Season Three: Episode Twelve

APRIL 11, 2022

So my A1C is at 10.2. That’s not good. Last Thursday I went to do my DOT physical for work. Because of my sugars, the doctor only cleared me for three months then I have to go back in and do a recheck.

I have to get my sugar under control in that time or I will be disqualified. Also, I can’t take injectable insulin because that’s another thing that could disqualify me. But the doctor did say I can take Ozempic so I let my endocrinologist know on Friday during that appointment.

I have another appointment with my endocrinologist next month to check up and see how things are going. Right now my fasting sugar was not great so I have to seriously rethink everything because I want to keep this job.

I got one of those weighted hula hoops to hopefully help with weight loss and lose some inches around my waist. I’m pretty active while on tour, but until tourism is back full force, which I’m not looking forward to, tours will be a little less frequent for now.

I’m hoping I can do what’s necessary to keep my job. I need to get a new glucose monitor. The one I have has to be replaced every year, but I’ve had mine for two years now. I just wanna make sure it stays fresh.

Tomorrow, I have a dentist appointment for the first time in a couple years. I hope my teeth are doing okay and diabetes hasn’t affected them in the mean time. I don’t think I’ve been to the dentist since my diabetes diagnosis in 2017.

I hope I can do this. I really like my job a lot. I can do this.

Diabetes and the Workplace

Here’s where you can know your rights in the workplace. Even with diabetes, we may still have the need to be in the workforce, whether it’s for employer-based health insurance or because we just need the money. But did you know diabetes can be considered a disability?

A disability is defined as a mental or physical impairment that substantially limits one or more major life activities.

Diabetes is a disability because it substantially limits major life activities such as the functioning of the endocrine system.

What are my rights on the job?

As a person with a disability, you are protected from discrimination because of your diabetes. You will be protected under the Americans with Disabilities Act (ADA), a federal law that prohibits discrimination against qualified individuals with disabilities.

  • An employer cannot fail to hire or promote you because of your diabetes.
  • They cannot terminate you because of your diabetes (unless you pose a safety hazard).
  • They must provide you reasonable accommodations that help you perform the essential functions of your job.
  • They must not discriminate with regard to employer-provided health insurance.

You also have the right to medical leave to care for your diabetes. The Family and Medical Leave Act requires employers to provide up to 12 weeks of leave per year. This can be used for short term problems caused by managing your blood glucose levels or doctor appointments.

What are some accommodations I can request?

Remember these accommodations must be reasonable and not hinder the job description you were hired for. They may include, but are not limited to:

  • A private area to test your blood glucose levels or to administer insulin injections.
  • A place to rest until your blood glucose levels become normal.
  • Breaks to eat or drink, take medication, or test blood glucose levels.
  • Leave for treatment, recuperation, or training on managing diabetes (like diabetes education courses).
  • A modified work schedule or shift change.

To request an accommodation there is no magic words for it. Simply go to your employer and tell them what adjustments or changes are needed. This can also be done by someone else on your behalf, like your healthcare professionals.

What can employers do to help?

Employers can educate themselves on how to keep their employees healthy and maintain productivity. There are programs that can be provided through the employer-based health insurance too. They’re called the National Diabetes Prevention Program (National DPP) for people at risk of type 2 diabetes and Diabetes Self-Management, Education, and Support (DSMES) services for people diagnosed with diabetes.

The CDC has resources for employers to maintain healthy employees.

Please Note: These resources are for those living in the United States. I’m personally not too familiar with international resources but, hopefully, it shouldn’t be too hard to find. Look up the disability protection laws in your own country to see what protections may exist for you. Good luck!


References

American Diabetes Association
CDC
US EEOC
dQ&A
diaTribe

Season Three: Episode Nine

MARCH 13, 2022

I have apparently gained two pounds since my last doctor visit on February 11. What a shame. I am currently 194 lbs. I’m a little disappointed in that since my lowest weight last year was 186lbs and since then it’s kind of gone up. It’s definitely because I’m eating more. I’ve been finding myself to be more hungry these past couple of months.

