Saturday, 15 April 2017

My Regression

Regression is a tough one. In my first post, I referred to my diabetes regression. I mentioned that I behaved like I was in my teen years again: rebelling, ignoring, pretending the obvious didn't exist, etc. Now if you're a teenager, those temporary behaviours are what help to shape you into an amazing adult. Rebelling makes change in the world. Ignoring teaches patience. Pretending things don't exist is a way of giving yourself a time out while you figure out what your opinion is. In a teenager or young adult, these can be/are positive attitributes. For an adult with a significant health concern, not so much.

I think my diabetes regression started around the time the new Canadian Diabetes Guidelines came out. I had been testing my blood sugars approximately seven times a day. Sounds like a lot, I know, especially since I wasn't on insulin. In my defence, another teen trait, that is how I went 8 years with just diet and exercise as my treatment. I knew my body very well. Not to offer TMI, but I could even tell when my periods were coming by the slight rise in my blood sugars! Now that is amazing info coming from one tiny drop of blood!! None of the health professionals in my care circle were concerned about the amount I was testing. Neither were the benefits companies my husband and I belonged to that co-pay for my supplies. Everyone was so supportive. I'd upload my blood values and enter my food data into my apps in the evening. This kept me busy after my walks. If I was busy, I wasn't thinking about snacking in the evening. It was all good. Everyone on my diabetes team was cheering me on. 

Then the Canadian Guidelines for people with Type 2 diabetes changed. 

The recommendations: if not on insulin, testing randomly 4 times a week at varying times is what was now expected. I was told there was "no need to test so often"; "not type 1, not on insulin"; "testing too often"; "don't be so focused on testing", etc. 

My husband's benefits company was now sending me letters of warning that soon they wouldn't be covering the test strips when I reached the limit they will co-pay for. I didn't even know there was a limit but apparently it had now been lowered based on the GUIDELINE which now became the absolute "RULE". The guideline was now carved in stone for that company. 

In a few moments of "ohhhh, crap" I decided to call my own benefits company. I hadn't gotten a letter from them. There was no issue. They will pay for the strips and supplies I need, even if they have to pay the full amount. Whew. Dodged that ball.

The message my diabetes circle of professional care was giving me had changed based on what was now considered best practice. Now, I understand what best practice means. Yes I do. I also understand how my team needs to promote best practice that is based on the current evidence. But 'best' practice is not the 'only' practice. Since I had been told I was unique in that I managed to keep my diabetes in line, I had preserved at least 80% of my pancreas from all my hard work then I failed to understand why I should fix what isn't broken. Diabetes is individualized care, right?

But. They are the experts. I go to them for a reason.

I found myself listening to the folks who knew, I found myself not testing. I found myself somewhat relieved I guess. I was being given permission. I found myself not caring about my diabetes. I heard myself saying things like "I'm not diabetic today" or "I'll test my blood sugar tomorrow" as I scarfed down whatever I saw that looked good. There were pangs of guilt, yes. Those pangs became very easy to ignore, especially since I was doing what was recommended. A very slippery slope indeed. 

Looking back, with the exception of my family doctor and my benefits company, my team all kinda missed the point. Diabetes is supposed to be individualized care. Testing is what kept me on track. It kept me healthy by keeping my eating and exercise in line. Testing was MY medicine.

The next 4 years were a struggle. 

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