Tag Archives: diabetes and doctors

Is it Your Doctor’s Job to Motivate You?

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I hope everyone’s Holiday weekend was grand.  Mine was full of wonderful memories, highly excited children, and some laryngitis.  I still sound like a dying squawking bird but luckily I can still write!

I recently read a doctor’s article on how health coaches are becoming more accepted and recognized for the service they provide.  His case was that doctors endure many years of medical school and get no training on human behavior and how to motivate others.  He says that really isn’t a doctor’s job.  He says that is why he “prescribes” patients a health coach, someone with the time and training to help get a person’s motives down to a nitty gritty and support them to follow through with lifestyle changes they want to make.

You know, I have always assumed it was a doctor’s job to motivate patients but now that I think about it, doctors really are trained in medicine and I doubt they get classes on perfecting their bedside manor and figuring out how to engage people.  I don’t think they’re trained in counseling.  Not to mention, most doctors have a very limited amount of time with each patient.  A former doctor of mine said he had about 7 to 15 minutes with each patient.  That’s barely enough time to figure out what’s wrong with a person let alone talk to them about how life is going and how they are feeling about their diet and exercise and the stress in their lives.

Ideally, health counselors or life coaches are built into the system and covered by insurance companies for widespread accessibility.  That is not the current state of our health system however and that means that so many people are left to their own devices.

I think that’s why I focus SO many of my posts somewhere inside the realm of motivation.  Every totally impressive person I know has locked into what personally motivates them.  They latch on to this and keep it in the forefront of their mind.  They eat, breathe, and sleep it.  There is no other way to be very successful at something than to know exactly why you want to do it.  Losing sight of this equals failure. The what, when, how, and where all sorts itself out as long as you know why you want to do something.

I’ll be taking on clients soon as a holistic health counselor and I am making plans right now to remember all those who can’t afford this service.  I’m thinking about giving local group sessions and seminars for free or at highly discounted rates.  Those with less money are probably those who don’t even make it to the doctor often enough and could use more support with their lifestyle habits.

Sometimes all some of us need is a little encouragement and attention to what motivates us and perhaps, in the current paradigm, it isn’t our doctor’s job to do all those things.

What do you think?

Getting to the Bottom of This

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Worrying is like a rocking chair, it gives you something to do, but it gets you nowhere.

Glenn Turner

 

“This” is whatever issue(s) I have going on which have been causing me to feel a lot less than great the last few months.  In the last few weeks I’ve been dealing with some stronger symptoms like frequent headaches and nausea and water retention.  I visited an allergist and we have ruled out Celiac disease but I’m still going to omit gluten to see if it helps in any way.  (Omitting gluten is a small price to pay if I just so happen to feel better!)  I had lots of other allergy testing done and we found I’m not allergic to any new things so that’s a plus.   Although I am allergic to about 30 different things.  No, my immune system is not confused at all. (Dry humor helps, try it!)

I was reminded that I have an asthma diagnosis from about 15 years ago.  It seems I have mild exercise induced asthma and have forgotten over all these years OR was initially misdiagnosed.  Perhaps when I’ve had my “panic attacks” I’m really just panicking over my breathing?  Could be.  I will get a breathing test soon.  In the meantime I’m just glad those symptoms are mild and I don’t require an inhaler.  Although I do get laryngeal spasms from time to time but although those can cause a person to pass out, the good thing there is that if I do, my throat will relax and air will pass once again.  Phew, what a relief.

Next I go get my hormones and ovaries checked.  Before having my kids, when my PCOS was causing more pain and ovarian cysts were growing all over the place, I remember having nausea and water retention-like I am now.  So hormonal imbalance issues may be the root of this.  It wouldn’t surprise me you know?  Lately, my blood sugars have been higher than they have been in a long time and that definitely affects hormones in the body.  My worry about that is how do I fix the problem?  I don’t feel well on birth control.  What else can I do?  Keep perfect blood sugars?  What else can I do?  Sometimes I dislike being a girl.

