Become Captain of Your Ship

People are sometimes so overwhelmed with the diagnosis of diabetes that they want two things to happen. One, they want it to go away, and two; they demand that I tell them what to do. They often want me to create a menu for the rest of their lives or tell them what parts of their lifestyles are good or bad or how to get through this terrible condition called diabetes. They don’t want to learn about meal planning or carbohydrate counting, they don’t need to test their blood with a meter, after all that’s my job.

They are willing to turn over complete control of their life to me, the Healthcare Professional. I can understand the fear and frustration of people who have just been told they have to deal with diabetes for the rest of their lives. Your diabetes is not going away.  I can teach you how to manage it and I can teach you how to deal with it.  It’s clearer and better now then it was 20 years ago.  We have new medications, treatments, new equipment, better funding now, and lot of other things.  You’re going to spend the rest of your life dealing with diabetes.  It’s not going away.  It doesn’t take a holiday.  It doesn’t take a day off.  You can’t say one day I’m not taking my insulin shots today because I need a vacation from diabetes.

Please don’t misunderstand my concept. I will do almost anything to help you and I will work with you to the very best of my ability, but I am not willing to take over your life. No one should be willing to hand over decision making at that level to another human being. I am asking you to be my partner because I believe we can accomplish anything if we do it together.

This column is intended to give you good information and serve as a resource for you, but it is not meant to replace face to face communication with your health care providers and the support team that you need to build in your life to help you manage your diabetes.

If you have diabetes you have a choice, you can be a DIABETIC, or a person who happens to have diabetes. How do you define yourself as a person? Does your diabetes define you or are you a human being who just like many others happens to have a chronic disease? You need to take responsibility. You need to become part of the health care team; in fact you need to be in charge of your team, The Captain of your ship. What are you willing to do?

Ask questions. Do you ever leave the doctor’s office and remember a question that you forgot to ask? You may not get to see the MD for three or six months after you leave that office and that question may be vital to your life. I suggest that you keep a list on the refrigerator for important questions, remember all questions are important. Bring the list with you and don’t leave the room until you ask all your questions and get the answers. If you are nervous and you might forget the answers, write them down. Insist on understanding the answers. We often use medical jargon and forget that everyone in the world doesn’t understand our language. We won’t be insulted if you remind us that you don’t know what NPO, A1c or FBS stand for. (Nothing by Month, a blood test averaging your blood sugar over the past two to three months and a Fasting Blood Sugar).

What are you willing to do to survive? Are you willing to follow a meal plan? That involves making decisions about the foods that affect your blood sugar, the amounts you eat and your thinking about food in a different way. Do you eat because you are hungry or because you love the taste of food and you want it? Most of us use both methods. Are you informed or just guessing about what foods are best for you? Do you make the choices or just eat what your significant other puts in front of you?  Often men come to my classes who have never shopped for food in their lives, or prepared a meal. I ask them to bring their wives with them so I can teach them about food preparation and then I teach the guys how to choose from a menu in a restaurant.

Are you willing to exercise? I hate that word. I conjure up a picture of a gym and sweating and skinny people moving in front of me. We now use the term increased activity, it sounds a lot more user friendly and less intimidating. Get up and move. Go walking, dancing, bowling, shopping, golfing, anything that gets you up and out of the chair. If you have arthritis or “bad knees”, talk to your doctor or educator about movements that will not hurt or cause more damage --swimming is wonderful. Increased activity is a vital part of diabetes care.

Take Control! Test your blood and know your numbers. I get so frustrated when I ask a patient what their daily blood sugars are or what their A1c level is and they say “I don’t know.” How can you make decisions about what to eat, when to exercise and the effectiveness of your medications if you don’t know the numbers? If you have diabetes, know what your A1c is, know what your blood pressure is and know what your cholesterol numbers are and what those numbers mean.

You are the person who makes the difference in your diabetes. I have seen the best physicians, educators and specialists frustrated and depressed because their patients were not doing well. Most often it’s because the patients were not aggressive in their care and in taking a major part in the true team approach to diabetes care.  People with diabetes do better when they are committed to improving their own lives.