Monday, 3 November 2014

Beating Perioral Dermatitis: 'My face looks like a baby's sore bottom!'

Although this post isn't exactly about diabetes (for the first time ever!) it is, of course, still distantly related to it.  I say 'of course' because it's usually the case that any other health issues aside from good old type 1 D are either caused by, or have something to do with, the fiendish workings of diabetes itself.

Around the end of August, a few dry, bumpy patches of skin appeared on one side of my chin.  They weren't very noticeable at this point, although it didn't matter how much moisturiser I applied or how much time passed, nothing made it go away.  In fact, if anything, it got worse.  What really made it flare up (here comes the D-Related bit!) was when I went for my diabetic retinopathy screening in mid-September.  I won't go into detail here (I'll save that for another post) but the test returned some unwanted results, for which I have been referred to hospital.  I'm not one to really get 'stressed' but, there's no denying it, I was a walking, talking vessel of stress after receiving this news.

This worry definitely manifested itself physically as, within a few days, the patch on my skin had spread not only to the other side of my chin as well, but also to both sides of my nose.  From then on, it only got worse.  I went to the doctors about it and was immediately diagnosed as having 'perioral dermatitis' (PD), which is often described as a cross between acne and eczema.  The GP prescribed me a topical antibiotic gel called 'metronidazole', but told me that it could take up to 8 weeks for it to have any effect.

Although I started applying the metronidazole twice a day, my PD only got more red, more spotty, sore and so dry that I couldn't even smile without feeling as though my face was going to crack.  Metronidazole also creates a 'film' over your skin, which is like glue (I wouldn't leave the house with it on - people will think your skin is peeling off!)  Just to give you an idea of what my PD looked like (and this wasn't even at it's worst) this is a photo of it:

This was taken 3 weeks after applying metronidazole, clearly to no effect.

Although I completely realise there are far worse conditions to have, it's fair to say PD was really getting me down. I've been very lucky to have never really suffered with my skin, I don't wear much make-up and I suppose I'm so used to living with an invisible condition, type 1 diabetes.  PD was making me feel very self-conscious and I was desperate to find some way of getting rid of this condition.

I thoroughly researched perioral dermatitis on the good old internet, over health sites and various forums.  All said about how common it is in women between the ages of 20-40 and also, because it has no one known cause, it can be extremely difficult to get rid of (a second doctor I saw about this reiterated this to me as well, telling me that I 'could have to live with this for years', which was exactly what I wanted to hear - NOT!)  One thing which did really surprise me was that I googled to see whether there was a link between type 1 diabetes and PD and, to my genuine surprise, there doesn't seem to be at all!  I figured the stress I'd caused myself after my retionopathy screening results had been what had made mine worse though, which is where my 'distant D-Link' comes in.

People who had suffered from PD seemed to think, according to the forums, that natural remedies and changes in lifestyle were the key to getting rid of this parasitic condition.  So, I tried pretty much every single one suggested and here's what I thought of each:

  • Coconut oil: This seemed to help with some of the dryness and is supposed to just be very good for skin anyway, but it's very greasy (there's no way you could attempt to apply make-up over it) and I don't feel it did anything to actually heal my PD.
  • Apple Cider Vinegar: Lots of people recommend applying this to get rid of perioral dermatitis, but it didn't help me at all.  To be honest I gave up on it very quickly as, even though I diluted it with water, it stung like crazy and only made my face more red and dry.
  • Aloe Vera: Again, I'm pretty sure this didn't help my PD one bit.  It's supposed to soothe it but I noticed no difference.
  • Drinking herbal tea: I don't feel this provided any solution to my skin problem, but it did make me feel healthier anyway.  I drank lots of peppermint, jasmine and camomile and honey teas.  I would even put the camomile and honey teabag to one side and would dab my PD-affected areas, which didn't visibly do anything but I reckon it probably had a positive psychological effect (every little helps!)
  • Switching toothpaste: Apparently PD can be caused by a reaction to fluoride-containing toothpastes.  I decided that I would only switch to an all-natural toothpaste as a very last resort, but I did remember that I had changed my brand of toothpaste over the summer to Oral-B.  Although I'm not sure if this had anything to do with the cause, I didn't want to take any chances so I changed back to trusty Colgate just as a precaution.
  • Natural shampoo: I was getting a tiny bit of dandruff too, so I worried my shampoo was acting as an irritant.  I bought 'Burt's Bees - 99% Natural Shampoo', which is mango scented and lovely.  Again though, this was more of a precaution than anything.
  • Extra tips: It should be noted that apparently PD sufferers should only use cool water on their face (and sometimes in showers too) and heat can irritate it.  Also avoid wearing make-up when you can, but when you do want to I found liquid based concealers were noooo good at covering PD.  Although my condition was still very noticeable, I used 'Dream Matte Mousse' by Maybelline as it rested on top better than any other BB-Creams or even tinted moisturisers I owned.