I also go to the eye doctor soon.  I’m sure my prescription has changed (everything is a tiny bit blurry) and although that is a bad sign of something diabetes eye related…I’m used to my prescription increasing every single year since age 14, so maybe that’s what the headaches are about.

Some of my symptoms could be tied to anxiety so I’m seeing a psychiatrist soon.  I know I said I would do this over a month ago but I have procrastinated.  But no more, I’ve just made an appointment.

I don’t necessarily want to share all of this with the world (Hello! Look at me! I’m broken!) but here is why I do:  Many of you out there are going through similar scenarios where you have multiple health issues going on and you can’t figure out what’s the cause of what and you feel really overwhelmed and as a result don’t do anything about it.

My advice is to just stop.  Breathe.  Write down your symptoms.  Make doctor appointments.  Visit one doctor at a time.  Get tests done.  Get to the bottom of this.  Ruling out different things will be strangely comforting as you move closer to what is making you feel ill.  Symptoms are our body’s way of saying “help!”   We need to listen and play detective and then tweak our lifestyle until we feel better.   We deserve it.

I should not have waited so long.  I’m already feeling better knowing I’m being proactive.

Any of you out there go through something similar?  Did it help?

Did You Take Your Exercise Today?

Photo courtesy of photostock

Photo courtesy of photostock

 

When a physician prescribes us a medication, we take it right?

It’s assumed that exercise is important and great for health and wellness.  Maybe it’s so obvious many doctors don’t stress it very much and therefore miss a wonderful opportunity.  An opportunity to prescribe exercise.  The respect people have for doctors doesn’t seem to be as high as it used to be because we often feel let down by the system, but the respect for what doctors say individually tends to be pretty strong I think.  After all, we know they went to school for many years, they must know what they’re talking about.  They wear the snazzy white coat.  The’ve got the prestigious degree. 

I wish doctors would try prescribing exercise more.  I know some do but I don’t think enough do it.  If they did I think people might be more inclined to plan around their schedules and insert some exercise.  They might be more inclined to say, “Nope, can’t meet at that time, that half hour is for my walking-doctor’s orders.”  We don’t skip our pills do we?  When I went to a physical therapist years ago, I was ordered (“asked” if you prefer) to do a particular set of exercises.  Every day, I considered not doing them but then thought, “My doctor is going to ask me if I’ve done them or not” and so I did them.  I think the biggest impact with prescribing exercise is in the psychological effect.  The thought might cross my mind that, “I really need to take my medicine today”.  If that “medicine” is exercise, specifically prescribed by a doctor, maybe in a person’s mind there might be more motivation to do so. 

We all look for “outs” for the things we don’t feel like doing.  When we don’t want to exercise we might look to the fact our doctor hasn’t mentioned it or insisted upon it as a sort of excuse to ourselves not to do it.  It’s how we function.  I learned this through working at a call center for AARP 10 years ago.  Every day I talked to hundreds of customers, many of whom were calling because their medication was a day late.  These people put me through long monologues about how they needed to take their medication and could not skip a dose.  I completely understood of course, but what struck me as interesting was how many times I heard something like this: “I know I ordered my refills late but if you guys can’t send it to me right away and I have a heart attack, then I will let my doctor know it’s on YOU!” 

And no, I suppose this wouldn’t work for everyone.  Nothing works for everyone.  If it worked on a handful of people though, and I suspect it would work on more than that, I think it would be worth it.  As long as doctors were appropriate and kind when we didn’t take our “medicine” of course.  It’s not about them ordering us to do something.  It’s more about them acknowledging the benefits of exercise by really encouraging us to think of it being as important as taking our medications every day.

Exercise has been proven to help manage blood pressure, cholesterol, blood sugars, and alleviate depression and anxiety. 

So why wouldn’t a doctor insist on exercise with the same urgency with which he or she insists on us taking our pills?  I’ll be the first to admit, I listen when a doctor speaks.  Must be that nicely framed prestigious degree hanging in their office ;)

VLOG about Endo Visit

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Some notes before you see this video:  I was SO nervous so you’ll have to forgive me for that.  On an interesting note, I wasn’t aware until I saw this video that a country accent is still clearly discernable even when I’m actively monitoring it.  Hmm. 

