Monday, May 15, 2017

Doctors, Stop the Diabetic Shaming!

Today I'm going to open up about a topic I'm usually pretty quiet about: my diabetes. For those who don't know, I've had type 1 diabetes for almost 20 years. In those 20 years I've only been hospitalized once; that was in January of 2015, and had more to do with exhaustion from the rape than my actual diabetes, so you can say I have it fairly under control. In fact, I can't tell you how many times I've heard, "you don't look like a diabetic!" although, I'm not entirely sure what I'm supposed to look like...but I digress. 

Like most of my fellow diabetics, I sometimes run across medical personnel who like to tell me what I should and should not eat, and like my beta cell-less cohorts, this is my reaction 9 out of 10 times:



Why, do you ask? Are diabetics just self-destructive little morons? Some of us are, yes, but for me and my friends, the real reason we respond the way we do is because you guys really don't know what you're talking about and should leave the carb counting to us. 

The thing diabetics have to watch out for/monitor is their carb intake. For every number of carbohydrates we consume, we have to take a unit of insulin via injection, and the ratio for carbs to units varies from diabetic to diabetic depending on a variety of factors. 

Here's the thing: the diabetic's body doesn't differentiate if it is getting carbs from a starchy meal, or a dang cupcake, it registers it all the same and the insulin we inject works the same to counteract the carbs we consume no matter what the carbs are from (and just as an FYI, veggies and especially fruits, have plenty of carbs in them as well). 

Not too long ago I was out having dinner with one of my girlfriend's and her boyfriend. At dinner, my girl had spaghetti; if you read the nutrition facts on a package of spaghetti, there are 43 grams of carbs in it BEFORE you add any tomato sauce. Like most people, she had some bread with her spaghetti and easily consumed over 60 grams of carbs that meal and no one batted an eye at her; however, when we went to Baskin Robbin's later and she wanted a small scoop of ice cream, everyone about lost their freaking minds. Knowing full well that there was a measly 17 grams of carbs in that scoop of ice cream versus her carb fest at dinner, she and I shared a look and these were our reactions to everyone telling us we needed to be "good diabetics:"




and for the record, I don't even really like ice cream.


This post isn't just to inform the general public, but to express my ongoing frustration with the ineffective methods doctors attempt to use on me and others who share my disease after my most recent unpleasant run-in with a doctor. 

My old doc, who was really amazing recently retired and I had to find someone new. I walked in to his office reluctantly but optimistic. After checking my feet to see if I'd lost any sensitivity (where I felt every annoying pin prick), he asked me if I checked my feet every night for sores. I honestly answered no, because my feet are sensitive and I would feel if I had a sore long before I saw it. He freaked out and told me I needed to be actually staring at my feet every night to be looking for sores. I tried again, "Look, I can't even walk across a cement driveway barefoot because my feet are so sensitive I feel the little pebbles and they hu-" "DO YOU KNOW the risk you run as a diabetic of having your feet amputated?" at this point the communication broke down and I realized he was just one more ignorant doctor and I started treating him how most diabetes treat those in the medical field. "Oh no," I replied, "somehow I've gone 20 years without anyone mentioning those possibilities to me." He sent me home with a diabetic foot care pamphlet. 

I wish I could say that that situation was isolated, but I can't. From stories my friends have shared, my personal experiences, as well as articles I've read online, it's very apparent that medical personnel tend to treat diabetics like we are irresponsible idiots. But here's the thing: we aren't. Diabetes is an incredibly complicated animal. What works for my girl Becca does not work for me, and what works for me doesn't work for my girl Cassidy. Our bodies, our schedules, and our lifestyles are completely different, therefore our diabetes management styles are completely different. When I was a child, I had a friend who was a diabetic and our lifestyles were very similar, and yet she was hospitalized many times when I wasn't and no one, not even us, knew why. Which is why: 



Now, I know there's another side of this, the ugly side when diabetes isn't being managed well. I had another friend who was in the ER last fall because he wasn't doing what he needed to. His doctor walked into his room and said, "so you're the diabetic who isn't taking his insulin. How is that working out for you?" Doctors, let me ask you this: if your intent is truly to help and you would like us to hear what you have to say, how on earth do you expect your patient to be at all willing to communicate with you and overcome the issues that are preventing them from doing what they know they need to after a comment like that? 

When I was diagnosed at the age of 4 and my poor, sweet mother was still learning how to take care of me and stressing herself out, my doctor told her to relax, that she was doing great and that the biggest problem they face with diabetics is getting them to come in for their checkups. At the time, that made no sense to my mother, but after reading my experiences and those of my friends, perhaps you can see why that may be. 


For me, I can eat whatever I want and take insulin and my body reacts the way I want it to. Some are not so lucky and have to be more strict with their diet. Then there are those diabetics who, knowing what's at stake, don't take care of themselves at all. In all three cases, however, none of us deserve to be treated like we're intellectually inferior to doctors or nurses, because, in reality, when diabetics are first diagnosed, it's their fellow diabetics who are the best help because we have real life experience and application of what it's like to live with this disease, not just an outside view of life with diabetes. In fact, when I was first diagnosed I saw a pediatric endocrinologist who was himself a diabetic and his take on diabetes management and his advice was quite different than what any medical staff has since communicated. While I would never wish diabetes on anyone, if there was a way to give every medical personnel diabetes for one month so they could see what it's like, I would, because I know then they would sing a much different, kinder tune.

To my non diabetic friends, thanks for taking the time to read this. To my diabetics, remember, food is to be enjoyed, just remember your insulin 💖