[Diabetes-talk] Emotions
The Jacobs' Family
bandbjacobs at verizon.net
Sun Nov 9 03:20:14 UTC 2008
Hey Mike!!! That was phantabulous!!! I enjoy making doctors look silly
like that too. Rather fun to see them fall on their faces. Huh?
----- Original Message -----
From: <diabetes-talk-request at nfbnet.org>
To: <diabetes-talk at nfbnet.org>
Sent: Friday, November 07, 2008 11:52 AM
Subject: Diabetes-talk Digest, Vol 16, Issue 5
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> Today's Topics:
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> 1. Re: Emotions (K C)
> 2. Re: Emotions (K C)
> 3. Re: Emotions (K C)
> 4. Re: Fw: Diamyd Medical News (catdancing)
> 5. Fw: ISMP Medication Safety Alert! November 6, 2008 Vol. 13,
> Issue 22 (Ed Bryant)
>
>
> ----------------------------------------------------------------------
>
> Message: 1
> Date: Thu, 6 Nov 2008 11:45:09 -0500
> From: "K C" <kcc86 at hotmail.com>
> Subject: Re: [Diabetes-talk] Emotions
> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
> Message-ID: <COL0-DAV443D5675B576281C2C39C0AA190 at phx.gbl>
> Content-Type: text/plain; format=flowed; charset="iso-8859-1";
> reply-type=response
>
> Yes, Mike, it was good! As with everything you've said so far, it's both
> amusing, and informative. smiley
>
> K
>
>
> ----- Original Message -----
> From: "dmgina" <dmgina at qwest.net>
> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
> Sent: Thursday, November 06, 2008 10:36 AM
> Subject: Re: [Diabetes-talk] Emotions
>
>
>> Mike that was good.
>> I bet he did laugh.
>> I was reading about a lady who has sugars over 450 and will die says the
>> doctors, since the liver is bad and the kidneys are bad.
>> They sent her home to die.
>> They didn't know what to do for her.
>> I just said a prayer.
>> Dar
>>
>> ----- Original Message -----
>> From: "Mike Freeman" <k7uij at panix.com>
>> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
>> Sent: Wednesday, November 05, 2008 11:21 PM
>> Subject: Re: [Diabetes-talk] Emotions
>>
>>
>>> Of course it's all right to complain and moan and groan and bitch and
>>> vent. After all, you're only human. Diabetes is one of those diseases
>>> that, if handled correctly, doesn't have to be considered
>>> overly-burdensome (although, like blindness, it is a damned nuisance and
>>> can never be reduced to a nullity). At the same time, though, as you
>>> know and fear, if untreated, diabetes can lead to complications and,
>>> sooner or later, to severe illness or death. So your fear and even your
>>> wish to take a trip down that great African river, Denial, is certainly
>>> understanding and, if not carried to an extreme, even healthy.
>>>
>>> Where we all get into trouble is when we seek to make that sojourn into
>>> a year's sebatical, a four-year course of study or even long-term stay
>>> abroad! That way lies future trouble.
>>>
>>> As you say, though, the problem is that you don't feel ill so it's
>>> devilishly hard to convince yourself that you really have a disease --
>>> one that, if left untreated, can be a royal pain-in-the-posterior!
>>>
>>> I am not really the person to advise you on this as, for all intents and
>>> purposes, I went crashing into diabetes. It's kind of hard to ignore a
>>> disease when you land in the hospital darn near unconscious! It tends
>>> (after one's blood glucose is more-or-less back in control) to
>>> concentrate the mind wonderfully! (grin)
>>>
>>> But know this: the fear of the lancet (that's the thing you stick
>>> yourself with) is far, far worse than the actual finger-stick itself. In
>>> fact, I almost wrather have the sting; that way, I know I've penetrated
>>> deeply enough to get some blood flowing (let's hear it for Raynaud's
>>> Symdrome!). But that's hard to tell someone when s/he isn't used to it.
>>>
>>> What got me was not so much the finger-sticking but the fact that I had
>>> to get over the conditioning that taking a blood sample was inherently
>>> messy. You know how if you cut your finger, everyone around you runs
>>> around like chickens with their heads cut off trying to find a bandade!
>>> Well, it's hard to contemplate that one is deliberately making oneself
>>> bleed. But I got over it pretty quickly since I realized I had no
>>> choice, presuming I wished to live a healthy life.
