In a blink of an eye

Back in 2010 I did the most stupid thing, I briefly got an eye lash separator aka “ weapon of cornea destruction “ as I now call it (and I think my Mum does too) into my right eye which caused a corneal abrasion.   I already had a cataract forming in the same eye that my ophthalmologist had discovered just a few weeks prior (that really shocked me abit … but remember I am getting to be an old cat here). 

Fast forward almost 5 years later.  I’ve been noticing lately that I always seem to have sand in my eyes, and I put it down to air quality, heat.  I use eye drops once in awhile, and even use Muro 128 that is meant for this type of eye problem when I “remember” to you both the eye drops and gel.  See note below what I had been using had been recalled – yikes!   

Come Halloween night, I had a pretty teary and red eyeball that seemed to just come out of the blue. It made for that extra scary affect as I swung open the door and demanded to know what they wanted (some kids coming up the doorstep said my house creeped them out … jezz Louise … this is Halloween!!! Boo to you little cute Princesses, etc. etc.).

The next day, I was in agony. Eyes welling up with tears and I was even feeling depressed or down like I have been lately.  My eye was just leaking on its own accord and PAINFUL!!  Light made me feel like I was a vampire, wanting to seek shelter in the ground.  Sadly, I can’t do that, and even worse, working my shift with a lit up terminal was agony. 

Because of my fear of going into a walk-in clinic like I had back in 2010,  I called up the optometrist I was going to see for my yearly diabetic exam in December ( free for us in this province when it’s diabetes related – otherwise like in this case – I paid for each visit of $35).    I've been wearing glasses since Grade 5 and I’ve never been to an optometrist  for diabetic eye check ups except for vision testing ( you pay for this in most provinces of Canada).  I’m hoping that if my optometrist can’t help me with a problem that is diabetes related, that he will refer me to an ophthalmologist, and at that point, I no longer pay out of pocket.  If anyone from Ontario is reading this, correct me if I’m wrong.

Unlike Quebec though, where trying to see someone right away is impossible which is what occurred to me in 2010 … this optometrist office said get here stat.  Luckily, it’s within a 5 minute walk since I wasn’t fit to drive a car with this wacko eyeball affecting the other one, so off I trotted.

Long story short?  I had a pretty serious corneal abrasion that meant wearing a temporary clear contact lens for at least 24-48 hours (it was a bitch to put in by the optician since according to him I’m 1 in 100 that has very small eyes for my age and he had to use a child’s contact in the end).  Also, an antibiotic drop was given for 4 days to be on safe side along with keeping the eyeball bathed in gel drops for AM/PM use and other drops that will keep my eyeball encased in fluid (hang on a moment – off to put in some drops).  

The one thing he mentioned is what I have is very common in children and women due to our rubbing our eyes (which I don’t – so I’m wondering if part of the problem was from using the Muro 128 gel that had been recalled).  Also, this problem of dry eyes is seen in women in their menopause period of life, and can go on for … well like forever is the way I am understand him.  Time to buy stock in Alcon or Bausch & Lomb!

With a few follow ups over the first 2 weeks after the initial visit I’m now diligently putting those drops in my eyes and due to the seriousness of the abrasion, I’m on a tetracycline antibiotic for the next 3-6 months in order to save the cornea from further damage (hey wonder if my teeth will discolour like one of my friends did as a teenager when she had to go on them for skin issues).  Anyway, vanity aside of my pearly whites because I don’t use my teeth to see J .  The best thing about this optometrist is he's is up front and honest saying that it was serious and stated that if anything unusual occurs in the eye in the meantime, get myself either to his office STAT when it’s open or go to ER.  He gets right to the point with no sugar coating.

Now, if I lived back in Quebec … the land of waiting waiting waiting … I might not be writing this out today because my eyesight would be badly compromised at this point.  So far, this move to Ontario has been a good one, despite my home sickness for Montreal and friends.  Medically speaking, even with what occurred at Cornwall Community Hospital in September, along with recent endo appointment, all is good in my little world of medical practise.

So, shout out to Dr. Steve Bacher of Cornwall (gotta love his recent post on his wall about the 20-20-20 rule)!!  My eyesight has been saved … and even better … it’s not due to diabetes!!  Whoo! Whoo! 

