The Angry Type 2 Diabetic: March 2012

Tuesday, March 27, 2012

It's Type 2 Diabetes Alert Day? Really?

I don't keep track of all the designated days for things... and in fact, often, various organizations just randomly make up a day, out of the blue, whenever they want to promote something... (Not necessarily a bad thing, really.)

So, apparently, today is Type 2 Diabetes Alert Day. 

The American Diabetes Association wants to create awareness of the risks a person might have for developing Type 2 Diabetes... by having them answer some basic, simplistic questions. Yeah, pretty basic and simplistic:

  • Are you old?
  • Are you a man or a woman (because apparently men are more screwed than women)?
  • Do you have high blood pressure?
  • Did you have gestational diabetes (which should be a big DUH, right)?
  • Did you have a mother or father with Type 2 Diabetes (another big DUH)?
  • Are you a fat, couch potato? 
Yeah, that's about it. 

Don't get me wrong... there are some people out there who still, to this day and age, don't realize they are at risk (even with the big indicators above). There are, also, a lot of minority communities who receive very little information, and outreach. 

But, the thing is... these tests don't do much for people who truly are at a HUGE risk, for other reasons. Where are the questions about "Do you have Depression, or are you on anti-depressants or other mood altering drugs?," "Do you have Polycystic Ovarian Syndrome?," "Do you take statins, and have high cholesterol?", "Were you ever exposed to Agent Orange?," "Do you take steroids?," etc, etc. When we keep these questions OFF of the radar, what we do is keep on people's minds the notion that only fat people get diabetes, and that all they have to do is stop being a fat person.

There are a LOT of people, more so than we think, getting diagnosed when NOT fitting any of these descriptions. Just by the sheer number of the people I speak to, every day, if I had to take a sample... I'd say a huge chunk of them were NOT obese when diagnosed, and not inactive. (A small minority of them are misdiagnosed, and are Type 1.5 (or LADA), instead... but it's just a minority.) 

What's worse is that we have so over-abused this word, prevention. 

NO ONE can prevent diabetes, of any kind. What we can do... is REDUCE OUR RISK for Diabetes. Reduce our ODDS. We look at diabetes in the face, and we try to call it's bluff. 

That's what we do. 

Again, don't get me wrong... PLEASE CALL DIABETES' BLUFF. Fight, with tooth and nail. Maybe you'll be one of the ones who DON'T win this lottery. But, please understand that at the end of the day, it really is still... a lottery. 

Now, yesterday, in preparation for Type 2 Diabetes Alert Day, the American Diabetes Association asked their "fans" if they had success stories to share; stories of having learned their risk, or having been diagnosed with Type 2, and taking control. (Suspiciously, that post is gone, now.) 

I assume they may have gotten many responses like this... The ones someone like ME would have given: 

