Power Struggles

My AM BG reading today was 95. That's down a little bit. Dr. Parts and I have been pigging out on cake & cookies in the evening. (By pigging out, I mean eating some, especially after dinner.)

I visited my physician this week. She prescribed Effexor and gave me samples to last 6 weeks. We'll re-assess my mood then. I forgot to mention the restless leg thing to her. I "forgot" to schedule my follow up appointment. I went to the lab for the blood draw. They politely explained, that, as it was a Friday, and one of the tests ordered was one that required immediate processing of the sample and no lab performed that test on the weekend, I would have to come back on a day next week. No problem, I said. I'd be happy to go away.

Ah, but will you come back, asked the wiley phlebotomist. No fool, that one.

I've been thinking about the relationships between persons with diabetes and their physicians. I'm not always sure who's in charge of that relationship, or who's in charge of the diabetes. It probably goes back and forth.

I strongly believe that a person with diabetes needs allopathic medical care as part of their regimin. (That means, in the USA, IMHO, a treating MD or DO, or maybe an ND. You know, someone who knows the western European scientific tradition and can write prescriptions for you.) I also believe that the physician needs to be your partner, and you need to be their partner, in order for the diabetes management to work in your life.

The doc can order labs and tests to help you get numbers to know more about how your body's doing. The doc can order medications to help you manage and alter your body's processes, not just with diabetes, but with all the other things that go along with living in a human body. (Yes, diabetes will not be the only thing that goes wrong with your body as the years go by. Sorry, but I believe that to be true.) The doc can also help diagnosis things, putting the symptoms together in a way that us non-trained personnel cannot do.

As an aside, I also must say that anything I say here in the blog, should not be taken as medical advice. I have attended the Johns Hopkins University. I have not attended nor graduated from the Johns Hopkins School of Medicine. I am not trained or qualified to give medical advice.

The diabetic, however, is the one in charge of implementing the plan. You're the one who has to exercise. You're the one who chooses to take the meds or not take them. You're the one who chooses whether to eat broccoli or cheescake for dinner. You're the one who has to test daily to get those daily BG numbers.

The patient has to trust the doc. The patient has to be sure that the doc has her best interests in mind. You have to trust that the doc is not going to over-intervene, medically. You have to trust that the doc is going to listen.

The doc has to also trust the patient, that the patient knows whats going on in his own body. The doc has to trust that the patient, if the patient says he will take a certain course to correct a medical problem, that the patient will do it. And that if the patient fails, or the course of action fails, that the patient will report it and, together, you can make a different plan to tackle that medical problem.

Of course, that's how it would work in ideal circumstances.

I have known at least one diabetic who, whenever a physician would say to her something along the lines of "your diabetes and your health is out of control and we need to do more to bring it under control," her response would be to fire the physician. She was a mentally unhealthy person, IMHO, always with the excuses, for her eating, for her inactivity, for not testing. She went on insulin, gained a lot of weight (because the insulin allowed her to eat as much as she wished-that's my guess), was unhappy with the weight gain, and went off the insulin without telling her doctor. She refused to go to counseling, to exercise, to go to diabetes education classes.

Last I heard, she had enrolled in a training class to become a pastry chef. Yes, an obese, diabetic pastry chef, making desserts for a living. I don't know whether to laugh or cry. It's close to suicidal. Hey, maybe by now, she's had gastric bypass surgery.

Sometimes, it's the doctor's job to give you bad news. Sometimes, it's her job to bring you back to reality. Sometimes, it's her job to lecture you and to stimulate you to change your habits or your diabetes management plan. Yes, even the kick-in-the-pants, figurative of course. Okay, so it's better if you learn to give yourself the lecture and the kick-in-the-pants when you need it.

So, find a physician who will be a good partner to you. But don't break up with them if they say things that make you uncomfortable. Sometimes a diabetic does have to fire a physician.

But if you have to fire several physicians in a row, all for saying the same thing to you, maybe it's time to fire the patient. Maybe it's time to listen to the things the physician is saying to you. Sometimes, when the universe is trying to talk to you, it will use many different mouths to speak the same message to you, because it is the message that you need to hear. Listen for that message.