Tag Archive | Diabetes mellitus type 2

dominique et moi

November was Diabetes Awareness month. Or, so I am told. For me, every month is diabetes month and every day is diabetes day, as nary an hour goes by without my sharing sacred space with someone who has diabetes. Sometimes this is the shell-shocked newly diagnosed, other times, it is the weary veteran of the disease.

So, a few weeks ago when my dear friend and favorite diabetes educator Marie handed me a flyer of some local events in my community, sponsored by one of the national diabetes organizations, I agreed to distribute copies to my patients. Looking it over, I caught sight of something interesting. Tucked among the listings for some talks at a nearby hotel on various dietary topics, like Healthy Eating for the Holidays by some local nutritionists–was mention of a presentation to be made by Dominique Wilkins–the former NBA All-Star who played primarily with the Atlanta Hawks. My inner basketball jones, relatively well tuned from my life with Pete and Morgan perked up.   photo (2)

Dominique Wilkins–who was just so you know, born in France–was diagnosed with Type 2 Diabetes in 2000, just shortly after retiring from his long career. He is now a committed ambassador for the cause, passionate about helping others. While I doubted if many of my patients would travel across town for the other events, I thought some of them might be excited by the prospect of seeing the Human Highlight Film to make the effort. I asked Marie to get the date posted on our electronic message board.

A few days later Marie called me into her office and said, look at this email. Our CEO was informing her that the basketball legend’s PR folk had offered us a drop-in appearance at the Health Center and was wondering if we could garner interest with only a few days notice. Go for it, I exclaimed giddily, anxious for the opportunity to present some celebrity inspiration at our humble clinic. I quickly found a few other employees who shared my excitement and called a few of my “guys”, apologizing for making any assumptions about race, gender, age and sports interest. When a 13-year-old patient of mine who I mentioned it to seemed quite aware of Mr. Wilkins’ basketball legacy and excitedly understood the significance of such a visit, I maintained my enthusiasm.

At the appointed day and time, wearing sensible high heels to enhance my own short stature, I walked through the doors to the waiting room and there was Dominique Wilkins–graceful and stunning. I went right up to him, looked way up, introduced myself and shook his hand. We were now on a first name basis. I told him my husband taught me to enjoy the game of basketball by watching him play. I appreciate sport for its expression of the human body and its choreography, and Dominique certainly embodied both. He seemed touched.

The crowd in the waiting room was small but attentive. Some were there to see him. Others were just innocently waiting for their medical appointments. Dominique addressed his mixed audience. Basically, his impromptu message was that diabetes is a serious but manageable disease. Do what you have to do to deal with it. He matter-of-factly listed the basic dictates: do some physical activity that you enjoy for at least thirty minutes on most days, give up the sweets, stop drinking juice and soda and follow your doctor’s advice.

Apparently, as he was talking his talk, a woman sitting behind me was reacting with noticeable disbelief. He challenged her discomfort and questioned her on what she was thinking. She essentially said she thought he was talking crazy stuff–mere mortals could not do what he was suggesting. These simple declarations which are easy to espouse, are unfathomable and overwhelming to many–no matter who is delivering the message.

Diabetes is crazy making. It pulls the rug right out from under you when you thought you were just minding your own business. No other health condition asks so much of so many. The multiple actions required for ‘self-management’ are daunting. Once the blood is commandeered by an excessive army of sugar molecules, it demands some pretty strong sacrifice and extreme behavioral changes in a bargain to help assure that you get to keep all your digits. Minions are condemned for just starting the day with that big bright sunny glass of OJ and satisfying thirst with one of those ubiquitous caramel colored cola elixirs. No one said anything about diabetes and how it damages the heart along with the kidneys, nerves, eyes and brain, did they?  As Dominique gently goaded the woman to challenge her resistance, I saw in her face the communal shock of the masses, the same shock that had evidently once brought this Adonis of a man to his own knees when he received his diabetes diagnosis.

I then raised my hand to ask a question. I was interested to know his thoughts about celebrities–and celebrity athletes in particular–who endorse products known to be detrimental to health. I did mention a player’s name and I did mention a beverage product. Dominique’s defense was a little weak as he responded with “Who wouldn’t do that for a million dollars?”  I don’t know–millionaires, people who know their messages matter, someone who might spend a day with me in my office seeing the onslaught of diabetes–its victims increasingly both younger and more significantly laden with this burden of glucose metabolism gone awry? He rebounded by saying that many athletes give a lot of their time and money to supporting important causes. Yes, this is true, but nonetheless, there it was, the constant contradiction.

