If You Read Nothing Else Today, Read This…

503662_17204362I’m not being overly dramatic when I say this should be mandatory reading for anyone who comes in contact with a person who has diabetes – and that is pretty much everyone in this country (and quite possibly, the world).

The best article I’ve ever read about the psychological manifestations of the physical issues of this disease.

Written by one of the most the most well-known diabetes blogger in the U.S. (and quite possibly, the world) and a person who has seen my ups and downs of diabetes and life since we met online before the DOC existed, Kerri just simply put my heart’s and head’s unintelligible aches into words.

This disease is not just numbers and data. It’s more than that, but often (too much), we are thrust under a spotlight (sometimes self-directed) and grilled about things that we may not have control over.

The guilt of complications, whether you have been “perfect” or like me, just “perfect” by blog moniker, is the same. We wander through days and nights with a tremendous burden that no one can take from us, but can add to the weight and guilt without knowing.

We don’t talk about complications enough, because to do so is soul exposing and frightening for anyone who wants not judgement, but understanding and support. We often, unfortunately, get judgement…. but no one judges as harsh as we do.

So, thanks to diaTribe for allowing Kerri to say what needs to be said:

Complications happen, and discussions about them shouldn’t be relegated to whispered fears in the bedroom after the lights are turned out. The language around complications needs to change from one of fault and guilt to that of perseverance and renewed hope. We, as a patient community, have the right to disclose our diabetes complications without being blanketed – and suffocated – by judgment.

Kerri says we shouldn’t just talk about it when the lights are out and I also believe that the light in which we share our complications and fears about them shouldn’t be under a bright spotlight of interrogation… starting with ourselves.

 

 

DAM: Diabetes & Feet

IMG_3178This is not a post about foot fetishes. Please. Go away.

(Are they gone? Good.) Thank you to those who are interested in learning about diabetes and what it can do to your tootsies. Diabetes isn’t a slacker disease, only hurting (or intimating that it will hurt) one part of your body. It can get you from head to toe….and so we’re talking about feet today.

Why Does Diabetes Affect Feet?

Nerve damage from diabetes (called neuropathy) can do a couple of nasty things to your feet. It can prevent you from feeling a wound or a cut if you step on something. Left untreated, that wound or cut can fester and develop an infection. People with diabetes don’t heal quite as quickly as those who aren’t pancreatically challenged, so untreated infections can cause major systematic damage throughout the body, including the foot. Don’t google diabetic ulcer or foot infections if you have eaten anything in the past hour day lifetime.

Untreated wounds or cuts can end in ulcers, gangrene, or amputation. Even an untreated blister can rupture and go Chernobyl on your foot and without feeling it due to the sensory diabetic neuropathy, you may not know until it’s advanced to epically serious proportions.

Then there’s the other side of neuropathy. The fiery pain, tingling, numbness that feels like a thousand tiny knives. My D-brother, George Simmons (a.k.a. Ninjabetic) talks about how the neuropathy in his feet impacts his life in a number of descriptive posts on his blog (The B.A.D. Blog): Foot Freakout and Resistance.

People with diabetes also tend to develop circulation issues over time. Poor blood flow means that the outer ends of the body (hands and feet and head) get less blood than they should, so they lose out. Peripheral Artery Disease (PAD) is the culprit, causing narrowing and hardening of the blood vessels, which can cause the loss of blood flow to the feet. No blood flow = no more foot.

It Rubs The Lotion On Its Skin

I apologize for the Silence of The Lambs reference.

Skin, the largest organ in our body (Yes, it’s an organ!), needs moisture and people with diabetes sometimes don’t have enough, whether through high blood sugars or not enough hydration or just the lack of oil production due to… yeah, that nerve damage I mentioned earlier. People with diabetes are notorious for having occasional (or permanent) dry, cracked heels and rough feet. Solution? Lotion. Plain and simple. The cracks can get infected if they become large enough.

Calluses are also common. Thick calluses can develop and what’s the worst thing you can do? Try to peel them or shave them or whatever gross thing you attempt. If they don’t go away with healthy applications of lotion or a daily pumice stone, then see a podiatrist.

In my teens, I hated my feet because the high blood sugars I lived with caused huge cracks in my heels. It was embarrassing.  Lotion wasn’t enough. It wasn’t until I got my blood glucose levels under control that the cracks started to disappear. Even now, I still need lotion to keep those hoofers smooth and silky.

Other Not Fun Things Diabetes Gives Our Feet

Athlete’s Foot is more common. Bunions. Planters Warts. Fungal nail infections. Corns. Blisters. Hammertoes. (Not to be confused with Hammertime, which involves big pants and righteous dance moves.) Basically, if you don’t want it, it’s a possibility.

I’m only scratching the surface. There’s also Charcot’s Joint (neuropathic arthropathy), a painful degeneration of the weight bearing joint and foot deformity.

