Category Archives: eyes

Diabetes type 1 on the rise?

Is type 1 on the rise or is it just that we are better at diagnosing it?

Type 1 diabetes is where your pancreas or B cells are not able to produce any insulin and thus your cells are not able to get any glucose into them and literally “starve” and are forced to metabolise other substrates in order to attempt survival. This is what causes the massive weight loss associated with initial diagnosis.

The anniversary for the first successful insulin being dosed was yesterday.

1921 – Banting and Best (accredited -though there were more people involved).Ninety six years ago. So before that if you had type 1 diabetes you would not really survive.

Now however type 1 ‘s sometimes outlive non-diabetic patients.

We have come a long way.

Is type 1 hereditary ? In part so that is one reason why we do have an increase in type 1 diabetics. It is not the whole story.

However type 2 diabetes has risen out of proportion to any other chronic disease on the planet. To say it is a tsunami logarithmic disaster is to be polite about it.

Type 2 is preventable as well as treatable. And yet! we have this huge huge burden on our health economics worldwide. Does not make sense.

So a challenge for the new year – are you on a trajectory to developing type 2 ? You have the power to stop that. IF you are already type 2 there are so many things you can do to get better control as well as control  the progression and not go onto the inevitable : insulin.

For inspiration and ideas : follow Fran Steart on Facebook for wonderful recipes, get exercising (in any way that takes your fancy) and see a team of practitioners who can get you to target. 🙂






Diabetes -wish it would trend like Trump- in an ideal world (sigh)

Diabetes is a scourge of modern day living. Why are we not winning ?

This is a simple disease – type 2 that is perfectly PREVENTABLE and perfectly treatable and yet we are losing this battle left right and centre.

Dialysis, amputations, blindness abound and really should not.

WE have the tools but we do not have political will or the will of the people.

We live in an age where as humans we choose easy street time and time again. Easy street in eating, easy street in not exercising, easy street in unhealthy choices.

One hundred years ago we were skinny and ate half of what we do currently and guess what we had a almost nil type 2 problem. Fast forward to 2016 and the numbers are staggering (like a drunkard) – out of control.

For a disease that is preventable and treatable.

A sugar above 10 has an effect much like coke on the floor – everything becomes one sticky stuck together mess – that’s a poorly controlled diabetic’s body.

Keep your sugar below 10 and voila – no problems in fact, keep your sugar at target and you live longer than a non-diabetic !

Easy peasy lemon squeezy – but we are not doing it ?

I urge you to look after your body – the only one you have – check your sugar regularly -pick up diabetes early and treat it. Better still eat healthily and exercise and skip it. It is possible. It is really possible – however if you would rather just be fat and still – have some diabetes.



Bono and justice and yet few seem to really take cogniscience

I recently watched a brilliant TED talk where Bono delineates the current “fires” in Africa and how the west essentially is watching.

It is always interesting to hear the opinion of a non-native to africa and often surprises me how much more sympathetic than even our own “native” -meaning born here- politicians and players are to the plight of the poor. And by and large Africa’s main bleeding to death literally is happening amongst it’s vast poor.

Even more poignant in light of the panama papers.

MMMmm, I really do wonder how the powers that be justify to themselves the awful treatment of their own. IT is one thing to treat your enemies badly, quite another to treat your kin poorly. Or as Ghandi puts it you can tell a lot about a person as to how they treat animals. Sometimes the poor are treated worse than neglected animals.

This may seem inflammatory, but when we inspect for the truth of the matter, what is the truth of the matter?

Bono describes himself as a very annoying thing – a rockstar with a cause. But why is it that there are some folk on earth that are concerned with justice whilst others seem to trample it in the daylight.

Just or not, we will indeed all be judged at the time designated for such. Each will respond for themselves.

On a daily basis I have the privilege of “treating” people and possibly helping on a physical and hopefully deeper level. The hardest moments are those where “treatment” seems to be withheld for no real or good reason and the person left for poorer – physically and sometimes mentally and sometimes even no longer.

I do wish more people would “hear” the justice message and respond. If only every 4th person did the world would be a better place. Small small can make a difference. I can hear the cries as if a constant scream and yet some don’t seem to hear at all. The boko haram girls in Nigeria are one small example – a gaping gaping wound bleeding to death in the hearts of their parents and the international community gape and stare blankly. Because those girls don’t open up an oil field?? How can Bin Ladin be “found” and these many girls be “lost”???

Justice continues to press my buttons, and I mourn at the lack of it pressing many others 😦



Skills and upskilling

Should one be afraid to do something that you may not quite be as skilled in as you once were ? This is a question I asked myself repeatedly last week and this is my very honest and open and frank reflection of this process that is not unique in a sense.

Doing eye surgery is a skill set that I have been privileged to learn though  a process of years of working in a government eye department, doing a diploma in Ophthalmology and then spending time on the mercy ship with a passionate and amazing teacher of the scleral tunnel technique. The process of learning almost always involves a curve that is quite steep and during that upward slant of the curve one is bound to make mistakes.

Now when one is learning to bake a cake and it flops – and I am useless at baking, it is not really the end of the world (and don’t get me wrong I am in awe of such skill) when one makes a mistake in eye surgery generally it ranges from the patient not seeing very well post-op to not seeing at all depending on how the mistake is dealt with. This is where the dilemma for me starts, does one “risk” upskilling and making mistakes in order to help people down the line or does one simply not take that risk. Which is the better choice?

I grappled with this and mainly because I am a grappler. It perplexes me that I am so hard on myself and yet time and time again I find myself in this place of reflection.

I have come to the conclusion that there is a degree of “living” with failure on the up slant of the curve in order to “be” better and perform better and also then in turn to get better results going forward. I really do think that this applies to many other aspects of life.

Just me being philosophical? OR are there others out there who grapple as I do?zithulele1

Zithulele – mercy vision week

I have just returned from spending a week at a very special place in deed. Zithulele hospital in the transkei (about 1.5 hours from Umtata) is your average government hospital in a rural setting only it is FAR from average due to the staff that work diilgently, tirelessly and passionately to change rural people’s lives on every level of functioning.

I had the privilege of performing scleral tunnel surgery to remove cataracts from folk who were “blind” due to the cataract and allow them to “see” again. This is one of the most amazing gifts that I have been bestowed – the ability to do this surgery.

To see their smiling faces day one post-op is a sight that I never grow accustomed to – it “overflows” my happiness well every time.

The mercy vision team at large is incredibly passionate at what they are doing for a population previously forgotten. The whole experience costs the patients nothing. They get transported from home to Zithulele, fed for the time they are there and then transported back to their home. For a rural dwelling person the blessing of this is not something that a privileged person can understand, for them it is truly a huge blessing and life changing.

Their other alternative is to pay (about R400 one way) to Umtata and have a few trips like this before their surgery is scheduled. This is something most of them simply can not afford and so they just accept the blindness.

Back in my own practice I am a little tired after the long journeys with my two littlies but have a very happy heart.zithulele zithulele1 zithulele2