Monday, 8 May 2017

But First, The Specialized Service Appointments--Diabetes

My diabetes has always been managed by myself primarily, and my family doctor. I had control by diet and exercise for the first 8 years of my journey. I had a few visits here and there over the years to some of the specialty services available for diabetes. I was open to it at first and I gained some good information. They had a plan. And back then, we moved forward together. I would drop in and out of the services as I needed. This was ok within the system and the accepted norm. They were too busy with the newly diagnosed Type 2 folks to keep me on board unnecessarily. I was good with that.

Now, my diabetes was changing. I was older too. I no longer had the control of my blood sugars I'd had in past. The last four years were difficult ones. In part because I rebelled like a teenager, I didn't want to be diabetic anymore. My parents needed support and I didn't have time for diabetes. My diabetes needed attention. As life settled down, and I grew up again, I knew I had to take care of myself. It was time to get back to it.

Off I went to see my family doctor. We talked about going back to the specialized services but I wasn't interested. My last couple of visits with them left me feeling pretty uneasy. No. Not uneasy. Angry. The specialized service professionals had a plan for me. Problem was, it was their plan. For the first time in my life, I was excluded from my own health care plan. It wasn't being done with me, it was being done to me. They decided a number of things that I initially went along with. They were the experts. It became very clear very quickly, we were not on the same path. They decided I was going on insulin. My doctor did not feel it was time for that. I did not feel it was time for that. I was being slotted into a protocol. Being fairly well educated, I had read the Canadian Diabetes Guidelines. I read and re-read about the importance of individualized care with diabetes. How each person is different, one size does not fit all. I had tried over the last 4 years, three different diabetes drugs. I was well aware there was a much longer list of drugs available. So why were we jumping to insulin? To make it quick and easy for the professionals? There was no individualized care here. And I wasn't about to accept that. 

Now, I must state in all fairness, I'm not against insulin. I'm against insulin before my time. I repeat. I'm against insulin BEFORE my time. I recognize that diabetes is progressive. I recognize that there may be a need for insulin eventually. But I felt like we hadn't tried hard enough to find a drug that worked for me along with my lifestyle changes. I had already gained back about 25 lbs with my rebellion. I used to weigh close to 230 lbs. I got down around 160. Now I was back up to 180-ish. Insulin is noted for weight gain. Like I needed more of that. I clearly didn't need a bigger weight obstacle than I currently had. I just couldn't get my head around what seemed to me to be this massive jump to insulin. And there was to be no discussion. They were in control.And I'd lost all of it.

But not for long.

I went back to the family doctor and had the conversation. From his chair, visiting the specialized services was the starting point for care as endocrinologists are difficult to get access to. Endo's are swamped with people in much greater need than I had been for the last 12 years. I understand the system. I live within it with my diabetes. I still was not going to forced into a health care plan that didn't include me. My doctor agreed.

My doctor made two referrals, one to an endocrinologist and another to a cardiologist. Cardiologist? Yes. When we talk about diabetes, we need to talk about its affect on the heart. Ok. I'm game.

Time to move forward with my new supports.

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