Note:  I only discovered when writing up this blog today that the Muro 128 eye gel drops I am using have the serial number that had been recalled back in June 18, 2014!  I have been using these gel drops since July of this year, which is sort of when I started to notice problems with something in my eye.  Why the pharmacy (Costco in Laval)  that distributed these drops didn’t inform patients of this problem is abit frightening because I would have continued using them! 

My first endo visit in over 30 years!

I had my first meeting with an endocrinologist who works with insulin pump patients last month.  In the past I’ve used either my GP or a doctor that works in the endocrine area of the health field, but does not hold the title after their name (just like me, at times I’m like a CDE, but in reality, I’m just someone with 50 years of experience with T1D).  None of my past care givers understood pump technology, so as I’ve mentioned in the past, I do my own tweaking, and had been doing fine until menopause hit me last year.

The last time I’d seen an endocrinologist was way back in the 80’s … and I rarely saw them due to being busy with life, and in those days, we didn’t have all the technology today, so in some ways, at least for me, diabetes was just something in my life that today now seems to encompass my every waking moment with machines that read your blood sugars (CGM), or control the amount of insulin that goes into your body (insulin pump), along with blood glucose (BG) meters, and different types of insulin. 

It was an interesting meet up with the, originally they were coming to where I live (an hour and a half drive for them), but then a week before I was told they would have their head contained in a screen (my words – not the CDE’s words) … think of Max Headroom if you are of my age group you will know.  So, with the CDE in the meeting … we got started on figuring out my control of my diabetes, that I’ve basically been doing by myself the past 30 years.

I’d downloaded all my pump/CGM/BG meter info to Diasend that morning from home, so while the endo asked me questions, the CDE punched numbers on her screen while listening.   The endo couldn’t quite understand why I wanted a lower A1c which puzzled me, as I thought she would encourage me to attain a better number.  Explaining how many of us want to avoid complications, etc. with keeping a lower A1c didn’t interest her.

Their main concern was the hypoglycemic (hypo) reactions I have been having at night lately that they saw with the Diasend report.  Which is understandable after learning from various conferences I’ve attended over the year, hypos are harder on a diabetic body then a hyperglycemic (hyper) – e.g. going up high.  Of course, it all depends on how high you go up, but to me, anything over 15 / 270 freaks me out and the methods I use to bring even higher ones down she did not approve of.  I’m also still very lucky, I wake up to hypos, CGM or not, and generally do not over treat them which is what many diabetics do which results in that crazy roller swing.  I’ve learned over the years, depending on the BG number, to go from 5-15 grams of fast acting carbs, wait 15 minutes, retest.   Helps to offset that crazy high in the morning when you wake up.

The endo asked me to set my CGM alarm during sleep time to 15 / 270 in order to have a solid sleep (as we all know – lack of sleep can affect our blood sugars not just our sanity in our work place the next day or relationship that for me is already compromised by menopausal mood swings!).   Of course, freak out, I did request permission from CDE a week later after tying to follow endo’s instructions so I am now able to correct anything over that number, “safety first” as the CDE told me.  They just want me to be more sparse about it and only anything over 10 / 180 – which I have been doing – but this is way against the way I’ve handled my diabetes over the years by myself.  They are hoping to see what happens with my BG without correction, does it go up and stay up, or does basal bring it down.

I started to realise around that point that I had an endo that sticks to the rules and no matter what I said (e.g. I asked her if I could go on metformin, which has been shown to help T1D teenagers in attaining more level blood sugars … and that a study was being done with adult T1D’s using the drug and showing great success).  No, unless I was using over 50 units of insulin a day, she would not consider it.  I felt like I had the door slammed in my face at that point.

 My promise to follow a snack plan (carb/protein) in the evening as the endo requested in order to avoid hypos overnight – nope - that didn't last long.  Though I have now gotten into soaking almonds in water, and having about a ¼ of a cup before bed time and BG’s seem to be great overnight.  I really don’t do snacks at night time, which is something I did as a kid at home when my parents followed the CDA/ADA meal plan.

So, overall, I am realizing that it is the CDE team that is the most knowledgeable in diabetes management.  I have yet to tell them that I’ve gone ahead with upping my basal (the high wake up blood sugars during some of my major hot flash periods that last longer since I had the hysterectomy a few months ago was too much for my control level of diabetes).

It’ll be interesting to see how things go for my next visit at the end of January.  I do have a friend in Ottawa (he is on the study with Metformin) who has told me his GP who follows his diabetes is taking on new patients.  It’s something to think about, and with how I’ve always taken care of my diabetes, where I only go to see a doctor when I need a new prescription or have blood work done to see how I’m doing … I may just go back to that routine. 