>>>
>>> As I've said, read Gretchen Becker's book and watch the videos whose
>>> links I've sent you.
>>>
>>> In a way, it's like blindness: talking about it and confronting it makes
>>> it at least less mysterious.
>>>
>>> In any event, everyone here is ready to help you!
>>>
>>> One story about my hospitalization that might amuse you and then I'll
>>> head for the sack: when I was brought in via ambulance almost
>>> unconscious, an ophthalmologist was looking at my eyes, trying to see, I
>>> suppose, if I'd gone blind from diabetic retinopathy. I was still with
>>> it enough to tell him - he must have been twenty years younger than was
>>> I -- "Please tell me if I've got retinopathy in that eye. Because if I
>>> do, I'm in a world of hurt because it's a silicone implant!" Whereupon
>>> he *jumped* back, totally taken aback, knowing he'd been had while I
>>> roared with laughter. I don't think he expected a semi-conscious
>>> gentleman to make him look silly! Damn, it was great!
>>>
>>> Anyway, cry and rant and rave all you wish. That African river, Denial,
>>> looks mighty nice now. But the scenerygets pretty shabby later.
>>>
>>> Hang in there!
>>>
>>> Mike
>>>
>>> ----- Original Message -----
>>> From: "K C" <kcc86 at hotmail.com>
>>> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
>>> Sent: Wednesday, November 05, 2008 7:28 PM
>>> Subject: Re: [Diabetes-talk] Emotions
>>>
>>>
>>> I'm writing this strictly off the cuff, so please forgive me if I'm just
>>> complaining here.
>>>
>>> This week, my first, I just don't want to stick myself. I don't know
>>> anything, beyond the huge amount of support I've gotten from this list,
>>> about controlling anything. I don't have any symptoms, nothing to base
>>> being in, or out of control on. This week, I don't want to hear how
>>> because
>>> my number is a mere 135, how it isn't any big deal. Then in the next
>>> breath, how I have to learn to consciously cause myself pain, put my
>>> blood
>>> into a meter, and interpret numbers I don't even understand.
>>>
>>> I was talking with a dear friend earlier this evening, and I tried to
>>> explain to him that in most cases you get time to deny, cry, scream, and
>>> then accept the situation if you choose to. After all, not choosing to
>>> use
>>> a Cane because you don't want to admit going blind may cause you
>>> personal
>>> pain, but you're not likely to get hit by the proverbial car. But in
>>> this
>>> case, someone says you have Diabetes, so you've then been hit by the
>>> car,
>>> and you have to get up, and do something about it, manage your injuries
>>> right now! This week I'm mixed between wanting to learn how to use the
>>> meter, start my medication, and to just cancel the order all together.
>>> This
>>> disease is an unknown quantity, and this week I want to keep it that
>>> way.
>>> But I can't.
>>> I hope it is all right for me to vent this way. You all can let me know
>>> if
>>> it isn't..
>>> K
>>>
>>>
>>>
>>> ----- Original Message -----
>>> From: "Ed Bryant" <ebryant at socket.net>
>>> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
>>> Sent: Wednesday, November 05, 2008 11:31 AM
>>> Subject: [Diabetes-talk] Emotions
>>>
>>>
>>>> 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
>>>>>>>
>>>>>>>
>>>>>>
>>>>>>
>>>>>> --------------------------------------------------------------------------------
>>>>>>
>>>>>>
>>>>>>> _______________________________________________
>>>>>>> Diabetes-talk mailing list
>>>>>>> Diabetes-talk at nfbnet.org
>>>>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>>>>> To unsubscribe, change your list options or get your account info
>>>>>>> for
>>>>>>> Diabetes-talk:
>>>>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/ebryant%40socket.net
>>>>>>>
>>>>>>
>>>>>>
>>>>>> _______________________________________________
>>>>>> Diabetes-talk mailing list
>>>>>> Diabetes-talk at nfbnet.org
>>>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>>>> To unsubscribe, change your list options or get your account info
>>>>>> for
>>>>>> Diabetes-talk:
>>>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/kcc86%40hotmail.com
>>>>>>
>>>>>
>>>>>
>>>>> _______________________________________________
>>>>> Diabetes-talk mailing list
>>>>> Diabetes-talk at nfbnet.org
>>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>>> To unsubscribe, change your list options or get your account info for
>>>>> Diabetes-talk:
