like this one, who are passionate about what they do, happy to really engage with patients, and demonstrate in-depth knowledge of medicine and the human body.