Diabetes Self-Management Blog

This week I’m obsessing about the continuing saga of my Achilles tendon (and you’re nowhere near as tired of hearing about it as I am of putting up with it) and attitudes about people with Type 2 diabetes.

To bring you up to date, I tore my Achilles tendon and it was surgically repaired. Then the incision got infected and I had surgery to clean that up and wore a wound V.A.C. (vacuum-assisted closure) device, which helped with part of the incision on my leg that was not healing. However, the part of the incision on my heel did not — and has not — healed. And the top part kind of grew too much tissue. The incision in between those two problem areas is just fine.

Which puts me at needing more surgery to deal with the over-healing wound as well as the nonhealing one. To top it off, the person reading my CT scan believes I may have a bone infection in my heel. My infectious disease doc, who I’m seeing for MRSA, also believes I have a bone infection. My podiatrist doesn’t believe I do. The bottom line is that I’m to be admitted to the hospital instead of just having outpatient surgery.

Oh, joy. I just love hospitals. They’re so good for people with diabetes. (NOT!)

To top it off, my podiatrist and infectious disease docs are in Indianapolis, and my primary-care doc is not. Neither the infectious disease doc nor the podiatrist can admit me, and my regular doctor doesn’t have privileges at that hospital. Therefore, instead of having an attending physician who knows me, I’ll have somebody who’s never met me and will — I promise you — make a lot of assumptions.

The first thing he will see is that I have Type 2 diabetes. From that, he will assume I’m a know-nothing, noncompliant idiot who is unable to care for herself. I will tell him my last HbA1c was 6.2% (and that was through surgery, infections, and nonactivity). He will not believe me and will waste my money by ordering an HbA1c. He will send the dietitian to talk to me and explain why I need a “diabetic diet” as I attempt to convince her to just give me a list of foods that are available all the time so I can make up my own meals. I will give him my endocrinologist’s number and tell him to call and ask about me. He won’t.

How do I know? It’s happened before. And I so enjoy using up my energy to try and make some doctor understand that I know how to take care of myself when I should be recuperating from surgery. (That “enjoy” word was sarcastic.)

It’s beyond my ken why doctors assume you don’t know anything. Wouldn’t it be just as easy to for them to find out what you know and go from there?

Do they do that to people with Type 1, too? I don’t know. There seems to be a perception that people with Type 1 know what they’re doing (although I’ve met some who don’t have a clue) and people with Type 2 don’t.

Admittedly, Type 2 can be a lot easier to ignore, and there are many who take full advantage of that. I’ve heard diabetes educators complain that people don’t show up for diabetes self-management classes. It seems to me that people would want to learn about something they’ll have for the rest of their lives and that can result in some very unpleasant complications.

It could be that they “know” all about diabetes because their grandmother had it. It could be they’re afraid they’ll be told they can’t eat many of their favorite foods. And, yes, I’m speaking for myself, too.

Gee, I wish more people knew how to manage their diabetes. It would make it a lot easier for me when I run up against doctors who don’t know me.

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Comments
  1. Yeah, they do that with Type 1 diabetes, too. I feel your pain. Will think good thoughts in your direction.

    Posted by Andrea Heitz |
  2. I love doctors, mine seems to feel for me at most times but then he ends up telling me I need to do more, it is hard to do it all and not have a failure now and then. I have neuropathy as well and I see you talking about your achillies tendons, what happened to your’s mine dont work, I can still walk but when the test to make them jump(like the one done on the knee) is done they wont jump and make the foot twitch like they should, yet no one has told me what this means, when I ask anyone I get a run around the bush answer.

    Posted by Sally Smart |
  3. one other thing, while being tested for an occupational physio abilities thing for my work I was shown that my right foot is weaker then the left, which always seemed to be the worst. I was asked to keep my feet flat on the floor and lift the toes, My right foot only lifts about half as high as the left, and even tho I keep trying there is just no movement further to match the left.

    Posted by Sally Smart |
  4. That is tough news. The bright side is you will be getting IV antibiotics so any infection will get some serious attention. Try to relax as stress is another cause of trouble, as you well know. I look forward to hearing good news in your next post.
    Now Get Better!!