>>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/ebryant%40socket.net
>>>>>
>>>>>
>>>>>
>>>>>
>>>>
>>>>
>>>> _______________________________________________
>>>> Diabetes-talk mailing list
>>>> Diabetes-talk at nfbnet.org
>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>> To unsubscribe, change your list options or get your account info for
>>>> Diabetes-talk:
>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/kcc86%40hotmail.com
>>>>
>>>
>>>
>>> _______________________________________________
>>> Diabetes-talk mailing list
>>> Diabetes-talk at nfbnet.org
>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>> To unsubscribe, change your list options or get your account info for
>>> Diabetes-talk:
>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/k7uij%40panix.com
>>>
>>>
>>> _______________________________________________
>>> Diabetes-talk mailing list
>>> Diabetes-talk at nfbnet.org
>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>> To unsubscribe, change your list options or get your account info for
>>> Diabetes-talk:
>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/dmgina%40qwest.net
>>>
>>
>>
>> _______________________________________________
>> Diabetes-talk mailing list
>> Diabetes-talk at nfbnet.org
>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>> To unsubscribe, change your list options or get your account info for
>> Diabetes-talk:
>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/kcc86%40hotmail.com
>>
>
>
>
>
> ------------------------------
>
> Message: 2
> Date: Fri, 7 Nov 2008 08:09:06 -0500
> From: "K C" <kcc86 at hotmail.com>
> Subject: Re: [Diabetes-talk] Emotions
> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
> Message-ID: <COL0-DAV22E61D77ECE2E4B880F18DAA190 at phx.gbl>
> Content-Type: text/plain; format=flowed; charset="iso-8859-1";
> reply-type=response
>
> Hello, Everyone. I went to my initial visit at the regional Diabetes
> center
> yesterday, and it was really rewarding! I couldn't push the button to
> poke
> myself though. lol
>
> I now know that the dietitian doesn't tell you specifically what you can,
> and cannot eat. That made me happy. I know that the coming days, and
> weeks
> will be hard, but Diabetes isn't all out of proportion for me like it was
> before I went. You're all wonderful.. :) Thanks..
>
>
> Kijuana
>
> ----- Original Message -----
> From: "dmgina" <dmgina at qwest.net>
> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
> Sent: Thursday, November 06, 2008 11:00 AM
> Subject: Re: [Diabetes-talk] Emotions
>
>
>> You have come to the rite list.
>> Talking about your concerns helps you get into perspective what you are
>> learning to do.
>> Hope this helps.
>> Dar
>>
>> ----- Original Message -----
>> From: "K C" <kcc86 at hotmail.com>
>> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
>> Sent: Wednesday, November 05, 2008 8:28 PM
>> Subject: Re: [Diabetes-talk] Emotions
>>
>>
>>> I'm writing this strictly off the cuff, so please forgive me if I'm just
>>> complaining here.
>>>
>>> This week, my first, I just don't want to stick myself. I don't know
>>> anything, beyond the huge amount of support I've gotten from this list,
>>> about controlling anything. I don't have any symptoms, nothing to base
>>> being in, or out of control on. This week, I don't want to hear how
>>> because my number is a mere 135, how it isn't any big deal. Then in the
>>> next breath, how I have to learn to consciously cause myself pain, put
>>> my
>>> blood into a meter, and interpret numbers I don't even understand.
>>>
>>> I was talking with a dear friend earlier this evening, and I tried to
>>> explain to him that in most cases you get time to deny, cry, scream, and
>>> then accept the situation if you choose to. After all, not choosing to
>>> use a Cane because you don't want to admit going blind may cause you
>>> personal pain, but you're not likely to get hit by the proverbial car.
>>> But in this case, someone says you have Diabetes, so you've then been
>>> hit
>>> by the car, and you have to get up, and do something about it, manage
>>> your injuries right now! This week I'm mixed between wanting to learn
>>> how to use the meter, start my medication, and to just cancel the order
>>> all together. This disease is an unknown quantity, and this week I want
>>> to keep it that way. But I can't.
>>> I hope it is all right for me to vent this way. You all can let me know
>>> if it isn't..
