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/
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