[[0019]] Eye screening results are back... and when you thought things could NOT get any worse...

... when you think things cannot get any worse...

AND THEY DO.

(Because this is my life and they always get worse).

To be quite honest with you, I had been having a somewhat reasonable day for many reasons, such as payday, eating food I want to eat, having the drinks I like, new stuff in Pokémon Sword, getting a Shiny Lucario (at last) for my Shiny Zapdos, working with people I like, being good at biting my tongue and the most important thing... PLANNING MY AMAZING LONDON/WALES BIRTHDAY and then you get slammed in the face by a massive fat brick and you're like, "oh well, honestly can't have nice things, can I?" (Enjoy the picture of the shiny Lucario, she deserved to be on here to brighten all of your days).

This my friends, is the life I keep joking and telling you all about but now you get to see how it unfolds as it unfolds as I only just opened these letters myself... and I am just... I don't even know. I might laugh and joke about all of this, but deep down, I'm tearing myself apart on a daily basis because trying and doing is never good enough and will never be good enough because there never, ever seems to be any good news about my health, only more and more little bits of bad. Maybe I should try and take the crap in my life more seriously but I think if I did that, I don't think I'd be standing and I don't want to live and wallow in my own self pity, so may as well be blunt and honest with everyone; if I do that, I can't get hurt, because means I get the truth out there before people start to make things up about me. Honesty is the best policy supposedly...

So... the eye screening results and why my brain is word vomiting a blog post for you all... well, I am getting to it. I didn't actually get my screening results first... turned out I had been sent an appointment at my local hospital in the Ophthalmology Dept, which if I am honest, I am kind of used to those by now as they are a regular occurrence. 

So, I got this this morning... well, yesterday but I just didn't check the door as I had not heard the postman yesterday. I expected an appointment or a check up but this letter didn't really explain why, plus, that appointment was not going to stick for long because: 

1. Need appointments later in the afternoon because of the eye drops making my eyes too blurry to actually do my job
2. It's on my birthday and going to the hospital on my birthday is just bloody depressing and I can think of things I would rather be doing than sitting in a waiting room, unable to see for like three hours or more afterwards

I never actually got round to changing the appointment today, but it was on my list to do tomorrow... the least I could ask for is an appointment towards the end of April, or somehow get put on an earlier clinic if the powers let be could. 

And then I got home. And saw the letter with the return address for Bristol so kind of knew the eye screening results were back (and quicker then I anticipated as well). And then I actually read it. And then the above appointment suddenly made a lot of bloody sense. 

I don't really remember what my old diabetic eye screening letters read or looked like, but I don't think I have ever read one quite this harsh or blunt. "Sight-threatening retinopathy". "Serious changes to the blood vessels". 

Either way, it looks like yet again, the stress and the illnesses I went through last year is causing my eyes to give me problems as well. Don't get me wrong, my vision has been blurry for a while and some days I can see screens and things fine and then others I need to wear reading glasses to magnify the letters in books on screens so I can read clearly, heck, I've been able to wear the glasses less at work because my vision has not been blurring as bad and yet... this is just potentially, the straw that might break the camels back (oh yeah, update, my mental health has been in a trash place as well, supposedly wrecked the kitchen on Tuesday but don't remember doing it, just remember crying cos no pans to make dinner, then my porridge died in the microwave and after that is a blur of crying and going to bed to depresso sleep so....... yeah). 

What does this all mean, bar well, my head going three thousand plus miles an hour and refusing to shut up as it weights up all the scenarios from the good (saving my eyesight) to the terrifying (eventually being blind) so I am prepared for every single eventuality that could happen (this also includes how people will speak to me and treat me, to what work might or might not do, to having to quit working... my brain will think of EVERYTHING that may or may not happen)?

Well... long story short (although I won't know for certain until I attend the appointment), this might mean I have to have laser surgery again. I have had this three times before, the last time I think being six or so years ago, maybe five. I think I've had it twice in my left eye and once on my right. I need to make it clear (lol, no pun intended), that surgery for retinopathy is nothing like the corrective surgery for those who wear glasses... it doesn't help you see better or fix the problem and damn I wish it did. Alas, like most diabetic problems, all laser surgery does it prevent the problem from getting worse for a time (so in this case, slow down the chance of you becoming blind). Long story short, laser surgery for diabetic retinopathy involves firing a laser to the area where the small blood vessels are leaking fluid (I think sugar) into the back of the eye. Type 1 diabetes can affect the microvascular blood vessel system, which is why a lot of use end up with eye, kidney, nerve and heart problems (and look at me, being 30 and having three of the four already). 

