Diabetes a reason to share and educate.

I have always been told that I’m sweet… Now I have proof! This week I went for a checkup with my physician. Overall, I am a health 37 year old male. A little over weight, but I have lost 12 pounds since my last visit. During the course of his interview and assessment I explained that I have been having extreme night sweats for the past couple of months. Being a nurse, I knew that I had no signs or symptoms of Mono or Tuberculosis. I, of course, assumed the worst, renal cell carcinoma. As he chuckled at my worst case scenario, he said it is probably your blood sugar levels. If it falls at night while you’re sleeping, diaphoresis (sweating) can occur. Blood sugar… what does he know? After all, I am a registered nurse. In fact, as we banter back and forth, he often asks why I even come to see him. I like to pretend that he plays a part in keeping me healthy. (Actually he does.)

Being adopted, I don't know much about my family health history. I am fortunate to know the health history of my biological mom. She got pregnant at the age of 15. It was 1973, her options included birth and keep me, adoption, and abortion. He father, my grandfather, was a minister. While I have to assume he was disappointed with the situation, he wanted to keep me around. (He always loved me. No matter what was going on in my life that was one constant that I knew.) In saying that, he did not want the burden of raising a child placed on his 15 year old daughter. His other daughter was 19 during the pregnancy. She had experienced several miscarriages and wanted to have a child. She and her husband lived in Oklahoma just across the border from Arkansas. My grandfather arranged for his older daughter to adopt me. He sent the 15 year old to live with her sister until she gave birth. So my biological mother is now my Aunt and my biological Aunt is now my mother. My grandfather had arranged for all of the legal work, and the adoption was final the day after I was born (my adopted mom's 20th birthday).

So back to diabetes… many men on my mother’s side of the family had diabetes. I am not sure about my grandfather’s family, but in my maternal grandmother’s family it was a big issue. So during a physical exam and checkup early last year, my doctor said he was going to check my hemoglobin A1c (a test that measures blood glucose control over a period of time). I had experienced some hypoglycemia (low blood sugar) on a rare occasion, but otherwise my sugars were fine. A day later he called to inform me that I was diabetic. My HgA1c was 5.7. That is 0.7 above normal. I told him not to put that diagnosis in my chart. He said, it is elevated, and you are diabetic. He gave me the same shpeel that I give my patients. Eat right, exercise, and you will not need any medication. Fortunately, I was signed up for a mini-triathlon. I did not take the time to prepare for the tri the way that was needed. (I should have taken a session off of grad school to have more time.) It did however; help me lose some weight and my HgA1c decreased to 4.6 or 4.8. I was excited, only to be told that I was still diabetic. Ugh!

Fast forward to my office visit this week. I was worried about these night sweats, and yet it took me 2 months to go see him. This was my main concern. Blood sugar, what does his 4 years of med school, 4 years of residency, and additional training have to do with his miss diagnosis. At least that is what I am thinking. Secretly knowing he was right, but hoping he was wrong. Tuesday, the phone rings. It is my physician saying, “Bill your hepatitis panel and HIV screen is negative. Your chemistry looks immaculate, no issue with you CBC, your testosterone and thyroid levels look great." As I started to say thank you for calling, he interrupts to say, “Your HgA1c is 10.7.” I told him that can’t be right. I mean I am down 12 pounds. If you lose weight that number should go down. In a kind voice, without the usual banter back and forth, “Bill you are diabetic. You know the consequences of poor or uncontrolled blood sugar. I am calling you in some oral medications. We can’t let this progress.” As I sighed and thought about the extremes of my thought process (renal cell carcinoma), I realized there are worse diagnoses to have.

So why am I blogging about this issue and experience? First, is to surrender my pride and say that I did not want to believe my doctor. Not because I knew he was wrong, but because I did not want to admit that I have this disease. Thank God I can diet, exercise, and possibly get off of this medication in the future. There are many diseases were that is not an option. Second, I think it is important for people to speak out and educate about things that they experience. In a world where HIPAA privacy laws exist, one can still share their story. As a nurse, I feel like I have more reason to share. You see nurses are educators. It is part of the job. We have to take very complex information and simplify it for everyone involved. We educate one another, members of the multidisciplinary team, patients, their families, and yes sometimes doctors. Every day when I wake up, I have a goal to learn something new and teach someone something new. With almost 30 million diabetics in America, it is necessary to speak up and share. It could save a life.

Below are some statistic from the American Diabetic Accosiation, and a link to read more.

Data from the 2011 National Diabetes Fact Sheet (released Jan. 26, 2011)
Total prevalence of diabetes
Total: 25.8 million children and adults in the United States—8.3% of the population—have diabetes.
Diagnosed: 18.8 million people
Undiagnosed: 7.0 million people
Prediabetes: 79 million people*
New Cases: 1.9 million new cases of diabetes are diagnosed in people aged 20 years and older in 2010.
* In contrast to the 2007 National Diabetes Fact Sheet, which used fasting glucose data to estimate undiagnosed diabetes and prediabetes, the 2011 National Diabetes Fact Sheet uses both fasting glucose and A1C levels to derive estimates for undiagnosed diabetes and prediabetes. These tests were chosen because they are most frequently used in clinical practice.

http://www.diabetes.org/diabetes-basics/diabetes-statistics/

Is true joy and happiness possible?