Also, at the end of the video I say some things that I’d like to say a little different here:

I think there are probably plenty of good doctors out there who don’t make eye contact or who aren’t very friendly.  We should probably cut them some slack.  I mean, I’ve been known to read people’s lips when they talk and I often forget to make eye contact myself!  So I think what is important is a doctor that you in particular can easily communicate with.  I’ve gone to doctors that other people “love” and left the office totally confused because I was not feeling the love at all.  Finding the right match is probably what is most important.  That and finding a doctor that doesn’t look at you like you’re crazy or arrogant when you show them you know a few things about your diabetes.  This doctor I went to today said, “The way you adjust your insulin sounds very good.  You’re intelligent, I like that!”  And honestly, If there is a best way to compliment me, that is it!

So with that clarification, here is moi:

HAWMC# Word of the Day Post!

 

Courtesy of Luigi Diamanti
Courtesy of Luigi Diamanti

 

*Please forgive me, this post is a day late because my site got majorly hacked! 

For today the prompt is to go to dictionary.com and write a post inspired by their word of the day.

Dictionary.com’s word of the day is: unctuous. 

I’ve had some unfair encounters with doctors in my time.  On the whole I am positive they are mostly decent and well-mannered, professional, and patient.  However this one doctor would have made them all hang their heads in shame.  Not really but if they only knew they might.  They might not want to be in the same professional community as this guy.  I’m sure of it.  Anyway, I was seeing him to talk about my diabetes because at the time I was only seeing an Internal Specialist (instead of an Endocrinologist) and I decided I wanted to try being off of the pump for a while.  So this Internist, feeling a bit uncomfortable about moving someone off of the pump said, “Why don’t I have you make a visit with my friend and fellow Internist, Dr. —–?”  I looked at my doctor with my head curiously tilted to one side.  “Ok, but…why?”  “Well, he has been to two conferences on diabetes so he will definitely be able to give you more blood sugar management than me.  “But, I never talk to you about blood sugar management, I manage my blood sugars, and you check my blood pressure and run my labs, I go to you with specific questions…”  “Yes, I know but, this doctor might be able to help you.”  Fine, I thought.

So Dr. —– walks in on a different day.  I’m interested to see what enlightenment he can offer me.  He begins by not looking me in the eye and proceeds to stare at his computer screen as he rambles on quickly about the conferences he attended which taught him about how healthy blood sugar management worked.  He said he could help me a lot because of his experience.  (And my years of experience counted for nothing?)  I leaned in intently and shot a look to my husband who was next to me and furrowing his brow in amusement. 

Then this doctor asked me a few questions about what my typical blood sugars looked like and spat off a few diabetes blood sugar facts such as, “Blood sugars which are out of range can hurt your kidneys” and “You need to know, the body can literally produce a form of glucose when you’re low.” to which I said, “Oh yes, the liver”.  He looked at me like I had shot an arrow into his chest.  Then he continued, “You need to keep good blood sugar control for all sorts of reasons so send me your blood sugars each week and I will make adjustments as necessary.”  Finally, as genuinely as I could I said. “I just want you to know I manage my blood sugars pretty well on my own and have a pretty good grasp of all I need to know, in fact you didn’t say anything to me just now that was news.  I will send you my blood sugars but ultimately I decide what insulin changes to make, although I don’t mind discussing any of it thoroughly with you and I don’t mind listening to what you have to say.” 

Dr. —– smiled the way that celebrities at award shows do when the host is poking fun at them and then he looked at my husband and said in the most unctuous manor, “Wow, she’s cocky isn’t she?”

Cut to me.  My eyes are narrowed.  Ggggrrrggghhh….