>>> K
>>>
>>>
>>>
>>> ----- Original Message -----
>>> From: "Ed Bryant" <ebryant at socket.net>
>>> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
>>> Sent: Wednesday, November 05, 2008 11:31 AM
>>> Subject: [Diabetes-talk] Emotions
>>>
>>>
>>>> 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
>>>>>>>
>>>>>>>
>>>>>>
>>>>>>
>>>>>> --------------------------------------------------------------------------------
>>>>>>
>>>>>>
>>>>>>> _______________________________________________
>>>>>>> Diabetes-talk mailing list
>>>>>>> Diabetes-talk at nfbnet.org
>>>>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>>>>> To unsubscribe, change your list options or get your account info
>>>>>>> for
>>>>>>> Diabetes-talk:
>>>>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/ebryant%40socket.net
>>>>>>>
>>>>>>
>>>>>>
>>>>>> _______________________________________________
>>>>>> Diabetes-talk mailing list
>>>>>> Diabetes-talk at nfbnet.org
>>>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>>>> To unsubscribe, change your list options or get your account info for
>>>>>> Diabetes-talk:
>>>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/kcc86%40hotmail.com
>>>>>>
>>>>>
>>>>>
>>>>> _______________________________________________
>>>>> Diabetes-talk mailing list
>>>>> Diabetes-talk at nfbnet.org
>>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>>> To unsubscribe, change your list options or get your account info for
>>>>> Diabetes-talk:
>>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/ebryant%40socket.net
>>>>>
>>>>>
>>>>>
>>>>>
>>>>
>>>>
>>>> _______________________________________________
>>>> Diabetes-talk mailing list
>>>> Diabetes-talk at nfbnet.org
>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>> To unsubscribe, change your list options or get your account info for
>>>> Diabetes-talk:
>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/kcc86%40hotmail.com
>>>>
>>>
>>>
>>> _______________________________________________
>>> Diabetes-talk mailing list
>>> Diabetes-talk at nfbnet.org
>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>> To unsubscribe, change your list options or get your account info for
>>> Diabetes-talk:
>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/dmgina%40qwest.net
>>>
>>
>>
>> _______________________________________________
>> Diabetes-talk mailing list
>> Diabetes-talk at nfbnet.org
>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>> To unsubscribe, change your list options or get your account info for
>> Diabetes-talk:
>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/kcc86%40hotmail.com
>>
>
>
>
>
> ------------------------------
>
> Message: 3
> Date: Fri, 7 Nov 2008 08:20:39 -0500
> From: "K C" <kcc86 at hotmail.com>
> Subject: Re: [Diabetes-talk] Emotions
> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
> Message-ID: <COL0-DAV4556D3E10150DD01AFE4D2AA190 at phx.gbl>
> Content-Type: text/plain; format=flowed; charset="iso-8859-1";
> reply-type=response
>
> Thanks, Deb. Yeah, I know it will eventually get better. I just feel
> like
> someone slapped me, knocked me down, and now is saying, "Get up!" :)
> Appreciate your encouragement. Now I gotta push that damn button.. lol!
> K
>
>
> ----- Original Message -----
> From: "catdancing" <catdancing at sbcglobal.net>
> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
> Sent: Thursday, November 06, 2008 10:38 AM
> Subject: Re: [Diabetes-talk] Emotions
>
>
>> K
>> can't say i blame u at all for not wanting anything to do with diabetes.
>> i'm sure none of us on here have ever choosen diabetes as a desied way of
>> life, but we HAVE GOT TO TAKE CAREof those levels of blood sugar because
>> no one can do it for us. In time it will become as normal to u as eating
>> dinner.i know u can do it.
>> Debbie
>> ----- Original Message -----
>> From: "K C" <kcc86 at hotmail.com>
>> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
>> Sent: Wednesday, November 05, 2008 9:28 PM
>> Subject: Re: [Diabetes-talk] Emotions
>>
>>
>>> I'm writing this strictly off the cuff, so please forgive me if I'm just
>>> complaining here.
>>>
>>> This week, my first, I just don't want to stick myself. I don't know
>>> anything, beyond the huge amount of support I've gotten from this list,
>>> about controlling anything. I don't have any symptoms, nothing to base
>>> being in, or out of control on. This week, I don't want to hear how
>>> because my number is a mere 135, how it isn't any big deal. Then in the
>>> next breath, how I have to learn to consciously cause myself pain, put
>>> my
>>> blood into a meter, and interpret numbers I don't even understand.
>>>
>>> I was talking with a dear friend earlier this evening, and I tried to
>>> explain to him that in most cases you get time to deny, cry, scream, and
>>> then accept the situation if you choose to. After all, not choosing to
>>> use a Cane because you don't want to admit going blind may cause you
>>> personal pain, but you're not likely to get hit by the proverbial car.
