Hello. I went to the “endo” this afternoon and it got me thinking.
The endo I go to is in a public clinic, so it’s a take-who-is-available scenario. That’s fine by me, as I am basically healthy and largely self-managed, so I don’t need the detailed care that maybe some people need.
However what it means is that I don’t always see the same doctor. The doctor I had today hasn’t seen me for maybe 12 months and obviously has seen a lot of patients since then.
She is a good doctor; I have no complaints about her service to me. But she asked me a lot of questions, of the “I’ve been asked a thousands times before” kind, that she no doubt asks all of her patients. As I say, she’s a good doctor.
But maybe because I’m a smart arse who has lived with T1 for 46 years, some of the responses I gave to her questions might have had an ever-so-slight cheeky edge to them. It wasn’t until the second time she started asking more and more questions and was digging down deeper and deeper into my answers that I came to realise that she was taking every word I was saying at face value and wasn’t factoring in that I was a smart arse / grumpy older fellow who has lived with T1 for almost twice as long as she has been on this earth.
Obviously once I realised this was happening I measured my words for the rest of our time together.
But that scenario, and the fact she was so young, got me thinking about the modern approach to treating T1D. Now don’t get me wrong ….. I accept the modern approach is excellent and I wouldn’t for a moment advocate anybody changing anything. But built in to the modern approach is constant monitoring, constant vigilance and constant focus on information provided by the modern technology.
And that’s where things have changed radically.
45 years ago, the most high tech thing we had was a pill to drop into some wee that changed colour and gave a rough indication of whether the BGL was high or OK. It didn’t really show much more than that. Then you would have your injection of insulin, followed by your meal of measured carbohydrate. All that happened after that was if you started feeling a “hypo” coming on, you’d have some of your emergency food, like a sandwich with honey or a banana or, if it was a bit worse, some lollies (sweets / candy).
That was it. That was as controlled as it got back then. The rest of the time was spent just living life, of course always with the thought in the back of your mind about how you felt and when the next meal time was.
Today, the modern approach means constant monitoring, counting carbs, working out how much insulin to have, be it by injection or pump, managing the technology and just generally being reminded constantly that you need to be vigilant. The doctor today was asking a lot of questions that played directly into this constant monitoring regime, and was worried about any answer that indicated something that fell outside the accepted variation from optimum.
I left the clinic today with a couple of prescriptions and a booking for the next visit in 4 months. I am glad the clinic is there and I am happy to go along 2 or 3 times per year. But I do sometimes wonder if other people with T1D are too caught up in the hyper involvement that is now expected. I’m too grumpy and set in my ways to be so.
I’m happy about that.
That is my day as I have lived it.