I Care About Eye Care

Like most people with diabetes, I see an ophthalmologist (essentially an eye health specialist) once a year. This is because diabetes can affect vision and overall eye wellness, so an ophthalmologist will look for things like cataracts, glaucoma, and macular degeneration within my eyes to make sure they’re healthy.

These appointments have all followed a similar pattern for me in the last couple dozen years that I’ve had diabetes. I’m brought into an exam room, my vision is tested with an eye chart, and then my eyes are dilated and examined with extremely bright lights. And I’ve been very fortunate to hear the same verdict from the ophthalmologist year after year: There’s no evidence of diabetes in my eyes, which translates to my eyes look healthy and normal.

This lack of diagnosis has always reassured me, and this year it was no exception. The only thing that actually changed for me was that it dawned on me that this appointment really means a lot to me. It was relatively quick, completely painless, and, dare I say, pleasant because of my doctor’s deep personal connection to diabetes (her son is around my age and also has T1D). She truly gets what it’s like, and didn’t make a big deal whatsoever when my Dexcom interrupted our appointment with a high alarm.

My annual appointment with my ophthalmologist is like performing a maintenance check on a car – it’s my chance to make sure everything is operating smoothly.

I’ve come to realize that even though it’s a blip on the radar compared to all the other doctors and healthcare specialists I see throughout the year, it’s still significant to me because I don’t take my vision for granted. Sure, I can’t see much without the aid of my contacts or glasses, but I can still see without pain, blurriness, or any other general eye discomfort. That makes me lucky and also motivates me to continue doing all the right things for my eyes, such as replacing my contact lenses on schedule and taking care to use high-quality cosmetic products. I can’t say that those two factors alone have contributed to my eye health (in fact, I can say with certainty that it’s my diabetes management more than anything else), but even so…I recognize that eye health is not to be taken lightly.

I care about eye care, and I definitely see the connection that doing my best for my ‘betes benefits it, my eyes, and well…all of me.

A Little Bit More Under the Weather

Remember that post I wrote last month about my bout of covid? If not, you can read it here…and then come back to this post for the update.

The update is that my covid experience wound up lasting longer than I thought it would. You see, after completing my doses of Paxlovid, I was starting to feel great! I think I had about 5-7 days of normalcy before things took a turn and I officially got a case of rebound covid.

That’s right, it came back to haunt me. On a Sunday, days after finishing my Paxlovid, I noticed that my throat began to feel a little funky again. It was just as tingly as it felt at the initial onset of covid, which was a sign to me that perhaps I wasn’t out of the woods just yet.

I spent most of May feeling…a bit under the weather.

Sure enough, the next couple of days my symptoms intensified slightly. Only they were a different set of symptoms compared to my first round – this time, I was dealing with an extremely itchy and agitated nose. It could’ve been so much more worse, and I’m grateful it wasn’t, but my mental health seriously suffered when I took another at-home covid test that Monday and learned I was still positive.

At that point in time, I’d been in isolation for three weeks. This meant I’d have to complete another 10 days, at a minimum.

I was devastated. I was missing my family and friends. I felt like a prisoner in my own home, bound here because it was the right thing to do in order to protect my loved ones, but also resentful of how confined I was because overall, I really didn’t feel that bad. But I wouldn’t change a thing about my quarantine period because it was ultimately the only thing I was in control of throughout the whole experience, and having control over whether or not I exposed people to covid provided me a sense of comfort.

I was also extremely distraught because my business trip to New Orleans was rapidly approaching, and I knew I wouldn’t be able to travel again unless I started testing negative. So the following Tuesday after I tested positive again, I began consulting my healthcare team and we decided that I might benefit from receiving a monoclonal antibody infusion to help my immune system recover faster. Just like that, all my hopes became tied to this infusion as I longed for it to both alleviate my symptoms (even Benadryl wasn’t helping my itchy, sneezy nose) and help me produce a negative test as soon as possible.

Fortunately, the infusion did its job. Within 48 hours, I was feeling much more like myself. Even better, four days after receiving it, I began testing negative. I was beyond elated and relieved.

My covid ordeal taught me a few things. Number one, I feel so very lucky that I had access to the means to get better: a capable healthcare team, medical treatment, an understanding employer who let me take as much sick time as I needed, and the like. Number two, I feel similarly lucky that my diabetes seemed totally unaffected by the illness. I can’t imagine how much more difficult (and frustrated) it would’ve been if I’d also been chasing lows or highs. Number three, I’ve got so much more appreciation for the people and things I took for granted prior to my quarantine. I was absolutely giddy the first time I left the house after testing negative, and honestly, that feeling hasn’t changed with every subsequent plan I’ve made in the weeks that have followed.

Most of all, I’ve got a new level of gratitude for my support system: my family, my friends, my partner, and everyone who checked in on me when I was feeling depressed and lonely in quarantine. I would’ve been lost without them.

A Bit Under the Weather

Well, it finally happened…I tested positive for covid.

The past couple of weeks have been an absolute blur as I first dealt with my boyfriend’s bout of covid – during which I felt totally healthy and well – then woke up one morning with a sore throat that immediately signaled to me that I hadn’t managed to avoid it, despite being fully vaccinated and double boosted.

I’m grateful for my constant companion, Nurse Violet, throughout this whole ordeal.

But I think it’s because of those vaccinations that my personal experience with it has truly been very mild. I’ve had no symptoms other than a tingly throat, body aches, and a general sense of fatigue. The body aches have definitely been far from pleasant, but the silver lining in this whole situation is that my blood sugars have been completely and totally normal (knock on wood that this trend continues, seeing as I’m still positive as I write this post). They are maybe running just a tad bit higher than usual because I’m getting very little movement in throughout the day, but really, it’s nothing I can’t handle. And since I’ve started taking Paxlovid (as prescribed by my primary care doctor), I’m hopeful that I’ll be on the upswing of things before long.

