I have a friend who does diabetic foot care. She and I were visiting and I learned a few things. 
Did you know that if you are getting manicures and pedicures that you should let the person doing the service for you know that you have diabetes. 
When I asked her why, she said that a good licensed professional will give extra attention to your hands and feet. They will check for skin condition, nail condition, cuticle condition. They will take extra care when they are cutting nails and cuticles. They will look for damaged skin before they file dead skin off, and they may do it in a different way. 
Finally, the thing that I found the most interesting is that a person with diabetes may not be offered certain manicure and pedicure services because of diabetic health reasons. 
I asked if there were any tips that she could offer for my readers. Here they are: 

1. Wash your feet with soap and a washcloth. Make sure that you get in between each toe, and wash each toenail as well as under the toes. 
2. Get into a routine of how you wash your feet so that you know the entire foot has been cleaned and gently exfoliated with the washcloth. By doing this, you ensure that you are looking at your foot for any issues. 
3. When you are washing the heel of your foot, look at it for cracks in the skin as well as bruising or discolorations. 
4. Don't dry your feet roughly with a towel. Pat them dry, and go in between each toe as well. I asked why, and I was told that you can damage a toenail with rough drying, especially if you have neuropathy. 
5. Treat your feet to a cornstarch based powder, especially if you are going to be in heavy boots. Absorb sweat, and keep your feet cooler. 
6. If socks are leaving deep red indentations on your skin, they are either too small, too narrow, or both. Switch to a larger sock, and preferably a diabetic sock. You can even get them at Dollar Tree now. They feature a looser weave on the part that goes up your leg as well as a lighter elastic so that you don't create issues. 
7. If you are going to wear compression socks, ask your health care provider first. They are not an ideal solution for everyone. 
8. If you notice any skin conditions, loose or damaged nails, or other foot health issues, make an appointment with your doctor. You may have neuropathy, or your foot health may have changed. 
9. If you ever have deep bruising that looks like pooling blood, call your doctor immediately. She said that this could be something major, especially if you don't recall injuring yourself where the bruise is. 
10. Don't go barefoot in the house, especially if you have neuropathy. You may not feel an injury. 

A friend of mine, Joanne, told me that she knew that her diabetes must be "acting up" because her vision was a little blurry in the early evening light on her porch. I asked for clarification and she said that she had noticed that when she had blurred vision, it was time to hydrate, check her sugar and have at least a small snack. 
Vision issues are a well known concern of people that have diabetes. At first, I was shocked by what she said, and then I thought back to a very bad cold that I had a year ago. I felt absolutely awful. No matter what I did, I was tired. All that I wanted to do was sleep. A friend called to check in on me, waking me from my sleep. When I went to answer the phone, I had a hard time focusing on the name displayed on the phone screen. 
At the time, I blamed the vision issue to sleeping so much and being tired. When I was done talking with my friend, I went to the bathroom, had a snack, and got a drink of water. Climbing back into bed, I pulled up social media to have a look at what the world had been doing while I was asleep. The words were still slightly blurred. I grabbed my reading glasses, but there was still a blurred edge to the letters. 
Frustrated, I went back to sleep, blaming it on being "tired". When I woke the second time, everything seemed to be resolved, and I did not think about the incident again until Joanne told me about her blurry vision incident.  
When I went to the eye doctor for an exam, I remembered the incident and relayed it to my eye doctor, expecting them to dismiss it as coincidence. They went into detail about the risks of diabetes that is not in good control or monitoring. Blurry vision can occur when a diabetic is dehydrated because the body is doing everything that it can to keeps all systems go. When you are dehydrated, the actual shape of your eye can change. Your body can be so low on fluids that you are unable to tear properly or unable to tear at all. 
Additionally, dehydration affects your blood sugar levels. As your bodily fluids become more concentrated, your blood sugar levels will rise. It is important to consume adequate water in warmer weather to avoid overheating, which can also spike blood sugar. In cooler weather, we have to be mindful because we may not feel thirsty because we are not hot. 
When my optometrist and I talked, I asked if the 8 glasses of 8 ounces of water a day was the number to aim for. He suggested that I look at some of the water calculators that are online, and to be very honest when I filled in the information to get a good idea of where I needed to be. 
The water calculator that I chose is ​rehydratepro.com/hydration-calculator/ It allowed me to put in all of my information, including the fact that I really don't exersize as I should yet. (Baby steps, but I am not there yet.)
With all of the input, 1.85 liters or, 65.11 imperial ounces is the amount that I should consume every day. (Just barely over the 8 ounces per glass, 8 glasses per day recommendation.) There was even a suggested breakdown of ideal water consumption, 3 glasses in the morning, 3 glasses in the afternoon, 1 in the evening and one at bedtime. 
Here is how I have broken down the consumption to get it all done in a day:
Morning

