Friday, May 24, 2013

The ideal patient. Is there one?

On May 17th Doctor Calder wrote about a study that was done and he outlines the findings for you with one caveat.

He states..."Looking at the data in studies like this does does not show the full picture of the long term diabetes management . It is easy to set and achieve ideal target goals for A1c , blood pressure and the other 7 risk factors in the ideal patient. Unfortunately many of us do not fall into that category . Age , general life situation and medication cost play an important role in trying to achieve ideal diabetes management. One size  certainly does not fit all . It is important to remember , test result that are perfect for your neighbor may not be the best one for you."

Now I can tell you from my own perspective I am far from the ideal patient. I believe the Doc will agree with me knowing me the way I am. I have a hard time sticking to a diet. I have a hard time dealing with stress and to be honest all of these factors create and control my blood glucose and my heart. 

One minute I am perfect and then a little stress hits and BOOM my blood glucose flies high or low, just depending.

I use to post a picture of the DNA of diabetes and ask people, "when you do to your Doctor does he or she see this picture or your face?" I asked this because many Doctors, but of course not all look at us as books. They hear us, they try to listen and then they go to the book and they prescribe. The thing is they really don't hear us, they hear words and see numbers and then make a decision. No consultation no nothing.

Then on the other side once they begin to speak to us, how many of us actually understand what they are saying? They have a language all their own just like we are not a book. They speak to us we listen but do we truly understand? Do we really know what they have planned or do we just go out the door take the meds prescribed and go on with life till we see them again?

This scenario is more real than one may think. I happen to have an Internist who believes in listening to me and I do to her. We argue, we discuss, we develop a plan of attack when my numbers, like my A1C are out of whack and then we go to it. The thing is we understand each other and we listen to each other.

Doctor Calder wrote a book "The Diabetes Office Visit" ( get a copy if you haven't) that really help you to understand what your Doctor is saying and how you can speak to your Doctor so they can help you. Amazing book. The perfect guide for both Doctor and patient. In fact I gave a copy to my Internist and maybe that's why we have a great relationship. 

In closing what must be remembered is there is no ideal patient. I don't care what someone says. At some point in their life they were not ideal. So don't let people or Doctors intimidate you by telling you your not ideal. No one is! 

Be well

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Your comments and questions are appreciated. David Calder,MD