Diabetic Macular Edema, Pt. 2

As promised, I’m providing a bit of a step-by-step of the eye appointment I had today. Right from the outset I’m going to warn everyone that I took some photographs of my eyes. I only offer this warning because some people have difficulties handling “eye stuff”.

I arrived in Saskatoon and checked into my hotel that I’d be staying at for the night. I dropped off my bags and got set up in my room before booking the hotel’s guest shuttle to bring me to the hotel. The shuttle drove me and I arrived at Saskatoon City Hospital almost an hour prior to the appointment. I checked in at the admitting counter before starting the process.

The first step was a standard eye exam. I generally always score 20/20 on this, depending on how well-balanced my blood sugar is. On this occasion, I scored perfectly. The nurse then puts drops into both eyes that cause my pupils to dilate. Once this is done, I make my way to waiting room “B” where scans and photographs of my retina will be taken.

My “vampire eyes”, about fifteen minutes after they’ve been dilated.

I waited for quite some time before getting in for my scans. Unfortunately, getting to the hospital early does nothing for you, as the computer check-in places you in the queue based on your appointment time and not when you showed up. This sucks, especially when you happen to be early and people who have arrived after you end up getting ahead.

Once I get in to the “photographer”, he takes a detailed scan of the back of both eyes, as well as a photograph of each eye. This part of the process is simple and painless, despite having my eyes dilated like a vampire on coke, and every pinch of light causes a headache. Then, I made my way to waiting room “C”, which is ultimately where I will get the actual injections.

The medieval torture chair where I will be given my eye injections!

After another wait in the third waiting room, I was brought into an examination room as pictured above. I was strapped into the chair (Totally kidding! She didn’t strap me in!) and more drops were added to my eyes by the nurse. These drops freeze all sensation in the eyes (supposedly) but allow full movement.

The ophthalmologist (eye surgeon) then enters into the room and we look at the scans of my eyes together and compare them to the last appointment’s scans. During this discussion, we consider and decide whether the current injection regiment is still ideal or if it should be increased (my current regiment requires injections every eight weeks). I’ve been going at eight week intervals for almost a year now, with a couple of exceptions where I’ve allowed it to go to nine or ten weeks. This has resulted in worsened vision in the form of blurring, which is why we never push the appointments past the eight week mark.

The surgeon then places a clamp on one of the eyes (think Clockwork Orange) and puts a few drops of Bridine solution onto the white part of the eye. Bridine solution is a topical antiseptic generally used before surgeries. The white part if the eye is where the needle will penetrate the surface of the eye. I then pick a spot on the ceiling and hold fast, as the surgeon pushes the needle through and injects the medication.

Walking out the hospital in pain. Since I could barely see a thing, I’m surprised the photo turned out as well as it did!

As I’m staring at the ceiling and the medication enters the vitreous body, I can see swirls in my vision. It’d be a little bit freaky if one were not focused on the stinging pain ripping through that side of the face!

The needle gets pulled away and the excess is swabbed up by the surgeon. Then, I stagger into the scheduler’s office where she hands me a piece of paper indicating the date and time of my next appointment. She asks me if the appointment is fine, but I take the paper without reading it (because I can’t) and make my way down to the hospital lobby.

Normally, I get the hotel’s shuttle to pick me up and bring me back. On this occasion, the shuttle was tied up bringing guests to the airport so I had to hoof it! It’s about a fifteen minute walk through Rotary Park to reach the hotel. The walk itself would be refreshing and nice, considering it’s 4 degrees today. But since it’s a clear sky with a very bright, Prairie sun, it was torturous.

Right eye. The bright red line starts at the injection site.
The left eye. Notice the bright, red point is more prominent in this one.

Once I got back to my hotel room, I closed all the curtains and turned off the lights before crashing hard. It’s a catch-22! Having my eyes closed keeps the light from hurting me while the dilation wears off, but the rubbing of the eyelids on the eyeballs causes pain as well. Luckily, once I fall asleep I don’t notice this as much.

I’ll be taking it easy for the rest of the evening as my eyes recover then try and get a solid night’s sleep. Once I wake up tomorrow morning, I’ll make the trek back to Regina. I’ll have some latent headaches for the next day or two, but it’s a small price to pay to maintain my vision.