1. After brushing teeth
2. With antihistamine
3. With snack at work

Afternoon

1. With Lunch
2. With snack at home
3. With supper

Evening

1. With evening snack
2. After brushing teeth

It took a little work to get all the water in, and this is water. Not juice or other beverages. Those are liquids that have to be processed, which is work for my body. Water is a worker. Big difference. 
Since I have made it a point of consuming enough water, my vision problems have not occured again. Even if I am feeling under the weather, I make it a point to keep hydrating, which also helps to flush my system. 
Hydrate for the sake of your vision! 

I have been reading up on different sugars and substitutes to be better informed. 
Today's product was agave nectar. I thought that would be a good substitute because of all of the health benefits, after all, it is from a plant, and not a chemical plant! 
I read online about agave nectar. The health benefits of agave don't come from syrup. Only raw, cooked or dried. Syrup isn't that. So, agave is off the list. Apparently, it breaks down into 2 different sugars. One of them processes through the liver, and excess sugar through the liver can lead to diabetes. Imagine if you already have diabetes! 
Here is the article that I read if you are interested in reading it for yourself: www.sheknows.com/health-and-wellness/articles/1134994/health-benefits-of-agave-nectar/
I was actually debating replacing Log Cabin ( a very bad choice, but it is what I currently have in the pantry) for this syrup. However, it looks as though maple syrup would be a far better choice. Looking at where sugars are processed is important for sugar alcohol. 
The journey of diabetes is filled with a lot of good and bad information. I strive to research as much as I can so that I am making the most informed choices possible. I appreciate you being a reader here.
What is a sweetener that you learned about and no longer use? Leave your comments below. 

I had to go to the doctor today for a follow up from my injury. I was very agitated when I arrived because of a coworker needling me about my injury. Normally, I would have let this roll off my back, but when he decided to start picking on me, I didn't feel well, and he was coming at me with a lot of false statements that were meant to inflame. 
Between his comments, me getting irritated, and getting caught in a little traffic, when I arrived to the doctor's office, I was already irritated, to say the least. At the doctor's office, there was a little confusion about the appointment, leading to more irritation on my part. 
The office took my blood sugar reading, and it was high. I was fasting properly, so I was pretty surprised. 
The nurse asked me if I was angry or upset. I told her about the morning so far. She said something that was very scary to think about. "Be careful. Anger in diabetics can cause diabetic rage. Where your blood sugar climbs along with your temper. Something to be mindful of." 
She squeezed my hand and smiled. "Knowing is more than half the battle. Knowing means that you can control your anger, and then, that helps control your sugar. It is an advantage to know that anger is a trigger to how your body processes sugars."
I smiled because she was right. This knowledge was a gift. I thought about how in the past, sensitive discussions had led to me physically feeling very bad, and sometimes confused about what had happened. I would sit and wonder how things had escalated. It was confusing, sitting there on the papered exam table, wondering if a lot of events in my past would have turned out differently had I only known about this diabetes and anger correlation.
As soon as I got home, I went on the computer and started looking at correlations between diabetes and blood sugar. It is all over the internet. There is even a phrase, diabetic rage. It talks about some of the effects of blood sugar on the diabetic who is angry. Looking at all of these web pages made me resolve to take better care of myself so that I do not have to deal with this very dark side of diabetes. It has also made it a bigger priority to look closer at diabetic rage and see what are the best ways of dealing with this. This also means acknowledging that sometimes, with blood sugar affected while having serious discussions, I absolutely was at risk for not only not being at my best, but for having serious health complications. 
I am eternally grateful to this nurse for sharing the information with me about the correlation. This was not even the post that I had intended to write today, but I wanted to write it down and share before I lost all of the intense feelings that happened. 
I will be writing more about this as I learn more, but if you have diabetes, take the time to learn about diabetes and moods affecting your blood sugar as well as the diabetic rage that I shared with you. 
​

