Fighting the Unseen: Life With Diabetes

Four years.

I just received diagnosis of my first diabetes complication, and the doctor told me: "This usually happens after seven years with type 1."

This coming September 23rd will be my 11 year anniversary with Type 1.   I have struggled- boy, have I struggled, but I've always managed to come out okay.  It must be in the genes.  I get the flu once per year and only for a few days- living in the ever changing world of New England USA, that is a great feat in of itself!

My A1c has always been a little high, but it is not for lack of trying.  I have progressively grown immune to the insulins that I've taken, forever needing more and more... until they just don't. work. any. more.  I've switched from every brand that I know is available, and yet I'm still taking relatively high dosages of my current insulin- the last one on the market.

It takes a while to figure out the new medicines.  When compared with the constant, comfortable units of the previous insulin, sometimes it's hard to figure out how the next one will react.  When on Humalog, my carb: unit dosage was 7:1.  My correction ratio was 25:1 (BG: units).  Yet, on Apidra my carb ratio is 10:1 and my correction is 50:1 (double Humalog)  This definitely takes some getting used to and must be gradually increased to regulate without dipping into a coma.  Diabetes is NOT an exact science.  EVER.

I've gone into insulin shock comas and suffered through a few bouts with Dka (Ketoacidosis- a condition where the Blood sugar is so severely high that the blood turns acidic and begins eating at muscle tissue.  The only way out of Dka is to flush the body with fluids and saline solution- most likely in Intensive Care Unit or Emergency Room)

So, between all of that... I've had relatively high BGs throughout my life.  I switch insulins about every two years.  I've just started working with Apidra a few months ago.

But, all I can think is: four years.

Four years of extra bliss that I wasn't even aware that I held in my hands.  An extra four years without impending the end of my life... four years without complications.

I saw my opthomologist on Friday, the 4th.  It was a routine eye exam, one that I had scheduled months prior.  I see my eye doctor once per year.  He checks my prescriptions and dilates my pupils to look behind my eyes.  He says it's to see if I "have diabetes in" my eyes.  Nothing has ever come up from these dilations except for some discomfort while walking back into the sunny skied days.

But, on Friday, I received my first frown from my doctor.  He surveyed the images of my retina, crossed his arms across his chest, rolled his seat toward me, and had his sad eyes on.

"You have the beginning stages of diabetic retinopathy."

Wait, what?  I'm 25 years old!  Complications already?

"You have tiny hemorrages in the backs of your eyes that, if they are not stopped, will cause you to go blind."

Oh, shit.  "How do I stop them?"

"You have to keep your blood sugar levels stable.  It's not so much the spikes in the 200s, but the constant days in the 200s that are causing these ruptures behind your eyes."

Considering my insulin issues (listed above), a pit dropped in my stomach because I've been trying to CONTROL my blood sugars for the past 11 years.  To almost no avail.  What will happen if I stay where I'm at?

"If you can keep your constant blood sugars down around 150 or lower, you may even see your hemorraging stop completely."

"And if I stay where I am?" I asked, hoping against all hope that I would be able to figure out a way to stop my 190-250 platauing.

"Your hemorraging will continue, it will develop more, and you will completely lose vision."

Damn.   "If I can keep my blood sugars down, how long before I lose vision, based on what you see today?"

"You can be fine for as long as 40 more years- sometimes longer." He smiled awkwardly.  "I hate having these first talks with diabetics."

"it's scary."

"I know it is."

I scheduled a follow up for six months from now- to see how quickly the retnopathy is spreading.  My dad asked me to explain what retinopathy is and we came up with this imagery: Retinopathy is like a flat TV screen that has a few dead pixels.  You can still see the picture, but there are a few tiny dead spots.  If not treated, the pixels can grow larger, eventually making it so that you can't see the picture on the screen at all.

Four years.  I'm grateful, even though I'm still distraught, that I had those extra four years without any complications.

Being thankful for the small things is all that will get me through each day sometimes.