Friday, July 15, 2016
Doctor appointments are not something that most of us look forward to attending. We’re poked, prodded, weighed and asked lots of questions that we might not feel like answering. The idea of doing any of that in the presence of others doesn’t sound like something I would enjoy, so explain to me why I signed up to participate in a Shared Medical Appointment!
What the heck is a shared medical appointment? Visions of sitting in a room full of people wearing those horrid gowns, swinging their legs over the edge of the table…waiting, pop into my head. (shudder) Rest assured, that’s not what it is. It’s my understanding that the Cleveland Clinic started shared medical appointments as a way to work with larger groups of patients for their follow-up appointments. These patients all have the same condition/disease and could benefit from a group setting. Think support group/education. Here in Podunk, AZ, where we don’t even have a stop light, we have shared medical appointments! Just like in Cleveland but with more pine trees and less traffic!
- They push carbohydrates.
- Not much time with the doctor. (I’m used to using my check-up appointments for everything and now I will have to have another visit to discuss lady stuff, my thyroid and fibro.) It feels rushed.
- I see lightbulbs go off over some heads during the conversations (which is good) but there isn’t always time to adequately explain things and they often end up looking confused.
- While you are having your time with the doctor, the discussion continues in your absence and you might miss stuff.
- Some of the people in my town who desperately need to take charge of their diabetes are getting needed education in a group setting.
Thursday, July 7, 2016
Sunday, June 19, 2016
There are some things that I’m sure of:
- Snow is cold.
- Carbs are addictive.
- My husband’s love.
- The hospital is not the best place to spend your vacation.
There are some things of which I’m less sure:
- The price of tea in China.
- Selecting the best paint color.
- What my dishes do when I’m not looking.
- That I know what I’m doing when it comes to healthy dietary choices.
Ray and I had planned a summer vacation that would begin with a weekend camping trip with all my kids and grandsons in Utah, then north to Boise Idaho and east to South Dakota via Billings Montana. Instead we spent time in the hospital so Ray could have open-heart surgery. You know, like you do. In fact, I’m writing this on my tablet in his hospital room. This is day 12 here with a couple more to go if we’re lucky.
He’s doing amazingly well.
Ray was first diagnosed with coronary artery disease in July of 2008. He immediately quit smoking and has, over the ensuing years, added regular exercise, cut WAY back on beer consumption and made dramatic changes to his diet. He basically began doing everything he should to lead a healthy life and keep additional health issues at bay, and yet, here we are. The fact that we were doing everything right and his health still declined to scary-ass levels was shocking and confusing. Maybe all that research we’d done about healthy diets lead us down the wrong path! Maybe we don’t know what we’re doing after all! Did I just cook my husband into the hospital?
The answers: No, we do and hell no.
The body is an amazingly complex thing. There are no cut and dried answers or ways to ensure health. All we can do is our best, and we have been. When confronted with this situation, Ray and I experienced doubt. We wondered if our lower carb, no fear of fat ways had caused him to become sicker. Thankfully there was a doctor who explained it to us. Ray has heart disease and even though he had immediately changed his lifestyle, his disease didn’t just stop progressing. In fact, this great doctor told us that if he hadn’t made those changes he would have most likely become sicker long before this. In other words, his new lifestyle had prolonged a good life. Not only that, but his healthier body will most likely heal more quickly. Those changes were a good thing. Not one person, including the nutritionist, has had to tell us that we need to make changes because we already have! My husband is a rock star.
Dealing with any disease is scary, diabetes included. We are forced to make decisions about how we live, what we eat and the medications we take. Educating yourself on the best course of action for your life with diabetes is imperative. Make a plan and follow it. Don’t let doubt cloud your thoughts. Do what feels right to you and stick with it. If you feel stronger and healthier most of the time then you’re most likely on the right track.
Ray has a long road to recovery ahead of him but we’re hopeful that he will come out the other side able to continue doing the things he loves. There will be other chances for the family to camp together and Mount Rushmore isn’t going anywhere. Our summer “vacation” may not have ended up as we’d planned but we’re making the best of it and looking ahead to more years together. Self-doubt is a liar and I no longer believe it. We will make a few minor tweaks to our diet and forge ahead together. I hope that our story will prompt you to make some needed changes to your life too, whatever they may be.
Oh, and love your people like there’s no tomorrow. You never know.
Wednesday, April 13, 2016
Wednesday, April 6, 2016
The reality is that some people who are newly diagnosed have been used to eating upwards of 200 grams of carbohydrates per meal and the idea that they can miraculously reduce that carb intake to 35 grams is ludicrous at best.
