Thursday, May 3, 2018

Patterns


The crazy ups and downs of this spring’s weather have me thinking about patterns. Seasons come and go in a regular sequence. We humans act in fairly repetitive ways, too- especially us with T1D. So, of course I talk about patterns in Dear Warriors. There are some benefits to them. But we need to stop ourselves upon occasion, and ask ourselves if it's time for us to change things up.

Case in point: Is our foot-focus outdated?

People with diabetes know that a foot exam is part of the the checkup process. I was talking with a friend, who is also a doctor, about this recently, after she very graciously agreed to read through my current Dear Warriors manuscript. We discussed the parts of an annual exam and that lead me to this interesting article, How to do a 3-minute diabetic foot exam. I was curious, because my own experience with them, as with my overall 20+ year experience with this condition, has been a range of both scope and detail.

Foot exams are part of the diabetes codex, but why? Do you ever wonder if perhaps we should focus on something else? Or simply remodel what we do, like this article suggests, (supported with data) to get the most bang-for-our-buck? There is much that needs to be changed in our healthcare in the US. Assembly line meetings that last under 15 minutes do not lend themselves to in-depth relationships, for starters. The mad rush seems to skip over things that we know are really important. Instead of lots of time on our feet, how about some serious time on our mental health and how we feel, which affects how we operate? Which leads me to my next point.

We can do more together. This article specifies “patient education” for one of the three minutes involved in their suggested foot exam protocol. As it states, “Even with proper patient education, many patients may be in various stages of coping with this all-consuming, yet frequently asymptomatic condition, which makes the need for repeated patient education even more critical.” Patient education? Let’s think in terms of patient participation, self-advocacy and agency. The psychological element of not simply being a body to be examined is key. Looking at our whole beings and how we relate to others are huge parts of the message behind Dear Warriors. Swinging this whole conversation further into collaboration would be helpful, as I’ll bring up in my next question.

Why aren’t blood sugar tests done once a year on everyone? Perhaps it’s was never considered before, due to relative rates of cases and equipment costs. But what were once logical practices may not make sense today. Testing today is fast and inexpensive. There are still regular occurrences of people with elevated blood sugars going long periods of time with complaints that end up being rooted in glucose levels. Relative rates of this condition are on the rise. In addition, even if results are fine, this test could be used as a positive segue to discussing dietary and exercise practices, which are extremely important health subjects for everyone. The alienation those with diabetes regularly feel might be relieved a bit if everyone dealt with this testing in their own lives.

These were just some thoughts I’ve had recently while working on Dear Warriors. I wish you well, and if you have, or no anyone else who has, any images you’d like to share, please spread the word and email me at dearwarriors2018@gmail.com. More info on my blog entry here.



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