Diabetes and Healthcare Professionals

“How’s It All Going? Are You Managing It Alright?”

Leave a Comment

“Could I talk to you for a minute?”

“Sure.”

“Let’s go over to the desk.”

“I’m going to see my diabetes specialist on the 3rd of February in the afternoon. I wanted to work until 12 and then take the rest of the day as sick leave. I’ve got a letter underneath my form here to say where I’ll be.”

I stood there, waiting. Confident that she would sign my leave form. Sub consciously thinking that this is the second time that I’ve requested leave for my diabetes since November. Knowing that she was pretty understanding. But still half expecting a comment. (And no, this was not the person who told me I Should Be Making My Appointments Outside of Work Hours).

“How’s it all going?”

“What?” I replied, stunned, and a little bit lost for words.

“Are you managing it alright?”

“Um. Yeah, okay, I guess. I can only do the best I can, I suppose. I’ve got the type of diabetes that isn’t caused from being unhealthy.”

“I know. It’s just that your insulin’s not there. My friend has a hard time with it, too.”

“It’s hard. But I’ve only had it for a couple of years. I’m lucky that I got it when I was 17. Some kids get it from a very young age.”

“Yeah, she got it when she was an adult, too.”

“I can only do the best I can” I repeated, almost trying to convince myself of that fact, rather than her.

“Cool. I’ll sign it and payroll can put it through for you.”

Sometimes people can surprise you. That little conversation was enough to make an ordinary day brighter. It’s never a simple question to answer, but it was enough to help me to remember why I do what I do.

Happy Monday!

“You Should Be Making Your Appointments Outside of Work Hours.”

1 Comment

“You should be making your appointments outside of work hours” is something that I was recently told.

What a lot of people in my life don’t realise is that I have diabetes. There is a lot of work that goes on behind the scenes that you don’t see. Insulin injections, piles and piles of used test strips stuffed into the pocket of my meter, and countless bags of jellybeans that have been begrudgingly stuffed into my mouth over the years (except for the black ones).

I see specialists who assist me to manage my condition. Endocrinologists, diabetes educators, and dieticians to name a few. Then there are other issues that must be closely monitored by professionals including optometrists and podiatrists. All of these specialists are in short supply. These specialists have long waiting lists of patients, often spanning several clinics or places of work.

Which brings me to last week. I found myself in need of a consultation with my diabetes educator. Factoring in her volume of patients, Christmas break, and her annual leave that will not be replaced at the clinic, the earliest appointment available was February. Possibly even March. That’s an extremely long wait for an issue that I am dealing with right now. An issue that I want to work through and get past as soon as possible.

I wish managing diabetes was as easy as ringing the doctor to make an appointment after work. I wish that I was able to select the most convenient time of my day or night to see one of these specialists. But it’s not that simple.

I actively chased up a cancellation appointment with my diabetes educator this week, so I could have this issue sorted as soon as possible. I was not thinking about how it would interfere with my other commitments. Because getting this issue sorted is what will ensure that I will continue to be able to manage the other commitments around me to the best of my ability.

I am very proud of the fact that for the better part, I don’t let diabetes interfere with the other commitments in my life. I don’t make diabetes anyone else’s problem. Many people don’t realise, or remember that I have diabetes when I bring it up. That just shows how good I am at it.

I think that all of the benefits that come from my continued, healthy existence far outweighs an occasional inconvenience. Just saying.

My Brush With Diabetes and Cold Feet

Leave a Comment

Summer has come extremely early this year. There’s been no one-day-its-hot-the-next-day-its-cold sort of weather here like usual in the Spring. I swear that one week I was in my trackies and the next I was in my shorts. The only part of my body that didn’t want to agree with me, however, was my feet.

It was 30 degrees outside. I was wearing my shorts. But my feet were ice cold. I knew that something was wrong. I was sitting there on the couch, and my cold feet were irritating me. I couldn’t sit still as I was sitting on the couch watching The Walking Dead. I was sub consciously finding a corner of the couch to tuck my feet into, just to warm them up. I tried resting my foot against the warmer flesh on my upper thigh to heat it up. I was sticking my fingers underneath my socks as I anxiously waited for them to heat up. One night I even got out of bed to grab a second pair. I was stressing myself out, bigtime.

Straight away, I began to think about possible circulation problems and nerve damage to my feet. I scraped my finger nails against the underside of my feet, and against each toe, just to make sure I had feeling there. I googled the words diabetes and cold feet, only to find information to support the theories that I had been stressing out about. And I began to criticise myself for all of the imperfect decisions that I had made with my diabetes management lately.

I knew that there was a podiatrist at my doctor’s surgery, so I decided to make an appointment there. I was well overdue for a diabetic foot checkup nonetheless. The last time I had a proper foot checkup with a podiatrist was back in 2011 when I was receiving treatment for a stubborn plantar wart at my hospital outpatient centre. 

As he applied pressure to check the pulses in my feet, my nerves were instantly replaced with reassurance. I could feel the pressure of the blood pulsing through my feet. I could hear my pulses amplified as he placed an ultrasound-like machine up against my feet. And as he poked around to test my sensation, I could feel everything.