So there you have it! I warned you it might be gross. Something I didn’t mention in the previous post is that DME can be caused by bad blood sugar control over a long period of time. Being a Type 1 during my youth was chaotic. My blood sugars ran rampant and I’ve been comatose on more than one occasion. So, it’s very important to maintain your levels and get regular check ups, regardless of how big a pain it is. Because as much as I hate it when someone uses this line on me, it could always be worse!

Diabetic Macular Edema, Pt. 1

So, tomorrow I will be travelling to a neighbouring city to receive treatment for Diabetic Macular Edema (DME). This is a condition that is defined by an accumulation of fluid at the back of the macula, which is the part of the retina that helps to control our vision.

There are a number of causes for DME, but one that applies in my case is simply that I have been a Type 1 Diabetic for an extended period of time (thirty-six years, in fact).

The treatment includes injections into the eyes that help to dry up the fluid in the macula and alleviate the swelling it causes at the back of the eye. The eye is frozen by way of anesthesia drops. This allows for movement of the eye, but it prevents the pain associated with sticking it with a needle! Then, the ophthalmologist places a small needles into the white of the eye and injects a specialized medication into the vitreous body, which is the jelly-like substance that fills the inside of the eye.

Generally, the freezing drops wear off within twenty to thirty minutes and my head becomes a pulsing ball of pain. I can still see, although most of it is simply shapes and bright light, due to the dilated pupils required for the scans prior to the injections. A nap for an hour or two helps to take the edge off (plus, I get to have a nap!) and I can alleviate pain through more traditional methods throughout the evening.

By the next morning, besides the eyes being a little bit dry, I’m back to normal and can head home. It’s a nasty process that I have to repeat every eight weeks. In the beginning, I was receiving treatment every four weeks, but as better control and reduced swelling have been achieved, we’ve managed to taper it off to the eight weeks I’m currently sitting at.

Tomorrow, I will share photographs of the aftermath. Since it involves the eyeballs, it may be a bit much for some people, so be warned. The photographs will show the injection site and resulting irritation to the eyeball that it causes.

For more information on Diabetic macular Edema, you can visit the WebMD site at https://www.webmd.com/diabetes/diabetic-macular-edema#1

Nature Is All Around, Even When you Don’t See It…

Sometimes living in the city gives us the impression that we don’t have many aspects of nature around us. My family and I live in a suburb North of a city. We often see rabbits, squirrels and chipmunks wandering the yard.

A squirrel in the tree adjacent to my yard

This afternoon, my son and I were having a rather spirited snow ball fight in our back yard. Temperatures reached a warm high of 4 degrees, which is a welcome change to the frosty and foggy conditions we’ve had recently. While we were tossing snowballs at each other (with our dog Molly jumping around our legs) we noticed this cheeky squirrel chirping at us and leaping from one branch to the other.

It served as a great reminder that no matter where you live, nature finds a way to join in the fun!

This little guy seemed to be just as curious about us as we were about him! he hung around and chirped loudly at us for the longest time. Of course, maybe we were making too much noise and disturbing him.

With milder weather available, it’s important to get out and stay active. Get some fresh air, enjoy the outdoors and everything it has to offer.

Blood, Sweat & Tears…

Being a Type 1 Diabetic means exercising on the reg, even though EVERYONE should be exercising on a regular basis. Consistent exercising, in conjunction with proper diet (although I have a soft spot for nachos) has been proven to improve sleep habits, blood pressure and help to lose weight. It’s important to keep things varied and interesting so that it becomes something fun instead of a chore. One of the big problems with working out is that most people are gung-ho to start getting in shape at the beginning, but that often starts taking the wayside when muscle pain and fatigue kicks in.

I’m a big fan of Men’s Health magazine. There are usually a number of different workouts focusing on different muscle groupings. One I particularly enjoy is a US Marine workout designed for body-weight only, which is used by sailors on submarines when they have no space for workout equipment. When done properly, it is an intense assault on the body and I usually feel like battered bread dough the next morning. What’s nice about it, is you can do this workout anywhere since you don’t need anything but yourself. My wife Laura has done this workout with me on occasion, and she usually curses the day I was born the following day. That’s generally a sign that the workout was intense.