So none of these potential solutions did anything to prevent my PD from getting worse.  Not only was this frustrating because I wanted to feel confident in my skin again, but I'd also spent a fair amount of money on all these products to no effect!  That was until, last week, I decided to try one more recommended natural solution: calendula cream.  This stuff is made from extracts from marigolds and is commonly used for eczema, dry skin and nappy rash.  Seeing as my face looked like a sore baby's bottom, I figured I'd give it a shot and, I swear, this stuff works like a miracle for perioral dermatitis!

I bought the following brand (Nelson's Calendula Cream) costing around £5 from Holland and Barrett:

It's weird, it does sting and make your face go a little red when first applied, but within around 20 minutes it seems to soothe itself.  Within hours I could see that it wasn't quite as dry and within 2 days my face had gone from the image you saw above to this:

There was still some slight discolouration around my nose, but it was a million times better and now, after a week of applying calendula cream, my perioral dermatitis has gone!

My message is this: I know PD is irritating and embarrassing, but try not to stop living your life. 
 What I will say, with regards to my type 1 diabetes, is that although it can often be a problem that it is an invisible condition, having had this experience with perioral dermatitis has actually made me thankful that other people can't see my diabetes.  I genuinely feel that my PD could have continued to harass me for a very long time had I not tried calendula cream.  Thanks to that little miracle, I am now keeping much less-red, less-spotty, less-dry chin up! :)

Sunday, 18 May 2014

D-Blog Week: Diabetes Thankfulness

Diabetes Blog Week 2014 is coming to an end and I can't help but feel like it's gone super fast.  They say that happens when you're having fun!  With my University exams starting next week, I thought the past few days would have been pretty stressful as I attempt to learn and memorise an entire semester's worth of content.  However, thanks to the DOC, my week has been anything but.  To summarise why the past 7 days have been so special for me, here are some of favourite things from this D-Blog Week:

  • I have smiled, giggled and even had a lump in my throat trying to swallow my own tears, as I've read posts from all of the wonderful bloggers who have taken part this year.  The best part is that I haven't even read them all yet and I've got even more to look forward to!
  • Every participant in D-Blog Week reads the same prompt daily, yet each person's post is completely different!  D-Blog Week highlights our similarities and differences - this diversity, for me, makes the DOC an exciting and beautiful thing to be a part of.
  • I know I talk about this a lot, but I love how D-Blog Week allows me to be creative.  The themes for each post encourage me to think and write about aspects of my diabetes I may not normally give much thought to, or inspire me to do it in a completely different way.
  • This year, Friday's 'Diabetes Life Hacks' prompt was so helpful for me.  Other blogger's hints and tips about the things that make their lives with diabetes easier, reinforced to me how some little things can make such a huge difference!  There were definitely a few 'I wish I'd known about that years ago!' moments, but I know now thanks to you guys :)
  • Karen Graffeo.  Not only has she brought Diabetes Blog Week to the Diabetes Online Community for 5 years and writes posts that are a treat to read, but she also reads other's posts, comments on them and gives so much encouragement to so many people.  Thank you for bringing us together!
  • Finally, it means so much to me how, every year, D-Blog Week gives me the boost I need to pay more attention to my diabetes.  Sometimes we all need to turn the page and start afresh.  Diabetes Blog Week, for me, is like putting new batteries into my life with type 1, and pressing the 'reset' button.  Well, you know you're ready for a new start when you clear out all of the used, bloody test strips from your kit-bag...
(Is it bad that I think this is actually quite good going?! Haha)

I hope there will be plenty of annual D-Blog Weeks to come, as they make me thankful.  Thankful for the internet, thankful for my health, thankful for my life and, would you believe it, thankful for my diabetes.  Without it, I might not know some of the wonderful people in my life who I have met through the DOC.  It's amazing how something negative can bring about so much positivity, and I have you magical people to thank for that!