Have I ever mentioned one of my biggest fears? Going blind. Blindness is one of my top four most hated and feared things. I don't want to go blind. So yes, if it's laser surgery again then I will indeed go for it (even though you do have to sign forms and so on, which tell you this surgery could make you blond eep). I am not ready to be blind and I never will be ready. I like to draw and I like to write and I want my career in Science and I want to be able to see for all of these as best that I can. Hell, I want to be able to see my wedding. See my family. See my partner. See my cats. See my friends. See films and TV and musicians playing live. See the video games I play... so I'll take the laser surgery again. There could be other treatments but until I read the leaflet they sent, I have no idea what other options there are. But I'd probably take those options too. I don't have a choice, I cannot afford to lose my eye sight so young.

Needless to say, this has put a major downer on planning a fun birthday away from this town, with my friends and my fiance in London and in Wales. I still intend on planning these things, but I;m being fake if I seem happy about them cos all I want to do is crawl under my duvet and not come out until the problems go away even though I know that they will not. So yeah, I'll continue to plan my birthday. I'll try and change the appointment so it doesn't affect my birthday (pray for an earlier appointment for me please!!!) and we will just see what happens.

So yeah, thats that. I am yet again, not getting a break which I feel like I have fought for so damn hard. But I guess this is my life at the end of the day. Who am I to expect a break? The world just has to crap on people just to see how much they can take.

Alas, sometimes, strong people can break. Now that's a pre-warning to whatever is up there. Don't break me. It will not be fucking pretty.

  

[[0017]] The bane of a diabetics life... HYPERS/HIGHS

I have already written about hypoglycaemia over here so I felt it was time to write about the other end of the spectrum, hyperglycaemia (or highs as I will call them from here on out).

These are quite honestly the bane of mine (and I am sure other diabetics) life. Sometimes the highs cannot be helped, such as illness or stress, but other times, it doesn't matter how hard you try to keep your blood sugars stable, the highs just keep coming and coming and coming no matter what you do to try and stop them. Highs can also be deadly or just make you feel really sick and lethargic, amongst other things. I have actually suffered inadvertently with diabetic bulimia (diabulimia) due to constant high blood sugars, but that is a post for another date! 

Back to the post and what it is all about. Well, I will explain what hyperglycaemia is, symptoms of highs, how to treat highs and a couple of stories (alas, these will not be as funny as my hypo stories sadly, but they are poignant and bring the point home about how hard it can be to try and keep control of diabetes in an ever stressful world, or in my case, my not so ordinary world.

What is hyperglycaemia?

Hyperglycaemia is a result of too much glucose in the blood stream (check out the illustration above, those glucose molecules are definitely not making us feel very good). This can cause blood sugar readings to be very high, in my case, the highest I have achieved is 30mmol/L (be sure to check out my previous post about measuring blood glucose) but sugar levels can read higher than this, or in the case of my blood glucose metre, HI (which I think is about 35mmol/L but don't quote me on this). It is best to try and treat highs as quickly as possible, but this isn't as easy as treating a hypo... this can take longer to achieve and in my case, is not always successful.

The chart above shows just under a months amount of blood results... everything above the red line is out of range for me, or high. A lot of people have their highs set to 10mmol/L but mine is 15 due to the fact that I have struggled to keep control over the years so for the longest time, anything below 15 was decent enough for me. 

Looking at this, I realise how badly controlled my diabetes can be sometimes, especially towards lunch/afternoon. I'm still trying to figure out why I have the highs around that time of day, even when I have carb counted my breakfast and lunch, but that is a mystery for another day and not this post. 

How does hyperglycaemia happen?

Hyperglycaemia occurs due to a build up of glucose in the blood, which can simply be a result of an imbalance between the amount of insulin injected into the body and the amount of carbohydrate in food that has been eaten (although high levels of glucose can occur for other, not as common reasons).