Dear American Diabetes Association,  
When I was diagnosed with Type 2 Diabetes, the first thing I did (like any other person newly diagnosed), was to go visit your site. I studied it quite a bit... and gleaned some buzz words like "tight control," and goals of keeping my blood glucose under 180 mg/dL.  
Then I thought to myself... wait a minute? 180 mg/dL is awful close to 200 mg/dL. That sounds... quite dangerous and irresponsible. That can't be right...  
So I googled, more, and more... and even the American Association of Clinical Endocrinologists suggests keeping blood glucose levels under 140 mg/dL, and preferably, as close to normal as possible. 
I understand blood glucose goals are individual, and should be consulted with one's doctor, ADA... (Some of us have other illnesses and hurdles that might make tighter blood glucose control difficult.) But you are giving people a very risky, and low MINIMUM hurdle to shoot for, without much other guidance!! WHY???? Please excuse me if I don't immediately reject the theories that you have deep conflicts of interests with big pharmaceutical representatives lining your pockets.  
Now, dear ADA... you claim you don't embrace any particular diet, but say we should ALL just eat healthy as healthy should be considered for ANY person without diabetes, without further explanations... Honestly, ADA, shame on you. We all know that's just veiled talk for telling people they ought to eat a diet made up of 60% carbohydrates, rich in fruit, starchy grains, and vegetables. (Yes, a world in which corn is good for your health.) It sounds charming, and wise... But even to my mind, back then, that was just hogwash. Normal people don't have a BUSTED pancreas... If this were the case, then hey! Everyone, throw your glucose meters, oral medications, and your insulin away. 
So through more research of my own, I found out I could eat following the guidance of my glucose meter, instead. The way it SHOULD be. Oh, imagine that...?! I should eat meals, and use my glucose meter to TEST those meals, to see if they exceed 140 mg/dL! And OMG, instead of just eating whatever because it's "healthy..." Wow, what a concept! I'm sorry, but oatmeal, for my diabetes, is NOT healthy. Hope Warshaw might lie -- but my glucose meter NEVER will.
Don't get me wrong, ADA... some people DO need meds, as their poor pancreases are too pooped out... But why the hell should I put the BURDEN of my care and how well I do, on just meds and insulin? Requiring more and more meds as time goes on, and more and more insulin... and then, oh no... developing complications I could have delayed, or reduced a risk for? I would be just accelerating the damage, and pancreatic beta cell failure, by willingly keeping myself at 180 mg/dL goals all the time.. when I could help it.
It's not easy, ADA... but why should we lie to people and make them believe it is? You know what's harder? DIALYSIS. NEUROPATHY. AMPUTATIONS.  
Then I thought to myself... "Hey? Who the hell are the American Diabetes Association, anyway? They're not even endocrinologists! What THE fructose!"  
Yeah, that's right...  Just a bunch of six figured salaried talking heads for big pharma sponsored researchers.
So, in essence, American Diabetes Association... here is my success story: I went and read your site, and then I did the opposite. 
  • I made a goal of keeping blood glucose levels as close to normal as possible. 140 mg/dL or less, at 1 hour, and 120 mg/dL or less at 2 hours... with 140 mg/dL at 2 hours being the ABSOLUTE highest I will ever tolerate.
  • I decided I needed to find the TRUE point at which my blood glucose levels were spiking, and not just blindly test at 2 hours, thinking everything's right. I test at 70-75 minutes after taking the first bite, for most meals, with some exceptions. 
  • I test *EVERY* meal I eat, and every snack. I do not assume ANY food is healthy for me, just because Hope Warshaw, or anyone else, says so. If I can't (at the most) easily burn it off with exercise, I WILL NEVER EAT IT. 
  • I reduced my carb intake to 80-100 carbs a day. 15 or less for breakfast, 40 or less for lunch, and 30 or less for dinner... with an occasional 15 or less for a snack.
  • I did NOT go rushing to get on 20 pills, before even having the illnesses. Statins, and blood pressure meds, raise blood glucose levels and create other risks. Instead with my new diet and carb control... my blood pressure and cholesterol went right back to normal, on their own. Yes, ADA... you recommend diabetics keep their blood pressure under 130 systolic... but I keep mine between 100-110. 
  • You encourage people to just go lose 10 lbs... as if that's going to fix their diabetes. ADA, I've lost 80... and that hasn't fixed my diabetes, but it's a heck of a LOT better than if I did it your way.
On this Type 2 Diabetes Alert Day... I'd like to challenge you, ADA, to perhaps heed an alert of your OWN: A different approach is needed for treating type 2 diabetes.  People need to be diagnosed SOONER, by more thoroughly educated medical professionals, and not be kept in such obscurity.

When will you get with the program? Millions are waiting.

Friday, March 23, 2012

Diabetic Joke Fail?

I'm a little conflicted, lately.

I have a pretty good sense of humor, if I do say so myself. (You have to have a sense of humor to call yourself "The Angry Type 2 Diabetic" and still be able to handle every preachy a-hole out there thinking you're just bitter about your diabetes, and needing to get some anger management classes...) 

But... what exactly is OKAY as a diabetes joke? I find myself... somewhat at odds.

Let's see... at the "feather weight" level of jokes are references to the things we do every day, and that's awesome. I think it definitely HELPS heaps when people can sort of join in with us on how we see the world... Whether it's our struggles, or just things that make us go "hmmm..."

Then there are expressions, or tattoos that might encourage some mild debate... like "Sugar Free," and that can be okay, as well. This tattoo picture has provoked some argument and discussion in my Facebook diabetes group, and folks have gotten a chance to weigh in on the irony/misconception/message, however one might see it.

