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June 13, 2007
Before we began our cruise last week, I told my granddaughter how much she could charge on her room key/credit card and admonished her not to spend money in the arcade or the Internet café. That was Sunday.
On Monday, I assessed her account on the interactive television in our cabin (while she was present), and found that she had already exceeded her allowance. On arcade games and in the Internet café.
Did she think I wouldn’t notice until the end of the cruise, at which point it would be too late to have her charge privileges revoked? Or did she have a fatalistic attitude—i.e., “I’m going to do as I please because it won’t hurt me until later and, in the meantime, I’m going to have fun?”
The latter reminded me of a man I met on the trip. We were sitting side by side on a tender taking us from the ship to shore in Grand Cayman. Both of us were using canes. He began the conversation by nodding at my cane and asking, “Arthritis?” When I answered in the affirmative, he pointed to the scars on his knees and told me about his knee replacement surgery.
Did the surgery work? If so, why the cane? “I blew out my left ankle,” he responded. “And I’ve had a toe amputated.”
My ears perked up at the amputation part and I added that information to my observation that his teeth were not in great condition. “Do you have diabetes, too?” I asked.
Yep, I was right. He did have diabetes.
“What’s your HbA1c? Do you take meds?” I asked.
He didn’t appear to know what an HbA1c was, so I asked him about his blood glucose readings. “I’m lucky if I check my sugar once a month,” he responded.
Which led to nosy me asking why he didn’t take care of himself.
Well, he said, he just was never good at taking care of himself: He didn’t know why. “In fact,” he said, “that’s why I’m taking this trip now. I probably won’t be able to do something like this much longer. I’ll be in a wheelchair or something.”
At that point, the tender was pulling into the dock on shore. I had barely enough time to hastily tell him that he lived in a state (Massachusetts) with a well-respected diabetes center filled with people who could teach him about diabetes and how to incorporate it into his lifestyle.
Why do people take a fatalistic attitude toward a condition that is much more controllable today than in years past? Have they not been told how serious diabetes is? That they need to learn how to manage it? Have they even been sent for diabetes self-management education at all?
My friend Sandy, who was with me on the trip, has been a CDE for more than a dozen years. Even with all of the changes in diabetes knowledge and care over the past 20 or so years, she still sees people whose doctors hand them a printed diet and say: “Here. Follow this. Don’t eat any sugar.” And that’s the extent of their diabetes “education.”
Even worse, by the time she does see them, serious complications have set in. “Why,” they’ll ask her following a class or individual session, “didn’t somebody tell me this a long time ago?”
Why, indeed? I suppose those ultimately responsible for getting that much-needed education would be us. Of course, it would be nice if somebody—like our docs—would let us know it’s available.
However, there will always be those who ignore the obvious even when they’ve been warned. Because I didn’t want my granddaughter to be unable to get a soft drink with her friends, I failed to have her charge privileges revoked. By the end of the cruise, she had run up her charges to nearly four times what I had told her she could have.
Oh, not on the arcade and Internet this time. She’d learned that lesson. She hit the shops instead.
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