However, I have recently gone back to my job as a tour guide. We all got laid off when the pandemic started and now since our case numbers are lower, I feel a bit more comfortable to go back to work with them. It’s more active. I went on my first training tour on Friday and I walked over 8000 steps! I usually don’t walk more than 2000-3000 steps per day, 6000 when we’re doing the grocery shopping.

I can’t wait to get back to work with them. I really did love working for them and meeting new people from around the world. They’re kind of short staffed though which means I’ll be expected to do the longer tours that I didn’t do last time. But I’m looking forward to it.

I have my visual field eye appointment on the 21st. I’m hoping my visual field hasn’t changed too drastically since last year. I’ve never had to do that appointment until last year and I assume my diabetes is a bit of a concern for my eye doctor, which is totally understandable. I’m concerned too.

Please enjoy this picture I took while we were on tour at Hawaii Volcanoes National Park overlooking the glow of the lava lake in Halemaumau crater of Kilauea volcano.

I got the lab paperwork from my endocrinologist. I’ve got to do that a week before my appointment on April 7. Unfortunately, I won’t be able to let my ophthalmologist about my A1C as my eye appointment will be April 4. I’ll probably have to call them to update them on my newest A1C. I’m not looking forward to what it’ll be though.

And then my first dentist appointment in years will be on April 12. April is going to be a very active doctor appointment month. And I’m not looking forward to my A1C update nor am I looking forward to getting my blood taken. I hate needles!

Thankfully, the mask mandate for Hawaii should finally be lifted on March 26. At least I won’t have to wear a mask while I’m getting my blood taken and I think they’re also rolling back on social distancing and indoor max capacities. But I’m still a little scared about all of the rollbacks. I have lasted two years without getting COVID and I want to keep it that way.

Also the blog has reached 196 followers! I’m almost to 200 people who appreciate the information I share with them every week. I appreciate every single one of you always and forever. I love sharing my journey and the information I’m learning about diabetes with all of you.

If I can get to 300 followers, I will seriously consider trying to start a Patreon to help pay for the monthly and annual bills as well as bring more than just stickers to my blog shop. I’m thinking acrylic pins and window clings. Who knows really? It’s so exciting!

Thank you for each and every single one of you readers out there. Don’t forget to share my blog with your loved ones. And don’t forget that you are so loved and you matter, if not to the people in your life, then you are loved and matter to me. My inbox and DMs are always open, feel free to reach out if you need someone to talk to. I’ll be there.

7 Little Ways to Care for Your Diabetes

Whether you are newly diagnosed with type 2 diabetes or have been living with it for years, you can make small changes to your life that could potentially turn your life around. You could come off the insulin injections, you could stop taking tons of medications, you could potentially reverse your diabetes.

Be warned, it will not happen right away. You will need to have patience and persevere. You need to set your goals, keep them in your heart the entire time. It will be hard. You will feel devastated and tired and frustrated, but you can do this. My favorite quote from wherever I had heard it, “How do you eat an elephant? One bite at a time.”

1. Lose (Just A Little) Weight

As your body gains weight, it can have more difficulty regulating blood sugar levels with the insulin your body naturally produces. This leads to insulin resistance, your pancreas will produce more and more insulin to move the sugar from your blood into your cells. But it will become less effective and can cause damage to your pancreas.

Insulin promotes fat storage and weight gain. It causes an infinite cycle of weight gain, insulin resistance, more insulin production, more weight gain. But modest weight loss, 5 to 10% of your body weight, can lead to huge improvements. Just a 7% loss can improve insulin sensitivity by 57%!

2. Water Down Blood Sugar

The more dehydrated you are, the more concentrated the sugars in your blood become. Those who drink less than 16 ounces of water per day have a higher risk of developing elevated blood sugar levels compared with those who drank more. You can drink water, herbal tea, and milk. Coffee should be limited to three cups a day, caffeine can dehydrate you.

3. Try Exercise Snacking

Instead of doing 30 consecutive minutes of exercising, try to spread the physical activity throughout the day. Maybe three 10-minute walks throughout the day. Research suggests that these bite-size bits of activity can help control blood sugar better than one longer workout.