I kind of actually see it... as a way to tell 'The Sugar,' aka Diabetes, that I am not its slave. (Lots of people HATE IT when diabetes is called "The Sugar," by the way. Don't be surprised if when you call it as such, objects go flying in your direction.)

Now, a while back, the satirical, fake news publication, "The Onion," made an article making fun of Jay Cutler, a football athlete with Type 1 Diabetes... Lots of folks interpreted the article as though it was outright making fun of Type 1 Diabetes, when in fact, it seems they were really just trying to call Cutler a whiny bore... albeit, in a poorly thought out manner. They could have just referenced regular kids, NEVER mentioning diabetes at all, and still gotten the point across. (Me thinks those people, funny as they are sometimes, need a needle jab or two on the behind.) Clearly, this kind of humor is unacceptable... or is it? Is there a point when we can divorce our fears of losing our loved ones, or our own lives, so we can laugh at a joke? Yeah, on paper, this all seems good and well... in reality, I'm gonna tell you to go f off with that joke. lol

Then there's jokes where people laugh... uncomfortably so. Like these ones... Or the ones where people joke about "falling limbs" from eating too much candy.  These types of jokes get most diabetics riled up... because they showcase a terrible misconception that we can't have sugar, or candy, or worse... that we're all just going to lose life and limbs from even having as much as one bar too many. You'll find most diabetics standing up against these types of jokes, and I admit, they make me pretty crabby...

There's also the "well intentioned" (or so I try to tell myself), yet still incredibly ignorant person who'll reply something along the lines of "Oh, that's just Type 2 Diabetes... There's two kinds, you know." I think THAT makes me angrier than the joke itself, really. How is correcting one stereotype, by feeding another, suddenly acceptable in any way?

Then there's the McDonald's jokes... I'm sorry... but if you can't laugh at a candy bar joke, I'm not going to laugh at a Diabetes/McDonald's joke.

So... did all of us who got Type 2 Diabetes go pig out at McDonald's or something? Really? Or, are we trying to say anyone who eats at McDonald's is going to get Diabetes? Do we want to do that to Type 2 Diabetics... by spreading the myth that pigging out at some favorite fast food place is just going to give someone Type 2 Diabetes eventually or automatically, somehow? Never mind that out of those 300 million people, only 8.3% have diabetes (including ALL types of diabetes, and the undiagnosed)? Never mind that there are MYRIADS of ways to get Type 2 Diabetes, though the media will not cover ANY of them?  

Obesity does NOT cause Diabetes. Lots of fat people are going to live long, and full lives, without so much as ever having to prick their fingers... They will NEVER get diabetes. Stop drinking the media Kool-Aid and trying to make yourself feel better by making fun of MY diabetes. 

Was I supposed to laugh? *MY* bad.

Wednesday, March 21, 2012

You Are Enough...

It's a long, and lonely walk... 

The air is cool, and heavy with the various smells of earth and sulfur; and night crawlers have begun to pepper the sidewalks with their icky slithering. Only the one or two headlights are seen, and the occasional paperboy might go by...  Sometimes, you might even see a cop car. It's 4:05 AM, and very few are the souls who share my 45 minute journey, once or twice or thrice a week, as I make my way to work down our town's main avenue.

I don't like the journey; yet I do.

For a single, lonely woman... It's a dark, and scary journey. Imagination gets the best of you and you think anything and everything will jump out of some bush, and get you. You think that the car that just abruptly stopped in front of you means to hurt you, when it's really just a paperboy... just doing his thing.

You even get a little whiny during the journey: If only I had a car... if only I had a better job... Why didn't I do my Master's when I had the chance... Why didn't I just become a lawyer when I had the chance.. Why couldn't I have found a rich husband, so I could just sit on my can, and eat bonbons all day... *Really*

(I didn't say ALL my whining would be rational...)

Still, the 45 minute journey is a necessary time of introspection, which might otherwise go very much avoided thanks to our gadget-obsessed lives. (Sure, I could meditate while exercising at a comfortable time of the day, but I might not be as willing to face my fears as when they are staring at me so blatantly in the face.)

