Wednesday, August 10, 2016

Thoughts on being a health (semi)professional and a diabetic at the same time

3 years ago I became a CNA, which stands sometimes for certified nurses' aide and other times certified nursing assistant, and usually is just called by the letters CNA. In Illinois, CNAs are required to have taken a course, done clinicals, pass an exam, and demonstrate competence in 17 tasks, from hand washing to making a bed with somebody in it, to taking blood pressure. In my actual job, I did in fact hand wash (lots), make a bed (only a couple times with somebody in it), and take blood pressure (lots). I also did a lot of monitoring people, talking, escorting people various places, refereeing, laundry, reminding people to take their medication, etc. I also did a lot of assisting my supervisor and the nurses with whatever I could.
A couple weeks ago I got a promotion to Wellness Coordinator, which means I'm in charge of making doctor visits and ensuring people get to them, and also scheduling CNAs, and that I'm part of hiring a replacement CNA. So I've been thinking about writing about what it's like to be on the managerial end of the hiring process, as this is a first for me. However, if you're reading this blog you're almost automatically somebody I would hire (if you were qualified and actually wanted the actual position I'm hiring for- some people apply but then aren't available at the times I'm hiring for or are imagining some more glamorous job).

So another job related thing I've been thinking about writing about: as you know, I identify myself as diabetic. Not a person who so happens to have diabetes, but diabetic.  I originally did it in the hopes that I could integrate diabetes into my identity, in the belief that that would be a happier and healthier way to be; I've come to feel that it also helps with being responsible.
In my job, I often encounter people whose diabetes has caused all kinds of problems for them (as well as people whose diabetes has nothing to do with why they need care from me and people whose diabetes needs care but hasn't caused significant complications). I've worked with people whose diabetes has resulted in their losing their vision, their kidneys, their gastric motility, sensation in large parts of their bodies, jobs and job prospects, and their lives; they've had congestive heart failure, heart attacks, strokes, early onset dementia, UTIs, lots of infections, transplants, the works. Their diabetes control ranges from extremely good to extremely bad, although almost all have had some real variation where they had some years that were much better than others.

I identify with all of our diabetics- though much more so with the younger onset ones- to a degree that I do not identify with my other charges.
When the young diabetic doesn't comply with the (really difficult to comply with) instructions after surgery to reattach her retina, I take it personally in a way that I don't when a guy whose retina detached for non-diabetic reasons also doesn't fully comply.
When our only 50 year medal eligible patient was belligerent I found compassion coming to me more easily than with other belligerent folks.

I struggle with thoughts about control. The majority of patients I've seen with complications from diabetes have significantly worse diabetes control than I do... but then, so do those without complications, and some of those with complications have better control than I do.  Some of our diabetics with major complications tell me that because they were afraid of lows or because they didn't want to deal with diabetes at school, or because their home life was so bad they enjoyed being hospitalized, they skipped shots or purposely ran high. I don't know what to say when somebody who went blind due to type 2 diabetes in his 40s and whose blood sugar is normal except when his eating isn't, tells me it was worth drinking the 2 two liter bottles of soda he drank, or that last night he ate (another) whole box of donuts. Or when somebody tells me he was so afraid of lows on the job that he purposely ran in the 400s... and now he's waiting on a fifth kidney. Or when somebody says he would skip shots because the hospital was nicer than his foster home- and now the nurse doesn't think he'll see 30.

I ran a diabetes class for some years at my facility, and got a significant audience- mostly of non-diabetics who wanted to know how to support their friends or understand what they were going through, as well as a sprinkling of prediabetics and the worried well. Soon I'm supposed to be taking a diabetes training course that authorizes me to teach a diabetes course that I'll be required to teach. At those times, my living with diabetes lends me legitimacy- but I think my education and the living with diabetes together are better there because lots of the folks I work with have had diabetes a long time but are really not folks you'd trust to teach about diabetes.

In a few weeks I will hit 10 years from my diagnosis, and today I went to see my doctor, so in a couple weeks I think I'll be posting with an update on my health, but, spoiler, I'm pretty healthy. Although I think that there are lots of things that go into that, including luck, and although I know that 10 years is definitely not long enough to declare anything about my future health,  I think my determination to integrate diabetes into my sense of self has helped.

1 comment:

Rick said...

Nice post Jonah. Drop over and say hello sometime.


I referred your blog to the TUDiabetes.org blog page for the week of August 8, 2016.