Under the Microscope
“Have I seen you before?”
“No, I don’t think so. I definitely saw someone else the last time I was here.” But he definitely felt somewhat familiar as I walked into the exam room and took a seat in the chair.
“So, Frank, tell me your story.”
“Well, I have type 1 diabetes,” I blurted out. “So I’m here for my annual eye exam.”
I can’t exactly remember where the conversation went from here, but he definitely stressed the importance of eye checks and diabetes and commended me for coming in.
“Are you well controlled?”
I chuckled. “As best as I can.”
He asked me what my hba1c was, and I told him.
“How many units of insulin are you taking per day?”
“Around 35 units.”
“Lantus? Or Novorapid?”
“I use an insulin pump. So just rapid acting.”
He seemed somewhat surprised to see someone with a pump, even though he clearly knew what they were. As he asked me how long I’d owned it and how I found it, it was clear he seemed to think that they make diabetes far easier to ‘control.’
He placed the dilating drops into my eyes, and handed me a tissue. “If I don’t make you cry, I haven’t done my job correctly!” He joked.
He brought up the eye scans from my pre-appointment screenings, and explained that diabetes is of particular concern to the smaller blood vessels in the body, in places such as the eyes and feet. He showed me a scan of my eyeballs, and identified a tiny haemorrhage from one of the blood vessels on my eye. There was another one on the other eye.
I took a deep breath, but as he went on it didn’t seem to be anything of concern. He showed me another image of a straight line, interrupted by black spots where my retina was.
He had me peer into the microscope, and shined that bright line of light into the back of my eyes, directing me to look left, right, up and down.
“I’m really happy with these eyes. These are a really good set of eyes.”
I sat back in the chair, and we talked a bit more about diabetes. He expressed that there are so many tools out there today that give people with diabetes a really good chance to manage their condition well. He also remarked that GPs don’t know a lot about diabetes.
I concurred, telling him that a lot of people aren’t being linked into the support that they need. I told him that I was living in the dark for the first couple of years, and wasn’t all that engaged in my care until I linked into knowledge and peer support online.
“Oh – and hba1c isn’t the gold standard, either,” I blurted out. “I could have a hba1c of 6 that was full of highs and lows.”
He expressed that there’s a lot of unnecessary doom and gloom in diabetes. I was happy to talk about some of my past involvements with Diabetes Australia, and how much more input I am noticing from people with diabetes. That the messaging is striking more of a balance between the seriousness and not scaring people off of a cliff. But that other orgs are still catching up.
“Is there anything else?”
“What’s your connection to diabetes? You sound like you must have some kind of interest or experience with it.”
“Diabetes runs in my family. So far I seem to be the exception, touch wood.”
He beat me to my next question, asking me if there was someone who he could send a report to. I gave him the name of my endo, and then asked him for his card.
I don’t think I’ve ever had someone explain my eye scans so carefully to me. He didn’t know everything there was to know about diabetes, but then again who does? He approached it with the seriousness it deserved, but he was also a fellow human being with whom I could have a conversation with.
He ‘gets’ it. I knew that I would make sure to request him when I return for my next screening in 12 months time.
“So, is that – haemorrhage something that gets worse?”
“They come and go. Sometimes they’re triggered by things like sneezing or coughing. If I scanned your eyes in a day or two, they’d probably be gone.”