I wear steel toe boots. I ordered them really carefully by reading the reviews online and the sizing guide. Everything said that these boots were an exact fit, no need to go up or down a size. 
I work in a warehouse and the floors are poured and polished cement. The first days I was at the new job, I noticed that at the midpoint of my shift, my toes were really aching and when I got home, they were sort of numb. I had done everything I could to make my feet as comfortable as possible. Orthotic inserts, a pair of thin compression socks topped by a pair of thicker socks to prevent rubbing and chafing, and a couple of gel wraps for my little toes so that they did not rub along the side of the leather boot. 
Remember what I said? The boots were right on size. I was basically wrapping them like mummies to provide comfort and cushioning. So, I was cramming a bunch of stuffing and feet into a boot. If I was going to do this, I should have ordered a size up, and gone to a wide boot as well. 
I noticed the small little blister when I was washing my feet. Since being diagnosed, I make it a point to go over my feet really carefully at least one time a week. I look for injuries, blisters, nail and cuticle health, and make sure that each toe is in good condition as well as clean each foot carefully during this little health inspection. I had never found anything suspect, but I kept up with it. 
The blister was on my left foot's second toe. It didn't hurt. It was pretty small, and comparing it to where my composite in my "steel toe" boots hit, it seemed that the blister was at the edge between the regular boot and the toe guard portion. I marked it on my "diabetes calendar" so that I could accurately follow the progress of the blister. 
I then thought about all of the stuff that I was jamming into those doggone boots and decided to remove everything, including the orthotics and just wear a pair of diabetic socks until I could get a larger pair of boots ordered. 
The next day, my toes did not began being numb at the middle of my shift. Coming home, I took my boots off and looked at the toe with the blister on it. I had taken a photo the day before. I took another and looked at it. My blister was actually looking deflated and less angry. I monitored this blister carefully for the next few days. By day five, there was no blister, the skin was just ever so slightly more wrinkled than the other toes at the place where the blister had been. 
I did not apply anything that would soften the skin, such as ointments or lotions. I wanted to have the blister dry out and be absorbed, not apply a humectant to draw or trap moisture at the site. 
By day seven, all traces of the blister were gone. Since that point, I carry moleskin, the felt like protective fabric with a gentle adhesive backing in the trunk of my car with a small pair of safety scissors so that I can protect any tender skin areas on my feet and rest of my body.
I feel that by doing these frequent inspections of my feet, I avoided what could have been a significant issue. I do not have neuropathy, so the issue was not one of not feeling the injury. Instead, by monitoring my skin closely, I was able to catch something happening at early onset. 
​

The fall was spectacularly stupid. I was trying to maneuver a cracked plastic laundry basket that was too full around a corner of the bed. I tripped over a corner of the bedspread that was out of my siteline because of the basket. I fell to the ground, and a huge gash was bleeding on the middle of my outer calf. 
Everything hurt. The fall was hard. I must have literally laid there for at least 5 minutes, assessing each part of my body that hurt, because there was no one else home at the time. Gingerly, I began flexing and releasing fingers and toes, and then moving onto larger and deeper muscles. I knew that I was pretty banged up. When I went to move my head, the back of my head roared to life with pain receptors. I was assuredly injured.
Going into the bathroom, it was shocking. I had blood going down my face, and from my leg. I bandaged myself up, threw some petroleum jelly on the wounds to stanch the flow of the blood and took some Aleve for pain. 
The next few days were filled with the pain and soreness that you would expect. In about a week to ten days, the cut in my scalp was only a hardened little bump and scab that hurt only if I brushed or shampooed without giving a little tender treatment to the area. By the third week, my head was pretty much healed. The bumps and bruises all over my body were pretty much gone, save for the especially deep ones that were still present, but faded. 
The gash on my calf, though. That was a problem. No matter what I did, that gash was still an ugly purple and burgundy, with literal shades of blue and green in places. It was closed, but with a scab. I did not know that wound care was an issue with people that have diabetes. I researched cuts. and finally, at the one month mark, I decided that I needed to go see the doctor. 
The doctor looked at the cut, asked how it happened, and looked at the healed cut on my head as well. He gave me a couple of prescriptions, some instructions on bandaging and wound care, and I was sent home. 
At the two month mark, when I was finishing the last of the cortisone cream that I was prescribed, the cut really didn't look any better. It was sealed, but still very angry deep red and purplish at the cut. The skin felt thinner there, and I was embarrassed to wear shorts, dresses, or anything that showed my calf, because it was so shocking that strangers would ask what happened. So, I basically lived in leggings worn under a dress or anything else. 
I called the doctor, and he said that I should come back in, because it should be healed by now. At that visit, he said that I might have something call fragile skin. That meant that it could take me a little longer to heal. He said that because it was sealed close, we were just in a waiting game for the discoloration and sensitivity to heat and cold to come to and end. 
It took that wound nearly 8 months to heal completely, to where there was no discoloration, and no abnormal sensitivity or numbness. 
Here is what I would have done differently now, knowing that I am a diabetic:

