Wash Your Hands!

The BG roller coaster. If only I remembered the basics, I could have avoided taking this ride.

It’s grad season here. A busy time filled with celebration, ceremony, and light refreshment. No gathering is complete without some kind of food.

I found myself back home ready to take my dinner dose of insulin after eating dinner. Faced with my BG meter I knew the reading would be high. After all, tonight I was doing this backwards.

But I didn’t expect it to be that high.

It was so high it triggered a text from the CDE. Oh crud. Quickly, I dosed the insulin and took my shot. My phone buzzed.

“Are you okay?” was the text.

I texted back, “Yes, I’m okay. I was out at a graduation and ate before I took my diner meds. Just took my shot.”

Then I looked at my hands. And realized something. I hadn’t washed my hands before testing. And I had eaten pineapple earlier with my fingers. No toothpick. No chopsticks. No fork. Oh, crud.

I quickly washed my hands and tested again. My BG reading was 50 points lower. Still high. But not setting-off-the-alarm high.

I texted the CDE with this update.

And then I realized the dose of insulin I just took was higher than it needed to be. Oh, crap. I had a long night ahead of me. Now I had to monitor my BG to see if it would go too low.

Sigh.

If only I had remembered to wash my hands before testing.

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#dBlogWeek: More Than Diabetes

Life, an unalienable Right

Today’s Diabetes Blog Week prompt:

 Share an interest, hobby, passion, something that is YOU.  If you want to explore how it relates to or helps with diabetes you can.   Or let it be a part of you that is completely separate from diabetes, because there is more to life than just diabetes!

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I feel like I’ve been writing outside the lines all week. So, I guess I won’t stop now.

What is my passion?

Policy.

I’m a policy wonk.

I believe that politics matter because government can do good for the people—or it can do bad.

My voice and my vote is how I influence my government to do good.

Politics and government are difficult subjects to bring up in polite company. Especially these days when the country if so polarized and seems to be experiencing collective PTSD over the legitimacy of those in power.

Why is policy so important to me?

Maybe it’s because I’m the grandchild of immigrants who came to the US to escape a bloody revolution.

Maybe it’s because members of my family experienced poverty and that poverty was relieved by government programs.

Maybe it’s because I worked on education reform in the hope that my children would receive a quality public education.

Maybe because deep down I’m an idealist whose heart is still stirred by these words:

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed…”

What does this have to do with diabetes?

Right now? Everything.

In Washington we have a Congress hell-bent on repealing the ACA (a.k.a. Obamacare) and replacing it with tax breaks for the rich.

In the pharma industry we have companies who one week brag to their investors how profitable their insulin business is and the next week invite diabetes patient advocates to call out PBMs (Pharmacy Benefit Managers) for price increases.

We have people turning to crowdfunding sites to pay for their medication. And when that fails, their friends and family update their pleas to pay for a funeral.

It shouldn’t be this way. That’s why policy matters to me. And that’s why I advocate for health care affordability and access.

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#dBlogWeek: What Brings Me Down

The one thing that always brings me down about diabetes

Today’s Diabetes Blog Week prompt:

May is Mental Health Month so now seems like a great time to explore the emotional side of living with, or caring for someone with, diabetes. What things can make dealing with diabetes an emotional issue for you and / or your loved one, and how do you cope?

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There’s one thing in particular that always brings me down when it comes to diabetes. That is talk of a cure.

Talk of a cure, you say? Why would that bring you down? Wouldn’t it give you hope? Hope that one day you won’t have to take pills or shoot insulin? Hope that one day you can go for a hike without worry that you’ll go low on the trail? Hope that one day you can eat a carb-heavy meal without judgement?

First of all, when people talk about a cure for diabetes they aren’t talking about me. They’re talking about resurrecting the pancreas. Regenerating a vital organ. Finding a way for the body to make insulin again.

People think they know the cure for the type of diabetes that I have. It’s lifestyle change. Lose weight. Exercise. Stay away from sugar. Eat more vegetables. Cinnamon. Yeah, right.

