I saw quite a few different people who all looked at my eyes at various stations and with various impressive pieces of equipment. It felt a bit like speed dating, going from chair to chair and talking congenially with pleasant strangers.
The first technician performed some basic eye chart style vision checks, having me stand at a distance and read the eye chart covering one eye, then the other. Pretty standard.
The second technician took some pictures of my retinas for the doctor to review. He showed me the photos and explained what he was photographing.
My third station included an autorefractor that I've seen at my usual checkups - you're asked to focus on an image of a hot air balloon while the machine measures your specific vision correction needs.
My next stop was to measure my eye pressure. I believe it's actually called a tonometer, but I have always thought of it in my head as "the air puffer thingy." I've often seen my eye pressure in the borderline high range (normal is 12-22 mm Hg). I'm usually 18, 19, 20. I don't know that I've ever seen above 21. The day of this retinal screening? I was clocking in 24s, 25s. WTH? We measured it again. Same. Hmm. Not pleased.
It had been a rough night. I'd had a pod malfunction that had sent my overnight blood sugar into the 400s. I had taken a correction injection around 3am and decided to deal with changing out the pod the next morning. By breakfast, I was down into the high 200s, and by my retinal screening at 10:20am, I was still floating in the 200s well above my target range.
I was then directed to the machine that measures the thickness of your retina. I've been going to the ophthalmologist for 17 years and I had never encountered this piece of equipment before.
So what does that thickness mean? That's what this machine was able to tell us. He studied the image, focusing on the big black bulge in the middle.
It was one of the best moments I've ever had with a health care practitioner. I want every patient to experience that handhold. I want every patient to hear those words, admonishing them of the guilt that sits like a giant bulge under the surface.
"Have your blood sugars been high today?" he asked. I recounted what my last 8 hours had been like. "Well, that explains what we're seeing here," he said. "The bulge is fluid buildup from your high blood sugar. In about four hours, when you've stabilized, we will see this go away," he explained.
Without this machine and its capabilities, he explained, he would have been worried about my retinal thickness on a more long-term basis. He'd have been worried about degenerating tissue. But not this. This was primarily an acute situation.
"Have you ever noticed that your vision is blurry with a high blood sugar?" he asked. I haven't, actually, but I didn't interrupt. "It's because of this fluid that builds up under the retinal lining."
He went on to explain how critical tight standard deviation is to good retinal health. "The swinging up and down all the time," he said, "this is what we should worry about."
Not the first time I've heard this. Standard deviation. It's all about how tight we keep it. Not the averages. Not the A1cs. But the swings. The roller coaster we call (not so affectionately) the glucocoaster. Physicians report wanting to see standard deviations below 50 for people with diabetes. Mine averages in the 60-80 range and it is my number one goal to bring it down. (My best ever was 18 during my first pregnancy, but that intensity of management was insane and virtually unsustainable.)
The most impressive number I saw in Ed Damiano's presentation on the bionic pancreas was the standard deviation reported in all four instances of adult/adolescent prebolus/no-prebolus - they were all near 20! THIS IS THE FUTURE I DREAM OF.
Dr. Ben took me to the final station where we could review photos of my retinas. My optic nerves are gorgeous. (That's the bright spot with all the healthy looking blood vessels running through it. It means my brain is awesome, from what I understand, but we knew that.) The pinhole hemorrhages my doctor and I had been watching in January and June were all absorbed and healed by my body. Well done, little left eye! Keep on with your bad self!
But there it was again, my right eye behaving in a newly problematic way. Tiny pinhole retinal hemorrhages on the right eye - this time right on the macula where my ophthalmologist said she didn't want to see them.
|Zooming in on the macula (the dark red oval area).|
I've circled the unwelcome spots.
Hubster and Dibbs came back in just as I was finishing up. Dr. Ben's positive energy filled the room as he practically danced behind me, swooning over my beautiful son in the stroller. "I just love to see women with diabetes with babies!" he cooed. He was overjoyed to learn that I had not one, but two. When I told him that I was done having babies, he seemed disappointed. Haha.
It was an amazing experience - the whole screening lasted about half an hour and I never had to be dilated. It was all the positivity of a great ophthalmologist appointment with none of the stress of a waiting room, insurance cards, long waits in a dilation room. I not only had each image explained to me by the doctor, but they emailed the scans to me to keep and use on my blog.
If you're going to Friends for Life 2014, sign up for a slot (they fill up quickly) to have a retinal screening with Dr. Ben and company. And if you're not going to Friends for Life 2014, why not?
Also, because I don't have Rx sunglasses, I will now be sporting the most ridiculous old lady "wearover" sunglasses you've ever seen.
Because I'm too sexy for poor eye health.
|These are the medium size. I'd hate to see the LARGE ones.|