Korero: My Pechakucha

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My Mother painted this picture of my brother back when he wore glasses.

At age 12, I saw him have his eyes examined and thought that it was pretty cool helping people to see.

So I decided, then and there, that this was what I wanted to do.

Looking back, its quite ironic that, at age 12, I decided to devote myself to a career where I would sit in a dark room all day asking the patient whether what they are looking at is better with “1, or, 2?”

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Being devoted to one thing from such a young age meant I could focus my attention on other things, like sports. Growing up in Invercargill, where everything is just 5 minutes drive away, I chose to do all the sports.

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Getting to Auckland, I wasn’t quite prepared for the demands of University life and by not having the right balance of work and play; I did poorly in my first two mid terms, effectively ruling me out of gaining entry into the School of Optometry.

Every cloud has a silver lining however and two quality years in Otago, taught me how to balance study with play; Working at the famous Captain Cook Tavern and playing Rugby at the mighty University Rugby Club.

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Oh and while I was there I learnt about; anatomy, physiology and biochemistry, I dabbled in zoology and nutrition and they tried to teach me genetics.

Getting the balance right this time, I graduated with a bachelors of Science and was back to Auckland for four more years.

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After that time, I become proficient enough, through a series of confusing questions, to help people to see clearly again. Qualifying me to sit in that dark room all day.

Optometry however is less about helping people to see and more about preventing people from not seeing (Yes, I do have Irish heritage).

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You see (Pun intended) the eye is simply an organ. An organ that performs cellular functions. Functions that are supported by a blood supply and a flow of nutrients.

As Optometrists we are lucky enough to visualise the only organ in the body where you can directly see the vascular system.

Pole_Alexandra_OD2015_58146_1_rgbThis is actually my girlfriend Alex’s eye and unfortunately a large number of my patients eyes don’t look this good, but I might be biased.

Looking at the eye you can see the effects of medications, blood pressure, cholesterol deposition from inflamed vessels and diabetes.

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Here’s why seeing that day in day out breaks my heart and why I try to learn as much as I can about metabolic disease and share it with my patients, their families and their GPs.

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This Horse is Kelly Evander. After over 160 starts whilst getting a few second placing’s, she failed to win a single race, it’s a New Zealand record. She was owned and trained by my grandpa. I think I might have inherited some of that bloody-minded determination from him. Unfortunately, in my final year of University, my Grandpa passed away from type 2 diabetes.

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Like many with the condition, my grandpa believed that like the knee, shoulder and back surgeries had fixed his joints; his diabetes medicine was fixing his condition.

Unfortunately in the case of type 2 diabetes, as with many of our modern day chronic diseases, the medications treat the symptoms of the condition rather than the cause.

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A type 2 diabetic may spend up to 10 hours a week on average dealing with the process of their disease, whether that’s taking medication, monitoring their blood sugar, visiting their GP every 3 months, having retinal photos taken, to seeing an orthopaedic surgeon for amputation or having dialysis treatment.

Hardly good quality of life.

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So what do I tell my patients? As a disclaimer: As was the case with the two examples, please always work with your health professional or primary carer when making any drastic dietary changes. Especially if taking insulin or insulin promoting medications.

There’s a saying in health to treat your patient how you would treat your own grandma or grandpa.

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For me this is quite easy; Both my Gran and Grandpa have polymyalgia, high blood pressure, glaucoma and have had cataracts removed, my gran has also had heart surgery, my grandma has dry eyes and as mentioned my grandpa died of type 2 diabetes. So yeah, I have good genes.

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According to Canadian Nephrologist or Kidney Specialist: Dr Jason Fung, type 2 diabetes is a disease state of insulin resistance.

Insulin acts like a key to our cells, which allows sugar from our food to pass from the blood into the cells, to be used as energy.

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Type 2 diabetes is like someone slowly changing the locks, thus the sugar concentration in our blood rises despite high insulin, until someone is diagnosed type 2 diabetic.

Metformin, the medication most are put on is like letting sugar through the cat door. It’s a squeeze, but some sugar gets through into the cells, reducing blood sugar somewhat for a while.

When blood sugar is still too high, people are put on other medications to boost insulin release from the pancreas and eventually most people, like my grandpa, are put on insulin itself.

But the issue is too much insulin and this chronic high insulin is what causes the leaky blood vessels, the fluid retention, the fat deposition and the cholesterol coated blood vessels trying to heal.

So it’s like putting out fire with gasoline.

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Virta Health out of Silicon valley and Dr Fung’s Intensive Dietary Management Coaching Program are showing how the condition can be reversed and for many patients, put into remission.

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To begin they take people off carbohydrates. Even Clinical Nutritionist Ben Warren from Be Pure NZ advocates Carbohydrates as non-essential nutrients. Carbs are metabolised into sugar, increasing blood sugar, which if you are type 2 diabetic, despite high insulin has no place to go.

What the hell can you eat then?

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Replace your carbs on your plate with nutrient dense green leafy vegetables. This was my breakfast.

These help to support your hard working liver which is dealing with increased circulating blood sugar and insulin, cholesterol synthesis and not to mention your medications.

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Thirdly: exercise does matter, it uses stored glucose in your muscles called glycogen, meaning the muscle wants to replace this stored energy, so the body becomes more sensitive to insulin following exercise.

Finally they turn their patients into fat burning machines. Their patients use stored body fat and healthy fats from the likes of fish, avocado, red meat, coconut oil, nuts and seeds and yes butter on a ketogenic diet.

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Here’s why this matters so much to me.

A healthy patient is going to have healthy eyes.

Reducing blood sugar by 1% reduces the risk of diabetic retinopathy by 37%.

As the eye is an organ, with a blood supply.

If its vessels aren’t inflamed and leaking.

Then so too aren’t the blood vessels in the rest of the body.

From the Japanese word for ‘chit chat’ Pecha Kucha celebrates the unique stories we all have to tell.
Pecha Kucha Nights give a platform to a wide range of people, to speak on a diversity of topics. The model sees presenters define their own topic, with each having just 20 seconds for each of their 20 images. Embraced around the globe; from Tel Aviv to London, Toyko to Berlin, Pecha Kucha events connect people, fuel conversation & inspire thinking with topics ranging from the intellectual to the sublime to the hilarious.

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