Wednesday, August 24, 2011

Medical Care--or the lack thereof

I'm so angry and scared I can't find the words to say what I feel right now. I keep wondering whether what happened to me is how the American public really wants people to be treated. We have millions of unemployed people who don't have health care, since most health insurance is through people's employment. We have millions more working people who don't have health care because their employers don't offer it. Somehow we have to fix it, but I don't see how and certainly not in time to help me.

I recently had surgery. They diagnosed me with type 2 diabetes. They said I didn't need medication. I need follow-up medical care to try to keep me off medications. They sent me a referral letter and I called. The registration clerk told me the referral was for the classes I already attended. She offered to make an appointment with a pharmacist. I told her I didn't see why I needed to talk with a pharmacist since I don't need medication at this point. She told me they don't offer ongoing care for people who aren't on medication. I can get medical supplies to test my blood sugars and take all the healthy living and education classes they offer and attend the diabetes support group.

She said that I could get a primary care physician to work with me. I got the number from her and called. The clerk who answered that phone told me some garbage that made no sense about them redoing the clinics so no doctors are taking new patients right now. I wondered if I had insurance or cash if that would have been the case, but I saw no reason to ask because she'd say whatever she'd been told to say. Someone on Yelp posted that they got the same story and the post was over a year ago. The clerk said if I go to outside clinics there's no guarantee that they'd take the program I'm on. I got the message. If you don't have outside insurance or the money to pay, you don't get care unless you need something that specifically requires a doctor. In my case, that would be medications that need to be prescribed.

Right now my disease is barely started. My numbers are not in the "You're not diabetic" range, but they're pretty stable and mostly in the lower range of where you'd be diagnosed as diabetic. If I could get individualized help to tweak what I'm doing to try to keep it under control and improve those numbers, I may not need medication for a long time. But what do I do without that help? 

My research is leading me to the same brick wall. At some point, all the book authors, medical web sites, etc, all say to discuss various aspects of your care with your doctor or health care team because they have to be personalized to how your body is responding to your efforts to treat the disease. How do you personalize it when you have to be your own doctor and you don't have the medical degree and medical experience and access to a lab to test your blood regularly?

And back to my original question-Is leaving people to get sicker to make them need medication so they need to see a doctor to prescribe it, rather than helping people stay healthy and off medication, really what we want to do? Apparently, the answer is yes. When you don't have insurance, people ask why didn't you go to the doctor before it got this bad? Or get angry that you went to the emergency room because what you have isn't life-threatening. What else can you do when no doctor will treat you until you get sick enough to need the emergency room or, if the hospital has it, a clinic for immediate needs that aren't life-threatening?

Tuesday, August 16, 2011

Changes

This year has been about change. Life is always changing, but this year things have been turned on their head more drastically than any other time except for the other real biggies-getting married and having my children. This year I broke my arm-alerting me to the osteoporosis that I didn't know had started to develop. Several months later, I needed surgery and they discovered I've begun developing type 2 diabetes. That's a total life-changer. While still getting my head around that, we moved in with friends. I'm feeling a need to sort through it all in my head and I do that best by writing about it.

I've been researching the subject and finding that they don't, in fact, really know what to do. The literature seems to assume people won't do the diet, exercise and weight loss that's needed to perhaps avoid needing medication, at least for a long time, and to avoid the nasty complications of the disease. It's a progressive disease and, like every other physical process, your body's ability to produce/use insulin gets worse as you age. it's likely that even if you manage it for a long time without medication, eventually you may need it. But some doctors say they always prescribe medication, just in case you don't do what you're supposed to do. They figure they can always stop the medication.

But it seems to me that sets you up to fail. Plus, using the medication alters your numbers, so you really don't know what they would be if you didn't take the medication. Everyone is a bit different, so you have to tweak their advice based on your own body's reaction to what you eat and how much you exercise. When I was in the hospital, the doctors said I'd just begun to develop it, so they recommended I start with diet and exercise and losing weight.

To that end, I'm monitoring my blood sugars to start to figure out my body's pattern. I'm following the carb counting diet recommended by the dietician. I'm using Weight Watchers to keep track of appropriate portion sizes. And I'm walking the track every morning. I can do a mile. I could walk farther, but my post-surgery abdominal muscles aren't up to it yet. I'm hoping to build back up to walking an hour and aiming for at least 3 miles. None of that is especially difficult. It's doing all that stuff every day, all the time, that can burn you out.  Keeping accurate records is hard for me because it's tedious and time-consuming and I get bored and don't want to do it. But without the records, I'd have no idea what's working and what isn't.

The hardest part is the feeling that I'm pretty much on my own due to our broken health care system. I haven't yet seen a doctor about the diabetes, although I'm in the middle of the diabetes education classes. In order to see a doctor, I had to get the business/insurance stuff dealt with first and that took much longer than it should have. That's finally done and I'm calling this morning to make an appointment.

The blessing is that the woman we moved in with has had type 2 diabetes for years and she's been super helpful as I've started to learn how to live with this disease. She knows so much, but she waits for me to ask her for help because she knows I need to be ready to hear what she's learned. It's not just a physical disease. It affects you mentally and emotionally, too.

I think the hardest thing for me mentally and emotionally is that I knew it was in my family history, so I've always tried to exercise regularly and eat healthy food. I've not been able to sustain weight loss because of the emotional eating, but I can't just give up and quit  because of past failures. I've learned a lot from those failures and hope putting what I've learned to good use will help.

However, in the long run, the weight and the genes won out. I'd like to think I managed to stay healthy until I was almost 60 because of my attention to my health, but who knows? My grandfather's family has a lot of people with diabetes in it, including him. My aunt also had it. She died of kidney failure. She seemed to do less of what she needed to do as time went on, which was probably burnout. That's the lesson I'm taking. I'm not going to pretend it's going to go away or that it's a mistake or that I can ignore it and be OK, somehow. I'd rather be like my grandfather who lived well into his 80s and he was diagnosed much earlier in his life than I have been.

Thursday, August 11, 2011

Need a Techie Guru's Help

We've set up three computers in our recent move. I almost hesitate to say that the SJCO Mac, my work computer, is the only one that works properly when connected via the wireless network to the internet because I don't want unhelpful comments like, "Just replace your PCs with Macs" because that's not a viable solution for our situation. Neither do I want a PC vs. Mac war. So, please limit your comments to suggestions I might actually be able to use to fix the problem. Thanks. On to describing the problem:

Paul set up his computer and checked his email. When he tried to go to any site not connected with Google, the sites wouldn't load. He did get Craigslist to load, once, but after he shut the computer down and rebooted it would no longer load. It doesn't matter what browser he's using.

I set up the office Mac and, once the first page loaded, which took longer than normal, everything worked perfectly.

When Paul set up my desktop computer, I experienced the same problem he's having with his laptop. My computer will not load any pages except gmail, etc.

Here's where it really gets weird. Paul hooked up his laptop using a LAN cable and it worked perfectly. When he unhooked it and tried it wirelessly again, the problem returned.

Anyone ever heard of this? Anyone have any suggestions?

Thank you all for taking the time to read and consider our problem.