Wednesday, May 17, 2017

The Blame Game - Blog #3

My own mother said, when I was diagnosed 35 years ago,
"Ah well; fair, fat and... (forty).

I was twenty five at the time, 172 cms and 68k. I soon set her right, but it was ten years later, after I'd married, had a baby, gained my bachelor degree as a teacher and moved to a regional town in north Queensland, that the visiting Endocrinologist really floored me when he said the same thing. By then I was a little heavier, about 72k, but by no means heavily overweight.
This throwaway line of "fair, fat and forty", has so many things wrong with it, whether someone is Type 1 or Type 2. At the time I just said to him, "I have juvenile diabetes, not the other sort. I'm insulin dependent!" and he looked at his notes studiously and didn't make any more remarks. I decided that he wasn't much good as an Endocrinologist and decided not to listen to anything else he had to say. Unfortunately he was the only specialist available in that regional centre and I had no support group nearby as my family were all in another state. Fortunately, the two things I had going for me were that I was a member of Diabetes Australia, Victoria and received their magazines every month and I had a great GP who understood Type 1 (though we didn't call it that then, it was still 'Juvenile Diabetes'). I made it my business to be in charge of my own health, to read the research and keep myself informed.
If I could go back now and put words in that north Queensland Endocrinologist's mouth, this is what I would have heard on that first visit to see him.
"I've been looking at your notes and I see you have Juvenile Diabetes. What sort of information have you been given about self-management? ... Is there anything that is worrying you at the moment, regarding your treatment and your health? .... I can see from your notes that you have been doing very well so far, you've had a baby and you're working full time. Let's have a look at your record book and see if there's anything we need to fine tune." 
This is how my current Endo communicates, and he's wonderful. We actually hugged at my last appt. after a particularly good HbA1C.

Doctor Tan, if you're still alive and listening, I hope you have improved your attention to patient detail and communication!
On the whole, after 35 years of it, I'm pretty immune to ignorant remarks. If the timing is right, I use it as an opportunity to educate and get people thinking a little more deeply about how those with chronic illness deal with life, if I strike someone particularly ignorant, I just say "This is how it works. If I go without insulin for 24 hours I will be in a coma, and if I don't have insulin for a couple of weeks, I will die. If I have too much insulin and can't get food to balance it, I will be in a coma and if the reaction is severe enough I will die. That's it, end of story." It usually shuts them up.

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