1. Gone to the doctor as soon as possible. They would have properly cleaned the wound and come up with a care plan instead of me running around all over the internet, trying to figure out the best way to heal this gash. 
2. Taken photos from the very beginning so that I could properly assess if I was healing, or if there was no progress. Additionally, it would have given the doctors who were seeing me the same information without having to wonder if we were successfully communicating with one another. 
3. Created a folder, a literal folder with printouts from the doctor, copies of the injury photos and everything relating to the incident so that if I were referred anywhere else for treatment, that office had the same information. 
4. Asked questions about how long the healing time could be on the short and long side of things. I had no idea of how long that deep cut should take to heal, so there were times that I was overly concerned and other times where I should have been more proactive. 

Being proactive is something that everyone should do for themselves, but with wound care and diabetes, there can be some serious risks if that wound does not heal. Since this has happened, I have learned of people losing fingers, toes, limbs, and even dying because their wounds did not heal properly. My head healed fine, but when my calf was healing, I had strange tingling sensations, numbness, burning, and the very strange sensitivity to heat and sunlight. 
If you have a wound, call your doctor and do what they tell you. Ask if they have hand outs about wound care for diabetics, and any other resources to make sure that you are doing all that you can do for your health. If you don't get help from your physician, ask for a referral. Your doctor should be a partner in your well being. 
 

A concern that I have read about again and again for people with diabetes is vision problems, including blindness. My older sister has to have injections in her one eye because of complications from diabetes. My younger sister no longer wears contact lenses for the same reason. 
I had LASIK surgery about 20 years ago. About 15 years ago, my vision started changing. I noticed it first when I was cleaning a pair of glasses for a family member. As I looked through the lens to make sure that it was clean, I was seeing a sharper image. I was surprised because my vision had been constant since my surgery. 
I went to the eye doctor, and sure enough, there was enough of a change in my vision that I needed glasses. I got glasses and I also got fitted for contact lenses. I decided to go for the lenses that had the most positive reviews in terms of comfort, because at the time, I was working at the airport, and the constant changes in temperature/air pressure from opening and closing doors, etcetera was something that the optometrist was a little concerned about. 
The first few days of wearing the contacts, I was told that there would be an adjustment period. I called the eye doctor because the first day was absolutely miserable. My eyes felt dry all day long. I called the doctor and he told me that I should come in and let him have a look. During the visit, he said that it looked like I had eyes that were a little dry, and that wearing contacts to work would probably not be good for my eye health. He changed the contacts I was wearing, and I have it a second try. I was unable to wear them at home because it was just too uncomfortable.
In doing research, I discovered that vision problems are a massive problems in the diabetic community. Fear of blindness made me change how I handle my eye health. Here are the changes that I have made: 

1. If I use room fans and personal fans for cooling the room and circulating the air, I make sure that none of the breeze crosses my eyes. Dry eyes are not good for eye health. 
2. I stay hydrated and track it on my phone. I used to think that I was a good little water drinker. Then I added an app that is both on my phone and my smartwatch. Guess what? I wasn't consuming nearly as much water as I thought I was. Now, I have a little routine and it works really well. I will have a separate blog post about this, because it is really important. 
3. I see an in person optometrist or opthamologist once a year. A lot of the lower priced places use remote doctors that do all of the diagnostics through screens. For a few dollars more, I want to see a doctor that will look at me in person to see ocular changes that may not be visible through a screen by a distracted doctor. Peace of mind and not being blind are worth the extra money. 
4. I pay attention.

​

Supposedly, I have diabetes. Do I sound convinced? Not really. The reason? Before I had a physical, my doctor and his office did not tell me that I would need to be fasting before a blood draw. They didn't even tell me that there would be a blood draw.
Should I have known these things as common sense? Not really. I have been to the doctor for physicals and some of them have involved lab work and some of them have not. 