Our fears and inadequacies often haunt us; derail us from goals. Sometimes, it's outright paralyzing.

I have to admit that I'm a very dysfunctional adult. I'm riddled with mistakes to fix; mountainous obstacles from self made messes which I'll need to climb on my own... I admit I'm scared...

  • Scared I'll never find a good career path, or even an inclination for one;
  • Scared I'll never fix my credit and medical bills;
  • Scared I'll never be loved and fully accepted;
  • Scared of my impending divorce;
  • Scared of not having health insurance;
  • Scared that I don't see myself as an adult;
  • Scared of being healthy, and in shape, for the first time ever... in my adult life. 

Yes... it's true. All those things about me are TRUE. And yes... they are often my lonely, dark roads. 

They are there to remind me that I need to love myself. That I, and only I... am enough. That even those roads have beautiful moments, smells, and memories... all waiting to be found and had. 

We may, sometimes, have support to deal with some of our fears... but some roads will require that we walk alone, and in self love.

"And, oh boy, Diabetes, I don't want to self love," I tell myself... I spent a good, long childhood, being ignored by my parents; and a good young adulthood being a hermit crab... Ah, why must I pay attention now? 


Why must we dare to live, and have courage, and dream... And be vulnerable??  (Say no to the pushy woman, at work, with the box full of cookies...) 

Probably... because we are the biggest gift we could ever gift ourselves; WE... are the magic in our lives. And nothing else - NOTHING - will ever come close to that. 

I'll try my hardest not to let it slip by. 

Saturday, March 3, 2012

The 'Betes Preachers...

Art by: Ankhammentu
Pinups Girls and Vectors 
There are two things that often make me feel uncomfortable; no, three: discussing religion, the current state of politics... and discussing my diabetes regimen with another diabetic.

"Wow, you have to get out of this business if that makes you uncomfortable, Liz!"

You'd think.  :-) I still do all three.

Some of you might get where I'm going with this, before I even get there. You meet some diabetic folks, you share the management lessons (individual lessons) life with diabetes has taught you, and then you're told you're wrong; very wrong. You might even get accosted for it.

It's not surprising, really. More personal than spirituality, than who we vote for... I can't think of anything more personal than what we eat.

What we eat and when, is a language, and it speaks for us and who and what we are, as people; for what we believe, subconsciously. Besides hunger, it might say things like...
  • We're sick;
  • We're bored;
  • We're emotional;
  • We're religious;
  • We respect nature;
  • We're against corporate greed;
  • We believe in self-sustenance;
  • We believe we don't care;
  • We use food as filler;
  • We use food as comfort;
  • We use food as excitement; 
  • We use food as DOGMA; 
  • etc, etc, etc. 
I've truncated it considerably here, but the list for what our eating says can be quite lengthy...  and often perplexing.

For these very same reasons, there really isn't any other "belief" system in which so many folks try to "preach" to us, sell to us, get us to follow their way, their methods, their paths; get us to join their particular "culinary denomination," more strongly.  

... And, often, BEFORE illness even enters the mix! 

It doesn't help that for every need or illness, there's an opportunist out there hawking a book, a cure, a reversal, a miracle, and of course... a conspiracy theory, and a diet. A diet you must strictly follow to the letter. They all claim to be the experts on "weight loss," or the "it" revolutionary diets. They ALL claim they can work for any illness, regardless of your circumstances, and let me tell you, not a single one of these people... has ever said anything less than that they were 'renowned' experts. They all claim to be renowned doctors, dietitians, food scientists, etc. (Experts in everything, and nothing.) 

Folks with diabetes are just like everyone else, and can be vulnerable to the pulls of these jokers, and of fad dieting choices, from every which way. We are, after all, eager little sponges, wanting to soak up all that 'learning' out there in the big ol' 'interwebs'... and we want be on the cutting edge of managing our disease. We also want to be IN CONTROL, at all costs, and often under fed delusions that needing ANY medication at all is a bad thing.

Now, don't get me wrong... We must strive to be the healthiest we can and I am not against any particular way of eating, so long as it's something we can maintain long term, and it works for US and our daily diabetes management, as well as our personal beliefs. 