You know how much I abhor individuals who feel it’s perfectly acceptable to talk about someone who has diabetes and kicked the bucket earlier than expected. Often, they’ll mention the loss of a foot or a leg… well, boys and girls, if you don’t take care of your feet, someone could be talking about you like that someday. I refuse to be that person, so here’s the good things we can do right now…

Tips for Good Diabetes Foot Care

  • Check your feet every day. If you can’t see the bottom of your feet, get someone to check them for you. If you don’t have anyone who wants to be intimate like that (Hey, fetish person… I said go away.), then you can get a chair, put it in front of a full length mirror and lift them up to see the bottoms. If you see something abnormal, see your medical team right away.
  • After showering, pumice gently, rub lotion on your feet, and make sure the in betweens of your twinkle toes are dry. 
  • Wear comfy shoes and socks that don’t chafe. (You wouldn’t wear underwear that chafes all day, right? Same should go for your feet.) “But I love my high heel too-tight pumps!” Yeah, me too. But I love my feet more. I’m not wearing “diabetic socks” and “diabetic shoes” (shudder), but I’m much more picky about comfort over style. (I live in Birkenstocks when I’m home, but do love my Franco Sartos when I do boots.)
  • Don’t smoke. (Do I need to talk about why? If so, then so many public awareness campaigns have failed. Then again, I did smoke when I was younger. So, you know. Do as I say now and not as I did.)
  • In range blood glucose control will help prevent/delay complications – and if you do have a diabetic ulcer or infection, those in range blood sugars can help speed up healing.
  • Kick up your heels. Prop your dogs up when you’re not using them. Wiggle them around. Keep them moving.

The topic of feet is obviously not one of my favorites, but my feet are not allowed to go anywhere without me, so they need to stick around. When I was a youngster (Get off my lawn.), I didn’t think the topic of foot care was something that I needed to think about, listen to, or bother with. Seeing as how that miraculous cure that some tout as being only five years away is now twenty-five years past its arrival date, I figure I’d pass on the knowledge.

Doesn’t matter if you’ve had diabetes for a year or fifty – we can all have issues with our feet.

(Hey, foot fetish person? You still here? Well, hope you learned something about diabetes today. If you want to learn more about diabetes, subscribe to my blog. You’ll love it. Cross my feet.)

 

Diabetes Awareness Month: I'll Be Your DAM Guide

230436_5814November is Diabetes Awareness Month. (It’s also Awareness Months for epilepsy, COPD, Movember, pancreatic cancer, and prematurity.) For those of us living with diabetes, it’s also called… November.

I wanted to do something different this year to help raise awareness of a chronic illness that directly impacts 26 million people in the United States alone. (The indirect impact is staggering. Think of family members, friends, coworkers, employers, and health care professionals and you get dizzy and a little nauseous.)

Every day this month, I will share information about diabetes in an easy-to-read, easy-to-share post. I promise to be honest and not sugar-coat (Oh, the puns will happen. Just roll with it.) anything I share. I’ll give you facts. I’ll give you resources. I’ll give you experiences. I’ll give you the real deal. Some information will be common knowledge, but other posts will be ones that will make you stop and think.

For November, I’ll be your Diabetes Awareness Month guide. Your DAM guide, like Arnie.

 

 

 

Can I ask you to do one thing for me?

(You can do one thing – or many. Your choice. I’m happy with one, but go crazy if you feel like it. You’ll be in good company.)

  • If you haven’t subscribed to my blog, please do so. (Upper right hand corner. See? Over there? Where it says: “Get It In Your Inbox?”) Sign up and get posts about diabetes awareness and as a bonus, you’ll get other posts about diabetes and me. I don’t sell your email address, will never send you spam (not even the one in the can, because I hoard those), and you’ll never miss a post about the coolest toddler on the block.
  • Like this blog on FaceBook. Or you can follow this blog on Twitter. These don’t just have posts from this blog on them. I fish throughout the Internet for nifty snippets of diabetes goodness and throw them out as chum. Or delicacies. You pick.
  • But at least once this month, if you do nothing else, share a post about something you think is important for people in your life to hear about diabetes. (Each post has a share section at the bottom of it. You can even share a post via email!) Share with other people with diabetes. Share with a friend or a coworker. Anyone who will listen (and even those who may not want to listen, but need to hear it.), but share.

I am one woman, but I am aware that a single person can make a difference in the world. I am aware of what a few of us can do. I am aware of what many of us can accomplish. The Diabetes Online Community has shown me that. 

Now, before we start the DAM tour, does anyone have any DAM questions?

Alzheimer's & Diabetes: Can't Forget

IMG_3162This morning, The Kid donned her furry Halloween costume and, with the promise of candy, traipsed behind a kind lady to a room filled with older ladies and gentlemen. We were part of a toddler parade at the local Memory Care & Alzheimer’s facility and I watched as the faces of these individuals lit up when small fairies, Spidermen, Supermen, ladybugs, Dorothy clutching a stuffed Toto, and my daughter, cavorted around.

