Educating the diabetes educator

Today was another baby appointment. After the last visit three weeks ago where I waited for over an hour I was concerned this visit might involve me flipping furniture in the lobby like Godzilla. They must have made a note in my file, though, because I was called back at 1:35pm for my 1:30pm appointment. They whirled through my blood pressure, weight and other stats in under 10 minutes and I was situated in the exam room. The rest of the visit is usually where the nurse listens for a heartbeat, the diabetes educator looks at my blood sugar logs for the last three weeks and I wait to chat with the OB for a bit about anything pertinent. They take a few vials of blood for lab work and I'm on my way.

I love my OB but have had a strained relationship with the diabetes educator, Georgia. Because I'm forced to deal with her each visit it adds stress to the entire process. In the last visit (after waiting over an hour and having her dump my purse on my chest during the ultrasound) I got a little snippy with her. I wondered if she would remember me.

Interestingly, a new diabetes educator, Marilyn, came into the exam room. She had obviously been prepped about me because she knew I don't use their precious book and didn't give me attitude about it. She seemed to do better about not judging my blood sugars but then we started talking food. She fussed that I'm not eating enough protein during the day. When I asked her what she suggested, she said "you could have cheese or Canadian bacon." Seriously? Those are the two first things that come to mind when you think about protein? And why Canadian bacon? Not chicken or regular bacon or ham, but Canadian bacon.

Me: "I don't eat cheese." Her: "Oh, are you allergic?" Me: "I'm 19 weeks pregnant and you can see my food logs for the last three weeks. I eat 10 grams of fiber every morning. As far as I'm concerned, cheese is evil." Her: "Ahhh. Well, there's always Canadian bacon or other meats."

Marilyn returned to my logs. "I see you had a burger and fries. That's high in fat and will mess up your blood sugars." I just waited stoicly for her to get to the next line. "Hmm, but your sugars seem fine afterwards." Yeah, I'm kinda down with the Five Guys cheeseburger and fries combo.

"Frosted Mini Wheats? You shouldn't be eating stuff like that." She actually shook her head and looked over her papers at me. "You should eat multi-grain Cheerios instead of sugary cereals like that." I just looked at her and didn't say a word. I was starting to wish I had just dealt with Georgia instead.

When I was first diagnosed with diabetes in 1985, I was told I had to go the children's hospital instead of my parents' preferred and closer hospital because the children's hospital apparently had experts on juvenile diagnosed diabetics. We learned later that I was the first juvenile diabetic they had ever treated. The dietitian told us that I could have all the fruit juice I wanted but no sodas because fruit juice was a natural sugar and wouldn't affect my blood sugars. These people went to school to tell us that. I was allowed to have eggs and toast and milk for breakfast but not allowed to have french toast without the syrup because french toast was a forbidden food.

When I got back to the office and could look up my precious Frosted Mini Wheats, I found they have 10 fewer calories per ounce than Cheerios and more protein. Besides, Cheerios is now considered a drug so I'm sure they're bad for the baby.

After Marilyn left, I still got a visit from Georgia. She asked her usual question of "am I going to like these numbers?". I stammered. I knew she would probably ask this question and I wondered how I would react. I had scripted a few caustic retorts but nothing really sounded right. So instead I just stammered.

Georgia: "That sounds like I'm not going to like them." Me: "No, it's more like I don't like the question. I've been diabetic for exactly 24 years and every doctor and dietitian has stressed that I am responsible for my blood sugars. It's a lot of pressure to feel like you're responsible for anything that goes wrong with your disease because you could have prevented it."

I was surprised at how calmly I delivered all that. I think Georgia was surprised too because she turned from her paperwork and her mouth fell open.

Georgia: "But that's not fair to say that. The hormones affect your sugars and you can't control those." Me: "I think the whole point is that it's not fair. I just think a better way to phrase the question would be to ask me if I am happy with my numbers or even just to ask if I'm having any issues or problems." Georgia: "I ... you're right. That's a much better way to phrase it. So are you happy with these numbers?" Me: "I'm relatively happy with them, but maybe we can fix a few things."

So my appointment was still not very speedy but they're trying. I think by the time this baby is born, we'll all be a little better educated about maternal fetal medicine.

As my mother says, it's tough to get old

Everyone in the family seems to be under the weather this weekend. Rich's mom got sick and canceled our brunch so as to not give our unborn child swine flu or whatever she has. Both of my parents are recovering from bronchitis and Rich popped his back on Saturday. I'm the most able bodied of all of us and I'm almost 18 weeks pregnant! Our beloved elder stateshound Sarah has fallen ill again as well. Back in February she scared me to death by developing a head tilt that suddenly turned into her falling all over the backyard and being unable to walk or stand. I wondered if she had had a stroke but packed her in the car to take her to the emergency vet. Thankfully, as soon as I carried her inside they asked how old she was and when I said she was 12, the nurse said "I'm pretty sure what's wrong with her and she'll be fine."

Apparently older dogs can get a vestibular disease that gives them a horrible case of the dizzies. It runs its course in a few days or weeks but all you can do is give them dramamine for the nausea and benadryl to knock them out and prevent them from hurting themselves around the house.