I was pretty relieved to hear that everything was fine. He suggested some accupuncture to help deal with the cold feet, which was successful in 8 out of 10 patients with the same problem. I told him I’d leave the treatment for the time being and see how it goes.

So, nothing may have been wrong that day. But I certainly don’t regret going in. It was certainly well worth having that issue relieved, and a huge weight off my shoulders. And I was pleased to hear my podiatrist commend me for coming in, rather than accuse me of being a worry-wort.

Who knows – maybe my feet don’t want to come out of winter hibernation mode just yet!

Reading up on insulin pumps in my latest #DOCtober photo, after attending an information session on Wednesday evening.

https://instagram.com/p/82kMjtA_ea/

 

“How Are You” Makes a World of Difference

1 Comment

“How are you?” These are the three words which I absolutely hate to hear, but can’t seem to get away from. Almost every person who I pass during the day utters those words, and I hate it. I know they’re not doing it on purpose. I know that they’re just trying to be nice. But I never feel that question is a sincere one.

Do they really want to hear about my lousy diabetes day as we pass each other in the hallway? I think not. Is it fair for me to dump all of my problems onto them when they’re just being polite? Absolutely not. Most of the time, I give my enthusiastic-sounding “yeah, good” response and go on my way. I feel like a robot with no personality when I give the same stock standard response every day. I feel guilty for not saying “how are you” back. But I’m not going to say those words unless I really mean them. And I’m not going to give a genuine response unless the situation allows for it.

In the diabetes world, however, this couldn’t be further from the truth. In the diabetes world, I don’t feel that get asked “how are you” enough. I yearn for my doctor to ask me how I am. And I don’t mean how my diabetes management is going. I don’t mean how my blood sugar levels are. I don’t mean how my latest hba1c result stacks up from last time. And I don’t mean how was that blood test that he ordered last time I was here.

I want to be asked about how I am coping with having diabetes day in, day out. I want to be asked how I feel when I wake up in the morning ridiculously high, despite feeling that I did everything right the day before. I want to be asked how I feel when I wake up in the middle of the night sweating and shaking because I’m terrifyingly low despite all my efforts to avoid it from happening. I want to be asked how I feel when my mind is plagued with thoughts of nasty complications that could affect the quality of my life. And I want to be asked about my small diabetes victory that feels like a massive achievement.

Don’t get me wrong, I am happy with my health care professionals for the better part. And I am happy with my diabetes management, for the better part.

But when I’m in the diabetes world, hearing those three words “how are you” is enough to turn my day around for the better. And while it may seem like nothing to my doctor, hearing the words “I get it” can make a world of difference.

More how-are-you’s from healthcare professionals, please.

Be Realistic, But Don’t Settle for Satisfactory

4 Comments

How do you feel about a hba1c target of 6.5%? Chatter among the #DOC this week has been circling the new NICE (National Institute for Health and Care Excellence) guidelines for people with diabetes in the UK. I initially felt quite reactive to this like many others on social media, however some rational thinking has softened my view.

In Australia, I’ve always been told that I should strive for a hba1c of between 6 and 7%. That hasn’t changed in the 5 years that I’ve lived with diabetes. During that time, my hba1c has plummeted due to frequent hypoglycemia, it has gone up due to burnouts and it’s also fallen within the satisfactory range. And I can tell you from experience that a satisfactory hba1c level is extremely difficult to maintain while trying to live an active and ever changing life.

My main concern about this suggested target is that each and every person with diabetes is different. And we all have our own unique circumstances surrounding our diabetes. There are children, teenagers and adults living with diabetes. Some of us are newly diagnosed, while others have been living with it for several years. Some of us have a parent or carer to help us manage diabetes, while others do it on their own. Some of us are content with where we are at, while others are fine tuning and making room for improvement.

So, in that respect, a stock standard number for the masses is certainly not a one size fits all approach. That number will be easily achieveable for some, and completely unrealistic for others. That number is going to set some up for success after success, and others up for repeated failure. And while a number is a great means of motivation and goal setting, it isn’t always a true reflection of the hard work and effort we’ve put in to managing our diabetes.

On the other side of the argument, Mike at Everyday Ups and Downs points out that the lower target is a way of encouraging us not to settle for something satisfactory. I’ve been really excited at seeing borderline acceptable hba1c levels in the past, only to be told by doctor’s that it should be lower. My response at the time was more than dismissive, but looking back at it today, I finally get it. I should strive for a lower number if it’s a realistic goal for me, as it will further reduce my risk of complications in the future.

Mike also suggests the 6.5% target is a way of making doctors more comfortable with seeing lower hba1c numbers in patients. It’s news to me, but apparently some non-hypoglycemic patients are told that their hba1c levels are too low. Crazy!

So, what do I think of all of this? Don’t pay too much attention to what’s in the media or to others. Set your own goals that cater to you and your diabetes situation. Make them realistic. Have a team of people around to cheer you along. Take some time to relish an achievement, and then move the goalpost a little further back. And remember that nothing is impossible if you put your mind to it.

Like my blog? Follow me on Facebook: facebook.com/type1writes.