>>> But in this case, someone says you have Diabetes, so you've then been
>>> hit
>>> by the car, and you have to get up, and do something about it, manage
>>> your injuries right now! This week I'm mixed between wanting to learn
>>> how to use the meter, start my medication, and to just cancel the order
>>> all together. This disease is an unknown quantity, and this week I want
>>> to keep it that way. But I can't.
>>> I hope it is all right for me to vent this way. You all can let me know
>>> if it isn't..
>>> K
>>>
>>>
>>>
>>> ----- Original Message -----
>>> From: "Ed Bryant" <ebryant at socket.net>
>>> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
>>> Sent: Wednesday, November 05, 2008 11:31 AM
>>> Subject: [Diabetes-talk] Emotions
>>>
>>>
>>>> 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
>>>>>>>
>>>>>>>
>>>>>>
>>>>>>
>>>>>> --------------------------------------------------------------------------------
>>>>>>
>>>>>>
>>>>>>> _______________________________________________
>>>>>>> Diabetes-talk mailing list
>>>>>>> Diabetes-talk at nfbnet.org
>>>>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>>>>> To unsubscribe, change your list options or get your account info
>>>>>>> for
>>>>>>> Diabetes-talk:
>>>>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/ebryant%40socket.net
>>>>>>>
>>>>>>
>>>>>>
>>>>>> _______________________________________________
>>>>>> Diabetes-talk mailing list
>>>>>> Diabetes-talk at nfbnet.org
>>>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>>>> To unsubscribe, change your list options or get your account info for
>>>>>> Diabetes-talk:
>>>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/kcc86%40hotmail.com
>>>>>>
>>>>>
>>>>>
>>>>> _______________________________________________
>>>>> Diabetes-talk mailing list
>>>>> Diabetes-talk at nfbnet.org
>>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>>> To unsubscribe, change your list options or get your account info for
>>>>> Diabetes-talk:
>>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/ebryant%40socket.net
>>>>>
>>>>>
>>>>>
>>>>>
>>>>
>>>>
>>>> _______________________________________________
>>>> Diabetes-talk mailing list
>>>> Diabetes-talk at nfbnet.org
>>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>>> To unsubscribe, change your list options or get your account info for
>>>> Diabetes-talk:
>>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/kcc86%40hotmail.com
>>>>
>>>
>>>
>>> _______________________________________________
>>> Diabetes-talk mailing list
>>> Diabetes-talk at nfbnet.org
>>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>>> To unsubscribe, change your list options or get your account info for
>>> Diabetes-talk:
>>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/catdancing%40sbcglobal.net
>>
>>
>> _______________________________________________
>> Diabetes-talk mailing list
>> Diabetes-talk at nfbnet.org
>> http://www.nfbnet.org/mailman/listinfo/diabetes-talk_nfbnet.org
>> To unsubscribe, change your list options or get your account info for
>> Diabetes-talk:
>> http://www.nfbnet.org/mailman/options/diabetes-talk_nfbnet.org/kcc86%40hotmail.com
>>
>
>
>
>
> ------------------------------
>
> Message: 4
> Date: Fri, 7 Nov 2008 09:56:51 -0600
> From: "catdancing" <catdancing at sbcglobal.net>
> Subject: Re: [Diabetes-talk] Fw: Diamyd Medical News
> To: "Diabetes Talk for the Blind" <diabetes-talk at nfbnet.org>
> Message-ID: <000501c940f1$73d9a830$d7bafea9 at VALUED664B84C7>
> Content-Type: text/plain; format=flowed; charset="iso-8859-1";
> reply-type=original
>
> that sounds like good news. Is there any online way to get to the
> conference?
> Debbie
> ----- Original Message -----
> From: "Ed Bryant" <ebryant at socket.net>
> To: "Diabetes Talk" <diabetes-talk at nfbnet.org>
> Sent: Wednesday, October 22, 2008 2:29 PM
> Subject: [Diabetes-talk] Fw: Diamyd Medical News
>
>
> Diamyd NewsHi Folks,
> The following article provides information about a study that is
> working
> on an insulin vaccine.
>
> Regards,
> Ed Bryant
>
> Seattle, Swedish researchers working on diabetes vaccine
> Are we close to preventing type one diabetes? A vaccine may not be far
> off.
