Very Old, Very Healthy Diabetic

...or die trying.
I was diagnosed in 1998 at the age of 33 with NIDDM or Type 2 diabetes. I come from a diabetic clan. I even married a diabetic. Are you on the diabetes road, too?
This is my goal: to become a very old, very healthy diabetic by day to day choices regarding eating, exercise and medical management. Walk along with me...

Saturday, October 28, 2006

Good Tests

I got an HbA1c reading done last week. The result was 5.8. Hooray!

I'm excited and encouraged by that number, but I know that it won't always be easy to get such a number. Every time it takes a lot of work and many good decisions to help my numbers come out right.

I'm still on two medications. I'm still at 170 lbs. I'd rather have lost another five or ten pounds by now, but that hasn't happened. Hey, I haven't gained either!

Dr. Parts had a horrible flu/sinus thing going on this week. He missed three days of work. His fever was up to 102. I think he may be on the verge of making some changes to his diabetes management strategies. I cannot push, though. His diabetes is his own.

I've discovered some more co-workers in my building who have diabetes. We are everywhere.

The foot pain continues, but seems much more manageable now. I'm back on Effexor for depression, but it's only been a few weeks and it's hard for me to tell if my mood has lifted or what.

I wish I didn't have such a complicated life, with regards to medical doctors and daily medications. I take 6 meds in the morning and 2 (or more) in the evening. Doesn't that seem like a lot for a woman at age 41?

At the same time, I'm glad that these medications are available and that I have these options that wouldn't have existed for me, had I been born several decades earlier.

Life is good. Life goes on. I think I'll go shopping.

Tuesday, October 24, 2006

Diabetes may cause nuclear war

I'm not making this up.

Here's a link to the news piece on Yahoo! News Asia. In essence, Japan's ruling party's policy chief, Shoichi Nakagawa speculated that North Korea's ruler, Kim Jung Il, might make a nuclear attack on Japan due to his diabetes.

"One does not do such a thing normally. But because that country's leader has overeaten luxurious food and suffers from diabetes, he could think about it."

I knew that sometimes diabetes caused bad moods, and low blood sugars, and excessive medical bills. But nuclear war?

Does this guy owe us all an apology or what?

I'm all for peace. I hope for a peaceful resolution to the situation with North Korea. I hope for a peaceful resolution between the Type 1 and Type 2 camps, and all the other D-types.

Visualize world peace with me.

Or was that whirled peas?

Friday, October 20, 2006

Guinea Pigs, Again

One of the drugs I take to help control my diabetes is Actos. Today, this study was released, and the accompanying news article had the title of "Widely Used Diabetes Drug May Not Work."

So, rule number one, when reading such an alarming headline, is to read on. Headlines may be misleading. How big was the study? What measures did they use? One must ask these questions.

So, this researcher's conclusion was that Actos did not, in his review, show that it created a positive difference in "patient-oriented outcomes like mortality, morbidity, adverse effects and health-related quality of life." In other words, they can't show, by the numbers, that taking Actos will ensure that you, the person with diabetes, will live longer.

But, my favorite part of this article was the rebuttal statement towards the bottom. You've got to read this.

" "The kernel from this review is that pioglitazone is effective in glucose-lowering, has some other beneficial and potentially harmful associated features, and just has not been evaluated in the right way to prove that it will help people lead longer and more productive lives," Dr. John Buse, director of the Diabetes Care Center at the University of North Carolina School of Medicine at Chapel Hill, said in a prepared statement. "This is true for essentially every drug available for the treatment of diabetes," noted Buse, who was not involved in the review."

Did you get that? Let me repeat it: This is true for essentially every drug available for the treatment of diabetes.

In essence, in my interpretation, Dr. Buse is saying that every drug they use to treat diabetes lowers blood sugar, and has side effects (beneficial and potential harmful associated features), and that no drug has been proven to help diabetic people live longer and more productive lives.

So, they know that this drug reduces blood sugar readings, the DCCT showed that reduced blood sugar readings are associated with better outcomes and fewer incidences of complications, and the fans of this or that drug assume that all will be well and that any side effects are just the cost one pays.

This reinforces what Dr. McDougall has said for years: Don't take any oral hypoglycemic agent, because they increase your risk of of dying sooner.

We are guinea pigs. You do know that, don't you? The medical community is trying many different treatments on us, in the hope that the outcome will be good, but they don't know for sure.