Don’t forget to do various types of exercise, like aerobics and strength training. Adults naturally lose 8% of their muscle mass every 10 years between ages 40 and 70, diabetes can double that. Try spending 10 minutes a day building strength by using weights, resistance bands, or body weight moves.Another 10 minutes doing aerobic activity such as fast walking, swimming, jogging, etc. Then another 10 minutes of stretching, which will improve joint movement and reduce chances of injury.

Walking as much as possible throughout the day matters!

4. Muscle Up With Protein

Protein is important for maintaining muscle and stimulating several hormones that contribute to blood sugar regulation. Focus on fish, white-meat chicken, plant-based sources, and lean cuts of beef. Make sure you’re eating protein at breakfast, lunch, and dinner.

5. Get Vaccinated Against COVID-19

People with diabetes, obesity or both are at increased risk for severe illness and death from COVID-19. Research suggests that COVID can worsen diabetes by causing damage to the pancreas and system-wide inflammation that increases insulin resistance.

Even if you get COVID after having been vaccinated, it should indirectly result in less COVID impact for preexisting diabetes. You can get a milder case of COVID with the vaccine. Also don’t forget to stay up to date with your other vaccines as well.

6. Don’t Focus On Sugar

After being diagnosed with type 2 diabetes for the first time, people often go to extremes, like drastically limiting carbs. But too few carbs can lead to fatigue, nutritional deficiencies and dangerously low blood sugar. Women should aim for 30-45 grams per meal and men should get 60-75 grams.

Proper nutrition is so important after a diabetes diagnosis, meaning consulting with a registered dietician or certified diabetes care and education specialist is very important.

7. Let The Meds Come As Needed

It’s common for people who are trying to their diabetes to feel like failures if they can’t get off their medications. Even if you do manage to come off your medications, medications could still play an important role in your life, like insulin. Don’t feel defeated by the amount of medications you have, hopefully one day, you’ll knock them out. You can do this!


References

AARP Magazine, Dec 2021/Jan 2022

Season Three: Episode Eight

MARCH 6, 2022

I have my next PCP appointment this week for a refill of my prescriptions. I wish I could get an earlier appointment with my endocrinologist. I’m wondering, the mask mandates in Hawaii are supposed to go away by the end of the month. Supposedly. So does that mean my doctor will no longer do telephone appointments. Does that mean I have to fly to Oahu for my appointments again?

I mean I’d love to go to Oahu and stop by Ala Moana Center for sure, but the price of flights are ridiculous right now. The cheapest round trip being just under $200 per person. And I don’t like to go to Oahu by myself so obviously my husband would go with me.

I could do a travel reimbursement for our flights. That would have to go through my endocrinologist’s office to put the request in for me and then hopefully it gets approved. But knowing HMSA they’ll probably only reimburse if we take the cheapest flights, which means first flight in the morning and last flight in the evening.

Usually we take an Uber or Lyft from the airport to the doctor’s office because it’s quicker. Then it’s a decent walk from there to Ala Moana for lunch and some shopping. Then we take the bus back to the airport.

The last time we took the last flight out of Honolulu, the bus didn’t run after 6 so we had to take the 4:30pm or thereabouts. And we waited at the terminal for HOURS, it was so freaking boring especially because we took Southwest and that side of the terminal all the shops close early. Lame.

I’m not going to lie. I don’t really want to fly to Oahu for my appointments. It’s really draining and I hate flying. The motion sickness is unreal. Plus that’s a whole day that we’d have to take off and with the way things are going, I’m still afraid of COVID. But only time will tell I guess.

Season Three: Episode Seven

FEBRUARY 27, 2022

So far this nothing to report. I have a PCP appointment next week to refill my prescriptions and then an eye appointment later in March to check my visual field.

I have noticed my left eye’s periphery is starting to decrease but I’m still able to see okay. My left eye is definitely my concern as I notice my eyesight getting blurrier as time goes on. I’ve had to depend on my glasses more and more now when they used to be when I drive at night, now I need them during the day too.

My eye pressure has been elevated for the last couple of years and I’m sure that has to do with my diabetes. I have to get my diabetes under better control so the pressure in my eye hopefully can go down without the need of prescription eye drops.