So, I went to the doctor, he spent a few moments with me, and I was sent off to the lab. I was asked if I had fasted before they took my blood, and I said that I had not. The lab tech told me that it didn't really matter, they would "adjust for that", and then they did my blood draw. 
About a day or so later, a nurse from the doctor's office calls to tell me that I still have asthma and that I now have diabetes, based on the results from my lab work. She stated that the doctor was going to write some prescriptions for the asthma medication that I was on, and that he was also going to be writing a new prescription for Metformin, a medication that assists with blood sugar/diabetes. 
I got real firm real fast. "No. I am not accepting that I have diabetes. I did not fast for the test, in fact I had juice and cereal for breakfast." 
She got firm right back with me. "Well, doctor says...." 
I cut her off right there. Let me explain something. My mother is a doctor. I don't see doctors as being superhuman or super smart. I see them as a degreed professional practicing in their field of study. Do I hate doctors? No. But I surely am not going to accept the results of a test that I was literally not prepared for. Especially with a mother who has always told me to question something if you don't understand, or if it does not seem right or correct.
I took a breath before I spoke. "I am not accepting that I am a diabetic. I was not prepared for the test. I would like to be retested and prepare for the test properly. This feels like a crap shoot." 
I could literally hear her overly dramatic sigh over the phone. "I will relay your opinion to Doctor and see what he says." She snipped. 
"No, that isn't my opinion.That is fact. No one told me to fast. After I fast, I will accept the results of the test." 
So, the nurse hung up without so much as a goodbye. 
That was my introduction to possibly having diabetes. It was not great. 
I decided to ask about my medical history from my mother. Guess what? There are a lot of incidences of diabetes in my family. My grandmother had diabetes, my maternal side of the family is full of people who have or, in the case of deceased family members, had it. I am embarrassed to say that I knew prior to the conversation a lot of family members had diabetes, but I stupidly had never connected that to me as having a risk factor. 

My paternal side of the family was pretty much an echo chamber of my maternal side. Diabetes all over the place, like paper from a ticker tape parade, it was everywhere. This broke my heart. 

I have always had a sweet tooth. Sweet treats have always been my favorite thing in the world. Second favorite? Carb rich treats like chips and such, but they never held the sway over me like sweet foods did. 

That scared me into becoming proactive about this diabetes thing. 

The first thing that I did was create a little timeline of events in my life that could be related to diabetes. I didn't do this as a request from the doctor, but for my own peace of mind, to know what my life could look like, good and bad. 

The first possible incident that I could remember happened before I was of school age. I remember vague parts of it, but my mother used to tell it to friends. We were at an amusement park. This would have been in the early to mid 1970's. My siblings and I, on a beautiful spring day walked up a grassy hill to a picnic area where we were going to have lunch. My stepfather installed and maintained massive commercial air conditioners for amusement parks. As kids, we loved it, because the amusement parks would always swing him unlimited access for his wife (my mom) and the kids. That meant we could go as much as we wanted to. A lot of the time, especially when we were living in California, we would go all day. It was an awesome part of my childhood that I love thinking about. 
So, one of these times, there was this hill. Our stepdad would tell my mom where and when to meet him. She would have lunch in the baby bag that she carried for all of us, as well as other little snacks and things. On this particular day, we had been to a petting zoo, we had fed ducks at a pond, and a bunch of other things that were physically more active than standing in line or riding a ride. My mom said that she noticed that I was profusely sweating, and it was a lovely spring day with a good breeze. She said that I then told her "I feel sleepy, Momma" and when she looked at me, she said I was very pale, sweating even more, and my eyes were very glassy.
​Before she could say or do anything else, I fell to the ground. Luckily, my stepdad was there, he picked me up and we went to first aid. I was "diagnosed" with being dehydrated. The people at first aid gave me and my siblings cookies and drinks, and then we continued the rest of the day with me parked in an oversized stroller along with my siblings. 
My mother would tell that she was beyond scared when that happened. She would mention how she was scared that I had juvenile diabetes. Whoever she was telling would always comfort her, and I would always get a little hug, and then be sent on my way. 
I remember when that happened. I remember the feeling weird, the sweating, the clamminess. I remember all of it because it was something that was outside of the normal way I felt. I then thought about all of the times that I had those feelings, and a few times, my legs failed me, and I found myself on the ground, and at least 1 other time, I lost consciousness. 
I had to accept what it looked like. I have diabetes. 
However, my experience with my medical staff has been the same as too many other people. A lack of information about the disease, a lack of resources to deal with the disease, not even getting help with how to do a finger stick to get my correct blood sugar. I have become my own advocate, and you should do the same for yourself in reference to your health. ​