Im scared. [Archive] - Diabetes Forums

whimper

12-29-2006, 04:05 PM

Hi everyone. im new, just registered. Well im a type 1 and have been for almost 20 years. I was recently told that my eyes are hemorrhaging a bit. Ever since been diagnosed at the age of 6, i was reminded of all the complications that may occur. Especailly of going blind. Since then i have been afraid to go to bed because i am scared to wake up blind.
Now being told the bad news about my eyes, i am scared to death. I feel as though my eyes are getting worse. My eyes feel like there is something in my eyes (like lint) and even though i have my glasses on i still cant see clearly through them. Im always rubbing my eyes. Im terrified. Can someone help me?

xMenace

12-29-2006, 04:28 PM

First of all, please don't worry. I know it's scary as ****, but technology and treatments are very very good.

Of course you are seeing an Opthomologist.

Hemmorhaging is usually caused by proliferative retinopthay. Have you ever been treated for this? If not, we can educate you on it. The first line of treatment is a large amount of laser. Again don't fret. Many of us have had this treatment. There is very little pain, but it's a lot of work. You can expect to lose some peripheral vision, but not nearly enough to handicap you. At least one member is going through this now and has had hemmorhaging too. His prognosis is very good.

If you have been treated in the past, then they may try to cauterize the bleeding with laser. It may or may not work. If it doesn't, you can expect surgery. Surgery is very successful, especially when caught early. I had it two months ago, all my bleeding is gone, and my prognosis is excellent. If you go this route, we can tell you what to expect. It isn't as bad as it sounds.

It is imperative that you keep your sugars in control too. I'm shooting for a sub-6 a1c.

A lot of ifs, so please tell us
- your eye history to date
- your a1c and regimine - many here can help you

notme

12-29-2006, 04:42 PM

Hi Wimper and welcome to the forums.

I have also had type one for 20 years. However, I am a bit older than you. LOLLLLLLL.

How are your blood sugars most of the time? I went to see the opthomologist a couple of months ago and he saw the very first tiny spot. My doctor says it is nothing to worry about and we just need to keep check on it. Don't stress. Keep your blood sugar in control and visit your opthomologist at least once a year.

As far as your eyes bothering you, talk to your opthomologist about liquid tears or some other eye moisturizer. I use Systane and it helps the discomfort in my eyes a lot.

andypoo

12-29-2006, 06:29 PM

Welcome to the forum,first of all,you will like it here. And second do not stress,that is not healthy for you. Third there is help that you can get. Just listen to the folks that have had work done on there eyes,they got help and so will you.! Take care!

Doug

12-29-2006, 06:57 PM

Im another one thats near 20 years .

Im also worried about the future - BUT I have to tell myself that no matter what else happens the BEST thing I can do is keep my BG as close to normal as possible ...

The good news is that laser surgery has made HUGE improvements in the years since we were both diagnosed.

I focus on keeping my BG in check and doing what I need to to keep good health insurance so I can pay good doctors to take good care of me ....

If your Dr didn't give you enough information, go see another - Call your favorite Dr and get him to refer you to the BEST ophthalmologist he knows.

whimper

12-29-2006, 09:01 PM

I would like to thank everybody who replied back to me. I am really glad to know that i am not alone. Thank you all very much for the support! Also, it means alot more when it comes from another Diabetic person. Dr's can say so much but to know that there is a web-site full of diabetics who have this illness and who have experienced more and have lots of advice to give, really means alot.

My blood sugars are not that great and i know that, that is contributing to my complications. I check my BG frequently about 4 times a day.
I got my A1C checked earlier this month and it came out to be 8.0.
I saw the Opthomologist almost 6 months ago, and that is when the Dr. had told me about the hemorrhaging in my eyes. He said that the overall health of my eyes were healthy. Is hemorrahaging reversible? The Dr. told me then to rebook another appontment in 6 months to have another review of my eyes. I am booked for January. I saw my Endo when i recieved my result for my A1C and that is when i was informed about lazer surgery options. In February i have to under go surgery for carpal tunnel syndrome. My Endo informed me that if my eyes were hemorrahaging, that i had to correct my eyes before i get surgery on my wrists.

