[Diabetes-talk] Emotions
Ed Bryant
ebryant at socket.net
Wed Nov 5 16:31:19 UTC 2008
Hi Kijuana,
As I promised, the following is some information about emotions. In
fact, this info is part of a story called "Emotions", which appeared in
Voice of the Diabetic sometime back.
If you have questions, please feel free to ask.
Regards,
Ed Bryant
Understandably, most diabetes education materials focus on the physical
aspects of the disease. This is appropriate. But the common emotional
ramifications of diabetes need to be taken into account. An individual's
emotional state may determine whether he/she prevails, or is felled by
circumstances.
Anger
"Why ME?" We don't know what causes diabetes. Although we can manipulate
statistics and use them to make predictions, we can't tell why a given
individual gets diabetes, or any of its ramifications. And tight control
helps, but it is no panacea.
Folks used to believe that disability was the result of defective character.
If you developed a disease, you had brought it on yourself; you were a
"failure." We know better, but too many of us still judge ourselves harshly,
blaming ourselves for "being weak." Diabetes is not a sign of weakness.
"What did I do to deserve this?" Nobody gets diabetes, or ramifications,
because they "deserve them." We don't know why one person gets it, and
another does not. We have to do the best we can. Diabetes can be nasty and
unpleasant, but it is not "diabolical." It is not a punishment.
Denial
"It will never happen to ME!" Social workers and psychologists are very
familiar with the problem of denial, the conviction that in spite of the
facts, the rules do not apply in this particular case. The ramifications of
diabetes do not manifest immediately, but the more time spent with high
blood sugars, the greater the likelihood of future eye, kidney, and nervous
system complications. The diabetic who seeks to prove that he or she is
"exempt," and "gets away with it," short term, is only increasing the
likelihood of down-the-line problems. The literature is full of stories by
folks who were "non-compliant" in their youth, but saw the error of their
ways about the time their vision began to fail. Denial is a common problem,
and one that should be addressed right along with the need for conscientious
self-management.
"NO! I'm not BLIND!" Sight loss brings its own denial. There are people who
won't use their canes, or learn Braille, or even stop driving, because they
cannot admit they are going blind. Some delay learning adaptive skills with,
"It's only temporary; I'm sure my sight will come back!"
Fear
"What am I going to do? I won't be able to..." While some folks deny they'll
ever be affected, others swing to the opposite extreme. These diabetics pay
close attention, read the reports, and work diligently, but for them, there
are demons under the bed, and every bullet has their name on it. Too many
folks are convinced that a diagnosis of diabetes, or the need to start
injecting insulin, or blindness, or kidney failure, or any of the other
possible complications, means the cessation of life as they know it.
It doesn't. With proper adaptive equipment and training, blind diabetics,
those losing vision, even those coping with multiple ramifications, such as
blindness, amputation, and kidney failure, can maintain or recover
independence, and remain (or become!) fully productive participants in
mainstream society. Fear, or the use of fear to encourage diligent
compliance, is counter-productive, as we shall see below.
Burnout
"I'm tired of it!" Diabetes self-management is a discipline, seven days a
week, from now until doomsday. There are no reprieves, no opportunity to
take breaks, and short of a pancreas transplant, there is yet no cure. There
is only the routine, day after day after day.
Some folks thrive. Presented with the facts, the need for multiple
monitoring and insulin injections, one young man said, "Of course I will! I
want to stay healthy as long as possible!" He was, and is, ready. Others
find the prospects daunting.
A lifetime of dietary restrictions, regular exercise, blood glucose testing,
and multiple injections or oral medications can become wearing, especially
after a number of years with the condition. Some folks get tired of it;
others come to hate "doing it because they must." Still others stop
believing their own welfare is "worth the fuss." This is "burnout,"
psychological rebellion against one's duties.
When burnout leads to non-compliance, it is a recipe for trouble. Why do
some folks "burnout" and not others?
The answer is attitude. The folks who thrive, who make the best of a less
than perfect situation, are like savvy poker players who, dealt a doubtful
hand, play it for all it's worth. Often these folks outperform the ones
holding the aces! It's not the cards you're dealt; it's how you play the
game.
"Positive attitude" can mean so many different things, but here it means a
wholehearted belief in one's own capacities, and determination to overcome
all obstacles, regardless of how long it takes. If you don't believe in
yourself, even the small hills can look impassable.
Loss of independence
"How can I face my friends? How can I get anything done? I can't DO
anything!" Too many folks respond to disability, or other trauma, with the
"wounded animal response"-flight to solitude, to "lick one's wounds." Up to
a point, this is part of the grieving process, the mourning for what must be
let go. When it passes, rehabilitation can begin.
But some folks "get stuck" there. Some independent, self-reliant people,
high achievers, can be more traumatized by their own "incapacity" than by
their actual physical loss. The belief: "I have lost something, and am now
less than I was," discourages action. This can occur with most any
incapacity, but is not uncommon in cases of sight loss.
An adult type 1 diabetic, for example, may have been self-managing for 15
years or more, before retinopathy put an end to a sight-based lifestyle.
Some folks, with positive attitude, good instruction and proper adaptive
equipment, make a smooth transition. Others wilt.
It's a question of attitude again, so many times. An individual is
accustomed to being in charge, to caring for self and others, and to being
"a productive member of society." In his or her mind, loss of sight means
the end of their capacity to continue doing so. Feeling diminished, feeling
ashamed, the individual withdraws from society, and stays "out of
circulation." Belief in his/her incapacity has become a self-fulfilling
prophecy.