On Wednesday, Laura and I did a bicep and tricep workout that lasted just over half an hour. It was a good burn and I definitely got a sweat on, but I ended the evening thinking I’d done worse. The following evening, I went to karate class, where I practiced a lot of arm techniques and trained with escrima sticks. Apparently, the two workouts, one after another, was apparently enough to send electric bolts of workout pain through my arms and shoulders the following day!

It’s important to, as they say, feel the burn. I know way too many people who go on walks or something of the like but never put any serious effort into their fitness. Now, just to be clear… Anything that gets you moving and gets you out of the house for some fresh air will have some benefits. But in order to reap the proper benefits of exercise, you need to sweat! You need to get that heart rate up! Go join a local gym, take some classes, join Zumba (and yes, I’ve tried Zumba and it is a wicked workout! So is spinning!) You should have at least three or four workouts a week that result in a small puddle beneath your feet (And before any of you get sarcastic about it, I mean a puddle of sweat! If it’s a puddle of anything else, you should probably go see a doctor!)

Boxing drills and shadow sparring are fantastic ways to work up a sweat and help regulate blood sugars.

Why So Sensitive…?

Have you noticed that the world has changed its point of view significantly in the past ten years? Maybe it’s just me… I remember a time when people would speak with one another before a problem, became prominent, first and foremost, and everyone wasn’t so damned sensitive about everything.

“I identify as…”

“That offends me…”

“You know, SOME people may not appreciate your point of view…”

It seems as though no matter what you do nowadays, you can offend someone with almost anything you do. One of my favourites is how medical professionals have started getting offended when a patient offers up an opinion…“Oh, let me guess! You Googled that, didn’t you? Congratulations, you can searcgh for things online! Maybe you’d like to be the doctor???” Considering how many medical professionals I’ve dealt with due to my Type 1 Diabetes, I’ve had this retort thrown in my face on a number of occasions. I guess that all things considered, I can’t blame them! In my line of work, I’ve had people suggest that they know the law better than I do. Although that hasn’t saved them from getting charged. And with the World Wide Web at everyone’s fingertips, where does a professional draw the line in knowing when a client is simply postulating and not threatening your skills?

The other issue that seems to have changed radically in the past ten years is what I like to call “The Holiday Effect”. Canada is home to diverse cultures and multiple backgrounds. And even though we are living in 2019 and should all be able to just get along, this tends to cause an unmeasurable amount of head-butting! We see a great amount of that during the Christmas holidays. These days, saying “Merry Christmas” seems to have taken the wayside and the preferred greeting is “Happy Holidays”, so as to not offend those who may not celebrate Christmas.

Really? So just because you don’t celebrate Christmas, I can’t wish you a happy one, based on how I was raised? Seems kind of backwards, doesn’t it? Shouldn’t we be advanced enough in our development by now that we can respect and ACCEPT all beliefs and cultures?

As a Buddhist, I generally tell people that I am a student of all religions and beliefs. I pride myself on being open to anyone’s perspective (at least until I learn that it is realistically harmful to themselves or others, of course). But where do we draw the line at how far we are willing to change ourselves in order to accommodate others? And is it appropriate to do so?

Let’s say, for the sake of argument, that I change my habits to accommodate someone of different background or culture in order to accommodate them. Many would believe that it would be insensitive if I didn’t do so. How far does it go before it starts becoming insensitive to me?

These days, it seems everyone gets to choose the core aspects of themselves: Their name, their gender, EVERYTHING! And people get outright offended when you don’t refer to them based on their chosen lifestyle or perspective. And you know what? It’s okay to choose your own way of life. Maybe it’s not quite okay to get offended, and even angry, if I don’t understand, especially when I don’t know you.

A part of me believes that the advent of social media has made things worse. These issues have plagued the world for decades, but the arrival of information at the world’s fingertips has made it possible for us to hear about these things, even experience them in a much more comprehensive manner than we would of, say ten years ago.

The bottom line is this: No matter what your cultural, religious, racial or ancestral background may be, we can all co-exist. The world is a mighty big place (even at its current population of approximately 7,700,000,000 people (as per the World population Clock at http://www.worldometers.info/world-population/). But despite that fact, there’s room enough for us all to carry our beliefs with us, without disturbing or interfering with anyone else’s. If someone wishes you a Merry Christmas and you don’t celebrate it, no big deal! Just say thank you for the well wishes and move on. I’m certain your respective beliefs teach you to appreciate kindness, and it would be just that! If you identify in a way that may not be clear to other people, don’t get offended or angry; embrace your right to explain it so that people understand. We are all capable of learning, so take the opportunity to teach. If someone offers up a suggestion regarding something related to your professional trade, don’t take it as an insult; simply use it as an opportunity for open dialogue (and remember that YOU are the professional and the opinion is simply that: an opinion).