Saturday, 17 May 2014

D-Blog Week: Saturday Snapshot Of My D-Heaven

For as long as I can remember, I've struggled with very high morning blood sugars.  This has had a huge impact on my daily life, because waking up feeling sick, with a headache and a dry mouth means that you never start your day feeling like the best version of yourself.  As my bedtime blood sugar levels were always stable, and mid-night hypos had also been ruled out, there was speculation about whether the Dawn Phenomenon (the Somogyi Effect) was the cause of my morning highs.  However, my doctors were pretty sure that there was something else having an effect on them.

Maybe it was a hormone thing which has started to settle now I'm out of my teenage years, maybe it's a miracle...I don't know!  But what I do know is that for the past couple of months, my morning blood sugars have been good.  I can't pretend I have even the tiniest hint of a clue as to why, because I haven't changed anything about my diabetes management.  Still, I couldn't be happier as I can now wake up and actually feel ready to start my day!  There still seem to be 'anomaly mornings', but at least it's the high blood sugars that are now the odd-ones-out.

My Saturday Snapshot is my blood sugar level from this morning...

...I couldn't wish for a better way to start my weekend! :)

Friday, 16 May 2014

D-Blog Week: The Little Book Of Carb-Counting Tricks

For a long time, I put up a lot of barriers towards carb counting.  When I was diagnosed with diabetes 18 years ago, my parents and I weren't taught about the importance of knowing how much carbohydrate you're eating, and how much insulin to take for it.  Instead of altering how much insulin I'd inject depending on what I was eating, I had set doses for each meal and that was that.  It was only when I was about 15 years old that I was encouraged by my doctors to attend a DAFNE course but, as far as I saw it, there was no need - I thought everything was just fine the way I'd been doing it.

Thankfully, I eventually realised that carbohydrate counting not only made a lot of sense, but it's also essential to balanced blood-sugar levels.  My lifestyle, and the amount of food I'd eat, would change significantly from day-to-day and administering the same amount of insulin, regardless of whether I was eating one piece of toast or a whole plate-full of pasta, was a recipe for disaster.

When I finally started to learn how to carb count and began to realise which foods had carbohydrate in them (it had never occurred to me that a lot of meat products like sausages and burgers are packed with bread-crumbs!), it took me quite a long time before I had the hang of it.  The book 'Carbs & Cals'  acted as a bit of a lifeline for me during this time.  Each page has photos of different portion sizes for so many different carb-containing foods, and it tells you how many grams of carbohydrate are in each one - it is genius!  

Although I either weigh my carby food, or look at the nutritional information on the back of packets to know how much insulin to give myself, I still find Carbs & Cals really useful.  When I go out for a meal, when I can't find out the weight myself, I know that I can flick through the book and compare the portion size to the photos on the pages.  I've also found that, nowadays, I don't even need to carry the book with me as I know instantly what 60g of pasta, or 70g of rice looks like on my plate, because I've seen it so many times in Carbs & Cals.

So if I could give one tip that makes life with diabetes easier (aside from not wearing all-in-one clothing, after my injecting difficulty when wearing my floral playsuit a few weeks back [read here]), it would be to buy a copy of Carbs & Cals.  You'll never be left guesstimating again!

Thursday, 15 May 2014

D-Blog Week: The Tasty Treat Hypo-Treatment

As I wrote yesterday about the main thing that keeps me smiling through a bad diabetes day, I've decided to pick the 'Diabetes Dream Device' wildcard today.  As we know, hypos are horrible.  They can make you shake, give you headaches, make your lips and tongue numb and make you seem like a completely different person.  Maybe it would be easier to deal with if treating hypos was easy, but unfortunately that's not necessarily the case!

There are lots of misconceptions about the correct and most efficient way to treat a hypoglycaemic attack.  It's not just about eating anything with sugar in.  There are lots of foods with high sugar content, but the amount of fat and other ingredients in them significantly slows down how fast our bodies absorb the sugar to bring our blood sugars back up.  Also measuring how much sugar you have to eat to make your blood sugars rise, but not go too far and end up at the other end of the scale, is pretty much an art in itself.

I don't only hate hypos because of how awful they make me feel, but also because of how much I dislike the types of food and drink that makes the best treatment for them.  When my blood sugars are low, I can't help but crave all the food that wouldn't be a very fast solution in an emergency.  The most useful existing treatments like drinks like Lucozade are ones that I don't like the taste of, and glucose tablets only make my mouth feel like a desert.  Instead, all I want to eat or drink when I'm having a hypo is chocolate and milkshakes and other sugary, yet very fatty, treats that would take a lot longer for the sugar to take effect.

