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Re: [IP] Fw: The Pump for Kids

On  9 Oct 98 at 14:08, Ruth Elowitz wrote:

> Diane,
> I won't butden you or anyone else with negatives you don't want to hear. I like
> my pump.  It is a much better treatment than shots.  But I know lots of the
> problems the teenagers who lived with them for many years (some of whom quit
> along the way) experience and experienced.  Those are some of the reasons
> doctors are skeptical.

I think a lot of the skepticism also comes from the "not my idea" syndrome that 
so many professionals are infected with.  I know several doctors who don't 
think that keeping your bg in good control matters.  They routinely tell their 
patients to let their bg levels float around 200 so they will "feel better" and 
"the complications are going to get you anyway so why bother?"  

There are problems with any form of intensive therapy for any medical condition 
and the doctors, nurses and others are not really trained and prepared for 
chronic conditions.  They do well on things that can be "fixed" but they get 
frustrated dealing with chronic conditions too...   and after a while fighting  
problems with all their patients they can get burned out just as quickly as we 

Ruth's wisdom here is that problems do exist and we cannot easily ignore their 
existence - and the fact that some of the problems have entered into the 
medical culture as "urban legends" and have assumed mythic proportions 
continues to cause problems when medical professionals allow their myths to 
blind them to changes...  

> I don't want to be the voice of doom and gloom, but I
> think the reality check is important so if you want to know more you can ask.
> Otherwise, I'll keep quiet this time around.  They are also skeptical b/c
> diabetes care is traditionally directed at a low income, non compliant, poorly
> educated audience and that audience would have a hard time using a pump without
> lots and lots and lots of education and support which we don't provide in our
> society.

Reality checks are important, but it is also critical to remember whose reality 
we are dealing with.  Not just diabetes care but most medical care is directed 
at low income people - because people with chronic medical conditions tend to 
end up at the bottom of the economic scale because of job discrimination, high 
medical expenses and the difficulty of maintaining a job while continuing with 
treatment.  The term "non-compliant" is a form of "hate speech" because 
it usually comes from someone who has no idea of the impact of the "treatment 
plan" on the life of the patient.  Kind of like the old hospital story about 
the nurse waking up the patient every half hour during the night to ask if they 
want a sleeping pill because the "doctor prescribed it" - most "treatment 
protocols" are based on the medical version of "one size fits all" and are not 
integrated into the patient's lifestyle, cultural values.  Those important 
items are considered irrelevant to treatment.  

Many people are vulnerable to the garbage about medical treatment that spews 
from the tabloids and talk shows - "Take 125 ginseng tablets a day and cure 
your dog's bad breath..."  or "Eat this miracle food and cure your bad back"... 
and the medical profession doesn't understand that part of the response is to 
educate the patient.  Since our society doesn't value people much we don't seem 
to understand that a few dollars invested in patient education pay off in 
reduced medical costs downstream... just like the "system" doesn't care that a 
small investment in improved control of bg levels pays off big time in lower 
costs and better quality of life, with the return beginning on the first day of 
improved control...

You've correctly stated two things that we must keep in mind - 
1. The reality check that we must constantly do in order to not fall for the 
latest fad, rumor or "trendy treatment" that comes along, and that also helps 
us to demand proper treatment for ourselves and our families.  This must be 
accompanied by the realization that for any improvements in treatments there 
are associated problems and shortcomings.

2. The fact that as a society we just don't take good care of our caregivers, 
ourselves or the people in need of assistance...  information, treatment and 
support are often conspicuous by their absence.

I hear the boards on my soapbox creaking so I'd better jump off before they 
break under my stomping...  just remember that the reality the medical 
professionals inhabit, the reality that we live in and the reality of many 
people with diabetes are not always congruent and sometimes seem to be  
fluid entities rather than the concrete structures we imagine them to be.

Randall P. Winchester
* The views expressed here are mine and do not necessarily *
* reflect the official position of anyone in particular.            *
* There's no guarantee on anything said here...
* If I say I understand something completely the only thing
* we can both be assured of is that I must have completely
* misunderstood something. 

Insulin-Pumpers website http://www.bizsystems.com/Diabetes/