What are some signs of going blind? Does diabetic blindness mean that we go 100% blind?

mark-TN

12-30-2006, 03:31 AM

I do not believe that Proliferative Retinopathy is reversible, but it is treatable and controllable. If your doc said to wait six months before being re-examined I would guess that you have Nonproliferative diabetic retinopathy as Proliferative Retinopathy would have require immediate action. There are different stages of Retinopathy and you should find out from your doctor exactly what stage your eyes are at. Here is a chart describing the different stages. ( http://www.inoveon.com/iscore_report.html) With improved blood sugars (keeping as close to normal as possible) nonproliferative retinopathy can be slowed down or even halted. One caution, and I hope someone can correct me if I am wrong, improving BGs too quickly can lead to an initial worsening of existing diabetic retinopathy. I would seek advice from your ophthalmologist on this and seek a second opinion if he/she is unsure. Having good blood sugars is definitely preferable but it would be wise to get a professional opinion on how to proceed.

Best of luck to you!

Mark

xMenace

12-30-2006, 07:09 AM

There seems to be a ton of anecdotal evidence about the lowering of a1c's causing eye problems. I don't know what the scientific community thinks.

Blood in the eye is one form of blindness -- like looking through muddy water. Blood also clots. I had a very large clot where I was hemmorhaging, and this grew to block my entire central vision. It will eventually clear up on it's own, but a risk is scar tissue buildup which usually leads to detached retinas. It seems there's a cutoff point where they try to let it clear up on it's own vs. Hoovering it out.

Your 6 month wait is wonderful news IMHO as Mark noted. It sounds like they expect it to clear on it's own. But it sounds like it hasn't so expect some laser. My experience is 50 blasts. Still, be prepared for some proliferative treatment at some time. Mine was 1500 per eye; though I've read some here got twice that.

Let the Optho's worry about your eyes, and you worry about those a1c's. There are many good a1c managers here.

What is your regimine: insulins, dosages, diet, exercise, blah, blah, blah? Are you able to move to a pump?

xMenace

12-30-2006, 07:50 AM

Forms of blindness (I can see this becoming a sticky) due to diabetic retinopathy:

Laser - every blast destroys some vision. The effects of each are minute but are cumulative and irreversible.

Hemmorhaging - extreme but temporary. May lead to a detached retina.

Floaters and flashing/cobwebs - The vitreous is a gel like substance which fills the center of the eye. With age or injury it liquifies and pulls away from the retina. Cells, membranes, and protein like strands float in the vitreous and appear to the person like cobwebs, spots, or lines. They are called floaters. These are usually permanent.

Detached Retina - The retina pulls away from deeper layers of the eye and cannot function. If unrepaired the retina will degenerate. Surgery is usually necessary.

Removal - Everyone send money to Cyborg!

Dan Gato

12-30-2006, 08:34 AM

Mart-TN,
What is considered normal BG? is it 85?
or a range, let's say, 85 - 100?
I've read that damage starts at BG's over 140, is that correct?

Cyborg

12-30-2006, 08:43 AM

Removal - Everyone send money to Cyborg!

You don't need to have your eye removed to send me money! :biggrin:

xMenace

12-30-2006, 08:48 AM

Here's my layman's understanding of the improved a1c phenomenon:

I've been told that glucose molecules are very much like glass - they cut and scrape the blood vessels as they bounce through them. They also calcify - think log jam.

So the tiny vessels -- eyes, extremeties -- get damaged and clogged. The tissue they feed starts to die from lack of nourishment, and the body responds by growing new vessels: proliferative retinopathy.

((change in control!))

Now there's fewer glucose molecules in the blood stream. There's less pressure on the log jams, and some of it de-calcifies. More blood starts flowing through the vessels. BUT, where it was calcified, there is a problem. Some of those shards damaged the walls and weakend them, or the walls were weakend themselves by lack of nourishment and oxygen. With improved circulation a breach occurs.