The main causes of hyperglycaemia are:

• not enough insulin injected at meals
• not injecting before/after a meal or a sugary snack
• skipping meals
• illness
• non-diabetes related medications
• levels of physical activity
• stress/anxiety
• colder weather

As you can see, there are many factors that diabetics need to be in control of to help prevent highs from occurring. And it is vital that sugars are not high, as persistently high blood sugars can lead to diabetic complications later in life, such as:

• cardivascular disease/strokes/heart attacks
• diabetic peripheral neuropathy (nerve damage)
• diabetic retinopathy/diabetic maculopathy (damage to the small blood vessels in the eyes, leading to blindness)
• nephropathy (kidney damage/disease/failure)
• issues with the feet, such as infection, ulcers, blisters which can lead to amputation
• infection in the teeth and gums

What are the symptoms of hyperglycaemia? 

Hyperglycaemic symptoms I find, are not as obvious or noticeable as symptoms of hypoglycaemia. I have found that the symptoms of highs are subtle and only noticeable to myself... and the symptoms that I do get are very frustrating and certainly annoying to have. I have found that in a way, there are two stages to high blood sugar symptoms, the more common ones for when blood sugar levels are elevated for a shorted amount of time, then a second bunch for when blood sugars are raised for a longer period of time. 

Symptoms of short-term hyperglycaemia include:

• headaches
• dry mouth
• increased thirst
• urinating more often 
• feeling fatigued/lethargic 

Symptoms of long-term hyperglycaemis include:

• nausea/vomiting/making yourself vomit
• acetone/pear drop smell on the breath
• shortness of breath
• feeling weak
• sleeping a lot/falling asleep
• abdominal pains (in particular, around the kidney area)
• mental disturbance/confusion
• urine that smells sweeter than normal/pale coloured urine

Hyperglycaemia is a very serious problem, and the build up of glucose can result in diabetic ketoacidosis (DKA) in which toxic ketones build up in the blood stream. This can lead to hospitalisation but if left untreated, can become severe and result in coma or death. DKA is classed as a medical emergency and most people with diabetes do end up in hospital if DKA occurs.

Ketones - why are they so deadly?

I shall do a proper big post about ketones and DKA in the future, but I figured a small section about them could help those who have friends or family members with diabetes as ketones can be spotted quite easily by other people.

Ketones occur when there is not enough insulin in the blood to convert glucose into energy, so the level of this sugar increases as the liver in turn, begins to turn fat into energy instead. This causes ketones to be formed in the blood which are toxic and require medical help immediately. Ketones lead to DKA, which occurs as ketones build-up to ever increasing toxic levels. 

A symptom of hyperglycaemia as mentioned above, is the unique smell of acetone/pear drops on the breath, which is often associated with ketones, as this smell tends to only be noticed when a diabetic's body has been in hyperglycaemia for a long period of time. IF YOU EVER SMELL KETONES AROUND SOMEONE WITH DIABETES, CHECK THEIR KETONES AND/OR CALL 999 IMMEDIATELY.  

How do you treat hyperglycaemia?

I personally find that highs are harder to treat than lows. I guess this is because it depends on why you are having the hyperglycaemic attack in the first place.

The easiest way to treat hyperglycaemia is by taking insulin, which as a starting point until diabetics have found their ratios, is a unit of insulin to reduce bloods by 3.0mmol/L. I also learnt in hospital, to drink a lot of water too, which can help flush glucose from the body (although this is not as effective as doing insulin, however it is best to do both of these at the same time).

But this only works if hyperglycaemia has occurred due to not doing enough insulin or physical activity; hyperglycaemia caused by illness and stress for example, can be more difficult to treat. 

One of the biggest problems that I have personally had in trying to control my blood sugars, is the result of stress on them. I have mentioned briefly in posts prior to this one, that stress has predominated my life from an early age and as I got older, I tended to brush my own health and mental health problems under the carpet to deal with everyone else's issues, and neglecting myself is the reason why I ignored my diabetes so much. I tended to inject when I could feel dry mouth and even then, I wasn't injecting to lower my blood sugars but just to get rid of the dry mouth. 

Stress causes high blood sugars due to the fight or flight response that is in-built within us from an early age. When put in a situation that causes stress, the body releases glucose from the glycogen (concentrated glucose) that is stored in the liver. In people without diabetes, the release of hormones that is a result of stress and deal with stress cause  this glucose to be released and the blood sugar rises, however insulin is also released but in type 1 diabetics, this does not occur. This can cause blood sugars to rise in those with diabetes and this kind of sugar I find, is difficult to medicate for. This also occurs when diabetics are struck with bugs and illnesses outside of their control... for example, when I had gastroenteritis last year, I was medicating but even though I was not eating food, my blood sugars remained consistently high, no matter how much insulin I did; it also turned out I had ketones when dealing with this illness, which was another reason I was admitted as well as the neuropathy. I have since learned that if I ever end up with an illness like gastroenteritis again, that I do need to go to hospital straight away and obviously, call 999. You live and you learn after all!!!

