Doing her job

8:28 a.m. A big, black paw hitting my shoulder awakes me. It hits me a few times. I reach out and pet the paw, and close my eyes--trying to get back in my dream.

The paw hits again, only this time on my face. I reach out and pet and attempt to coerce the dog to lie down and snuggle.

“Come on buddy. I’ll pet you. Lay down.”

Now the dog is standing over me, digging with her paws near my face.

8:32 am “FINE! I’M UP. O.K. I’ll TEST!”

Grab the testing kit next to my bed. The dog gives a heavy sigh and curls into a ball and rests on the bed. No more pawing me.

Fumble it open and slide a strip into the machine. Turn the light on so I can see where to put the blood.

Pick a finger to poke. Push the button. No blood.

“Dam, I need to put a new lancet in here.” It’s probably been a month since that lancet was changed.

After three pokes, I finally pierce a finger and squeeze blood on the strip.

The light goes out- sample was accepted.

Beep. 55.

Grab a juice box and slurp the whole thing down.

I reach over and pull the dog close to me. I kiss her head.

“Thanks. Good low. Good dog.”

The dog sighs and rolls over so that I can rub her belly.

We both fall back to sleep for 20 minutes.

She’s content.

I’m safe.

New diagnosis

I don’t understand the treatment for Type 2. I don’t really know a lot about medications that are available. I read Diabetes Forecast and have stopped skipping through the Type 2 articles and actually reading them. I’ve tried to understand this “other diabetes” because many friends and acquaintances have that disease.

A woman that I work with at school was diagnosed with Type 2 about a month ago. Her doctor (at a major medical center in the twin cities) sent her home with a prescription for Metformin, directions for its use, and a scheduled appointment for diabetes education four weeks from that time. She filled the Metformin and started taking it. I asked if she was testing, and she said that the doctor said that she could wait until the education class.

The education class was last Thursday. This woman left work early to attend it.

She came back to work on Friday. I asked how the class was. She said that she couldn’t be in the class because she had to meet individually with her doctor. Apparently her blood sugar was high. They did a “1AC” (A1c) and it was 19.8. My jaw dropped.

19.8. OH… MY…GOSH! I didn’t know the test range went that high. Isn’t that a serious medical condition?!?!

I ask if they gave her any insulin. She said no, that the doctor had just told her to keep taking the Metformin, test her blood sugar twice a day, and come back for a follow up appointment in another month. What?!

I wish this were the only time that I had heard about that kind of plan for someone newly diagnosed with Type 2. But it wasn’t. I’ve heard stories like that more that once.

Why aren’t people with Type 2 treated aggressively? Why wouldn’t this woman be instructed to test more frequently, to figure out if the Metformin was enough? Where’s the meal planning information?

Diabetes is a challenging chronic illness. I am constantly out there researching what is new and possible for my management. I’m an informed member of my health care team.

I have friends that are not. They take the back seat in their diabetes management. When I suggest that they ask their doctor about new things, they are reluctant. Their control often reflects that.

Heck, I have a family practice doctor who is my "primary care physician." It's the rule to have a doctor to call that, and it can't be a specialist like my endocrinologist. I see her if I have an illness or injury. She has suggested, many times, that she just manage my diabetes. No way. Although I appreciate her willingness, I'm not settling for anyone but an endocrinologist who specializes in diabetes. I have friends that do see just a general practitioner for their Type 1. They are also often the ones who aren't aggressively managing their disease.

If health care providers aggressively helped manage people’s diabetes, would the rate of complications be so high? Is our health care team content with basic management?

It seems like people with Type 1 are diagnosed, and expected to make major life changes immediately. MDI, insulin pumps, carb counting, sick day management, ratios, etc are all started quickly. Why not with Type 2 diagnoses? Why is the management plan for Type 2 so gentle, so slow? First try and lose some weight, test a couple times a week, take a couple pills. Where’s the urgency?

Is it our society that has made Type 2 “not a big deal.”? Lose a little weight, exercise, and you will be healed. It seems so simple that I fear people don’t understand the seriousness and the complexity of diabetes. The woman I work with told her doctor that she “…didn’t want the needle.” I hope her doctor told her that diabetes isn’t really a disease where you can “choose” your treatment. Certainly your life choices will affect the level of intervention that is needed—whichever kind of diabetes you have.