*sigh*

Doug

12-30-2006, 10:47 AM

xMenace

12-30-2006, 10:55 AM

I agree totally. A worthwhile tradeoff.

mark-TN

12-30-2006, 02:55 PM

Mart-TN,
What is considered normal BG? is it 85?
or a range, let's say, 85 - 100?
I've read that damage starts at BG's over 140, is that correct?A healthy non-diabetic will have BG’s that hover around 82-83mg/dl at all times except maybe right after a meal or especially after a high GI meal. In a healthy non-diabetic even if a meal causes a bit of a spike the body will reach euglycemia very quickly. It can be argued that any BG that averages much above this “normal” level is potentially harmful; and it can be further argued that with a slightly elevated average the complications come on slower and are much less severe and that the higher the BG average the faster and more sever the complications. And of course I belief there is some genetics involved to. Honestly I do not know where damage starts, but I try to keep my BG as close to normal as possible that is safely obtainable. IMO this is the best way to lower the risk of complications.

It CANT be argued that reducing A1c has a negative NET effect.
Even if it causes a minor setback in one area the rest of the body responds well to reduced BG
my $0.02 I totally agree, but I believe I read that it may be better for the eyes to improve BGs in stages over a certain period of time so as to avoid worsening of existing retinopathy. Again I may be wrong on this.

Mark

whimper

12-31-2006, 01:27 AM

xMenace:
What is your regimine: insulins, dosages, diet, exercise, blah, blah, blah? Are you able to move to a pump?

Insulins that i take are: Novo Rapid and Novo NPH. Total Rapid a day= 32 Units and NPH= 44 Units.

lol, i am very mobile! I started very recently to go to the gym 4/week mainly taking classes of some sort of arobics.

My diet...I'm a certified cook and i work in a fine dining french restaurant. I try to eat healthy as much as i can but overall, it's not so good. Tasting food makes the sugars go high, especially when it is french food.

What kinds of food does everybody eat? Can someone tell me their daily menu plan?
__________________________________________________ _______________
Thanks again to everybody for replying back, educating me and for giving me advice! I appreciate it very much!

winterbanyan

12-31-2006, 03:48 AM

As others here have told you, there have been huge advances in laser treatment for retinal hemmorhage. My son in law was diagnosed about the same time I was, and worse, they think he was an untreated Type 1 for many, many years. (He was diagnosed at 33!)

His eyes (as for so many) were the reason he was diagnosed. He had severe retinal bleeding, bad enough that he was nearly blind. They cleaned it all up, whimper. He's back to driving and working. Not only can they cauterize the bleeding vessels, but now they can completely replace the fluid in the eye, getting rid of all those terrible floaters that are caused by blood clots.

But, as everyone has said, be sure you are seeing an opthalmologist, and watch those sugar levels.

Hugs to you.

xMenace

12-31-2006, 09:18 AM

My diet...I'm a certified cook and i work in a fine dining french restaurant. I try to eat healthy as much as i can but overall, it's not so good. Tasting food makes the sugars go high, especially when it is french food.

What kinds of food does everybody eat? Can someone tell me their daily menu plan?

Whimper, this makes you a prime candidate for a pump! One of the benefits of pumping is the ability to graze - I bolused 17 times on Christmas Day! Every time you sample, you can dial in a bolus. You can refine that dialing down to around .1 units: sip - bolus, sample - bolus, nibble - bolus ... Justification to endos and insurance boobs is a no-brainer.

It's an expensive venture without insurance though.

I'm on one of those see-food diets ;) My plan is for 50 carbs at breakfast, 40 for lunch, 60 for dinner.

Do you count carbs?

whimper

12-31-2006, 11:32 AM

Hi winterbanyan,
I am very happy that your son in law is treated now and is able to see better again. Hearing your story gives me hope! Thank you.
It is amazing what new technology can achieve!

Hi xMenace,
I have thought about using the pump before and that's a very good alternative for someone like me. I'm sure there are a lot positives to using the pump but are there any negatives? (overdosing, infections, unreliability?)

No, i dont count carbs. But i would love to know how.

xMenace

12-31-2006, 05:55 PM

Counting carbs then is your first step. See your endo and a dietician if possible. You can always take 5 to step out and shoot up after a time of tasting. It is a vital skill to good control, and necessary for pumping too.