These people are not lazy. They are not "slackers," taking a long vacation
from responsibility. They are in emotional agony, grieving for losses they
don't know how to replace. These people need to be shown their options. They
need to hear of (or from!) others like themselves, who have looked the demon
of self-doubt in the eye and moved forward anyhow. They need support groups
and rehabilitation professionals who will respect their self-doubts-and then
show them how to overcome them. Some might declare, "You can't teach
attitude!" but what you can do is show such a person their options, show
them others who have "done it themselves," and then get out of the way.
The Cure
Nothing about diabetes, or blindness, or any other disability, diminishes a
person's human-ness. Loss of sight, or of a limb, or of mobility and
independence, does not make one "incomplete." There are no "part-people" out
there-we're ALL fully complete, real people.
But it hurts to have to give something up. We are not oxen, facing our
traumas with placid equanimity. Fear and pain are perfectly logical
responses. Some folks will pass smoothly through the stages of grief, and be
ready to learn the necessary adaptive skills. Most will need the support of
their fellows and the positive examples of their predecessors, and will need
to have their feelings validated. Passing this hurdle, they are ready for,
and fully capable of, independent self-management and full participation in
the mainstream.
The presence of emotional issues is not a sign of weakness, but of humanity.
Any holistic approach to health takes a person's mental/emotional state into
account, right along with their specific physical ramifications. We are
individuals, and we heal in our own way.
----- Original Message -----
From: "K C" <kcc86 at hotmail.com>
To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
Sent: Tuesday, November 04, 2008 4:23 AM
Subject: Re: [Diabetes-talk] I'm a silent Diabetic
> Thank you for the welcome. Actually I have only just gotten information
> about even ordering a meter yesterday. My state rehab is recommending the
> Prodigy auto code meter? What is the difference between that one, and the
> voice? I receive Medicate, and Medicare, all parts. In general, can you
> get new testing strips for these special meters at your local pharmacy, or
> do you have to order them always from Prodigy. And lastly does your list
> offer emotional support? I'm still in shock, and am scared to death...
> Before last Thursday I didn't even know I had this. Thank you all.
> Kijuana
>
>
> ----- Original Message -----
> From: "Ed Bryant" <ebryant at socket.net>
> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
> Sent: Monday, November 03, 2008 3:42 PM
> Subject: Re: [Diabetes-talk] I'm a silent Diabetic
>
>
>> Hi Kijuana,
>> I am glad you have joined our Diabetes talk list. There are probably
>> several ways we can assist you, but first it sounds like your blood
>> sugars are too high, so that should be an immediate goal to get the
>> sugars down.
>> Your doctor may have already had you do a lab called hemoglobin A1C,
>> which gives you your average blood sugar for a two or three month period.
>> It sounds like you are testing your blood glucose levels, but there is
>> a fairly new blood glucose monitor out, which is pretty easy to use for
>> someone who is blind or has low vision. It is called the Prodigy Voice
>> and can be ordered from:
>> Homecare Supply of America
>>
>> Big Sandy, TX
>>
>> 800-333-1412
>>
>> Meter: $89.95
>>
>> Container of 50 strips: $21.95
>>
>> If you have Medicare they will pay for the meter and a few strips, but
>> they will only purchase you a new meter, I believe, every three years.
>>
>> If you have Medicaid, they will help with a glucose meter, but they
>> can be difficult to work with. They are run state by state while
>> Medicare is nation wide.
>>
>> If you need to use Medicaid, please let us know, and I am sure you
>> will receive help from this list.
>>
>>
>>
>> Regards,
>>
>> Ed Bryant
>>
>> ----- Original Message -----
>> From: "K C" <kcc86 at hotmail.com>
>> To: <diabetes-talk at nfbnet.org>
>> Sent: Monday, November 03, 2008 9:12 AM
>> Subject: [Diabetes-talk] I'm a silent Diabetic
>>
>>
>>> Hello, everyone. My name is Kijuana.
>>> On Thursday the 30th of October I was diagnosed with Diabetes after
>>> Uterine surgery on the 23rd of October. I had no idea I had it.
>>>
>>> I'm so scared! I have never had to stick myself to test my blood sugar
>>> or
>>> anything else. I know a little about it because I have had personal
>>> friends
>>> who have
>>> suffered major complications from this disease, and some of them have
>>> died.
>>> Logically I know it is something people live with, and control everyday.
>>> I
>>> also understand that it is a very common illness. It's just that it has
>>> never been a part of my daily life.
>>>
>>> I don't know how to act, or react now. Because I have no symptoms I
>>> don't
>>> know how to eat differently or anything else. Over the past few days I
>>> have
>>> continued to do like I always have, but the numbers on the blood tests
>>> say
>>> different. Its silence scares me more than if I had some weird
>>> symptoms,
>>> went to my Doctor, and was diagnosed then.
>>>
>>> How do you deal
>>> with the days, weeks, and months after diagnoses emotionally? They'll
>>> be a
>>> lot of education I'll get in the coming weeks on diet, life style
>>> changes,
>>> etc. But what I really need right now is those who're living with this
>>> disease to share their experiences with me so I can put my feet on some
>>> kind
>>> of ground. Thank you for reading all this. I feel totally disoriented.
>>> My
>>> state services for the blind leave a lot to be desired, so my councilor
>>> doesn't even know where to begin as far as purchasing a meter, testing
>>> supplies, etc. Any help will really be appreciated.
>>> Kijuana
>>>
>>>
>>
>>
>> --------------------------------------------------------------------------------
>>
>>
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>>
>>
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>
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