Dire Beatitude

I learned I had diabetes last year. I’m not really having any health issues related to it, no symptoms or side effects, no weakness or vertigo or fatigue. I quit smoking, an ordeal to say the least and I’ve changed the diet, doing all the right things as everybody in healthcare loves to say. I think they just say this to reinforce our insipid positive-reinforcement culture. They’re obliged to perpetuate the system.

Diabetes is like this silent killer, relentless. It doesn’t matter how good you feel or the lack of symptoms. The disease never goes away There’s no cure and no prevention. Either fate or genetics, use whichever term you are more comfortable with; my mother on my father’s side and my father on my mother’s side had the condition, which skips a generation.

My siblings have normal insulin levels. I’m more comfortable with fate. Genetics are not subject to simple twists.

I am learning new stuff about my dire beatitude all the time. It’s tedious stuff. I’m not depressed or frustrated. I’m lying. I completely am depressed and frustrated, but luckily I am sick of worrying about inevitability.

I have to get my eyes examined once a year now. Since my teenage years, I’ve been myopic, a common condition that delays the onset of presbyopia, the need for reading glasses. Other folks need reading glasses at about 40, nearsighted people can wait another 10, 15 years, maybe longer. My vision correction prescription changed only slightly over the decades, so I wait three years or more between eye exams. Myopes as we are called take off our glasses to read. Eventually not wearing glasses isn’t good enough and you will need corrective lenses (confession: I’ve written for the eye care industry and ghostwrote a book on lasik surgery for a Park Avenue Ophthalmologist).

Words gradually got blurry when I read, after a bit, not immediately. I knew this is a sign of preysbyopia and since my last visit to the primary care physician, she insisted that I need to get my eyes examined, for the diabetes. The optometrist informed me that my prescription had slightly changed—the distance in one eye went up a half a diopter—but my “plus” that is reading prescription hadn’t changed.

“What about the blurriness when I was reading?”

“That’s probably blood sugar levels. What are they?”

I didn’t know, I got sick of pricking my finger every morning. I wondered why I had to get my eyes examined because of diabetes.

“It will effect your eyes. You have to stabilize the sugars, because it can change your vision.”

“Should I get a plus prescription for when my blood sugar is high?”

“You would need dozens of glasses. Are you on insulin?”

That is my current fear. Shooting up. For all the partying I did in my youth, needle drugs was never an interest, or an option. I do not like needles. Maybe if I booted horse I would be better prepared for this chronic condition. Another opportunity missed.

“You can still take your distance glasses off to read, I’m showing that except for the two diopter change in the right eye, your refraction hasn’t change. You have to check with endocrinologist and have them adjust your medication. Otherwise, you’re eyes are clear as a bell.”

“What does that mean?”

“The blood vessels in your eyes develop micro-aneurysms, they leak blood and you go blind. You’re not having any signs of problems, but it happens after years of having diabetes.”

“And you control it by controlling your blood sugar?”

“The micro-aneurysms can occur no matter what, that’s why you need to get your eyes examined very year.”

“There’s no stopping it?”

“Only delaying it by maintaining your insulin levels.”

“What are the side effects of these micro-aneurysms.”

“Blindness. You have to see a retina specialist when that starts to happens.”

That’s the good news, the blindness won’t be sudden!

I got new glasses and they’re fine. The blurred reading faded too. I have no idea what caused it, since my diet didn’t change. I did nothing to bring it on and did nothing to make it go away.

Diabetes means my pancreas is shot. The only response is a series of coping mechanisms. Medicine is an art and a science and diabetes treatment is more art than science. In terms of accuracy, it’s Jackson Pollock not Remington.

My primary care doctor reassured me: “Your pancreas isn’t shot, it is still working, it is not just producing the amount of insulin you need.”

My biggest concern was the injecting insulin. I wondered how many different stations between the metaformin I am on and the shooting up of insulin.

“Well they have this pen that makes injections very easy, but there are a few things we can try before we go there. But you have to start testing your blood again.”

When I frowned, she said. “There have been a lot of advances, there will probably be a cure in your lifetime.”

“You know how that will work out, Doc. When there’s a cure, that will be the front page headline of the newspaper and on the same day, in the back pages, will be my obituary.”

“You must be a lot of fun at parties.”

“I can’t go to parties. I have diabetes.”