> Researchers from Sweden are in Seattle this weekend to announce their
> findings on a promising new study.
> Wendy Martin traveled all the way from Spokane a year ago so her son,
> Rylan,
> could be enrolled in a Seattle clinical trial for Type 1 diabetes. Another
> son also has disease.
>
> "It's a hard way to live, it's hard in school, it's hard to deal with it
> and
> the vigilance it takes to stay on top of it, so I hope that we can save
> somebody else," said Martin.
>
> Swedish businessman Anders Essen-Moehler took an even more ambitious
> approach when his daughter was diagnosed.
>
> "I decided that as she got this disease, I could very well switch gears
> and
> start looking for a cure for her," he said.
>
> Related Content
> Seattle Sweden Diabetes Awareness Day
>
> Essen-Moehler founded a company called Diamyd that is testing a vaccine
> based on a compound co-developed at the University of Washington.
>
> "What we do is we give two injections of this vaccine and that will stop
> the
> attack of the insulin-producing cells," he said.
>
> Unlike other vaccines that have been studied, this one does not suppress
> the
> entire immune system so patients so far haven't experienced side effects.
> The key seems to be early intervention.
>
> In a phase 2 study coming out in the New England Journal of Medicine, the
> injections did not cure the disease, but stopped it's progression in newly
> diagnosed patients. The goal is to make it a preventive vaccine for
> high-risk children.
>
> "So theoretically if you can just give it before you present with the
> disease, you should be able to stop it," said Essen-Moehler.
>
> Seattle and Sweden both have higher diabetes rates and the next phase of
> clinical trials will be in both places.
>
> To find out more about this and other research, you can attend the third
> annual Seattle-Sweden Diabetes Awareness Day this Saturday at the Bel
> Harbor
> Conference Center. It's free and open to the public.
>
>
>
> ----- Original Message -----
> From: Diamyd Medical AB
> To: ebryant at socket.net
> Sent: Wednesday, October 22, 2008 8:56 AM
> Subject: Diamyd Medical News
>
>
>
>
> TV channel King 5: Seattle, Swedish researchers working on diabetes
> vaccine
> Diamyd's founder and chairman Mr Anders Essen-M?ller interviewed on
> TV
> channel King 5.
>
> Please see attached link below to a TV interview with Diamyd
> Medical's
> Chairman Anders Essen-Moller, that was recently broadcasted in the US.
>
> See the clip here
>
> Web site: www.diamyd.com
> If you no longer wish to recieve information from Diamyd Medical, or
> wish to update your subscription, please visit
> www.diamyd.com/docs/mailSubscribe.aspx to unsubscribe or to update your
> subscription.
>
> _______________________________________________
> Diabetes-talk mailing list
> Diabetes-talk at nfbnet.org
> http://www.nfbnet.org/mailman/listinfo/diabetes-talk
> To unsubscribe, change your list options or get your account info for
> Diabetes-talk:
> http://www.nfbnet.org/mailman/options/diabetes-talk/catdancing%40sbcglobal.net
>
>
>
>
> ------------------------------
>
> Message: 5
> Date: Fri, 7 Nov 2008 10:58:08 -0600
> From: "Ed Bryant" <ebryant at socket.net>
> Subject: [Diabetes-talk] Fw: ISMP Medication Safety Alert! November 6,
> 2008 Vol. 13, Issue 22
> To: "Diabetes Talk" <diabetes-talk at nfbnet.org>
> Message-ID: <003701c940fa$0299b800$0200a8c0 at Satellite>
> Content-Type: text/plain; charset="utf-8"
>
> Hi Folks,
> Please see the following section titled "Safety Briefs-'Flag' Insulin
> Pen Labels".
> If you use an insulin pen, or know someone who does, this may be
> helpful.
>
> Regards,
> Ed Bryant
> ----- Original Message -----
> From: newsletter at ismp.org
> To: ebryant at socket.net
> Sent: Wednesday, November 05, 2008 9:41 PM
> Subject: ISMP Medication Safety Alert! November 6, 2008 Vol. 13, Issue 22
>
>
> Institute For Safe Medication Practices
>
>
>
> The Agency for Healthcare Research and Quality (AHRQ) has notified us of
> our certification as a patient safety organization under the Patient
> Safety and Quality Improvement Act of 2005. This federally certified PSO
> status allows hospitals, doctors, and other healthcare providers to
> voluntarily report information to ISMP for privileged and confidential
> analysis to help reduce risks and hazards associated with patient care.