In these situations I find its best to do everything you can to beat the illness, such as drinking a lot of water to help flush the bad stuff out of the body and increasing medication. If you are lucky enough to be able to predict when an anxious moment is coming, then do a little extra insulin, but honestly, unless you are logging every little thing that causes you stress, it is hard to know when you will become anxious or stressed, especially if it is spontaneous. Can you believe it, but some people's blood sugars can go up due to anxiety caused by a scary film! 

That is it for now folks! I hope you enjoyed this post about hyperglycaemia and how to treat it as best you can. Needless to say, all diabetics are different and what is said here may work for some but not for others. All information provided is based on my own experiences, but please, get talking to everyone else out there and find out their stories too!!! I also hope you're looking forward to future posts hinted at in this post, such as DKA and diabulimia, cold weather with diabetes and more!

Also, a big thank you to all those of you who are still following and reading my posts but also a big thank you to a member of a diabetes group I recently joined, Taz Marie, who gave me the idea to write about highs and eventually DKA and a couple of other interesting posts/interviews coming in the future!!!

[[0011]] Week 4 Overview

Happy Sunday evening everyone... and apologies for the muchas late weekly review post. It has been a day and a half and then some on the organising front... and even then, things aren't organised. Slightly better, but not organised. And somewhat more disorganised too, if that is even possible. 

But we will get on to that later. First things first, the weekly blood test results review... and... it's been bad. 

Since going to the Diabetic Clinic on Tuesday, I honestly have felt so damn burned out by the diabetes again, which I haven't felt like since before hospital, when I was stressed, had stress going on in my life, when everyday was stress and I had no time to think of the diabetes. 

Again, the clinic was great and I am glad I went, as there are some positive changes on the way, hopefully tomorrow or Tuesday, whenever my prescription gets updated and changed and I have new medication but... it's the age old chat of "you are too young for complications" along with, "yes, you have been stressed and stuff but complications..." and yes I damn well know all of this and I have known for absolutely YEARS and nothing will ever change the fact that I have lived the vast majority of my life with some kind of stress and anxiety and depression and so forth... and just, I get it. I get it and I just want some changes to be positive about, like, "well done on lowering the HbA1c into the nurses target range" and "well done for having the balls to remove toxic people and life stress from your life to get better" and heck, even "well done for trying to keep on top of things and trying to keep your bloods in range" and blah blah blah. 

Urgh... its a burn out week. It really is. I'm hoping with next week being a new week, things are going to be a little bit better but, I honestly can never tell. The fact I can feel that the diabetes control is slowly starting to major control my life is starting and continuing to eat away at me and I hate it. Its becoming an obsession, and I hate that it is, because I just want to deal with it and get on with my life as normally as possible but it honestly doesn't feel like I can do that right now... not with the carb counting dietitian appointment coming up. Like I know how to carb count, I've read how too... but it seems to consume every little thing you do when you eat and I hate that... I get why, I get why it's fantastic... I just hate it because we all know eating is vital to staying alive but it shouldn't make me feel like it is taking over... and it is. I hate it so much. This is one of the reasons I rebelled so much as a kid... that and being in secondary school with T1D is bloody hard anyway when peer pressure is everywhere and you get picked on for being diabetic amongst other things. Oh well, at least I know, after following some diabetes groups on Facebook, that I am not the only one who has so many problems.

However, I have been preparing for my trip to London, which I feel like I may actually need at this point because I don't think I've had a mini break since June last year, so it's long overdue and might just give me a chance to relax, de-stress and for once, enjoy myself in the city I love. 

I've also been preparing my next blog post for you all, which I am hoping will be like a show and tell kind of thing. The picture to the left is a little bag I found whilst packing my stuff for London, and I've decided to use it for all my diabetes kit and stuff. I've never done something like this before, and tend to let things hang loose in the bottom/front pocket of my bag, but I've been seeing people doing similar so it seemed a great thing to do, and something my mental health doesn't seem to mind doing because it appeals to my sense of organisation. Plus, geeky is best haha, would you expect anything less from me? Eitherway, the other half is gonna grab some dextros tablets and what not to put in the pouch tomorrow and then it will be ready for show and tell on Tuesday, so be ready to check out post 0012! I am actually quite excited about it!!