It's just that there's a lot of intransigence being taught out there, as well; a lot of 'evangelizing' and a lot of intransigence. People use these food platforms to tell others that there are NO other ways to health, but through their own plans; that they will lose control and binge uncontrollably, or never attain tight control, and go to diabetic complication hell if they don't follow as they do, or that they are lacking in scruples if they decide differently. And it gets so annoying! 

To me... THIS is what getting "diabetes religion" means: that you are so self focused on what works for YOU, that you forget that your own mileage varies, as well as everyone else's, and that we all have the RIGHT to find our own path in our management, without someone else making us feel that we are the devil in a blue dress for daring to do so. 

I'm a moderate low carber, myself. I'll still eat some ice cream, some tiny amounts of pasta mixed in with a lot of veggies, or tiny amounts of rice; I'll even occasionally, go jogging for the pleasure of having a cupcake... or I'll eat a cheeseburger on a lower carb bun. I EAT BACON. I, personally, do not view foods as "good" or "bad." And honestly, I *believe* it's wrong to do so. I believe life is about moderation. I hate to admit that, because I can get attacked at any point by no carbers, low carbers, no-restrictions on carbs people, vegans, raw foodists, and I have! 

But quite frankly, since what I put in my mouth is between me, my God or lack of a God, my glucose meter, and my doctor, it's no one's damn business! (It's insane for anyone to think that it is!) 

Keeping it between you, and your glucose meter and your doctor, is what we truly ought to be evangelizing. Finding that balance that is right FOR YOU, so that you can keep a good pace during the long-life marathon that is diabetes. 

(... And yes, I do not take any medications. I've lost nearly 80 lbs, and yes... my A1C is 5.5%, and yes... I have a beautiful cholesterol panel. Thank you, very much. I've worked HARD for that... even if I got to have a burger or some ice cream, along the way, while achieving it.) 

Your diabetes mileage can and WILL vary. Help where you are asked for help, support those who need it, and NEVER lecture another for being different than you, or having different needs than you. After all, you wouldn't want them deciding what you should eat. Remember the code of Diabetes Etiquette for Diabetics.


Thursday, March 1, 2012

You Never Want to Feel That Kind of Panic When You Have No Insurance

This isn't exactly what I wanted to write about, tonight. I'm not exactly an "on-schedule" blogger, but I know this is definitely not what I was expecting to write about, tonight.

[Before I proceed, though... I just want to say that I don't want ANY pity. No pity... No feeling sorry for me... No hurting for my circumstances. No advice on what I could have done better (I will rip you a new one, if you do, just be forewarned). Life is what it is, and we are all dealt... what we are dealt, sometimes. Whatever that is. There are people, right now, going through a LOT more difficult circumstances. They deserve our support... so don't you worry about me. Also, this post might have a lot of swearing.]

I just need to process, and I need to vent. So to heck with it.

... Where do I start, I don't know. It's such a blur,  now.

Last Sunday.

Last Sunday, running my hands through my hair, while wanting to put it up in a clasp, I found a large, swollen lump or area on the upper right side above the nape of my neck. It wasn't entirely dissimilar to the one on my left side, but distinctly swollen feeling, and sore if one put gentle pressure on it... and irradiating discomfort.

Of course, being The Angry Type 2 Diabetic that I am, I freaked out... said a few choice phrases rhyming with "What the fructose??" and sort of felt the clammy feel of panic rising up my spine. (You never want to feel that kind of panic when you have no insurance.)

I decided, though... that I was going to remain calm. (HA!) Just monitor it for the week, and wait until Thursday (today), for the Free Clinic, to get it checked out. As things sometimes go, I started feeling... unwell.  "Woozy," feverish... just uncomfortable from the growing pressure in that area of my head... The "soreness" was starting to radiate down to my right shoulder, down my neck... And today, well, it was just difficult to focus, at work, and I noticed I couldn't really walk a good distance without feeling... just weird. Light-headed. Nauseated. "It's okay, though," I thought... "Today is the Free Clinic, and they'll have a look at it."