Yeah, yeah. And I'm on two oral hypoglycemic agents. And I'm not following the diet Dr. McDougall recommends.

Blech.

Well, we increased my anti-depressant medication today. Perhaps that will help.

Tuesday, October 17, 2006

Life continues

I'm still a diabetic. I'm still here. I'm still eating. I'm still testing.

I ran into my dad the other day. His 65th birthday is tomorrow. He (and his brother) have this obsession with dying, because their male relatives have died at relatively young ages. Dad's grandfather died at 69, and his father died at 67. He's not sure he's going to make it.

Of course, I gotta tell you that I ran into him with his Beloved in one of our favorite restaurants, on their way to a dance lesson. East Coast Swing, no less. They skipped dessert (so did we). Does this sound like a diabetic who's in danger of dying this week? I don't think so. And, he has a CPAP machine.

I'm betting he lives longer than Grandpa. Or Sam.

I mostly had to post today for this link to an article entitled "Tips on How to Be a Good Patient". Very nice. I hope I remember all these tips. I have two doctors appointments this week.

I finally got to watch dLife this weekend. As it started, Dr. Parts, exhausted after 7 days straight at work, walked through the room and wondered if I had found the all-diabetes all-the-time network. (He thinks I think I work for the diabetes police.) "No, sweetie. It's one half-hour show that airs once a week."

Tuesday, October 10, 2006

Neglect

I've had several trainings or sessions with coworkers and have been thinking about disability this week.

One national leader, talking about transportation, mentioned that a person might get a particular diagnosis, and then went on to say that it depends on how that person intends to "wear" their diagnosis. In other words, if you're a person who enjoys having services, having something that makes you special or gives you an entitlement, you may wear your diagnosis differently from someone else, who might prefer to have independence, to enjoy being the same as everyone else, to continue doing the things one did before diagnosis.

What does your diagnosis of diabetes mean to you?

Does a diagnosis alone mean that you can claim a disability? I don't think so. There is some language in the law that talks about limitations on the activities of daily living. For many diabetics, the disease does not significantly limit their ability to perform the activities of daily living. For others, the disease, or its complications, does produce limitations and changes to one's ability to do the things one once did.

I was doing some reading on the American Diabetes Association website, after the mother of a 10-year-old child, three years post IDDM diagnosis, informed me that they had certified that her child had a disability, and the ADA does use the term 'disability' with regards to minors in an educational setting, and the disability or diagnosis providing some protection against discrimination. But I don't think that the ADA has the authority to determine that a particular person has a disability. That's not the business they're in. (That being said, I recognize that a minor, in an educational setting, still needs access to the best possible diabetes care. I applaud the ADA in their role in gaining rights for persons with diabetes, including in schools.)

I want to be the healthiest diabetic that I can be, with the resources and health choices that I make today. I want to be the healthiest diabetic that I can be, on any given day, regardless of where, on the continuum of disability, I place myself. Or perhaps, regardless of the progression of my disease, and where, on the continuum of disability, it has placed me.

I want to be mentally healthy, no matter what my physical health does. I want to be physically healthy, too. I'm not giving up.

At one of the training sessions, a county worker was talking about elder abuse. She introduced the topic of neglect as abuse, certainly true, and included the idea of self-neglect as abuse. Her two examples of self-neglect were 1) a person whose living space was so messy that you only had pathways to move around from the couch to the kitchen to the bathroom and back again, or 2) a person whose home was clean, but who only had breakfast sausage and oreo cookie ice cream to eat, when they had diabetes.

She went on to say that, in most cases, adults have a certain amount of control over their own lives. Adults are, for the most part, allowed to make really bad decisions about their own lives. And she agreed that there is a balance point between imposing some order and care on a person, and allowing them to have their own independence and control and live with the results of their own (bad) decisions.

So, how true is that in my life? If I have an idea about how best to live healthfully with a diagnosis of diabetes, then it becomes an issue of how close or far I am from that ideal on any particular day. If I am very far away from the ideal diet, the ideal exercise plan, when does it become neglectful to me? When does it become self abuse? And how do I stop the abuse?

And how does it play out when there is a pair of diabetics in the home?

Just asking a lot of questions right now.

PS. Work has been very busy. I love having projects, but it may mean that I don't post as much.
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