    Posted by Gail P |
  5. Hi Jan, your blog is funny, because its so true. I just went thru the same thing. I think I spent two of the four days I was in arguing with the doctor that I didn’t need a diabetic diet. I wasn’t in the hospital for diabeties or heart problems. I has burned my legs. Of course the doctors knew what to do. Needless to say I made them mad. They finally gave me a menu with regular food, and I eat what I knew I could.

    Posted by phillip vaughan |
  6. Sound’s like you had a bad doctor. They are not all like that. Remember they are working for you, if you can’t work with a doctor fire them.

    Posted by Bill |
  7. I am a 71 year old female, diagnosed with Type 2 Diabetes 11 years ago. I have always had good control, with meds, diet and exercise. In Feb. I underwent back surgery and was in the hospital 3 days. I told the hospital on three different occasions about my Diabetes BEFORE I went in and told them again upon entering. When I awoke from the surgery I asked for something to eat and was brought some very sugery pudding. When I remarked that I didn’t think I could have THAT pudding, because of my Diabetes, the Nurses aide went running out and soon they came back with a different IV than the one that was in my arm (post surgery). When I asked them what that was about, they said that the first one was pure glucose. You guessed it! By the time I left the hospital, it was necessary to have 3 insulin shots. (a first for me) I have had trouble controlling my blood sugar levels ever since, but just recently, after taking cinnamon and eating Lemon Grass and having an adjustment in my meds, I am finally gaining on it. Why are the hospitals not paying attention when we tell them about our Diabetes? Do they think that we are too stupid to know what we are talking about?

    Posted by Sylvia Weltz |
  8. Jan et al - I commiserate with your hospitalization experiences. Can I offer two of mine? (I’m Type 1 for 44 yrs, a pumper)

    Recently broke some ribs and clavicle, the latter pretty badly - right at the shoulder end. No hospitalization needed, but after outpatient Xrays surgery to install a plate was needed. As with Sylvia, I told ‘em before during and even on the litter into the O.R. about my diabetes (being a pumper I had the advantage of my pump-infusion gear being VERY visible). In Pre-Admit I got a great nurse to get it neatly slipped inside a sterile white gauze pouch with long cloth straps tied into a loop around my neck.

    They were pretty insistent that I suspend basal for the duration of the procedure, which I reluctantly did, but at least I got them to let me start on a low-ish BG, 86, because I showed them how it had been ascending from 72 that morning.

    So when I awoke in Recovery the first thing I asked was “What’s in my IV bag?” but was so woozy I could not remember the answer until some more time & a couple more repeats of my question . It was an unpronounceable antibiotic in saline! Hoorah!

    But now in my room for a mandated overnight stay (due to my age & Type 1 on top of my surgery) I faced the several shift nurses, each with different experience sets and different caseloads etc. They were all happy enough with BGs over 200, although I was the opposite - at least they did NOTHING to try administering insulin by injection, so they must have read TYPE 1, PUMPER or the like in my Chart. Again, Hooray!! I was discharged after just one night, as predicted & selected by my doctors.

    But it took 3 days (!!) to get BGs back down despite my careful dining from the “diabetic” menu for the 3 or four meals while admitted. NB: they were all great… how one could tell that it was not a regular diet meal is a mystery to me… I got everything from Cream of Wheat to eggs&sausage to fried chicken & steamed green beans & fresh fruit cup, etc. etc.

    So buck up, folks - do your homework beforehand and don’t fret too much. After all, those folks in hospital uniform went through YEARS of training including **practical** training to reach even the lowest, entry level of hospital work. I find showing every single one of them respect FIRST pays off immensely when you want them to “hear” your desires & questions.

    Live long and prosper!!

    Posted by Bill Marston |
  9. I too have Type 2. So does my brother. He is 5′10 and about 150 lbs. He is very active and hikes a lot. Yet when he goes to the docs he gets told that he has to be physically active and eat right-trust me he does!
    I had been going to a military base clinic for my health care and I was always treated as if I knew nothing. My a1c is 6. I have been diabetic for over 12 years now and yes I do know how to manage. Never did they want to focus any attention over to my other diseases as they aren’t so easy. I changed doctors completely. Now I have a team that I put together and it is working MUCH better.
    I hope that you get healed soon.

    Posted by KL Bell |

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