Yes, the contradiction that favors and forgives corporate irresponsibility while individual and societal health is decimated in its wake. Another example of the kind that leaves our government and the rest of us pathetically pawing the ground trying to find and fund ways to clean up the mess. Per year, the company that makes the product I referred to, spends something like 1.7 billion dollars–could that be right–on advertising just its beverages; and the athlete will earn about $60 million. May I add that the companies that market diabetes drugs are also raking in some big bucks. Meanwhile, my patients and many like them sit among the rubble of a broken health care and food system often without two good glucometer strips to rub together.

Dominique’s response did not diminish my admiration for his work or for his play. He is doing something valuable in bringing his efforts to diabetes awareness. He showed up and talked to my patients. They and I appreciated it. Still, I sighed deeply. Diabetes can be a grim disease–especially for those without some modicum of financial resources, intelligence and fortitude–and access to good quality food and medicine defined in its truest sense.

Interestingly, Dominique, well endowed with more than a modicum of these necessary ingredients, shared that the most challenging part for him to do in order to address his own condition was exercise. After 18 years as an elite athlete in top physical form, peeling his body back off the couch and wrangling it back into servitude, was the last thing he wanted to do.

Well, here’s to all the things I would do in service to the public health if I had just a few of those millions of dollars. What do you think? What would you do?  Let me know.

In health, Elyn

Check out this infographic from this company American Recall Center which is committed to providing important consumer health information particularly related to prescription drugs and medical devices. http://www.recallcenter.com/life-diabetes-diabetic-bloggers-want-know/

Rose's Plate

Rose’s Plate

My Plate Haiku

Food is medicine

Farmers are doctors, Cooks priests

Eat, pray, eat, pray, love.  by Gordon

a cinderella story

Yesterday, at 2:00, I had my last client guest of the year. I was visited by the young Haitian princess Atabei. I have had the pleasure of working with her over the course of the past year. I was granted permission to be in her highness’ presence because her royally endowed  figure put her by age sixteen very close to 300 lbs. Now, she is almost eighteen. She is not the heaviest of my young clients but I do particularly worry about her because she has Type 2 diabetes.

HISTORY | Her Serene Highness Princess Olive, Daughter of Emperor Soulouque. Haiti C. 1858

Haitian Princess

As we know from many fairy tales, life is not always easy for the crown-wearing crowd. Atabei has had a not so rosy past and has been fending for herself  for a very long time. She has a queen mother and an older prince brother who love her–but who are caught up in their own problems to have much time for her. She navigates most of her medical care essentially on her own. Unfortunately, medicaid doesn’t pay physicians for castle calls.

Like  many royals and commoners alike, Atabei was used to eating in a bacchanalian fashion and was not subscribing to my pedestrian nutritional guidebook. She mainly craved and consumed foods that in her own giggly adolescent words were magically delicious. For those of you who may not know what that means, Lucky Charms, Toaster Streudels and Dunkin’ Donut Munchkins are magically delicious, while whole wheat bread and oatmeal are not.

Progress was very slow, but she got a lot of credit for what we call just showing up–despite multiple challenges and limited ability to change her food environment; and she was succeeding at what I like to refer to as weight gain stabilization–she wasn’t losing weight but she wasn’t gaining either. Being evicted from the castle and landing in a motel does not usually lend itself to being able to focus on one’s eating habits and feeling good about oneself. Still, despite a few missed appointments here and there, she kept coming and she kept journaling. She was never too shy to hide her utter disgust at some of my suggestions, and held tight to the foods that comforted her.

Eventually, I began to encourage her to get over to the local YMCA, where I have a partner in crime–Ben. Ben’s a little wiry guy, but as the wellness director responsible for youth programming and as a trainer, he is deeply committed to catching any kid–no matter how big- I can throw his way. Patiently, he serves to help re-knit the self-esteem that has been unraveled from so many through the art of attention and physical activity.

After a few failed attempts, Atabei gathered her horses, got in her coach and proceeded over to the Y.  Yesterday was the first time I had seen her in awhile. She arrived in her radiant beauty, sans tiara, more alert and positive than I have ever seen her. She has only been going to the Y for a month, but she is already enjoying that her endurance and strength have increased. She is drinking a lot more water, is less obsessed and possessed by her old magically delicious foods, and is shocked to realize she can now choose to leave food behind. Gradually, she has made some significant diet changes which will help heal her insulin resistance.  I had to almost stand on my desk and shout for her to acknowledge this. But, when the scale confirmed what I  already had, her beautiful princess smile widened even more.

At the end of the session, I helped her set some of her goals for the new year. She had never before been able to even imagine that there was a possibility for change that she could empower herself. Now she finally could. What did I ask of her? That she keep really listening to her body and seeing what it actually needs; and that she not give up on herself. She will try–she does like to humor me.

When the clock struck three and she stepped off the curb in front of the building, she may have looked like just another poor, fat kid– but things are not always as they appear in the kingdom. Blessed be. Tres Bonne Annee, Atabei!

Please honor–and if you care to, share here your own small victories. Cheers.