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Living With Diabetes

Joe“Friends for Life … this conference is delicious.  It’s like the Woodstock of diabetes,” he said, pacing around the room and smiling warmly.

Meet Joe Solowiejczyk.

According to his bio on the CWD website, “He [Solowiejczyk] currently works for LifeScan, as Manager of Diabetes Counseling & Training and is a faculty member of the Johnson & Johnson Diabetes Institute. Joe is healthcare professional who has lived with Type 1 diabetes for over 47 years, Mr. Solowiejczyk has been able to translate his personal experience into patient care.”

To my untrained eye, Joe is the “guy who gets it.”  He’s a diabetes nurse educator, and a person with diabetes himself.  If he was a member of my personal medical team, he’d be the one I take most seriously because when I say, “It sucks,” he could respond, truthfully, with “I know.”

Joe hosted a session at Children With Diabetes called “It’s Not Just a Numbers Game.”  This grabbed my attention because I write constantly about how an A1C is only one part of diabetes management.  There’s all this emotional and mental stuff that comes into play.

“Ask me if I like it,” Joe said to the group of us.  He paused for a second.  “I hate it.”

I was sitting at a table with a bunch of CWD parents (including Bennet and Michelle) and I heard them all chuckle, but I just nodded in agreement.  Empowerment is being able to say that diabetes is hard and that it sucks sometimes, but still forging ahead and working towards better health.  I was glad to hear Joe telling this group of parents (and adults diabetics) that diabetes doesn’t have to be something we like.  We can hate it, openly, and still remain positive.

“I schedule my diabetes depression days,” he said.  “I plan them and then I tell everyone I know to call me every hour and tell me how courageous I am.”  He laughed.  “After about an hour, I’m sick of it and I just want to move on with my day.”

I like Joe.  I like listening to him talk and I respect him for managing diabetes for over 47 years.  I respect him for saying, “It took years for me to be able to say, ‘I’m having a hard time with diabetes,’ without it being a chip on my integrity.”  This statement resonated for me because I think people want to read blogs about diabetes and find a lot of upbeat moments and happiness.  But the truth of life is that there is an emotional gamut to be run and we have the right to run it, diabetes or no diabetes.

“You can not like it and still do it.  Hating it [diabetes] and doing it are not mutually exclusive states.”

He talked about the daily duties of a person with diabetes, from waking up in the morning and testing to all of the bits and pieces of precision management that are required along the way.  The possibility of a cure was mentioned.  And while many diabetics say “I’ll eat the contents of an entire Crumb’s Bakery,” or “I’ll drink orange juice FOR FUN,” Joe smiled gently.

“If there’s a cure?  What will I do?  I’ll sit on a park bench for three weeks and stare at the sky and do nothing.”

Counting clouds for a cure.

It’ll be 23 years for me this September.

I’d love to sit on a park bench and count clouds for a while.

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

Thoughts From The Official Twitter Reporter Of The Medblogger National Press Club Event


“The doctor will see you now.” I’m hoping to hear those golden words soon because I’m sitting in my primary care physician’s office on my day off from work. I’m lucky that I have a primary care physician who is still taking new patients. Did you know that a lot of primary care doctors are struggling to keep their doors open? That was just one of the issues that healthcare bloggers were talking about last week in Washington, D.C.

I was honored to receive an invitation to serve as the official Twitter Reporter for Better Health’s Putting Patients First event. The summit on healthcare reform took place last week at the National Press Club in Washington, D.C. I sat under the Twitter Gallery sign (pictured above) during the conference. The experience was amazing, but I’d like to make two suggestions to the management of the National Press Club. First, please install more electric wall sockets in your building. There were no wall sockets to plug my computer into during the conference, so my battery almost went dead while I was tweeting. Next, please have Anderson Cooper onsite when I’m in the building. He’s hot.


I was happy to finally get to meet the people behind the blogs that I read everyday. I met Kim from Emergiblog, Dr. Wes, DrRich, Dr.Rob, Dr.Kevin, and Better Health contributors Dr. Alan Dappen, Valerie Tinley, NP and Dr. James Herndon. I sat in the Twitter Gallery with Kerri Morrone Sparling from Six Until Me , Dr. Edwin Leap, and Evan Falchuk from See First Blog. I also got to meet Lisa Emrich from Brass and Ivory, and Duncan Cross. I think Kim was a knockout in her new Calvin Klein suit. Note to Fox News: You need to hire Kim as one of your Sunday morning talking heads. She has a lot of good ideas about healthcare reform and she looked right at home at the National Press Club. She also comes complete with her own professional wardrobe.

