Consultation

Health Matters


Consultation

    I'm a bit nervous.

    Four days following second blood test results and T2 diagnosis and I'm off the the local surgery - again.

 

** This occurred a few years ago and is a frank portrayal of what happened.

At the end of this page I will give you a brief update of subsequent visits. **


    I'm called in to see the diabetic nurse.

    In the room also was the very nice lady who'd already robbed me of most of my blood – twice.

    She was training to be a diabetic nurse and needed experience.

   Why do they need more trained diabetic specialists? Because the disease is increasing at exponential levels. Or more accurately, it's now being diagnosed at exponential levels.


    I sat down opposite the specialist nurse.

    She leaned forward. She was so close that her face was no more than 12 inches from mine. Head cocked slightly to one side, she looked me straight in the eye and asked. 'So Jo, how do you feel to be a diabetic?'

    I was a bit nonplussed. What the heck was I supposed to say to a lady who had invaded my personal space.

    What I wanted to say was, 'bugger off to your own side of the room.'

    Leaning back in my chair, what I actually said was something like, 'well, I don't know really. Not too bad I suppose, it could be worse.'


    And to be honest, at that stage, I didn't feel too bad. I'd had a wobbly day or two, which is perhaps not surprising, but I'd bucked up considerably having found my new community on the diabetes internet site, and had been welcomed in.


    She went on to give me a confusing, detailed explanation of what diabetes actually is (too detailed) and all in all it was rather frightening.

    I wasn't frightened of her being in my space, no, it was the way she told me about the severity of the condition and potential complications.

    I'd come in feeling pretty optimistic but not long into the discussion I was ready to swallow a bottle of pills and end it all!


    She appeared to be following a script. Whether this is how she was taught to treat new patients, I'm not sure, but I was neither consoled, reassured nor greatly helped. Surely this can't have been her intention. Perhaps she meant to shock me. Perhaps I'd done her ill in a past life and she'd returned, venting fury, getting her own back.


    I told her, having done a little research, that I would like to try and tackle things through diet and exercise, without medication. This didn't go down well at all. I told her of the low carbohydrate / high fat approach, with which many people I'd read about had had success. She unbendingly advocated the 'healthy plate' which is the 'national guideline' outlined on the NHS* website.


    Looking at advice on one 'NHS dietary advice page', they are recommending all sorts of stuff that I, and many other T2s would never entertain. Here, have a look at this PDF - what not to do.  In my opinion that is!

   

     (* For those abroad, NHS = UK National Health Service – which is normally pretty damn good.)


    I received little or no support from my nurse for my chosen direction.

    'Don't believe all you read on forums,' was one thing she said. 


    I can assure you, I don't believe everything I read on the internet. But what I had read, time and time again during the brief time I'd had to research, was the manner in which some new diabetics had been treated during their initial consultations. Some of it little short of callous.

    There are some wonderful, inspiring diabetic medics, but there are others too......


    If I come across as being confrontational, I suppose in a way I was. At the end of the day she's the professional, but she wouldn't acknowledge my views, there was little or no support and there appeared to be a lack of compassion. Perhaps it was because I had gone in with an idea or two of my own but, WALLOP, her way is correct, end of story.

    As I say, I'd seen enough to believe that the 'conforming to national guidelines' approach may not be the best.

    Over the coming weeks I was to learn much, much more about all this.


    I can't blame her for following the government-conceived dictats. She had to follow the script, or at least the guidelines, that she'd been given.

    In these litigious days, she can't afford to offer duff advice, therefore, understandably followed the party line. Actually, that's not right, she can offer duff advice. What she can't afford to do is veer from the establishment view. There's no protection for alternative thought. 

    What I was miffed about was her completely ignoring of my personal view.

   Put it this way, if I'd followed her advice, and that of the doctor, to the letter, I would have been on two different medications and eating food I believe worked against my low sugar / glucose objective. Although, I concede, with fledgling knowledge.


    (I was to discover that I'm not the only one to come up against similar intransigence, not by a long way).

 

    One of the side-effects of diabetes is poor circulation which, among other things, can cause foot problems. She gave me a through examination and alarmingly struggled to find much of a pulse in my feet. They didn't pain me, but I have had chilly feet since I can remember – certainly the last few years. As a result of this she booked an appointment for me with the podiatrist.


    She also said that retinopathy was another potential complication. This is where the tiny blood vessels in the back of the eyes can become short of blood, causing blurred vision and potentially serious disorders, even blindness. So she booked me in for a retinal scan too.

    I'm not sure if my vision had been a little blurry, but after the overload of information I got that day, I could certainly go a long way to imagining it had been.

 

    BUT - I have to say that the clinical side of my appointment was very professional.

    I was to be passed on to further specialists and those appointments came through quickly.

 

    So, from being an slightly porky 57-year-old, ignorant of any malady and happy with life, within a month I'd been bombarded with stuff I could frankly have done without.

    Blood tests, T2 diagnosis and all the potential misery that could heap, doctors visits and a struggle with the nurse. And now imminent retinal scan and in depth foot / lower leg appraisal.


    One of these latter two would lead to further problems – but we'll get to that in due course.


    One thing I have to say is that the speed with which I've been shunted through the system is impressive – all because of something picked up at a routine test.

 

    I don't want to preach but I'd like to encourage everyone to keep an eye on things.

    DO NOT IGNORE WARNING SIGNS (Particularly men who tend to ignore things! - except if they involve beer or football).

 

    The test for blood sugars is called the HbA1c. It measures your average blood sugar count over the previous 3 months. (3 months because that's the 'shelf-life' of our red blood cells which is where, in effect, the sugar sticks.)

    I've no idea how long I've actually had diabetes, likewise how long I have been developing it. It could have been coming on gradually for years, decades even. As I've said, the symptoms were not severe enough for me to flag it up.

    Having said that I wouldn't have known what the symptoms referred to had I noticed them.

    I suppose I was lucky that I was picked up during a routine check.

    Some people only discover they have diabetes when one of the side effects has got to the point worthy of a doctors consultation or even an emergency trip to A & E.

 

    You can usually prevent T2 diabetes by basically looking after yourself.

    If you are unfortunate enough to develop it, with the right guidance, you can manage it.


    At least that's what I hope at this stage.


    Notes in mitigation of my nurse........


    ** I have visited the (my) diabetes specialist on three occasions now. 

    Above I come across harsh - but I was being honest and it was just how it was.

    She is a good person, I know that now but we still have differing ideas on, for example, cholesterol.

    She is widely read on her subject, and is obviously very smart. In the inyerests of balance and fairness, I am less widely read and inherently dim. BUT, it's my body. My life.

    The fact is that, in a couple of areas, she is reading from a different hymn sheet to me.

   

    You see, at the end of the day we are all responsible for our own well-being. My (limited) knowledge is gleaned from speaking to people who share my condition. Many of them have literally turned their lives around. They have no reason to bullshit me about how they manage their problems. So I listen to them and I THINK that so far they seem to be right.

    I am sure my specialist is on my side, she has encouraged me and praised me.

    We'll just have to agree to disagree on one or two points, but I have come to like and respect her. **



    Read on.......Testing times. Lots of tests.