I hear people talk about being happy, or what brings them joy. Honestly, I am not sure that I have ever known true joy or happiness. Merriam-Webster defines joy as the emotion evoked by well-being, success, or good fortune or by the prospect of possessing what one desires. It is a state of happiness or felicity. Happiness is a state of wellbeing or contentment. Do most people live in a state of joy and happiness for the most part of their lives and experience moments of sadness or sorrow? For me it seems to be the opposite. I am never content in life. I do not know what it is to experience joy on a daily basis. I experience moments of joy and happiness, but they seem few and far between. Recently, one evening, I was asked what brings me joy. The answer, I don’t know. I love my kids, and they bring me moments of joy. I have experienced joy as a nurse caring for someone that is dying, or helping others live. I have always felt great joy when I am able to preach, teach, and/or sing. These are but moments in my life.
Am I broken? As I think about this question I think about my life growing up. Joy was never a lasting feeling. I had material things, and that was supposed to bring me joy. It was the way my mom showed love. There was no holding or cuddling from a parental figure. Rarely was there a male figure present. When my mother was married, she was sure to pick a man that worked a lot. Usually these men would work off shifts. Birthdays, were celebrated with great fan fare. It looked good to people. Grand decorations, lovely cakes, and food that would be the envy of the town would fill the house. As a boy, I would remember the excitement leading up to the day. We would all wear our perfect smile for everyone to see, and laugh like we were happy inside. Then things would take a horrible twist. Out of nowhere, my mother would change. One example was my 10th birthday in 1983. The house was decorated, and my mom’s current husband Rich often took us out to camp and fish. He was by far one of the most active male figures in my life. I do not remember all of details. I do remember that I asked for a piece of my cake with something on it. The cake had a boy fishing on it. I do not recall what piece of cake, with what item on it, which I wanted. I am not even sure what or how it occurred, but my mother flipped out. That was not uncommon for her, as she was often erratic in her behavior. In a flash of a moment, she started to beat the piece of cake and ice cream in a Correlle bowl, with her fist. The dishware that is supposed to be unbreakable shattered into a million pieces. Other holidays were often similar. Christmas would start off with baking throughout the night during Christmas Eve, and lead to a joyous storybook Christmas morning. It never lasted. The joy always turned into sadness and morning.
Learned behavior taught me that material goods bring joy. As an adult, I know that is not true. I am not rich, but I have material things. They do not bring joy. Am I broken? Maybe I am. At this point in my life, I have no spiritual home. I struggle to find peace in my life working through my own struggles and brokenness. Dealing with a childhood of sexual abuse and rape that most people don’t fully understand, has been a challenge. Yet, God has allowed those things to be used for His good, as I have been able to share His amazing grace with so many people around the country. Helping those with similar history to walk out their healing has been very healing for me. Sharing with men in prison who have been victim, perpetrator or both, has brought me healing. Now if I can learn to be mindfully present and experience joy… true joy and happiness. That is my prayer for me and those like me. May the joy of God invade your heart in a way that only He can. A resurrection of the heart to experience joy everlasting.

April Fool's Day

Have you ever felt like your life was an April Fool's joke. You know, the most ridiculous story that you just know has to be a joke, but it turns out to be true. This April 4Th, my wife and I have been married for 19 years. Getting married right out of high school is no joke. No one is fully prepared, and I would not recommend it for everyone. The best thing is your both young and think your invincible. We married in April, Deana was pregnant, and it was a rough pregnancy. From toxemia, pre-eclampsia, diabetes, and OB's that treated us like kids, we muddled through the 4 months until Jay was born. Prior to his birth, I asked the physician about his size. Not being a nurse back then, I read a book and calculated Jay's birth weight to be around 10 lbs. The doctor basically said I was stupid, and that the baby would be around 8lbs. Well, an induced, 21+ hours, labor, a resident who didn't know how to do an epidural, and an emergent c-section equals a 11lbs, 7 oz baby boy. Our life was forever changed. From that point on, we inherited what I call the issues of Job. One problem after another occurred and yet we survived. Just when we would recover from one setback, another would occur. Each incident seemed like a bad April Fool's Day joke, only know one was yelling out after a while.

As we celebrate this anniversary, Deana, Natalie, and I are getting ready to celebrate the graduation of our son Jay, James Thomas Freeman. He is an amazing young man, and the thing that went right in my life when so many things went wrong. I often wonder where I would be, or what my life would be like without him. Would I have been motivated to go back to school and become a nurse? Would I have finished my BSN? What about the MBA/MHSM degrees that I will finish by the end of this year? Honestly, I do not think I would have done it for Deana or for me. People who know me, say no. They tell me I would have pursued more in life, but I am not so sure. You see, he was my motivation during that time in my life. I had to provide for him. I do good for him. I needed to be someone for him. When he was a little boy, he would want to hear my stories from work. The more gross and disgusting the better. He made me laugh, he made me cry, made me proud, and frustrated... sometimes within minutes of each other. You see I never had a consistent father figure in my life. Two step fathers that lasted the longest, Rich Sergott and Tom Semchee. Both very good men. Each added to who I am as a person. While things were not always perfect I learned the value of being a hard worker and provider from both of these men. Now, my son is planning on becoming a nurse. Poor boy, he has no idea what he is getting into. He will start to look for a nurses aide job when he graduates. This is my advise any young person who wants to be a nurse. You see, if you can't handle the needs of residents and families in a nursing home, you don't need to be a nurse. I know so many people that think they will come out of school and never have to bathe or clean an incontinent patient. To them I say, you will not like your job. Because in addition to the science, assessment, and medical care provided to each patient, you almost always have to wipe some one's ass at the bedside. If you can not humble yourself and and help someone in their weakest moment, often a moment of shame and discomfort for them, you should not be a nurse. I couldn't be more proud of my son.