Every blogger expressed their personal viewpoint about healthcare reform at the conference. The bloggers were not told what to say, and I was not told what to tweet, or what comments to make before, during, or after the conference. We came to D.C. to add our voices to the healthcare debate. No, I didn’t agree with everything that I heard during the conference. I thought a lot of the information presented by the keynote speakers was bunk. I’m in favor of a public option healthcare reform bill, and I don’t like the disinformation being spread via partisan politics about this important issue. I get infuriated when members of Congress from both sides of the aisle play partisan politics while my patients languish in a healthcare system that’s literally killing them. I’m really very frustrated, and I’m just like everyone else in this country that wants to give our politicians a good swift kick in the butt. What gives me hope is seeing good people from both sides of this debate coming together at a healthcare blogger conference in Washington, D.C. Healthcare providers truly want to put patients first.

*This blog post was originally published at Nurse Ratched's Place*

Valerie Jarrett, White House Senior Advisor At BlogHer09

Valerie_Jarrett_official_portrait_smallI was honored to receive an unprecedented opportunity to hear a Senior Advisor to President Obama speak about his health care reform efforts at BlogHer 09.

Valerie Jarrett, Senior Advisor and Assistant to the President for Public Engagement and Intergovernmental Affairs, spoke to an intimate group of bloggers at a luncheon today.

And I was 15 minutes late.

How humiliating! This was definitely not the event where one should be “fashionably late”.

Ms. Jarrett was totally cool though, and said “Come on in and tell us who you are!” Apparently I had just missed intros; the discussion was just starting.

(Photo credit: Wikipedia)

********************

Now I’ve been pretty clear about not wanting a government run health care system, and I attended the luncheon knowing I did not have a clear grasp on the President’s proposal. (I have downloaded the Bill, have not had a chance to finish it.) I wanted to keep an open mind; I wanted to learn as opposed to opine.

The best way to learn is to keep your mouth shut and listen. That is exactly what I did.

It was not easy.

*****

Ms. Jarrett is warm, sincere and truly passionate about the President’s efforts at health care reform;  Ms. Jarrett has full faith in the ability of the President to positively reform our health care system.

Now, if I heard and understood correctly, what the President wants is a public plan as an option; a choice to obtain health care coverage through the government should you find yourself unemployed/without any health care coverage.  Ms. Jarrett was adamant that the goal is not a single-payer government run plan, but there was some group questioning of (1) why the idea of a government plan is perceived as scary and (2) whether or not it would be tantamount to socialism and indeed, what would be wrong with that anyway. One blogger noted that she knew many Canadians who were happy with their health care.

These questions were more rhetorical in nature. Honestly, I don’t think time would have permitted in-depth discussion.

*****

There was discussion on how bloggers can get out the message of health care reform and ideas on how the President can best communicate his ideas to the public.  It was noted that the President is holding press conferences for which he is asking full coverage because he wants the entire story told, not just sound bytes.  (Side note: I found this interesting because just recently ABC News encamped in the White House for an entire day – and the topic was health care reform.)

I actually did have a question enter my mind, as I was intrigued by the idea that the public plan was an option: I wanted to know if one could move in and out of the public plan as desired, or were you stuck in the public plan once it was chosen.

I didn’t get a chance to ask, as the discussion moved forward with two bloggers sharing stories of their personal experiences with the health care system.  Very personal, heart wrenching stories. Their frustration and anguish was palpable. Ms. Jarrett listened with empathy; she truly cared about what my fellow bloggers had/were enduring.

I found out later that both bloggers left with her personal business card with her office number for them to call her directly after the conference.  That was impressive.

*****

So, some final thoughts.

I like Valerie Jarrett.  It was amazing that she took time to come and speak to us, and it was informative. She speaks straight, she is sincere and she seems very passionate and compassionate regarding health care reform.  I’m a bit more informed about what the President is looking for.  This was the advantage shutting up and listening. I don’t necessarily agree but I’m starting to at least get a hold of the concept.

Gratuitous political commentary: I think a little too much time was spent decrying the last administration. It’s over; time to move on.

Now for my totally off-the-cuff observation. I could not help but notice this was the exact opposite of my experience in DC last week. This was a full-on Obamafest, last week seemed like an “anything BUT Obamafest”. This week the “opposition” was putting out misinformation, last week the “opposition” was trying to cram a bill through before Congress could read it.

