Monday, September 7, 2020

Complicated

I think the majority of you will know about the complications associated with Type 1 Diabetes. Perhaps they were hammered into you at a young age? I remember a DSN once offering me a tour of the amputations ward and promising me that was my future if I didn't "buck up" my ideas. I was probably 12 years old and the invite didn't make me buck up my ideas in the slightest. Perhaps you've read leaflets or things on the Internet? Or even a had some kind words spoken to you by a HCP. The point is we mostly know about the eye things (I certainly do!) and the kidney stuff and the dickie hearts and the nerve damage. Yep, we know the big stuff already. They're scary but we carry on and we do our best because what choice is there?

What doesn't get mentioned as often, perhaps because they don't make sexy headlines, are the less serious but arguably more frequent complications.

I've had a sore and stiff shoulder for a couple of months. It's gradually become worse to the point that I've sought medical attention. It looks like it might be a frozen shoulder, at this stage. I'm taking Naproxen and I'm about to embark on 2 weeks of exercises before the physiotherapist decides on the next move. Before my "embracing" of my diabetes and jumping head first into social media I had no idea that frozen shoulders were associated with diabetes or even what a frozen shoulder was! Another great reason to join in with your peers on social media, I guess.

Shoulder aside, the latest possible complication on my diabetes journey has brought the other lesser-spoken-about complications to my mind. I'm delighted that mental health has been spoken about more often in relation to diabetes, as are eating disorders and perhaps a bigger focus will fall on those in the years to come but what about the other "niggly" complaints that we shy away from or just shoulder (pardon the pun) the burden of quietly?

Let's get straight into the biggest "little" one! Sexual dysfunction. @diabetic_me and I have spoken about this one, albeit briefly in a podcast. Following those few minutes of audio back in 2019, several men got in contact with me to tell me about their problems and to ask advice. I'm not a medical professional and don't give advice so I could only offer supportive replies and suggest a chat with their HCPs. The common reply was that they couldn't because they were embarrassed. I've heard of similar issues facing women too. I cannot find an explanation as to why it is embarrassing. I wonder if the smirks and jokes from our youth remain fresh in the memory as an adult? Perhaps the jokes and bullying online make it too much of a risk to talk about. I wonder, if I ever needed help for this complication, would I seek it? Honestly, probably not. I'd probably look for a private and no doubt expensive solution. And this is me! I'll talk to anybody about anything, right? Still, the stigma. I get it. It needs to end for both men and women. 

So, HCPs! If it's an embarrassing subject, bring it up! (stop making me pun) and treat it as a matter of fact health check. 

How about something more common? Fatigue. Everybody gets tired, don't they? But have you ever worked a long day with high blood glucose, peeing out every fluid in your body because you over treated a biblical hypo at 3am from the night before? You were so full and bloated after that hypo that you couldn't sleep and had stomach cramps. But you had to work. Another sick day doesn't look great. So, in you go. Bloodshot eyes and into autopilot.

Perhaps that fatigue brought on a migraine when you got home? You couldn't really eat much dinner, which you'd bolused for, and it sent you hypo again. So you're trying to stay alive now while feeling nauseous and that headache isn't getting any better.

Meanwhile you're ignoring your friends and family. They want to talk to you, see you, go out for a meal or a drink or do something fun. But your head is throbbing and mostly over your toilet bowl as you throw up that bottle of energy drink which you drank too quickly to fix the hypo.

Fatigue, I would argue, is certainly a complication of diabetes that you're almost guaranteed to get at times. Nobody appreciates the luxury of a full nights sleep like a T1D.

What else? How about those grouchy moods? When you're hypo and somebody dares to exist in your company. Or hyper! and that day in 2004 when somebody jumped the queue in the coffee shop! Grrrrr! Is mood a complication? I certainly feel less my "normal chirpy self" at the top and bottom end of the scale.

How can these things (and others) be resolved? I think talking openly is a great starting point. Shall we continue? Tell me what other problems diabetes causes you in the comments box below.