Let’s find the balance. Let’s learn to co-exist with one another. In a world where every culture is available and visible to the entire globe, it becomes more important than ever for us to learn to get along.

Balance!

Happy Pi Day!

Today is Pi Day, due to the date description being of 3.14, which is the most commonly known form of Pi.

Pi is a number that is considered a mathematical constant and was originally used to calculate the ratio of a circle’s circumference to it diameter. The number is has been since been used in various mathematical and physics formulas. Because the number is named “Pi”, it is often represented by a Greek letter and is often referred to as “Archemede’s Constant”. The Pi number is a mathematical constant with a never-ending decimal representation that never repeats itself. Many people enjoy showing their prowess by how many numbers AFTER the decimal they can recite.

These days, Pi Day is celebrated as a day to enjoy just that: Pie! Since the use of the Pi constant is in relation to a circular constant, a pie is the perfect way to represent this. So have yourself a slice! And just to demonstrate the number for those who are not familiar with it, this is the longest form of Pi after the decimal I was able to find (without searching too deeply):

3.1415926535897932384626433

I love me some Chocolate Pie!


Holy Hiccups!!!

I’ve just hd hiccups for over an hour! Here’s a call out: what’s the longest you’ve ever had hiccups? Has it kept you awake?

A hiccup is an involuntary contraction of the diaphragm that can occur several times a minute. Hiccups are involuntary an often tend to lend an annoying presence in your day!

So far, I’ve tried to hold my breath, taking deep drinks and holding my breath some more.

Way back in 2001, I had the owner of the business I managed who told me that drinking a cup of water with a plastic knife on it would help to “cut the hiccups out”. I never understood it, but man, did it work.

Sometimes, some of the things we face in life require a little faith. We don’t always have to know WHY it works, we simply have to close our eyes and accept that it will. The same applies to many of the mysteries of our lives. Sometimes, we have to close our eyes and jump off the ledge, knowing that “all things happen for a reason.”

We Sometimes Only Recognize The Light Because Of The Darkness…

Depression is a very real thing. Unfortunately, the term “depression” is thrown around far too much these days, as most people generally use it as a word to describe simply feeling down. The reality, however, is much more elaborate.

The American Psychiatric Association defines Depression as “a common and serious medical illness that negatively affects how you feel, the way you think and how you act.” One of the big problems associated to depression is that the person in question will often be unaware that this is what they’re going through. The website goes on to describe some of the symptoms as changes in appetite, trouble sleeping or sleeping too much, loss of energy or increased fatigue and often obvious thoughts of death or suicide. These are just to name a few. More can be read on this at the actual website (https://www.psychiatry.org/patients-families/depression/what-is-depression)

I believe that most people have suffered from depression at some point in their lives. It’s not a sign of weakness nor is it a sign that they “can’t handle life.” Sometimes it sneaks up on us when we least expect it. Sometimes it comes as a result of matters that are outside our control, which is the case for yours truly.

It’s a lot easier to deal with if you happen to have a good support system in place. Great friends, great wife and an awesome four-year old Tasmanian Devil who destroys everything in his path but makes me giggle as he does so (that’s my boy!); these things all go a long way towards helping me deal with the frightening demons that accompany depression.

Sometimes I feel as though my body won’t respond to my brain ordering it out of bed. Some days I can’t seem to get to sleep, regardless of how exhausted I am, and when I do I’m plagued by nightmares. Motivation seems to bleed out of me for even the most beloved of activities (and I don’t think I need to explain how this can affect play time with a four-year old). There is constant pain and often lack of understanding as to how life could have gotten to this point… Any of this sound familiar to anyone out there?