This is why my diabetes dream device would be the 'Tasty Treat Hypo-Treatment'!  You would have a small electronic device into which you would input how many grams of fast-acting sugar you require to bring your blood sugars up to the desired level.  You would then choose whichever food you fancied and the device would transmit the sugar to the food.  This would take the place of any existing sugar or fat that was already in it.  Then you can enjoy a very yummy hypo-treatment that gets into your system quickly, and not have to suffer a raging high-peak later in the day...ta-daaaaa!

Okay, so there are definitely a few practical issues as it could never actually be made but still...I can dream, right!? :)

Wednesday, 14 May 2014

D-Blog Week: What Brings Me Down & What Keeps Me Up

Today, the theme for Diabetes Blog Week posts is 'what brings me down'.  Talking about the moments, days and, for some, weeks when diabetes is making you want to scream, cry or hide away is really important.

During the majority of my teenage years, I went through a lot of times when I would completely ignore my diabetes and never talk about it.  There would be many meals eaten which I wouldn't give any insulin for and my body would be flooded with ketones.  There were whole days when I wouldn't test my blood sugars at all.  At one point, my HbA1c hit 12%.  I wasn't in contact with anyone else with type 1 diabetes, and I attempted to deal with that by pretending that I didn't have it either.

Things only began to change when I started blogging 3 years ago and I attended a DAFNE course.  I finally felt like I was surrounded by others who understood exactly what I was going through.  Most of the time nowadays, the reasons why I'm irritated by diabetes are because I'm putting all my effort into looking after myself, and sometimes what I see on my glucose meter doesn't reflect that.  For me, however, this is a better result than the exhaustion and illness I suffered when I paid no attention to my diabetes at all.  At least now, when I'm feeling down about it, it shows that I care about my health.

There are numerous aspects of diabetes that get to me, for example like when I'm covered in bruises from injections, or my blood sugars seem to make no sense at all.  There will probably always be times when diabetes will try to get the better of me but, when it does, I know where to come.  So thank you to the Diabetes Online Community - you have been crucial to my physical and mental health.  Because of you guys, I know that whatever aspect of diabetes is bringing me down, I'm not alone. 


Tuesday, 13 May 2014

D-Blog Week: The Positive Diabetes Poem

The prompt for today's post is to write a poem about diabetes.  In 2012 I wrote a poem for the 'Health Activist Writer's Month Challenge' called Bad Diabetes Day, which I loved writing!  I'm always excited about opportunities to do something a bit creative and different, so I really enjoyed writing this one too:

The Positive Diabetes Poem

As a little girl I'd never tell,
That I had type 1 D.
I was worried what people might say,
And what they would think of me.

Did her parents feed her too much sugar?
Did she used to be fat?
I was embarrassed of my diabetes,
Didn't want to answer questions like that.

I just wanted to be normal,
Eat whatever I liked for tea,
Not have to think about my blood sugars,
Be injection and blood test free.

But as I got older I realised,
No one can be blamed.
I didn't 'make' myself diabetic,
I shouldn't feel ashamed.

Sometimes bad things happen,
But they make you who you are.
Focusing on the positives
Can get you really far!

Now when I inject in public,
Where other people might be sat,
I remind myself I have diabetes,
And there's nothing wrong with that!

Monday, 12 May 2014

D-Blog Week: Change The World

Diabetes Blog Week 2014 is here!  This is my fourth year of taking part and it's fair to say that if there's one thing that diabetes does make me excited about, it's this!  Thank you to Karen Graffeo at Bitter~Sweet for the opportunity to do this every year.  I'm currently in the latter stages of revising for my first year university exams, but the real test will be finding out how to tear myself away from reading all of the wonderful D-Related posts over the next 7 days.

The topic for the first post of D-Blog Week is to share something that we're passionate about.  I'm completely with my friend Vicki from Vicki's Notebook on this one.  I have a fire in my heart for a lot of causes and the right for all people with diabetes to have access to the insulin, test strips, needles and technology they need is one of the ones at the very top.  It sounds pretty awful now I think about it, but it wasn't something I remembering thinking about until last year when I received this tweet on Twitter:

I took a look at the website for Marjorie's Fund and my outlook on my own diabetes changed significantly.  Marjorie was born in Uganda and was diagnosed with type 1 diabetes when she was 3 years old - the same age that I received my diagnosis.  She died when she was just 29 years old from kidney failure, caused by her diabetes.  She wasn't much older than I am now when she passed away, yet Marjorie was considered to be 'one of the lucky ones'.

