Patients = People
We are all patients, at some point in our lives.
with Amy Tenderich
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
October 2008 —I've been spending a lot of time lately with people working in the healthcare and medical industries. Funny how they constantly refer to "patients" as if we were some block of faceless subjects, seemingly resistant to everything that's good for us. It's a very "us and them" mentality, in fact: Those "patients" never take their meds on time. They're too inactive! They complain about doctor's recommendations.
I constantly try to remind these professionals that we are all patients, at some point in our lives. We are all people. We are all consumers, of healthcare and medical products. In other words, we hate medical procedures and pills and injections and strict diets and daily inconveniences just as much as YOU do.
So when you're thinking about whether patients will be "compliant" with a certain medical regime, the easiest way to answer that question is to put yourself in their shoes. Would YOU want to take 13 different pills every day? Would YOU be diligent about weighing and measuring every bite you eat, even for a few weeks? Think hard about what you do every day, every week, every month. Life's pretty busy, isn't it? There are work deadlines, and relatives and friends, community events, and sometimes bad days and bad moods and sickness and infections. There are planned vacations, and unexpected travel, and house guests and holiday celebrations with all sorts of "off-limits" foods in your face.
So I had a good laugh at some feedback from a project conducted by the TRUE Research Foundation (University of Washington) recently. They set out to develop a sophisticated data system to help people better manage their diabetes. To their credit, while gathering input for the system, they recognized that it's important to measure something they call "ODL" or "observations of daily living."
One of their big goals was to record what patients ate, so the system could later give feedback on the metabolic effects of each meal. So they tried instructing patients to use a cell-phone camera to take a photo of each meal before they ate it, and email that photo to their physicians. What fun!
"People just wouldn't do it," reported the project's principal investigator. "They felt it was invasive, or else that it stigmatized them. When people sat down to eat their dinner, they didn't want to take pictures of their food, they wanted to eat."
Ya think? I have to ask myself if that lead doctor and his team actually tried the photo method themselves.
I'm envisioning myself in the mayhem of our dinner hour, with four kids or more bobbing in their seats, spilling lemonade, singing Hannah Montana songs at max volume, while I'm juggling plastic cups and plates and spatulas -- trying to serve the whole family while holding just still enough to test my glucose and set my insulin dose all at the same time. "Oh wait, just let me stop to take a photograph of that plate of chicken and rice!" NOT.
Or in a restaurant with friends, where we're saying our L'chaim's over glasses of wine. Everybody's laughing and talking and the waiter is jockeying to fit all our plates on our cozy corner table. "Just a sec, let me get a shot of that shrimp scampi right there!" NOT.
Because when I'm sitting down to a meal, that's the time when I'm most prominently a person first, not a patient. Because diabetes is PART of our lives, not all of it.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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Well maybe not so much a furor as a controversy. The question, bluntly put, is whether or not a single HbA1c reading should be sufficient and adequate to diagnose diabetes — and whether the conditions under which the test was conducted should have any bearing on the diagnostic or non-diagnostic value of the test. The lede from