Speaking of packing... it is what I have spent most of today doing... as well as washing up a lot of clothes because my wonderful cats are absolute dicks... and decided at some point over the last week or so, to make my life hell. Not that I didn't have a lot of washing to do or ought, but I knew what I wanted to take to London with me and for once I intended on packing early so that I wasn't rushing the night before (we will be streaming Tuesday night before we go so the more prepared the better yo!). 

Alas, I entered the bathroom on Saturday... realised a lot of the dirty clothes in there were a bit damp... and then the smell hit me. The cats had decided to protest the old litter tray and their hate of it and decided to pee on the clothes... (I think Pom Pom did most of the peeing mind you, I'll post a picture of her in another post)... but then I found some cat poop hidden neatly under some clothes and I knew exactly who had done that one. Pictured above is my beautiful shit bag of cat, who has pooped in my bedroom before and covered it with my shorts... which is kind of sweet because she is a clean kitty but OMG WHY POOP AND PEE IN THE BATHROOM WHEN YOUR LITTER TRAY IS LESS THAN TO METRES AWAY? Seriously, I love my baby snuggle butt, but I do question her life choices at the best of times. Needless to say though, both kitties now have a new litter tray, with litter liners and freshener and a cute cat paw print mat and they seem to be loving their new toilet as there have been no more accidents.

However, it has not changed the fact I am now uber behind of clothes washing to the point I have had to set up two airers, as well as hanging washing off shower doors and radiators and trying to dry stuff in the tumble dryer (which is actually drying slower than the radiators... BLEH!) I mean, I have nearly finished packing, bar two pairs of jeans and a t-shirt which I am waiting to dry/finish washing and then obvs, my back pack for travelling but... at least I am getting there? It's pretty much the only thing in my life right now that is actually organised haha

I am looking forward to London though... I get to see friends I don't get to see often (missed you Misa and Meg and Brum/Manchester crew ❤️) but I also get to see an amazing band I absolutely love, buy more band merch for the band merch/music room but also planning on going to the Natural History Museum, which was one of my all time favourite places as a kid!!! Our friends who live near us, Sarah and Mike, are also coming to see Dir en Grey for the first time and I am actually so bloody excited for them too eeeeeeeeeeee!!!

Speaking of music... guess who got tickets to see My Chemical Romance in June for a certain someones birthday? I did!!! The other halfs family helped towards them seen as he's always wanted to see MCR, and tbh I am quite excited. My diabetes on the other hand, went absolutely mental during and after buying tickets because of the anxiety of the queue and then the fact I actually managed to get them. Needless to say, this year is a fantastic year for seeing music, and I have been saying for ages that I wanted to enjoy life a bit more now I am not as stressed and bogged down with things. So roll on Dir en Grey on Wednesday, then MUCC and Skindred for my birthday and finally MCR in June! Now to pray Versailles, Jupiter or Kamijo announce for this year... would be pretty perfect! 

But I should probably bring this back round to diabetes... as per usual. I'm not sure, but I think my neuropathy might be getting worse, or the medication just is not working (because I know for a fact it is not working as an anti-depressant). Today, after all the walking I did yesterday, alongside the super manual job I did at work on Friday alongside hunting through the house and climbing over things today, the pins and needles in my bad foot has intensified again to the point that I am finally feeling the pain everyone goes on about. I am a bit concerned and  don't really know what to do because its a nerve problem so normal over the counter pain killers do absolutely nothing. I'm hoping it gets better before London, and might have to beg the fiance for a foot rub when he's filling less sick... so I'm just going to cross my fingers and hope I get some new medication for neuropathy this week.

I also think I may have figured out a way to sleep better without the aid of my old anti-depressant, Mirtazapine. I've actually been getting to sleep easier since Wednesday when I bought the new thermal 15tog duvet (we have a freezing house omg)... and I have been dropping off a lot easier. I've been reading for a while about those weighted blankets and I know its not the same but... this duvet is heavier and I think I might actually need something weighted to help me sleep better. Maybe, if I ever make some pennies off this blog, I could put them towards one of those heavy blankets? Would be awesome!!!

Anyway... that be enough rambling for one week, plus I need some damn good rest before work tomorrow as I am on the super manual job again as well as training someone on the lead role. So... be back on Tuesday guys, and thank you for sticking around!