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Re: [IP] Fw: The Pump for Kids



Hear, Hear!  Good words, Randall.=20
Bonnie

>>> "Randall Winchester" <email @ redacted> 10/14 5:33 AM >>>
On  9 Oct 98 at 14:08, Ruth Elowitz wrote:

> Diane,
>=20
> 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=20
so many professionals are infected with.  I know several doctors who =
don't=20
think that keeping your bg in good control matters.  They routinely tell =
their=20
patients to let their bg levels float around 200 so they will "feel =
better" and=20
"the complications are going to get you anyway so why bother?" =20

There are problems with any form of intensive therapy for any medical =
condition=20
and the doctors, nurses and others are not really trained and prepared =
for=20
chronic conditions.  They do well on things that can be "fixed" but they =
get=20
frustrated dealing with chronic conditions too...   and after a while =
fighting =20
problems with all their patients they can get burned out just as quickly =
as we=20
can.

Ruth's wisdom here is that problems do exist and we cannot easily ignore =
their=20
existence - and the fact that some of the problems have entered into =
the=20
medical culture as "urban legends" and have assumed mythic proportions=20
continues to cause problems when medical professionals allow their myths =
to=20
blind them to changes... =20

> 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=20
we are dealing with.  Not just diabetes care but most medical care is =
directed=20
at low income people - because people with chronic medical conditions tend =
to=20
end up at the bottom of the economic scale because of job discrimination, =
high=20
medical expenses and the difficulty of maintaining a job while continuing =
with=20
treatment.  The term "non-compliant" is a form of "hate speech" because=20
it usually comes from someone who has no idea of the impact of the =
"treatment=20
plan" on the life of the patient.  Kind of like the old hospital story =
about=20
the nurse waking up the patient every half hour during the night to ask if =
they=20
want a sleeping pill because the "doctor prescribed it" - most "treatment=
=20
protocols" are based on the medical version of "one size fits all" and are =
not=20
integrated into the patient's lifestyle, cultural values.  Those =
important=20
items are considered irrelevant to treatment. =20

Many people are vulnerable to the garbage about medical treatment that =
spews=20
from the tabloids and talk shows - "Take 125 ginseng tablets a day and =
cure=20
your dog's bad breath..."  or "Eat this miracle food and cure your bad =
back"...=20
and the medical profession doesn't understand that part of the response is =
to=20
educate the patient.  Since our society doesn't value people much we don't =
seem=20
to understand that a few dollars invested in patient education pay off =
in=20
reduced medical costs downstream... just like the "system" doesn't care =
that a=20
small investment in improved control of bg levels pays off big time in =
lower=20
costs and better quality of life, with the return beginning on the first =
day of=20
improved control...

You've correctly stated two things that we must keep in mind -=20
1. The reality check that we must constantly do in order to not fall for =
the=20
latest fad, rumor or "trendy treatment" that comes along, and that also =
helps=20
us to demand proper treatment for ourselves and our families.  This must =
be=20
accompanied by the realization that for any improvements in treatments =
there=20
are associated problems and shortcomings.

2. The fact that as a society we just don't take good care of our =
caregivers,=20
ourselves or the people in need of assistance...  information, treatment =
and=20
support are often conspicuous by their absence.

I hear the boards on my soapbox creaking so I'd better jump off before =
they=20
break under my stomping...  just remember that the reality the medical=20
professionals inhabit, the reality that we live in and the reality of =
many=20
people with diabetes are not always congruent and sometimes seem to be =20
fluid entities rather than the concrete structures we imagine them to be.


Randall P. Winchester
WD4HVA
************************************************************
* 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.=20
***********************************************************

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