Is there no middle ground? Does it have to be this contentious? Maybe it’s the way of politics and I’m just now realizing it.

Between the two events, I guess I have now been exposed to a “fair and balanced” view of health care reform by Washington insiders.

So….why does it still feel like I have vertigo?

*****

This post was written from my own notes and memory. It was actually live-blogged in real time and if you would like to read the entire transcript, it is written here: Valerie Jarrett/Health Care Reform Live Blog BlogHer 09.

Valerie Jarrett, White House Senior Advisor Talks to Bloggers at BlogHer09

*This blog post was originally published at Emergiblog*

Advertising On Cigarette Packs May Help Smokers Quit

You may have noticed that over the past few years the cigarette companies have been trying to persuade the pubic that they are really nice people trying to make the world a better place. For example, at the start of this decade in the U.S. we saw ads on T.V. showing that Philip Morris tobacco company was bringing bottled water to flood victims or donating to good causes. Why would I be cynical and call this a P.R. stunt? Well for one thing because they spent more money on telling the public about the good deeds than on the good deeds themselves!

More recently companies like Philip Morris have been involved in such odd activities as providing consumers with booklets designed to help them to quit smoking. Of course, if the tobacco companies really did have their customers best interests at heart they would withdraw their products completely. But that isn’t going to happen. The management of these companies have a duty and a responsibility to do their best to help the company make money and provide value to their shareholders. So when it comes to activities apparently designed to help smokers quit, one can be pretty sure that’s not the long term intent. The intent is to provide a PR benefit that will outweigh any effect of helping smokers to quit.

One thing tobacco companies do have control over is the cigarette pack itself. Right now the United States is one of many countries that has inadequate health warnings on the pack. Compare the rather weak and small written health warning on the side of a US cigarette pack with the powerful (and large) pictorial warnings on cigarette packs in numerous other countries. You can view pictorial pack warnings from around the world here.
The new legislation giving FDA the power to regulate tobacco products in the United States provides a new opportunity for the government to regulate not only the product but also the packaging. At the recent UK National Smoking Cessation Conference, Dr David Hammond of University of Waterloo in Canada gave an excellent presentation on the most effective ways to use the cigarette pack to inform smokers about the harmfulness of tobacco and to encourage them to quit. He showed that strong emotional pictures of the harms from tobacco on the pack itself, combined with limiting brand information, adding direct information about help to quit on the pack (e.g. the national quitline number) plus a quit smoking “onsert” added to the pack will all have the effect of encouraging smokers to make a quit attempt.

He made it clear that every country in the world should be much more active in using the cigarette pack as a means of encouraging smokers to quit. The companies themselves clearly won’t do it voluntarily, so governments need to take control of the packs via legislation and require much more effective warnings and quitting information be included on cigarette packs.

You can listen to Dr Hammond’s full presentation and view his slides by clicking on the appropriate icon at the following website.

This post, Advertising On Cigarette Packs May Help Smokers Quit, was originally published on Healthine.com by Jonathan Foulds, Ph.D..

MD Seniority Determined By Pocket Content?

Long, long ago, when I was a medical student, we joked that you could tell how senior a physician was by how much junk was in their lab coat pockets.  As students, we tended to carry around big bags full of every medical gadget we could think of, plus a few reference texts.  The attendings were slim and graceful in their long white coats with empty pockets.

When I became an intern and moved into the hospital full-time, all that crap became just too much to lug around.  I ditched the bag, and my short white coat (with interior pockets, thank god) became loaded down with tons of stuff: reflex hammers, pocket reference guides, photocopied research papers for reading, patient lists, a procedure log, a PDA with epocrates, a bit of a snack maybe, and more.  The coat weighed at least ten pounds fully loaded.  As a junior resident, I pared it down to the few references and gadgets I actually used frequently, and the coat got a lot lighter.  With each succeeding year I have lightened the load somewhat, down to the absolute essentials.  I shed the white coat years and years ago.  Now the only things I bring with me to the hospital are:

tools

Three items.  It’s very liberating.  Of course, I have epocrates and more on every computer workstation, so the references are there in the ER for me, but still, it’s something of a victory over inanimate junk and my own packrat tendencies that I can go to work with only three things in my pockets.

The downside is that if I happen to forget any one of these three sacred totems, it totally ruins my whole day.

*This blog post was originally published at Movin' Meat*

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