I've certainly read other people's blogs who are living with Type 2, and they seem to be very educated about treatments, etc. Maybe I just know the people who aren't...

I hope that people with diabetes, despite which kind, get attentive medical care that gives them the chance at having a great quality of life.



DIXIE TIDBIT:

Yesterday I got a hair cut. (as my students would say “you got lots of hairs cut.”) The woman called my name and walked me back to her station. She looked uncomfortable. She told me that she was afraid of dogs. I assured her that Dixie was well trained and had passed an exam that allowed her to be in public places without people having to worry about their safety. I don’t think that she bought it.

She was clearly nervous during the whole process. Dixie was perfect. She just lay on the floor with pieces of hair dropping on her. It’s awkward. It’s the first time anyone has ever said that to me.

It made for an uncomfortable 20 minutes.

(the photo of Dixie is from school. She had just alerted me - by jumping on the table and hitting me with her paws. It's her last behavior, when I've ignored all the other alerts.)

Traveling by plane

I just found out that I was approved to attend a technology workshop in June that is in Georgia. I was thrilled that I was selected. It’s a great opportunity. Teachers don’t often get chances to travel to state of the art conferences.

Then I remembered that

I
hate
to
fly

It’s not the flying part that I don’t like. It’s the build up to the flight. I worry the entire ride to the airport. Mostly about not getting an aisle seat when I check in. I have had times that I wasn’t able to get a seat assignment prior to arriving at the airport. This creates even more anxiety. I get this picture of myself sitting in a cramped seat without elbow room. I’m sure that the plane I’m getting on is unbearably hot. And the takeoff is probably going to be delayed, so I will have to sit in the plane sweating and squished—probably in a middle seat.

Once I actually get on the plane I am o.k. I realize that there is room, the temperature isn’t close to sauna like, and there is air to breath. I can usually just take my aisle seat and set up my dvd player and be quite content.

I guess that you could say that I am a reluctant traveler. Friends and family that have flown with me cringe at the thought of sharing that opportunity with me again. They say that I make them nuts. (They, of course, say it in a gentle way)

So I squirm a little thinking of it.

Then I realize that I will be flying with Dixie for the first time.

Oh no.

Holy smokes.

I can probably cope with flying alone. But flying alone with Dixie. Ahh!

How do you even fly with a dog?! How will I convince my lab that flying is no big deal when I’m a basket case?!

I spent a day or two panicking about this, but then realized that I would make my life much easier, eliminate many of my worries, and fly first class. (no, my district won't pay for first class, just coach. So I'll be paying the difference) I call Northwest and talk to a very nice woman who gets my ticket squared away (and it’s really not much more than coach—I can’t believe it!). She asks if I would like an aisle or window. Of course I say aisle. Then I mention that I have a service animal that will be traveling with me. She asks if it is a dog or a monkey.

A MONKEY? Who’s heard of a service monkey. Whenever I think of trained monkeys, I always get a picture in my mind of that movie – can’t remember the name- but it had a guy and his monkey who rode around with him in a truck. The monkey wore a little red, hooded sweatshirt and jeans. Very cute. Then I thought of the monkeys that you see on public television that are trained to use sign language to communicate. I don’t think I would want a monkey pulling at my hand and using sign language to tell me I should test my blood sugar, or screaming at me if I didn’t promptly treat a low.

I tell the woman that Dixie is a dog. Then she asks if she is a Chihuahua. (WHAT?!) I tell her that she is a 55 pound lab mix. She says that I will need to sit in seat 1-A, which is the “handicapped” seat. I assure her that I’m not handicapped, and don’t need a special seat. (although friends would say that I’m handicapped by my wacky traveling behaviors:-) She says that it’s the seat with the most room, so Dixie will have plenty of space to stretch out. Oh, o.k.

I got off the phone and took a deep breath. I can do this. I’m sure Dixie will love Atlanta.

I’m all lined up to travel. If anyone happens to lurk by and read this, and works in the airline or vet business, I’d love to have some tips for flying with a dog.