Although diabetes can be awful for anyone who has to live with it, reading about the lack of resources and care available to those with type 1 in other parts of the world definitely made me feel very blessed.  I have entire drawers packed with needles, test strips, ketone sticks, spare injection pens and old glucose monitors and a whole compartment in the fridge full of insulin cartridges.  Other people with diabetes, like Marjorie, are battling to stay alive and living on as little as one insulin injection a day, if that.

However, the amount of medication a person has for any health condition should not be about luck.  A person with type 1 diabetes needs insulin, test strips, glucose monitors and diabetes education.  They have the right to those resources, irrespective of what part of the world they live in.  This is why organisations like Marjorie's Fund are so important - they help to give people the life they have a right to. 

R.I.P Marjorie

Sunday, 20 April 2014

Diabetes Firsts

Happy Easter everyone! :)  After Christmas, Easter is probably the next most daunting annual celebration for a lot of people with diabetes. (There's a lot of temptation with chocolate covered treats and super sweet hot cross buns absolutely everywhere.)  Regardless, Easter is definitely something to be celebrated.  Whether you're religious or not, Easter is about new beginnings.  As much as I've been obsessively reading other diabetes blogs, I haven't, for whatever reason, been feeling as though I have been able to write about my own experience with the D for a while.  However, as this is a time of new beginnings, I'm feeling excited and motivated to join the rest of the online community and get posting once more!

Speaking of new beginnings, I recently watched a lovely video online, which follows the journey of two elderly ladies as they embark on their first flight on an aeroplane.  It is a part of the telecommunication service 'Vodafone's series of 'firsts' films, which claim that 'doing things for the first time keeps the world interesting'.  When it comes to diabetes, it's easy to get stuck in routines - good and bad.  To an extent, the D actually requires routine.  However, as I discovered last Monday, there's still opportunity for diabetes 'firsts'. 

I was travelling home from a long weekend spent with my dad and step mum. The sun was shining and I'd decided to wear an all-in-one floral playsuit, which turned out to be a diabetes no, no.  Diabetes isn't exactly the first thing I consider when I'm picking clothing garments from my wardrobe in the morning, so it's fair to say that I couldn't have predicted how impractical wearing such an outfit would make administering injections.

After Anthony and I got engaged in Paris in January (yay!), a friend of my dad's had kindly surprised us by doing a beautiful painting of us, which had been waiting at my dad's house for me to pick it up.  Luckily the canvas and frame weren't heavy, as I was absolutely determined that I was going to single-handedly take it back home with me on the train.  Still, after hauling my suitcase, handbag and the painting onto my second train-change, and I'd successfully found myself a seat, all I could think about was the tuna sandwich and cherry tomatoes I had packed for my lunch.  

I tested my blood - 5.8 mmol, which gave me a smile! - and ate my lunch.  I felt immensely satisfied, until the realisation hit me that I now needed to find a way of taking my insulin.  I normally inject into the tops of my legs or my stomach, which were not at all accessible in my playsuit without pretty much taking the whole thing off.  I thought about venturing to the toilet, but I didn't want to leave the painting which I was guarding by my feet.  The only 'injectable' part of my body, which I could get to easily, was my arm.

My parents used to inject into my arms for me when I was younger as I used to get lots of lumps and bruises on my legs and tummy.  In fact, Anthony will administer insulin there for me now if my usual sites aren't looking too good.  However I've never done my own injection in my arm.  In fact, I have a bit of a fear of injecting into new sites.  I don't know why - a needle's a needle at the end of the day.

It took me a good few minutes to pluck up the courage to do it (and a lot of taking the needle guard off, putting it back on, taking it off etc.) but eventually I did my first insulin injection into my arm, all by myself!  It hurt a little as I pulled it out at a funny angle, because my hands were shaking from the nerves, but it was fine and I spent the rest of the journey feeling very happy.  To some people it may sound like nothing, but I felt like I'd accomplished something.  I guess I proved to myself that new diabetes beginnings and D-'Firsts' are possible, even after nearly 18 years of living with type 1!  More than anything, this experience gave me further confirmation that nothing can stop me having a completely 'normal' life, even with diabetes - not even a floral playsuit.