Why Testing is Queen and What Docs Should Know

 

Ok, weird title, I know.  Let me make sense of it.  For us type 1 and type 1.5 diabetics and some type 2 diabetics, Insulin is king.  We need it so bad we can’t live without it.  And In my opinion, testing is queen.  We don’t stand a good chance without testing our blood sugars every day.  Just look at what happens to the insulin dependent diabetics in 3rd world countries.  They don’t live very long.  Some don’t get enough insulin and most don’t have a personal glucose meter to use.  They’re blind before blindness sets in.

I’ve long tried to understand why I rarely meet a doctor that is okay with me testing frequently (8-12 times a day).  They have told me “it’s an exaggeration”, “it’s not necessary”, and “four times a day should be sufficient”.  Well, Doctors…it’s not an exaggeration when I say to you, “It is necessary, and four times a day just isn’t as good as 8”.

I wish I could sit down with all the doctors who have felt this way and explain to them a typical day of mine.  I’d include the way I feel when I’m not in range and how it affects the way I do things.  I’d talk about how low and high blood sugars really hurt my quality of life.  I don’t test more than four times a day because I enjoy it.  I have small hands, small fingertips, and I favor two fingers on each hand for testing and believe me it hurts.  Not to me mention how awkward it can be to test in the middle of a dark theater using the small light from my cell phone, hoping no one will notice and get me kicked out or be offended.  I test more than four times a day because catching a 150 before it becomes a 250 is priceless.  Because finding out my blood sugar is 70 before carrying my 25 pound twin babies down three flights of stairs and to the playground is just being safe.  And because I’m the one with the kidney failure, blindness, and amputation risks hovering over my head each and every day. 

No.  I don’t test because I want to, I test because after 16 years I’ve tried it all.  I’ve tested 4 times a day, 12 times a day, and 0 times a day.  And in the end, my blood sugars speak the truth.  They tell me testing more equals better blood sugar management. 

How come famous type 1 diabetic athletes have doctors supporting them when they test 25 times a day?  They’re not more special than the rest of us and even though I’m not trying to win an Olympic medal, I am trying to stay at the top of my game of life.  And I refuse to settle.

I will say, I can have pretty good glucose control with 4 blood sugar tests a day IF I limit variables within my control.  For example, If I do the following: 

-Eat the same exact meals each day, at the same exact times each day.

-Do the same exact amount of exercise and type of exercise at the exact same time each day

-Go to sleep and wake up at the exact same times each day

-Test at the exact same times each day

Now, since many of us can’t or don’t want to live this way, 4 tests a day isn’t going to cut it.  And this doesn’t even begin to mention sick days where diabetics may have to monitor their blood sugars much more frequently nor does it take into account stress and hormone fluctuations that cannot be controlled like a machine.

I used to keep a reasonable amount of routine in my day because it does help avoid unusual blood sugar surprises, but for me personally, and I’m sure many others, every moment is changing and lots of variables come into play.  It’s just not possible.

Another thing:  Why would I be told to test before getting into a car and driving and before each meal and before physical activity and then told to only test 4 times a day?  I’m not too good with math but, even I can see this doesn’t add up.

Dear doctors, insulin dependent diabetes is dependent on quickly adjusting the sails from breezes that come in from all different directions.  Testing is how we adjust the sails.  Insulin is our boat.  We are the captain, and you are our trusted advisor and mate.  Please listen and consider our words.  I don’t like feeling hopeless, like I should just jump ship over some little test strips you won’t let me have.

Friends, if you’re in the same situation as me or if you have a loved one who is or if you care about your fellow diabetics, please read Wil’s important reporting on what the new plans will be for testing supplies and medicare patients and find out what we can all do to help.   Read: The New Minutemen and a Completely Different Kind of Tea Party. 

Endocrinologists, you know better than the General Practitioners and Internists out there when it comes to diabetes and testing and I hope you’ll fight for us on this, too.

I leave you with another enlightening article from Wil over at his blog, please read: Meters Matter.  I highly recommend it to all persons with diabetes and to all doctors.  He gives 10 can’t-ignore reasons why meters matter to all diabetics.

If we choose not to fight for our rights to test as needed, we are starting to see ourselves as undeserving of excellent health and that should never happen.

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