No consideration is given to genetic or environmental factors that trigger or encourage insulin resistance. There’s conflicting evidence on whether obesity is a cause or a co-morbidity. There’s disagreement as to whether type 2 diabetes is a metabolic disorder or an autoimmune disease. There’s more judgement than curiosity.

Bottom line is I don’t think I’ll see a cure in my lifetime. Not because I don’t think we’re capable of finding or developing a cure. But because we don’t have the social and political will to do so.

We’re stuck in the paradigm of how to treat an infectious epidemic. Find the cause and neutralize it. Make a pill or a medicine. Develop a surgery or an artificial organ. We have established industries of businesses and organizations doing this kind of work.

What we don’t have is a coordinated, science-based industry focused on what we need to change to stop the rise of chronic disease.

Such an industry would look at the rise of chronic illness in the national context of policy decisions, societal norms, and physical environment, as well as human behavior and health care practices. This is a complex and difficult undertaking. It would involve looking at everything—from the effect of chemicals in our environment to the effect of favoring feed crops and dairy in subsidized school lunch programs.

It’s unlikely that we will find a single factor that, if addressed, will solve the epidemic of chronic illness we face today. The cure will require major changes in a lot of different areas. That will require going up against a lot of entrenched and conflicting interests.

Which brings me back to the question of having social and political will.

Which I don’t think exists for the kind of lifestyle change we, as a society, need.

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#dBlogWeek: The Blame Game

When health becomes the target of judgement

Today’s Diabetes Blog Week prompt:

Having diabetes often makes a visit to the doctor a dreaded experience, as there is invariably bad news of one kind or another.  And sometimes the way the doctor talks to you can leave you feeling like you’re at fault.  Or maybe you have a fantastic healthcare team, but have experienced blame and judgement from someone else in your life – friend, loved one, complete stranger.  Think about a particularly bad instance, how that person talked to you, the words they used and the conversation you had.  Now, the game part.  Let’s turn this around.  If you could turn that person into a puppet, what would you have them say that would leave you feeling empowered and good about yourself?   Let’s help teach people how to support us, rather than blame us!

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There’s plenty of blame to go around

There is plenty of talk about how people with diabetes feel the sting of  blame from comments and assumptions made by people outside the diabetes community.

Only this past week the internet blew up when federal budget director Mick Mulvaney in commenting on healthcare reform said, “It doesn’t mean we should be required to take care of the person who sits home, drinks sugary drinks, doesn’t exercise, eats poorly, and gets diabetes.”

Ouch. That hurt.

Also, it’s ignorant.

As the American Diabetes Association declared shortly after Mulvaney’s comments, “No one chooses diabetes.”

We also talk about the blame game that goes on with our health care teams. The very people who are supposed to be in a position to help us manage our health better can be just as negative and uninformed.

My friend Brian tells the story of how his (former) endo undermined Brian’s confidence and motivation with the message “If You Weren’t So Fat You Wouldn’t Have Diabetes.”

Before you assume that only people with type 2 experience this kind of condescending treatment from their doctors, take a look at what my friend Steven has to say about “The Blame Game.”

Language and tone are important. They can build or undermine confidence and motivation. They are so important that Diabetes Australia has even issued a position statement on the language to use when communicating about diabetes.

What we don’t talk about

But there’s a version of the blame game that we don’t talk about.

That’s the blame game that goes on within the diabetes community. When one person or group touched by diabetes snarks on another.

It’s when someone says, “I couldn’t prevent my diabetes.”

It’s when someone says, “Without insulin, I die.”

It’s when someone says, “We should change the names so that people know there’s a difference.”

These comments are often couched in terms of trying to clarify the differences between one type and another. In reality it’s a way of distancing themselves from the other.

It’s a way of saying “I’m not like you.”

It’s a way of saying “I’m better than you.”

And it’s just as hurtful, demeaning, and as undermining as any blaming comment made by someone outside the diabetes community.

Maybe even more so.

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