They were all in varying stages of the disease that robs them of the thing I hold most dearly: their memories.

Some clapped and joyfully engaged with the children, asking them about their costumes. Others sat quietly, staring without emotion at the hullabaloo. One man didn’t speak at all, but when The Kid batted an orange balloon at him, he smiled and tossed it back to her. She fell down, giggling, in front of him and he reached down to grab her foot and shake it playfully. She grinned at him, he grinned back, and then she took off to look at the fish tank.

When I glanced back thirty seconds later, he was gone; physically still there, but lost in himself. I saw his spark ignite and extinguish in the space of a few minutes. My heart didn’t so much as break as melted.

One of my great uncles (my grandfather was one of thirteen, so there were a lot of great aunts and uncles growing up), Bill, drifted off into the horizon with Alzheimer’s when I was young, but I was shielded to the devastation that it wreaks on a family. It’s one of my greatest fears to be diagnosed with it (along with having a fatal myocardial infarction at a young age) and here I was, face-to-face with those who live with it – and in it.

Scientists are linking diabetes to Alzheimer’s disease these days. You can read about the link here , or here, or get your scholarly info here.

In a nutshell, the people who are a lot smarter than most of the world say that blood vessels in the brain are damaged by high blood sugars and that inflammation also plays a part in the aging of brain cells. The damage can be done years before the first signs of Alzheimer’s disease show up, so all anyone can say is the same as we always hear: keep your glucose levels within range, eat healthy, and get regular exercise.

I can’t forget the happy look on that man’s face – and then the absence of any emotion – and I sit here now, wondering if diabetes will take away yet something else from me in the years ahead.

If you wonder why I advocate and raise my voice for diabetes awareness and healthy living, this is one reason. One reason of many.

Et Tu, Brute?

CaesarCaesar got his on the Senate floor; I got mine in a bright conference room.

The meeting yesterday was going well. One of my goals after settling into the house was to become involved with the local diabetes chapter, and I’m so glad that I reached out. The people I’ve met there so far have been enthusiastic, engaged, and forward thinkers. I’m looking forward to seeing what they come up with to provide support and research funding opportunities  and to lend a hand (thankfully, not a shoulder) and my talents where they are needed.

Another new individual was attending this meeting and he soon realized that we were the anomalies; T1s with at least 30 years under our belts (or our non-functioning pancreases). With the DOC and many face-to-face meetings of other T1s in the past few years, coming into contact with another T1 isn’t much of a big deal to me, but reflecting on what happened, I can only assume that he rarely has opportunity to chat with other people with diabetes.

The conversations flowed about the topic at hand, which wasn’t about diabetes management. He would interrupt and ask questions every few minutes, which were politely answered. I understood he was eager to learn about the project, had lots to say, and was retired. He had all the time in the world. I didn’t. I was eager to get through the meeting in the allotted time I had scheduled for someone to watch The Kid.

He wanted to talk about how we (he and I) had so much to offer newly diagnosed families and individuals because we’ve had diabetes for so long. I had to stop him. And so I did, as politely as I could.

“Skippy (not his real name, but I think it’s a cute one), while we have had diabetes for quite a long time, our experiences are very different. In fact, all people with diabetes and their families have different experiences, so it’s hard to just say that because I’ve had diabetes for 30 years, I’m better qualified to talk with someone. For instance,” I added, “even though you and I are both Type 1, you most likely didn’t deal with an eating disorder called diabulimia in your youth. I may be better suited to talk with parents or kids who may be experiencing that.”

And then it happened without warning. I didn’t even feel it until it was in up to the hilt.

“But you look so healthy.”

I’m almost immune to the crazy comments I hear these days when people find out that I’m living with diabetes. To hear one of my least favorite responses coming from another Type 1 left me mentally staggering around, trying to pull that knife out of my back.

Ours is an invisible disease. Yes, we may wear insulin pumps and CGMs and medical alert bracelets, but if we are doing it right, people can’t tell we live with a chronic illness. (And sometimes, even when we’re not having a great day with diabetes, it’s still invisible unless you know us well.)

I’m healthy. For a Type 1 who had multiple treatments for trigger finger and frozen shoulders.  For a Type 1 with a clinically significant macular edema diagnosis and laser surgery to stop it from getting worse. For a Type 1 with a past of diabulimia and emotional stress of living with a chronic illness. For a Type 1 who is scared of being a victim of dead in bed syndrome. For a Type 1 who deals with serious hypoglycemic episodes and the consequences of them.

The disease is invisible. So are the battle scars.

I’m worried that if he sees me as healthy, what does the public see in us?

  • Healthy and therefore less in need of support or research for a cure?
  • That the majority of us live long lives and therefore don’t need to focus on eradicating this disease?
  • Not living on borrowed time because we can “manage” what we ended up with?

That we’re fine?

We aren’t. Except not everyone can apparently see that.

Even other people with diabetes.