The good news is that for the most part, depression is treatable. If you’re able to speak to someone, reach out. Your family doctor can definitely be a fantastic resource and can refer you to people who can help. If you or someone you know is in immediate danger of harming themselves, make sure to dial 911! Otherwise, the Canada Suicide Prevention Service can be reached by dealing 1-833-456-4566 and they even have a Crisis Text Line that you can reach by texting “TALK” to 686868. They have some different ways of contact, which you can check out here: https://thelifelinecanada.ca/help/crisis-centres/canadian-crisis-centres/?utm_source=google&utm_medium=cpc&utm_term=suicide%20hotline%20canada&utm_content=!acq!v3!39436515258_kwd-55273995352__288566371603_g_c__&utm_campaign=Branded+-+Canada&gclid=EAIaIQobChMIht_D-Kv-4AIVBS9pCh1RIwcsEAAYASAAEgJtq_D_BwE

The bottom line is that we wouldn’t recognize the light if it weren’t seen from the dark. There’s always a way out and it’s always worth fighting for. If there’s one thing that the past ten years have taught me, it’s that even though I’ve seen and dealt with things no person should have to, I know I can still find the strength to fight if I can just dig down deep. The strength you need is right there. Make sure you search for it, and never be afraid to ask for help.

Take care if yourself before you can take care of others!

National Nap Day

Today happens to be National Nap Day in the United States. Now, I happen to be Canadian but I am a firm advocate of the power of napping. Here are some facts…

Naps have been proven to increase memory and can even lower the amount of time it takes to fall asleep. There are a number of doctors who believe that naps are almost as important as exercise and should be included in your weekly routine the same way as exercising.

Some work industries actually believe in providing nap periods throughout the work day as studies have shown that a small nap in the middle of the work day can help increase productivity and imagination. The Japanese have this practice and they call it “inemuri” which means “to be asleep while present.”

Certain studies have found that napping can help reduce heart issues and just knowing a nap is coming can help lower your blood pressure. And contrary to popular opinion, napping will NOT affect the sleep you get at night. Of course, this is offset if you decide to nap for hours during the day. Then you start falling into a deep sleep cycle and can cause grogginess that can last despite coffee and the other fun stuff you may take to wake yourself up.

But the takeaway here is that naps can be good. So if it’s a rainy afternoon and you have a cozy couch and thick blanket, stretch out and let yourself drift off for half an hour to sixty minutes. I took a nap this afternoon, which is how I’ve managed to post twice today! Sleep well!

Fear Is Temporary. Regret Is Forever.

Many years ago, someone in my life once told me that “we often find our destiny on the road we least thought to travel.” I can’t recall who said it to me, but it’s been a guiding principle that I’ve followed throughout my entire life. The closest I’ve ever found to this saying is Jean de la Fontaine’s saying, which reads “A person often meets his destiny on the road he took to avoid it.” Pretty close to what my forgotten role model was trying to relay, I think.

In recent months, I’ve had the opportunity to examine life and the opportunities it provides. Keeping with the Buddhist state of mind, it’s important to remember that for every opportunity, there is the chance for loss. I’ve experienced a lot of good opportunities in my life, but I’ve also had life firmly kick me in the gonads more times than I can count. The thing is, and I often say this to people, is that life rarely cares about your plan.

I’m a fighter. Through and through, I’ve taken on every obstacle that life has thrown at me. But about a year ago, I had a bad turn of luck. The proverbial rug has been pulled out from under me, as it were. My year has been one of difficulty, on my family, my home, my career and on myself. It hasn’t been easy. When these difficulties slapped me out of my comfort zone, I could have sat in the corner and sulked about it with my head in my hands. I know that most people in my position would have. But instead, I embraced the opportunity that this difficulty produced. I learned new skills. I made new friends (you know who you are). I used the silver lining of my situation to contain the otherwise dark cloud of what was happening to me.

We always hear people talk about what they regret in life. But here’s the thing: you should never regret anything in life. Regret is a weight on your soul; a blight on your existence. Regret saps your positive energy and makes it difficult for you to focus on the positive. Is it possible to consider how you would have done something different? Sure! but every decision you’ve ever made and every event you’ve ever lived through has brought you to the hear and now. If you ever had the opportunity to go back and change something because you regret it, you would ultimately change the person you are now. And the person you are now is great.

L. Ron Hubbard said: “Never regret yesterday. Life is in you today and you make your tomorrow.” And I’m going to say that you can never reach the top without a rough uphill climb. So get at it. One step at a time and one foot in front of the other.