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[IP] Diabetes, The Medical Community, and Who's Driving Your Car...

Here are a few comments related to the recent discussions about medical
professionals and how they are often lacking in their treatment and advice...
Perhaps they will be helpful...

If you became Type 1 in the 1960's and were under the age of 10 years old,
like I was, the National Institue of Health estimated that you would die, on
average, at the age of 39. However, technological advances developed since
then allow most individuals who take advantage of them to live a lot longer
and with less long-term complications. These advantages include what you can
do to control bg while living with diabetes, and what can be done to correct
the long-term complications of the condition iof they do occur.

If we look at diabetes from the more distant perspective of the medical
historian, the treatments available today have occurred in the wink of an
eye. It's amazing that we can now often mimic (albiet with a lot of work) a
normal lifespan in length and often in quality of life--and if we do get eye
or kidney or nerve damage it's usually not the end of the road by any means!
Treatmets for retinopathy today, for example, are simply miraculous. Thus,
medical research has helped to establish the rules and treatment to greatly
enhance our lives even though it has seemed painfully slow to us.

The physician sometimes views the treatment of disease and its symptoms as
the major goal of medicine more than the prevention of disease, because
that's how most people--including many with diabetes ( and the established
medical community sometimes)--seem to want things. In addition the nature of
some conditions and diseases is such that there is not much the patient can
do to influence its course. The doctor thus treats the condition without too
much patient impact over the course. This can have an impact on the
physician's viewpoint....The doctor may think you fit into that spectrum as

Thus, it is  often up to you to come to an understanding with your doctor.  I
believe that there is no other condition that allows the "victim" more
influence over its course than diabetes (especially Type 1). It's important
to recognize that once you have gained a thorough knowledge of diabetes
(mainly through carbohydrate counting, established insulin therapy algorithm
(sliding scale), accounting for the effects of exercise on bg, and strategic
blood glucose testing)
 you are now the manager of the "team."  Indeed, those of us on the
cutting-edge of diabetes control are probably the biggest vangaurd of  the
movement of  individuals who take responsibility to prevent disease, or the
effects of disease, by aggressive interaction. Therefore we are now defining
true physical health not necessarily as the absence of disease but the
prevention of it's negative impact by conscious application of well
established principles. 

The medical professionals who assist you are your coaches and must understand
this role.  While you are conscious and in good mental health and know the
rules, you make the major decisions regarding the control of your bg levels.
And if conflict occurs, discussion should entail to iron out the differences.
If this fails--as it has in my circumstances in the past when I was
introduced to a rather dogmatic pump team as I obtained my fisrt Mini-Med)--yo
u have the right, indeed the obligation to not renew your coach's contract (
ie., seek another physician ). If you do this amicably your own physician may
agree with you, and find your decision reasonable--mine did..

The point I'm making is

 1.) That you are really the boss of your condition after you have combined
lots of serious study of diabetes from some meaty texts, with your personal
experiences of how to control your bg levels. Diabetes --particularly Type
1--should really be approached as you would approach a serious academic study.
 It's so complex, and so important, that it deserves prominance as if it were
"Diabetes 101", a tough college course, and you had to get an "A". 

2.) Doctors--especially those who are not diabetologists, often have way too
much information overload to keep up with you if you're really managing your
disease according to the latest technology and data. Not only this, but you
are applying the theories in the real world gaining valuable insights that
can intially be hard for the medical community to understand. 

3.) It's ok to get upset with your doctor ( as I have before), but try hard
not to bicker with him as you gain insight into diabetes and how to care for
it... Do make sure that you have an understanding with the doctor so that
when you have developed good skills in managing your condition, you are
percieved as the "driver of your car," who would appreciate a relationship of
mutual respect and interactions where you can gain insight from each other.

See Yah!