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A Patient’s Contagious Confidence And Endless Possibilities

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In a recent post I wrote why patients are the most important part of the medical team, and my colleagues, Elizabeth Cohen, Kevin Pho, MD, Donna Cryer, JD, and Carl R. Sullivan, MD, shared their insights as well. Today, Ginger Vieira, a patient living with type 1 diabetes and celiac disease, says:

“You, as the patient, are the most important part of the medical team because you are the one who makes the daily decisions, who balances your disease around dinners, soccer games, long hours at work without enough time to check your blood sugar and eat lunch. You are the one who takes the knowledge you learn from your doctor and fits it into your everyday life. That’s a huge role, and it’s never easy.”

Ginger Vieira shares her story about the challenges and how her positive attitude is allowing her to lead a life she thought was off limits.

Contagious Confidence, Endless Possibilities

By Ginger Vieira

“Don’t let anyone tell you that you can’t do something.” My twin brother, Pete, said this to me several months ago. I wrote it down on an index card and taped it to my bathroom mirror. Funny thing is, it’s never been other people telling me I can or cannot do something. The loudest voice I hear is my own.

When I was diagnosed with type 1 diabetes in the seventh grade over eleven years ago, the first list that ran through my head was the list of things I probably couldn’t do anymore. I couldn’t eat ice cream without first counting the grams of carbohydrates in the bowl and determining how much insulin I needed. I couldn’t play basketball anymore (at least, that’s what I thought). I couldn’t buy candy and popcorn with my friends when we go to the movies without feeling overwhelmingly guilty about eating such diabetic-off-limits food. The list of foods, activities, dreams and goals I thought were off-limits seemed endless. Read more »

*This blog post was originally published at Health in 30*

Blood Print: “Am I, The Doctor, Bleeding?”

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I’m diligently writing a detailed note in the patient’s chart as he speaks of his multiple concerns — severe depression, headaches, and dizziness. I’m not making good eye contact. Often this is effective because I can resist the allure of passively following his narrative to its own diagnostic suspicions. Instead I can record his intuitive guesses without persuasion, formulating my own independent ideas even as I value his. Except that as I write in his chart I notice streaks of red blood appearing among the black script. Am I hallucinating? Am I capable of making paper bleed? Am I, the doctor, bleeding?

With closer inspection I notice three small cuts on my chapped knuckles and fingers, products of the incessant and obsessive handwashing compelled by modern medicine. We are obliged to wash our hands before and after each patient contact, which leads to about 60 hand washings per day. In the dry winter air this can become punishing to the integrity of the skin barrier.

I apologize to the patient for marring his chart, yet it almost seems symbolic — physician blood spilled upon a script of human affliction. I know I should tear the page out of his chart and write a clean new one, yet the scrawls of black ink and stripes of red blood look like art. It is a poem, punctuated with living iron and crimson flourish. Despite having made poor eye contact in an attempt to distance and strengthen my consideration of his symptoms, ironically I see the commonality of our bleeding.

*This blog post was originally published at The Examining Room of Dr. Charles*

The Heart And The Holidays

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The human heart resides in a lighltless 98.6-degree chest cavity. Its contracting muscles are further cushioned by the well-lubricated glistening smooth pericardial sac. One wouldn’t think that the heart could sense the time of year. The heart’s rhythm should remain independent of the holiday season. But then there is December in the EP lab. They are as busy as the malls.

Is it the depressing weather? Or the short days? Or a post-Thanksgiving hangover? It’s hard to say, but every year for as many as I can remember, the EP lab rocks in November and December. And with the advent of deductible health plans, this holiday phenomenon has only intensified.

The I-90 of the heart, the AV node, seems to give out more in the holidays. I’ll never forget the Saturday in December many years ago when I did five “urgent” pacemakers — and neither will the pacemaker rep. Read more »

*This blog post was originally published at Dr John M*

Santabetes: How Diabetes Is Like Santa Claus

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(Note:  This post contains spoilers.  If you are like my girl Brittany and you believe happily in the story of Santa, skip down to where it says “Diabetes is like Santa Claus.”)

My husband and I share a philosophy on Santa Claus.  

Santa gets too much credit.  Why should Santa get all the glory for the gifts that show up underneath the Christmas tree on Christmas morning?  Mom and Dad work their tails off to provide a fun and comfortable life for our child, and to have the fun thunder (funder?) stolen by Santa Claus is unfair.  “Thank you, Santa, for the Barbie and the Rockers van!”  I shouted as a kid, not realizing that Mom and Dad put in some extra hours (and spent half the night assembling the stupid thing) to get that Rocker Van under our Christmas tree. 

So BSparl will be fed the Santa story, but she’ll also understand that her Christmas gifts come mostly from her parents, and not from a fictional cookie thief who shimmies down the chimney.  Santa doesn’t work as hard as we do, so he shouldn’t get all the credit.

Diabetes is like Santa Claus.  (Welcome back, Brittany!)  Only in this case, it SHOULD be the one given most of the credit for certain things.  And I shouldn’t give myself so much of the blame and guilt.  I have a tendency to look at a blood sugar reading and instantly blame myself for it. Read more »

*This blog post was originally published at Six Until Me.*

Christmas Gifts For My Medical Colleagues

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This is my column in December’s Emergency Medicine News:

I like to think back on favorite Christmas gifts I have received down the years. I don’t think I can do any better than the children of mine who were born around Christmas. Three of the four came within one month of Christmas day. One came on December 23rd. What wonderful presents!

Going farther back, I recall sitting by the Christmas tree at my childhood home, or the homes of my grandparents. I found toy soldiers, toy horses, Matchbox cars, pocket knives and many other little-boy wonders. I remember the beautiful wooden stock and golden trigger of my first shotgun, and how it pulled me irresistably into a sense of impending manhood to know that my father and mother trusted me enough to give such a gift.

I have been thrilled to give gifts to my wife and children down the years. I smile when I consider stuffed animals, American Girl dolls, Polly Pockets, toy knights, castles, iPods, bicycles, books, a small harp, and a shiny sword. I admit that I love putting their packages under the tree.

I enjoy hearing about the things my loved ones love. It is my delight to know their hearts and to go and find the perfect thing that, when opened, will make their eyes light up and give them delight.

But there are people other than my family, and there are many kinds of gifts. I can’t help but think that if I were giving the perfect gift to my patients, some would love to open a gold-embossed Oxycontin prescription with the “infinity” emblem under “number of refills.” And others would be speechless to dump out their stocking and find their disability paperwork completed. The tears of joy would flow! Read more »

*This blog post was originally published at edwinleap.com*

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