In the meantime, though, it’s time for me to try to relish in taking it easy for a few more days as I complete my isolation period.

“You Need to Have Better Control”

I read those six words, all strung together in a terse message from my doctor’s office.

Not exactly the response I was anticipating when I reached out to them to express concerns over a minor health issue I was experiencing…

Let me back up a bit. In early January, I decided to message one of my doctor’s to discuss said minor health issue. A week went by and I didn’t hear anything from them, so I sent them another message, reminding them gently that I was hoping for a reply sooner rather than later. Several more days pass by and I start to get annoyed, but I still keep everything in perspective: Maybe they’re understaffed at the moment. Perhaps a computer error prevented them from getting my messages. Or they might be just crazy busy with beginning-of-the-year appointments and responsibilities. Whatever the case may be, I decided to message one more time, drawing attention to the fact that my first message had been sent two weeks prior and that if I didn’t hear back by the end of the week, then I’d just call the office to hopefully connect with a nurse.

Luckily, it didn’t come down to that because within 48 hours of me sending that third message, I finally heard back from someone. And this someone said something that left me a bit gobsmacked:

“…with an A1c of 7 – you need to be better with your control.”

Life with diabetes often feels like this image – like you’re the only one in the control room of a command center that dictates whether or not you live. And yep, it’s exhausting.

I couldn’t believe what I’d just read, for multiple reasons. For starters, I’d mentioned in my first message that I *think* my A1c was right around 7, but I couldn’t be sure because it’s been a bit since I last had my A1c checked. So clearly, by reading the response from my doctor, nobody had gone in to check my records or look up my historical A1c – which may or may not have provided them with better context so they could answer my question better, but that’s besides the point. What had me most irate was the fact that I’ve been told – time and time again – that I’m doing a great job with an A1c around 7. I’ve had endos and nurse practitioners alike tell me that I don’t need to make any major changes and that I’m too hard on myself when I express a desire to get a lower A1c. So to have a completely different medical professional make a snap judgment right then and there that implies I do not have control over my A1c is obviously in direct conflict with what I’ve heard from others. How maddening is that?

Furthermore…I’m sorry, but A1c does not paint a complete picture of my “control”. I believe, along with many other people in the diabetes community (including medical professionals) that time in range is where it’s at. The amount of time I spend in range is leaps and bounds better than where I was in college – and honestly, so is my A1c.

This is why it’s incredibly frustrating to me that this person handled my health issue as though it was directly related to my diabetes and their perception of my lack of control. The three-sentence, curt reply to my initial message didn’t exactly help matters either, though I’m trying to not read too much into that…after all, you can’t gauge tone via written message.

I’ve decided the best way to handle this whole exchange is to bring my issue up again when I see this doctor later in the year. I’m not going to reply in the message thread, because I don’t see how that would cause any good, but I will bring this up when I go to see the nurse practitioner at my endocrinologist’s office at the end of this month. While she likely can’t fully help me address my health concern, she’s bound to provide me with some insight and some actual helpful advice that won’t involve her jumping to conclusions about my control. We’ll see how it goes.

For now, I will just have to try to keep my head held up high by taking control of the situation, if not my diabetes.

Adding Yet Another Doctor to my Diabetes Care Team…

As a person with diabetes, I see (what feels like) a ton of doctors. It’s probably not that many more compared to most people, but in addition to seeing doctors like a primary care physician and a dentist, I also see an ophthalmologist (eye care specialist), an endocrinologist (my diabetes doctor), an allergist, and a mental health professional.

But recently, one more doctor got added to that list: a podiatrist.

A podiatrist has become the newest member of my diabetes care team.

I wrote about how the nurse practitioner at my endocrinologist’s office promised to hook me up with a referral to a podiatrist in this blog post. Long story short, I voiced my concerns to her over the calluses on my feet, and she suggested I see a podiatrist so I could get an expert’s opinion on whether or not they were something to be worried about.

Fortunately, my first meeting with the podiatrist went well as I was assured that my calluses aren’t anything to stress over…but that initial appointment turned into a series of follow-ups (I’ll be seeing him every six months) as I learned that the podiatrist wanted me to start wearing orthotics to support pronation in my feet that I never realized I had. The doctor advised me to come back every six months so the degenerative changes in my feet can continue to be monitored, even though he was very pleased to see in my X-rays that the overall health of the bones in both feet is good.

Naturally, I had mixed feelings regarding the outcome of my first two appointments with the podiatrist.

On the one hand, I was happy to hear that my diabetes wasn’t creating any complications (beyond poor circulation – my feet are always cold and according to the podiatrist, this is due to Raynaud’s). Nerve damage is always something that I fear and I was genuinely frightened that the doctor was going to tell me that I was beginning to show signs of diabetic neuropathy in my feet. Obviously, I’m so relieved that this isn’t the case.

On the other hand, I was bummed to hear that his recommendation was to wear orthotics. Orthotics? Before I’m 30?! I guess it’s just the connotation of the word (it conjures up images of elderly folks hobbling around on canes and wearing special-made sneakers to support unsteady gaits) that’s got me rattled. I never realized that my tendency to walk around on my tippy-toes was due to the way my foot is shaped…but honestly, if wearing orthotics in my shoes now will help prevent or delay hip and knee pain later on in life, then I’ll quit complaining and just get on with it, even though it means I’ve got another doctor to see semi-regularly now.

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.