Let’s see what else is there? I have a WordPress blog goal! I want to reach 300 followers with WordPress or email. Hopefully if I reach that goal, I’ll be able to set up a Patreon that way I have the ability to create even more content and reach even more people. I’d love to offer exclusive things to my patrons, including the freedom to choose what you want to read about as well as vote what sticker designs come next and I would love to send you folks stickers every month. Something to think about.

I have a 2022 reading goal of 50 books. Not going to lie, I think I’m going to reach that goal way before the end of the year. I read ten books in January and almost ten in February. I forgot how much I love sitting on my bed and reading a really awesome book. Of course, I also forgot about how it feels to come across BAD books. Like this one I just finished. I’m not even going to bother doing a review on the blog for it, it’s so bad.

My weight loss goal is to make it to 150 pounds by the end of the year. So far the first two months haven’t gone the way I want. I gained some weight, but this week I was able to get down to what I started at at the beginning of the year. So hopefully it keeps going down.

I’m on my last pen of Ozempic from my old insurance. I don’t think my new one covers Ozempic as far as I know. I still hate needles. Not looking forward to insulin that’s for sure.

I’m thinking I want to add something else to my physical activity besides just walking. I’m thinking about skateboarding. I like the idea of cruising down the road. My sisters used to have skateboards in school and they hardly used it so I’d go out and try them out. I didn’t know much and stayed on flat roads for safety reasons especially since I didn’t have a helmet or anything because I didn’t like their heads. But it’s been something I’ve been wanting to do since then.

The days are getting hotter in Hawaii and the nights are also getting warmer. I’m going to have to put away the thick blankets and sweatpants pajamas now. It’s going to be a hot summer.

Otherwise that’s pretty much it. I don’t think there will be much to report next week. Tuesday is Mardi Gras, Fat Tuesday, or in Hawaii, Malasada Day! My husband and I will be in Kona on Tuesday so I’m looking forward to getting malasadas from somewhere. Thursday is World Book Day and I will celebrate by reading. Check out my Twitter to see what I’m currently reading.

Hope you all had a great February and I hope you all have a BETTER March. Mahalo! 🌺

Diabetes and Your Kidneys

Do you know how terrifying it is to learn about diabetes? Learning about it and knowing there are millions out there that aren’t making the necessary lifestyle changes that can help them avoid the complications could befall them with this diagnosis.

We have gone over what diabetes can do to your teeth, your eyes, your feet, and now we’re looking at what it can do to your kidneys.


Diabetes can cause diabetic nephropathy, or diabetic kidney disease (DKD). Diabetes is the leading cause of kidney disease amongst adults. About 1 in 3 adults with diabetes has kidney disease. About 30% of those with type 1 diabetes will develop kidney disease and about 10-40% of those with type 2 diabetes will do the same.

The main job of your kidneys is to filter wastes and extra water out of your blood and create urine. Your kidneys also help control your blood pressure and make hormones that your body needs to stay healthy.

Diabetes can damage the small blood vessels in your kidneys causing your kidneys to not be able to clean your blood properly. This can cause your body to retain more salt and water than it should resulting in weight gain and ankle swelling. Waste material can start building up in your blood.

Diabetes can also damage the nerves in your kidneys that can lead to difficulty emptying your bladder. Pressure from your full bladder can back up and injure your kidneys. You can also develop an infection when urine remains in the bladder for too long.

You are more likely to develop DKD if you are a smoker, are not physically active, are overweight, don’t follow your diet plan, eat foods high in salt, have heart disease, or have a family history of kidney failure.

Some early signs of kidney disease include weight gain (from water retention), ankle swelling, frequent use of the bathroom at night, and high blood pressure.

Some late signs of kidney disease include nausea, vomiting, leg cramps, loss of appetite, weakness, anemia, increase fatigue, and itching.

Those with diabetes should have their blood, urine, and blood pressure tested at least once per year. Your kidney doctor, nephrologist, can plan your treatment with you, your family, and your dietician.

