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Eyes - The Epiphany

Posted Aug 07 2009 7:17pm
Its been a while since I talked about eyes. My eyes, to be specific. If you don't know the history; very long story short: my eyes were fine and dandy until early 07 when I developed diabetic retinopathy and had some laser therapy on both eyes and then I needed further laser again on both eyes towards the end of 07.

Its in a bit more detail here: http://www.blogofcrazynurse.blogspot.com/2008/06/eyes.html

I had an appointment at the eye hospital sometime in August, which I neglected to attend to my attentions being focused on my mental health, or perhaps more accurately, lack thereof - see archive for details. The eye hospital have a 'one non attendance and you're out' policy. But one way or another [I actually can't remember whether I rang my consultant secretary and begged for [yet another] a second chance; or whether the GP's had to re-refer me] I managed to get an appointment in December 08, by which time I was in a much better frame of mind.

It wasn't a particularly happy event. First up was the Snellen test: whilst my left eye managed to read quite far down their letterboard, my right only got the top letter. Seriously, I couldn't even see the next line, with two letters side by side on it. The nurse asked me if I drove. When I said no AND MENTAL NOTE TO SELF POST ABOUT MY DRIVING SAGA ONE DAY FOR THE AMUSEMENT FACTOR she failed to hide the look of sheer relief on her face. "fear not people, the crazy nurse isn't on the roads!". Next I saw the consultant, a lovely women with a soothing Scottinsh accent whom my diabetic consultant informs me is married to a diabetologist in a local hospital. I would love to ask her if they discuss diabetic eyes over dinner; but thus far have refrained from doing so. 

She asked if I had noticed any changes in my vision. I was my usual totally honest self, and told her that I was aware that I could see practically nothing out of the right. She told me I needed laser on the right eye immediately with follow up soonish.

We discussed the vital importance of blood sugar control to prevent further damage. I know all this, I've heard it all before. I always used to say to my diabetes nurse and lovely nurse practitioner at the GP how I almost wished complications would start developing because it might shock me into managing my diabetes appropriately. And then the complications came, and I was affected -  in the post I have linked to above I talk about how this is the end of all my insulin manipulation and how I am going to get a grip.

But somehow, I continued to let chocolate binges and being thin and insulin manipulation take priority. There are posts after that where I discuss putting myself into DKA as a coping mechanism. I wimped out of being responsible. I was too weak to stop myself from eating sugary food. I continued to engage in self-harming behaviour. I still sought out hyperglycamia. The hard fact of the matter is that when it comes to diabetes control, I am a failure, a total fuckwit who has no control. 
I know I am better than I used to be. I got the insulin pump is June 08, and have had only one episode of self induced DKA since then. But it isn't good enough. This meeting with the eye lady was well timed; since I was fed up of being off sick and not being allowed in the gym and possibly on the verge of another slide into stupidness - not to mention that christmas was only around the corner which lets be honest is a fest of sugar and fat and general indulgance.

So I renewed my efforts to control my diabetes over the festivities, with acceptable success. And now getting to the matter in hand - my appointment at the eye hospital on Tuesday (as in the one just gone, Jan 13th)

Let me just rant about how ridiculously overbooked the clinics are in that place. I was booked in at 14:00 and the letter did say to allow 2 hours for it, and I knew I was going to be there a while because I was having another fleurscin angiograpy and an OCT prior to seeing the doctor - but I was there until 17:20. FFS.

Now that I'd had the other tests, the eye doctor had all the images on her super big computer monitor. We started with the left eye: apparently although not brill, it is holding on. It's not getting enough oxygen and so its engaging in compensatory mechanisms; but thats okay. Her plan is a little more laser.
Then we moved onto the right eye. Its pretty much fucked, for want of a better description. When the images were compared side by side it was blatently obvious. Even with immaculate glycaemic control from now until death, there is no guarentee that it will ever get much better. Her focus is on preventing it from getting any worse. She is goign to laser it to try and maintain my peripheral vision. She said that loosing all sight in one eye was still a pain even if the other eye was perfect (which lets not forget, mine isn't) because it meant bumping into things at that side of your body and stuff.

It was gut wrenching to be sat there, having a serious conversation with a consultant opthalmologist about the prospect of being blind in one eye. And while she did keep re-iterating the need to be thankful that the left was bearing up, all I could think about was that; blindness was now a real possibility for me, not some far off distant scare tactic.

I was there, staring at the evidence of what I had knowingly done to myself, trying to take it all in. The doctor said she felt like this time she had got through to me, that she thought I was realising how serious this was. I could only nod. She said she wished she had managed to get through when my eye troubles had first began, but there was little point in focusing on the past, only the future. She was encouraging about keeping up my good work. My appointment for the next laser is in a fortnight.

A friend had come with me to the appointment [a real friend bless her sitting there for 3 hours with me] and so I didn't curl up in a heap and cry my heart out; which was what I wanted to do. To be honest I was quite vague with her about what had been said; but her presence meant I had to keep myself going. I ended up having tea at hers. I think it was a much better idea than going home alone and ruminating.

It feels like a shock, this eyesight thing feels like it has come out of nowhere. But objectively I know that isn't true. I have known this was going to happen for a long time. Even though I was expecting it, its still got to me. I wonder if my subconscious had developed a kind of rose tinted take on the whole thing, like, convincing itself that I was going to be the exception to the rule.

When I got the pump in June I was determined to get my act together. And when I had laser in December those thoughts were re-enforced. Now I feel as if someone has put a cannonball up my behind. I am determined to fight. I will not be blind at 30, I have been given the good grace of my left eye to continue to be able to work and see all the wonderful things the world has to offer me. I am not going to waste that on a £10 chocolate bar bill and a toilet bowl. No Chance

xXx



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