Let’s look at a typical trip to McDonald’s. Big Mac – 46 gr carbs, large fries – 63 gr of carbs and a large Coke – 86 = 195 grams of carbs. (information from their website) Wow. (We aren’t even going to discuss fat and sodium.) This meal is consumed by an awful lot of people in this country on a regular basis. Now, compare that to a recommended meal for someone with diabetes. 3 oz. 90%-lean hamburger patty, 1 cup 1% milk – 12.2 gr carbs, 1 whole-wheat roll – 21 gr carbs , 1 cup prepared coleslaw – 15 gr carbs = 48.2 grams of carbs. (approximations by Kate) 195 vs 48. Enlightening no? I wouldn’t eat that recommended diabetes meal now. I’d lose the roll and (add a lot more fat). But that’s me and I didn’t get here overnight!
The DPP may not be perfect, but it’s a start. I applaud the “powers that be” for trying to get the message out there that poor diet and being sedentary are causing us to become unhealthy. A scenario of fast food and couch surfing can increase your chances of developing type 2 diabetes. They don’t cause it, but they increase your risk. That’s an important message that this program can deliver to millions of older Americans; those people who are at greater risk of developing type 2 due to their age.
Do I wish that people would listen to Joe Shmoe instead of celebrities? Yes. Do I wish that the idea of low(er) carb would find its way into the minds of those who are teaching people with diabetes? Yup. But in the meantime, I have hope that these types of programs will cause the masses to pay better attention and bring the severity of type 2 diabetes to the forefront and, hopefully, remove some of the stigma. Heck, if James Earl Jones and Tom Hanks have type 2 and they’re cool dudes, then maybe people will think twice before condemning the rest of us for just being normal folks who happen to have type 2 diabetes.
Wednesday, March 30, 2016
An article appeared in my Facebook feed yesterday, several times. The article caused some uproar among the DOC due to the fact that it showed type 2 diabetes patients in a negative light. We don’t like that. My initial reaction was one of disbelief and anger and I commented that I felt a blog post coming on. I was right; here it is. However, as I let myself calm down and think about this situation, my attitude shifted a little bit and I re-read the article with different glasses.
The article (which I won’t link to here because, well just because I don’t want to) was written for healthcare professionals as a guide to help them help their diabetes patients “adhere to treatment protocols”.
The article, upon my second reading, actually contained some good stuff. There were quotes from doctors with good advice to help patients with the difficult task of accepting and learning to live with type 2 diabetes. There were suggestions that showed that these doctors understand how difficult it can be to make the necessary changes we face. They encourage better communication between the doctors and patients; essentially helping people along instead of shoving them out the door to figure it out for themselves. The use of technology was mentioned and even *gasp* the idea of reaching out to other diabetes patients through support groups!
It’s been nearly 11 years since I was diagnosed and these ideas were non-existent when I found myself floating in a sea of WTF as I left that first appointment. I find it encouraging that there may be a swing toward more understanding of the shit-storm that living with diabetes is.
Now let’s talk about what’s horribly wrong with this article.
The article lists 5 ways that patients don’t adhere to suggested protocols in their lives with diabetes, despite the fact that these protocols have been proven to show the best results down the road. Each and every one of the 5 areas was addressed as a failure on the part of the patient. The patient fails to make necessary lifestyle changes. The patient fails to adequately monitor their blood glucose. The patient fails to show up for appoints, etc. GAH! Just typing these things has raised my blood pressure yet again and made me feel like reaching through the computer screen and throttling the author of this article. The nerve! The unmitigated gall! The cheek!
Under each of these 5 horrible headings were some really good ideas about how HCPs can assist their patients, but who can get past the freaking headings! When depression, exhaustion or burnout cause me to slip up and eat things that I know aren’t the best choices, I’ve FAILED? Really? When someone can’t afford to buy extra test strips because their insurance only allows them 1 per day, they’ve FAILED to correctly monitor their blood glucose? The lack of adequate patient education on the importance of their medication regimen is a FAILURE on the patient’s part? THIS is what got our collective panties in a twist. Blaming the patient for the myriad ways the system fails us.
Words matter. Regardless of the fact that this article contains some good advice for doctors, it falsely blames the patient. Even an amazing HCP who treats their patients with kindness and compassion is seeing the word failure in conjunction with patients. If you see a correlation often enough you can begin to buy into it; you can begin to believe that patients are failing without considering that the system might be failing us. It’s bad enough that doctors might look upon us as failures, but it’s even worse when we begin to believe it too; and we do too often.
Living with diabetes is hard; it’s unbefrickenlievably hard. We need to be uplifted and admired for the changes we do make. We need recognition for the mental anguish we experience and help to overcome it. We need better education. We need help, not labels.
People with diabetes work hard, every day, to do the best they can with a sucky disease. As a community we will never “adhere” to protocols 100% of the time but those words like failure will stick, like glue.