End stage renal failure, or kidney failure, is when your kidneys are no longer able to support you in a reasonably healthy state. Your kidney function has fallen to 10-15% leading to drastic measures. This will be either dialysis or a kidney transplant.

Dialysis is the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions naturally. They will remove the blood from your body, put it through a machine for cleaning, and put it back in to your body. Most patients require 1-3 dialysis appointments a week.

To keep your kidneys working in proper functioning order, you need to work with your healthcare team to control your diabetes and high blood pressure (if applicable), get treatment for any urinary tract infections, correct any problems in your urinary system, and avoid medications that can damage your kidneys.

If you have a suspicion that something is going wrong with your kidneys like frequent or infrequent urination, go to your doctor as soon as you can to have it checked out. Better to be safe than sorry.


References

NIDDK
National Kidney Foundation
Mayo Clinic

Diabetes and Your Feet

Diabetes can lead to many complications that affect other parts of our body, like our eyes, teeth, and even feet. With feet, it is very important to check them daily. Why?

About half of all people with diabetes have some kind of nerve damage, or neuropathy. Nerves in the feet and legs are most often affected. This nerve damage can cause you to lose feeling in your feet and legs. If you can’t feel anything in your feet and you step on something sharp and penetrate skin, how would you know you’re injured? That’s why daily checks are so important for those with diabetes.

Symptoms include numbness, tingling, or pain, but also you may not be able to feel pain, hot or cold.

Other diabetes complications like slow healing can lead to cuts and wounds on your feet to become infected. If infections don’t get better with treatment, it can lead to amputation to keep the infection from spreading.

Factors that can increase your risk of neuropathy include, blood sugar levels that are hard to manage, being overweight, having high blood pressure and/or cholesterol, and being older than 40 years old.

Some ways you can keep on top of your foot health is:

1. Check your feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or any other changes.

2. Wash your feet every day in warm (not hot) water. Don’t soak your feet, it can dry your feet and cause your skin to crack. Dry your feet completely after you wash them and apply lotion. Don’t put lotion between your toes.

3. Never go barefoot. Always wear socks and shoes.

4. Make sure your shoes fit well and don’t rub your feet too much. Also before putting on your shoes, check them to make sure there’s nothing sharp hiding in them.

5. Trim toenails straight across and smooth any edges with a nail file. If you can’t do them yourselves, have your doctor or a trusted pedicurist help you.

6. Don’t remove corns and calluses yourself. See your doctor to have them removed.

7. Get your feet checked at every health care visit.

8. Keep the blood flowing. Put your feet up when you’re sitting and wiggle your toes for a few minutes several times per day.

9. Choose feet-friendly activities like walking, riding a bike, or swimming.

10. Protect your feet from hot and cold.

You should see your doctor if there are pains or cramps in your legs, thickened yellow toenails, dry or cracked skin of your feet, or if you have a callus with dried blood inside it. If you have a cut, blister, or bruise on your foot that doesn’t heal after a few days, you should seek medical help. If you have a foot infection that becomes black and smelly, you definitely need help.

If anything looks funky with your feet, give your podiatrist a call and get it checked out. Check your feet every day and make sure they’re okay. Also, remember to get your blood sugar under controlled levels to decrease your risk of neuropathy.


References

CDC
NIDDK

Season Three: Episode Four

FEBRUARY 6, 2022

Happy Black History Month!

Something a little different for a journey update this week. I have mixed feelings on Black History Month. I don’t think we should relegate African American history to only one month. We shouldn’t highlight black history and black businesses and just general blackness to one month. It should be celebrated every day of the year. Black history is American history and we should all know this history.

I saw a TikTok a while ago that was upset about how our education system doesn’t tell all of the United States of America’s history, the good AND the bad. Always focusing on the history as if there are winners all the time in this country. Trying to erase all of the bad. The TikTok user had issued a challenge, the American History Challenge.

In it, she challenges you to research the topics, learn about it, and share it with others. So I’m going to take this month to learn about America’s history and share it with you. Feel free to do your own research and I would love some suggestions on things you think I should research and learn more about. I will create a new page just for the American History Challenge.