Main thing for me, it’s an interesting experience to have a CDE team after all these years of my time with diabetes and even better is that they understand much of today's technology unlike my former doctors and I don't quite feel alone in working in the coal mine of my diabetes control.

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Low Carb Alfredo Carbonara

I thought I’d post a recipe for a change of pace in my blog because I am so in love with spaghetti squash and the versatility of it as a low carb option for those of us who are watching their carb intake, but want to eat well! This time of the year it’s very affordable, and if I store it correctly when I buy it on sale , I hope to keep some for another month (if it lasts that long since I have a cool storage area for items like this in my 1930’s house … where they built places to preserve).

This recipe was inspired from this site but I tweaked my version to reflect my taste buds and give more help to the newbie squash chef of how many cups rather than just the weight.  Also how many the recipe feeds.  Hopefully the way I’ve written up the recipe will help you to decide how much to make (and duplicate the ingredients to ensure everyone has a full bowl).

YIELDS :    4 servings

INGREDIENTS:

1 spaghetti squash (4-5 lbs / 1.8 – 2.3 kgs) about 4-5 cups total

8 slices of bacon, cooked crisp, diced after cooling down (save the fat if using in Step 8 below)

2-3 Tablespoon of olive oil

5+ cloves of garlic, chopped (if you like garlic … add more – for the ½  portion we used 5!)

¼ cup olive oil (see Step 8 below)

Parmesan cheese, grated or shaved (put in a bowl for people to help themselves too)

Salt and freshly ground pepper to taste

DIRECTIONS:

  1. You can either bake the squash in the oven which I show below in Step 2.  If you don’t have the time, you can cook it in your microwave oven which takes about 10 minutes per half side.

  2. First wash the squash, slice off the stem, and stand it on the cut side to cut in half. This can be a challenge, use a good solid knife and protect your hands.  If you are ensure about how to do this … watch the link above for microwaving … she shows how to cut one in half with ease.

  3. Scrape the seeds from center.  Sprinkle the insides with salt and ground pepper.

  4. Place cut side down on oiled pan (I use parchment paper ) – saves on cleaning afterwards.

  5. Bake for 30-45 minutes or when a sharp knife is inserted without any resistance.  Set aside to cool.

  6. Cook up the bacon over medium heat until crisp.  Place on some paper towels to take off excess fat. Let cool abit and crumbled with fingers.  Set aside.  Note:  if you are not a lover of bacon fat which can be used in the later stage of this recipe, drain the fat, and place a few tablespoons of olive oil in pan, to cook the chopped up garlic for a minute or two.  When you smell it’s fragrance that usually means it requires no further cooking).  Set aside

  7. Using a fork, scrape the flesh from the squash in long strings and set aside in a bowl (don’t worry if that doesn’t work, it’ll all be gobbled up soon).

  8. You can either add the squash to the fry pan to mix everything up together with either a dollop of the ¼ cup of olive oil (use your discretion) or you can add in the reserved bacon fat if you feel like being on the wild side … it’s up to you!  Or you can toss the fry pan mixture into the bowl (I prefer the fry pan method myself).

  9. Divide up amongst 4 plates (or 2 if you’ve halved the recipe - I save the other half of the plain squash for another meal).  Sprinkle Parmesan cheese ( use LOTS) on it along with some freshly ground pepper.

You may never go back to the full carb/fat version of this dish again!  The portion I had was almost triple what I would have when made with regular al dente pasta, and my blood sugar remained steady in my happy blood sugar zone with no spiking at all.  Even better, if you’re not on insulin and just medication/exercise regime … bonus … you may be able to have a little treat with your espresso afterwards (psst - I still did - because I didn't mind using up 15 grams of carbs for a little biscuit with my cafe later).  

NB:  For those of you who are vegetarian - do not turn your noses up at this that it contains meat.  You can easily substitute the bacon for your fav vegetarian substitute!!  One recipe I can vouch for when I’m wanting a change of pace for my gutt, is this recipe that uses affordable block tofu!  Another one if you have the extra $$$ for it, is this version using tempeh.  Either recipe can be “crumbled” to replace the bacon in the recipe above and still be satisfying to the taste buds (as well you will stay true to your ethical opposition of eating animals). 

Bon appétit!