Type 1 diabetes

YouTube

When I see patients, I often talk about the importance of taking risks, trying new things, and experimenting. So, I decided to take my own advice, and try something new… I’m on youtube. Yep, Dr. No-Social-Media is going to try and do something new, and see where it goes.

My goal is to post 2-4 times a month, and to post videos about things I often talk to patients about, or things that I think will be helpful. Topics will be on substance abuse treatment and recovery, as well as type 1 diabetes. I don’t know if this will work— its a grand experiment.

Video number 1: https://youtu.be/mswHwYC-kLA

Its just a number (part 2)

The last post on language, diabetes, and blood sugar numbers applies not just to diabetes. It applies to most chronic health conditions. Take blood pressure management. Or cholesterol. Or any one of a number of things that are related to health.

We all want to be healthy, and we want indicators that are health is good. But the reality is that sometimes, we have work we need to do. However, instead of viewing a high blood pressure as a sign that "I am a bad person" try re-framing that to, "I'm glad I have that information, so that now I can take care of it." Instead of and elevated LDL (cholesterol) being something bad, view it as an opportunity to focus more on exercise; or on gratitude that we have found out that its high, so that we can address it with medications. 

When it comes to data related to your health, good and bad are in the eye of the beholder. Focus on the data, not the baggage that comes with it. 

Its just a number

Language matters, and the language we use to talk about blood sugars matters a lot. Sometimes, blood sugar are discussed as either “good” or as “bad.” Oh, your blood sugar is 105mg/dl, that’s a good number. Hmm, your blood sugar is 248mg/dl, that’s a bad number. Its important that you test your blood sugar. 

The trouble with this is that no one wants a bad number. As a patient, you’ve put in all this work to take care of yourself, and then… you don’t get the result you want. You get A BAD NUMBER. You feel disappointment, discouragement. Thoughts like, “If I do everything I’m supposed to, and it still doesn’t work out, why bother trying.” Or, when you test your blood sugar, that might be a test that you fail.

But guess what? Type 1 diabetes is difficult to manage. You can be doing everything right, and blood sugars still aren’t where you want them to be. You can be checking constantly, carb counting, exercising, you name… and still blood sugars are high. That alone is frustrating enough, but when you then feel like you have failed, and gotten a bad number, its enough to make you throw up your hands and say, “I quit.”

Consider the following thought experiment: a person with type one checks their blood glucose 4 times per day (or checks a CGM 12 times per day)

(4 times per day) x (365 days per year) x (50 years) = 73,000

(12 times per day) x (365 days per year) x (50 years) = 219,000

Tens of thousands (or hundreds of thousands) of numbers. If every time someone views a number, they are thinking about it as a test that can be failed, guess what? No one likes to fail tests. 

So, no more good or bad numbers. A number is just a number. Its a piece of information, like the weather. Its helpful information, so that you have data you can use to take care of yourself. No more testing (how about checking?)

Its just a number. Its just data. Use to to take care of yourself, nothing more, nothing less.

Community

As many of you know, I spend a good amount of time each summer at Bearskin Meadow Camp, in Kings Canyon/Sequoia National Park. Its beautiful up in the mountains, and a tremendous amount of fun. The camp is for children and families who live with type 1 diabetes. My first summer there was over 20 years ago. 

There are many amazing things about camp, but one of the things that I took away most strongly from this summer is the community that camp offers. People living with diabetes often feel tremendously isolated. Many of the campers and staff that come to camp feel that most of the year, no one “gets it.” In contrast, while they are at camp, everyone “gets it.” There are a whole host of issues that living with diabetes comes with, and spending time with people who have shared those experiences, is profoundly healing. Why? I think, because it dispels the notion of “I am alone.” 

I like to say that the antidote for isolation is community. 

The challenge is that the feelings of isolation that go with living with a chronic illness are not isolated to diabetes. In fact, many of the patients I see daily struggle with this feeling. The irony is that this difficulty connecting with others is universal human experience. Everyone feels it, to a greater or lessor extent. 

So, for people who are lucky enough to be able to go to camp, come to Bearskin. But, everyone and anyone can practice creating community. If you are feeling nervous about striking a conversation with someone— a neighbor, a friend, someone in the checkout line— know that they are probably just as nervous as you are. And know that both of you will be richer, less lonely, and less isolated, with a bit more human connection. Whether at camp or at home, practice building community.