Now, the Free Clinic in my town is basically a rat pack of some medical professionals of various ilks who volunteer to provide some basic/minimal health care to uninsured people, no questions asked, and which only generally meets on Thursday evenings, from 6-8 pm. You have to arrive at 4 pm, though, and make quite the long line. Waiting for care often averages between 4-6 hours... and it's first come first served, of course. They can only see about 15 people.

The problem is... they used to have a somewhat permanent building, which has since been torn down by their tenant -- the next door church, while they make some new additions and changes to their facilities. So, the Free Clinic now has to share space with the next door church, and can only meet whenever the heck the church is not having some event. Which basically means... whenever a magic 8-ball decides.

I walk out there... just praying, praying under my breath that they are meeting. Lo and behold, as Murphy's Law loves me so much... They are not meeting. I think it's because of some stupid Pancake Day crap. I don't know. (Insert your personal sensibilities approved curses here.)

Then you have to make the tough decisions. Is this something that you think will go away; get better on its own? Am I overreacting? Is this... something that... could potentially get worse very quickly, and kill someone? Is this something that can be stopped, but it just needs immediate attention? I don't know... Do I go to the ER (because the local medical clinic is closed... and, even if it was open, they won't see me because I have no insurance and a hefty past medical bill that I can't prioritize to pay right now (don't judge me... you don't know me... and they won't let me pay anything less than an outrageous amount, every month...), while so underemployed and on food stamps...)? Or do I chance it?

Reluctantly, I decide... I'm going to go to the ER. I don't want to be the freak on tomorrow's front cover story that died within days, from something simple, or who knows what. The worst they can do is turn me away. And I was wrong. The worst they can do is shame me, while turning me away.

The doctor didn't even really look, or touch the area much. He basically pushed my hair around, said it looked exactly like the left side of my head, that he didn't see any physical injuries, and then asked have I ever cared to examine the left side of my head...

(Yes, doctor, the rest of us who aren't doctors are certainly idiots... We go entire lifetimes NOT touching our own bodies.)

....and then proceeded to tell me it was probably just me being worried about it, or at the very most a resented lymph node. He dismissed my other symptoms with the wave of a hand, gave me a smirk and a suppressed laugh, and said that I need to just let it stay like that, and come back in a week if it got much worse (with big disbelief all over his face).

I tried, very unsuccessfully to get his attention. He just basically acted like I was bullshitting him, and walked off.

Nurse Patronizer walks in. Nurse Patronizer notices I'm quite angry. I don't recall whatever tipped it off... (pffft!) But... Nurse Patronizer says to me "I don't know what you two discussed," and boy do I let the flood gates go... and I start crying, right there. She begs me to give her 5 minutes and goes off, basically to talk to Full of Himself Doctor, who says "Oh, she needs to just watch the area for 2 or 3 days (yeah, rather than a week, like he had said before... hmmm)..."

Nurse Patronizer repeated over and over again how it wasn't that I had no insurance, while at the same time pushing a flyer on me to go to the Free Clinic tonight.... After I had spent a good chunk of time explaining to them that the Free Clinic was closed. They wouldn't believe me, and kept asking me *why* it was closed. Now how in the &#$@ should *I* know?! All they had was a sign posted about "We will have No Free Clinic Tonight, 03/01/2012." I'm not their schedule keepers!

So, really... hmmm... If you are not punishing me for not having insurance, then perhaps you were punishing me for your perceived notion that I'm using the ER as a PCP provider's office, and not waiting until whenever the heck THEY would have given me an appointment (should I had been able to get one, which I know from experience, that I would have not, because of my outstanding bill. I know how those jerks work, too.)

So, off they sent me... With apparently, a few "lessons" for the road:
  • You've lived with your body for 35 years... and are quite educated, Liz, but you don't know your own head;
  • You have no insurance, and are underemployed, so you must be subhuman, or some mentally unstable person making stuff up... abusing our services;
  • You are nothing more than money;
  • I hope you don't die, but good luck. Suck it up, butter cup.
And THAT is the reality uninsured people have to put with... in America. 

I am, at home, and still feel... Odd... Feverish. Sick.

Off and on, it goes. I feel even more special I will get a nice, hefty bill in the mail, for absolutely nothing. For the theater of a man's arrogance, and a woman's patronizing. I've had more pleasant experiences there, before, but not today. 

Not today.