She got better then and just kept a bit of a head tilt as well as a fair amount of high end hearing loss (she can hear you clap your hands, but if you whistle or call her name she has no idea). Last night she took a nasty spill on the hardwood floors and it spooked her enough she wasn't inspired to leave the living room rug. We figured she would be okay, but this morning she couldn't walk in a straight line (she would have totally failed a sobriety test, never mind that she can't say her alphabet backwards). Since Rich's back was out, I've been on dog duty carrying her outside to potty and corralling her from wandering in the street (she has no idea where she is). I'm so grateful I'm still able to lift a 65 pound dog without my belly getting in the way.

This episode seems to be worse than the last one in that she can't feed herself very well. So I'm having to spoon feed her and put her water over her left shoulder since her head tilts that way.

Hopefully she'll get better in a few days on her own, but I'll still call the vet to see if they want to run tests. Last time they said as long as her eyes darted back and forth and not up and down that usually meant vestibular disease and not a brain tumor. Googling dog diseases is just as bad as surfing WebMD, so the Internet is convinced my dog is at death's door. But she seems fine if a bit sick to her stomach from all the dizziness.

In the meantime, we just call her Lucille Two.

Here's a video of feeding her, if you're interested.

Living Out Loud volume 5: Your personal folklore

My father is not a writer. I have watched him agonize over a single page document for hours until he has lost all perspective on it. The drafts folder within his email is overflowing with half-finished diatribes about politics, the price of lumber or whatever other things rile a man of his age. When he does manage to hit send on an email it reads as if he is convinced his internet service provider charges by the word. But my father is a storyteller. He has a story that relates to nearly every situation at hand and never hesitates to spread those stories to others. His father was a storyteller as well, illustrating his point with old bible stories, Aesop's fables or farm life folklore that had been told amongst men in the fields. It makes it difficult to have a short visit with either of them, but it does make them fascinating people.

If you're not a Star Trek fan, bear with me a moment for this next part. You know that episode of Star Trek: The Next Generation where Picard ends up on a planet with some other random captain that doesn't speak English so they can't understand each other? It turns out that Picard eventually realizes that this other species' language is based completely on metaphor. The climactic moment is when Picard realizes that "Darmok and Jalad at Tanagra" is a fable about two men with completely different backgrounds and cultures uniting to fight a common foe. (side note: Wikipedia kicks ass!)

While our own Earth culture may not have a Tanagra, each of us has a subculture from our family, friends and shared history and that gives us a foundation as we navigate our way through new situations.

When we had our bathroom installed upstairs at the new house, my father was supervising. They had delivered the tub and were trying to wrestle it into the space but they had made the space too small. While the random construction workers were using brute force to fix this problem our plumber was trying to set pipes in the same area. My father realized that the construction workers were about to trash our roof line with a sledgehammer if they pushed any harder so he started yelling at them to stop and chewed out the foreman. The foreman was unphased by my father and they settled their differences but at that same time I got panicked phone call from our plumber telling me my father was out of control and he was worried about him being there.

I had to call my father and tell him to be more mellow around the plumber because he had spooked him. Daddy was still riled about the injustice of our incompetent contractors nearly destroying our ceiling so he started yelling about how he had no beef with the plumber so he shouldn't have cared and he was trying to prevent a crisis. I told my father, "The plumber is Perry on the school bus." Suddenly my father stopped in mid-rant. He said, "Ah, I get it. I'll tread lightly around the plumber tomorrow and be more sensitive to him."

Why the big change? Because when my brother was about 8 or so, he would get off the school bus and be a total wreck. My mother would ask him what was wrong and he would mumble something about the bus driver yelling. The other children on the bus were like wild animals and the bus driver would yell at them constantly during the whole trip home. My brother was doing nothing wrong and he knew the bus driver wasn't yelling at him, but just being around all that animosity and strife stressed him out. My brother was a sensitive soul, just like our plumber.

For this month's Living Out Loud, I want you to tell us a story that you may never have written down but is a part of your personal subculture. Tell us about your Tanagra or your Perry on the school bus. It doesn't have to be some big moral analogy that would save us if we were teleported to a foreign planet. Perhaps it's just a story that's been told around a table or fire pit so many times all you have to say is "remember such and such" and everyone nods their heads in understanding. Part of what builds a community is a shared set of experiences. So let's get to sharing!

The nitty gritty details are:

• Tell us about one or more examples of your personal (family, friends, network) folklore. It can either be a written record of the legend itself and/or the story and your interpretation of it.

• Once you have completed your entry and posted it, please email me the link at genie [at] inabottle [dot] org.

• If you do not have a blog to host your story, you can email me the story directly and I will add it here as a guest post giving you credit.

• The due date for entries is Sunday, June 7th (the first Sunday of the month) at 5pm Eastern. I'm still pleased with the Sunday deadline because we all procrastinate.

• Once I have collected all the entries, I will post a wrap-up to list them all and announce a winner. The winner will receive some sort of prize to be determined but all participants will receive fame and glory and a link on our Living Out Loud blogroll.

Go forth and write good things. You can do it!