As an update on myself though, I am doing a challenge for myself this month. I am going to read every day this month and I will only drink water this month. The water drinking is a little hard because I’ve been having sugar cravings off the wall, but if I ignore them and just keep drinking water, they go away.

This year I decided to get back in to bullet journals. January’s layout sucked. So for February I decided to change it up. I love the appointment book style planner so I can keep track of times easier so I incorporated that. I’ve also added a ton of habit trackers that I didn’t have in January and I’m trying it out in February to see if I’ll continue them on. I’m keeping track of how much water I drink and how much rice I eat. I’m also tracking if I eat breakfast, lunch, and/or dinner, as well as how many steps I’m taking and if I’m doing my facial routine.

It’s a lot more fun to do than January’s spread that’s for sure. I’m still very bad at taking my blood sugar though. I haven’t taken it in quite some time. But I’m trying to figure out my habits so I can make changes to them.

I’m still waiting for my insurance cards to come in so I can set up an appointment with my endocrinologist. I have an appointment with my foot doctor tomorrow. I have a eye appointments coming up in the next couple of months and a dentist appointment in April. I’ve gotta call my PCP to schedule my next appointment to refill my prescriptions and birth control. Our healthcare system seriously sucks. Hopefully I’ll be able to get insulin again. Fingers crossed.

Diabetic Retinopathy

What is diabetic retinopathy?

Diabetic retinopathy is a diabetes complication that affects eyes caused by the damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). It can cause vision loss and blindness. It develops in type 1 and type 2 diabetes and can also affect those who are diagnosed with gestational diabetes. The longer you have diabetes and less controlled your blood sugar is, the higher your risk of developing diabetic retinopathy.

What causes diabetic retinopathy?

When there is too much sugar in your blood it can lead to the blockage of the tiny blood vessels in your eye, cutting off its blood supply. This causes new blood vessels to grow but they aren’t developed properly and can leak easily.

Are there any conditions that can be caused by diabetic retinopathy?

Yes, there are a couple of conditions that can be caused by diabetic retinopathy.

  • Diabetic macular edema: 1 in 15 diabetics will develop DME. DME occurs when the blood vessels in the retina leak fluid into the macula causing blurry vision.
  • Neovascular glaucoma: the growth of new, abnormal blood vessels can interfere with the normal flow of fluid out of the eye and pressure can build in the eyeball, this heightened pressure in the eye can cause damage to the optic nerve that carries images from the eye to the brain resulting in glaucoma.
  • Retinal detachment: the leaking of the new blood vessels causes scars to form in the back of the eye. The scars pull your retina away from the back of the eye.

Can diabetic retinopathy be treated?

There are several treatments for diabetic retinopathy.

  • Injections: anti-VEGF drugs or corticosteroids can slow down or reverse diabetic retinopathy.
  • Laser treatment: to reduce swelling in your retina, lasers can be used to make blood vessels shrink and stop leaking.
  • Eye surgery: if retina is bleeding a lot or you have a lot of scars, your eye doctor may recommend a vitrectomy.

Having high cholesterol or high blood pressure along with diabetes can increase your odds of getting diabetic retinopathy. You can start to see floaters in your vision, blurred vision, fluctuating vision, dark or empty areas in your vision, or vision loss.

Early diabetic retinopathy or non-proliferative diabetic retinopathy (NPDR), is when the new blood vessels aren’t growing properly. They are weakened as more vessels become blocked.

Advanced diabetic retinopathy or proliferation diabetic retinopathy, the damaged blood vessels close off causing the growth of new abnormal blood vessels in the retina. They are fragile and leak into the clear jelly-like substance that fills the center of the eye (vitreous). The scar tissue from the growth of new blood vessels can cause the retina to detach from the back of the eye or cause a build up of pressure in the eye.

Diabetic retinopathy is preventable with proper management of your diabetes. Having uncontrolled high blood sugar over a long period of time can increase your risk of getting diabetic retinopathy. So in order to prevent it, you need to stay physically active (150 minutes per week at least), eat healthy, and always take your medication when you are supposed to.


References

Mayo Clinic
NEI
American Academy of Ophthalmology

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