The Trouble with Sight
I'm both eager and nervous as I walk through the office doors to my optometrist. I'm kiddishly excited because I'm getting a new pair of frames, which will replace last year's already well used and scuffed glasses. But, I'm also anxious because I will have to face the results of a difficult year in diabetes management.
The first 10 minutes of the appointment were standard eye sight tests; checking for color blindness, eye pressure (high pressure increases risk for glaucoma), and proper eye muscle reactions. As anticipated, all was good with me on those counts. But, since my last visit, my A1c climbed a whole percent--not for lack of trying. I also had a temporary vision loss that lasted for about two hours in the fall of 2012, which I tried to pretend never happened. It was time to face the outcome of a disappointing and emotionally taxing health year.
In the exam room with the doctor, we discussed my previous year of diabetes care. I was very honest and detailed about the event with loss of vision--missing pieces of vision, fragmented. I was also forthcoming about my waves of uncontrolled glucose throughout the year, being distracted and exhausted from raising two toddlers.
He echoed my visual concerns and empathized with my stressful situation of time management, having a few young children at home himself. I relaxed a bit in his presence, as I usually do each year during his exams, and sailed through the sight tests that updated my lens prescription. Surprisingly, despite having many issues with disease management, my eye sight didn't seem to be affected and required no changes to the prescription. I breathed a sigh of relief.
He put two drops into each of my eyes, dilating the pupils. The texture was sticky and since my pupils were growing very wide, it was also difficult to see--there was too much light to absorb, causing discomfort. My lids felt grainy and heavy against my eyes. I was gently escorted to the waiting room for the required 15 minutes before they could perform the retinal photographs. I tried to read a magazine, but an article which normally would have taken me a few minutes to read, took the entire 15 minutes plus five more. I gave up and put the magazine aside, closing and resting my eyes.
In the dark room, where the photographs of my retina were taken, I sat down in the chair across from a complex and somewhat intimidating piece of machinery. Anxious about what they might find in the places where I couldn't see, I tried to remind myself that no matter what the damage to my eyes so far, most of it could be reversed with tighter glucose control. In 2010, I had a few black spots and clouded areas behind my right eye, and six months after tightening my control, all the spots were gone..
The technician rested my chin onto the equipment and took a series of photographs of each of my eyes. The images came up immediately onto the computer screen behind her, but aside from knowing it was a picture of the back of my eye, I couldn't make medical sense of them. My doctor took a lot of care to explain what he saw after taking a look at the photos. He calmed my nerves about the retinopathy beast that I had been terrified of for years. My vessels seemed to be in great condition, there were no spots or clouds, and no visible issues as of late. He said the loss of vision in 2012 was likely due to an ocular migraine and didn't seem convinced it was due to diabetes in any way.
He also eased my fears by assuring me that even if I were to get a worsened case of retinopathy, it wouldn't rear its head in the form of full-blown blindness. I wouldn't suddenly see those scary black spots in my vision that are often associated with retinopathy either. Aside from a serious retinal detachment, which is uncommon, blindness is an ailment that is still far off from my reality.
For the past 15 years, I was lead to believe that diabetes would attack and render me sightless one day, without warning. The truth is, it will happen in several stages of deterioration. With my annual exams, we will have full warning with options to take action before complete darkness sets in. That knowledge was a massive weight lifted from my shoulders.
I don't know that I was ever truly educated about how each of the harrowing complications of diabetes would fall upon my life. We all know about the impending diabetes doom of amputations, kidney disease, cardiovascular problems, depression, and blindness. At diagnosis, doctors basically gave me a list of things that could happen--many times seeming to imply they would absolutely happen at some point in the future--but they never fully explained the process of declining diabetic health.
I researched these ailments to the best of my ability over the course of my diabetes life, but for some reason, blindness sneaking up on me just seemed inevitable. I've been on guard about this for many years and it turns out I never really needed to be. Thank goodness for empathetic doctors who take the time to explain things that subconsciously plague a diseased girl's mind.
By the end of the exam, it's clear I don't have any signs of further damage to my eyes, despite a difficult health year. I'm relieved and thankful for such good blood circulation behind my eyes. I continue to try to better my health each day, but I'm also putting aside the emotional burden of complications awhile. I've worked very diligently on my well-being these past years and am continually evolving in my life and care.
But, to simply enjoy this life, I've got to relax a bit more. As of this moment, sight is good, health is good; life is good.
Katherine Marple was diagnosed with type 1 diabetes at age 14 in 1998. The mother of two small children, she has battled insulin resistance, pre-eclampsia, and pump failures, leading to insulin therapy via MDI using Levemir and Apidra, and sometimes metformin and a CGM. She is the author of two diabetes-related novels, "Wretched (this is my sorry)" and "Deathly Sweet."
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