Some extremists (berstein?) claim pumping is fraught with problems. There are issues you have to overcome, but nothing major. I brought this "attitude" up with my endo. He says there just isn't enough evidence yet to take this stance. My assessment is it provides the most flexibility, but along with that flexibility comes risks. You have to be prepared to manage it with your full attention. I found that a non-issue and being on one really forces you to take this stance, at least it did me.:top:

whimper

01-01-2007, 01:56 AM

Hi xMenace,

I will definately talk to my Endo about carb counting when i see her later this month. I am kind of embarresed to not know these things even though i have been diabetic for so long.

By the way...HAPPY NEW YEAR EVERYBODY! :D

Has anyone tried the new inhaler insulin?

Tattoo azz

01-09-2007, 11:34 AM

Lloyd

01-09-2007, 12:27 PM

Hi xMenace,

I will definately talk to my Endo about carb counting when i see her later this month. I am kind of embarresed to not know these things even though i have been diabetic for so long.

I think the easiest way to start carb counting is to read the package/can/bottle of what you eat. This won't cover everything, but it is a good start.

-Lloyd

xMenace

01-09-2007, 01:56 PM

So whimper, any news?

whimper

01-11-2007, 04:11 PM

hi Whimper-i've had D since i was 8,,32 now so over 20 yrs for me.Just stick with the great advice and people on here and you won't go far wrong.Not forgetting your endo and any other speciallists you may have.Good luck!!!

Hi Tatoo azz,
Thank you so much!
I am just scared of the future and i know i shouldn't be.
I take everybodys advice into consideration and I apprecaite it every much :)
Thanks again!

whimper

01-11-2007, 04:13 PM

I think the easiest way to start carb counting is to read the package/can/bottle of what you eat. This won't cover everything, but it is a good start.

-Lloyd

Hi Lloyd,

How many grams of carbs to you take per day?
I don't even know how much i am suppost to take per day.
But i will start reading the packages :)
Thanks for the advice!

whimper

01-11-2007, 04:15 PM

So whimper, any news?

Hi xMenace,

Im still waiting for my Opthomologists office to call for an appointment.
I am so nervous!
It should be any day that they call me.
I will let you know what happens!
Thanks!

xMenace

01-11-2007, 04:48 PM

Call em back if you haven't already.

FTW

01-11-2007, 05:15 PM

I think the idea above about keeping BG as close to normal as possible is "right on" especially in light of this:

DPP Data finds 1 in 12 "Prediabetics" Develop "Diabetic" Retinopathy
Diabetes Prevention Project data reported at the ADA 65th Annual Scientific Sessions showed that "Over three years of subsequent follow-up of 302 DPP participants, 13% of prediabetics who developed type 2 disease were found to have diabetic retinopathy, and nearly 8% of "prediabetics" also were found to have diabetic retinopathy, though they never developed diabetes per diagnostic criteria."

The diagnostic criteria used by the DPP to define "prediabetic" was a fasting plasma glucose test result that ranged between 100 and 125 mg/dl (5.5-6.9 mmol/l and/or a glucose tolerance test result showing impaired glucose tolerance: glucose tolerance test values at two hours that fell between 150 and 199 mg/dl (8.3-11 mmol/l).

This finding would suggest that prolonged exposure to post-challenge blood sugars over 150 mg/dl are highly dangerous to your retina, with or without a diabetes diagnosis, but even more so with a type 2 diabetes diagnosis.

ADA 65th Annual Scientific Sessions: Late-breaking trials. Presented June 12, 2005. cited in:

Paul Chous, M.A., OD. Diabetic Retinopathy Without Diabetes?
Diabetes In Control - Diabetic Retinopathy Without Diabetes? (http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3019)

Copied from here, (http://www.phlaunt.com/diabetes/14045678.php) a site I've found to be full of information.

I have my first opthamologist appointment scheduled for February.

FTW

whimper

01-13-2007, 10:58 AM

Call em back if you haven't already.

Hi xMenace,
I was referred to the Opthomologist through my Endo...I called a couple of weeks ago wondering why the Optho's office had not called me yet. It seemed as though that the receptionist at my Endo had forgotten to make that appointment for me. I was really and still am very upset with them. That is why it is taking so long. :(
I plan to call the Endo's office again on Tuesday when the office re-opens.