> For more information on available services, please contact Michelle
> Mandrack, RN, at 215-947-7797 or send an email to mmandrack at ismp.org..
> Please also see article in this week?s issue.
>
> ISMP teleconference. An ISMP NEVER EVENT! Presentation: Patient Falls and
> Medication Use: Making the Safety Connection, scheduled for November 20.
> This addresses an important CMS Never Event that could affect hospital
> reimbursement. For details and to register, please visit:
> www.ismp.org/educational/teleconferences.asp.
>
> ISMP Medication Safety Alert!
> November 6, 2008
> Volume 13, Issue 22
>
> Educating the healthcare community
> about safe medication practices
>
> ?2008 Institute for Safe Medication Practices
> ISMP?, A Nonprofit Organization
> Subscriber Hotline: 1-800-FAIL-SAFE
> E-mail: ismpinfo at ismp.org
>
> Using external errors to signal a clear and present danger
>
> Chances are you?ve scanned the headlines and read many of the stories
> about medication errors published in the ISMP Medication Safety Alert!,
> particularly the tragic errors: the death of a young child who received a
> massive overdose of zinc due to a miscommunicated compounding process; the
> prolonged readmission of an elderly man with deep vein thrombosis and
> pulmonary emboli because he was not instructed to continue taking warfarin
> upon discharge a week earlier; the death of an infant who received 5 mg of
> morphine instead of the prescribed ?.5 mg? dose when the naked decimal
> point was not seen. You?ve learned about many recurring errors: the death
> of another young man after intrathecal administration of IV vincristine;
> the death of another elderly patient from misprescribing of a fentanyl
> patch; the death of another young mother in labor after an intrathecal
> bupivacaine infusion was administered IV. There has been no shortage of
> harmful medication errors for us to relate in our
> newsletter.
>
> As you?ve read these stories, you?ve probably felt surprised or startled,
> saddened, anxious, unsettled, and perhaps even angry or frustrated. These
> initial gut feelings, which the airline industry has termed ?leemers,?
> cause you to feel ?leery? about errors (thus, the term ?leemers?), even if
> you can?t put your finger on the exact cause of your unease.1
> Unfortunately, we have a tendency to gloss over these initial gut feelings
> and treat many errors as inconsequential in our own lives and work.(1) The
> stories you hear about tragic medication errors may be compelling but are
> perhaps felt to be irrelevant to your practice?a sad story, but not
> something that could happen to you or at your hospital. People tend to
> ?normalize? the errors that have led to tragic events, and subsequently,
> they have difficulty learning from them.
>
> There are several biases that lead to normalization of errors and thwart
> our learning from mistakes, particularly the mistakes of others. First, we
> have a tendency to attribute good outcomes to skill, and bad outcomes to
> sheer bad luck.(2) We have a relatively fragile sense of self-esteem and a
> tendency to protect our professional self-image (and the image of our
> workplace) by believing the same errors we read about could not happen to
> us. It was just terrible luck that led to the bad outcome in another
> organization, soon to be forgotten by all except the few who were most
> intimately involved in the event.
>
> Next, we have a tendency to be too optimistic and overconfident in our
> abilities and systems,(2) particularly when assessing our vulnerability to
> fatal events. We thirst for agreement with our expectations that the
> tragic errors we read about could not happen in our workplace, seeking
> confirmation about our expectations of safety while avoiding any evidence
> of serious risk.(1-2) We may go through the motions of looking at our
> abilities and systems to determine if similar errors might happen in our
> organizations, but in the end, we tend to overlook any evidence that may
> suggest trouble (much like confirmation bias in which we view what we
> expect to see on a medication label, failing to see any disconfirming
> evidence). We subconsciously reach the conclusions we want to draw when it
> comes to assessing whether our patients are safe.(2)
>
> To best promote patient safety, it is crucial to seek out information
> about external errors, to hold on to your initial feelings of surprise and
> uncertainty when you read about these errors, and to resist the temptation
> to gloss over what happened.(1) It is in the brief interval between the
> initial surprise and unease when reading about an external error, and the
> normalization of error?convincing yourself that it couldn?t happen to
> you?that significant learning can occur. If you wait too long, you can be
> easily convinced that there is nothing applicable to learn. Most
> opportunities for learning come in brief ?ah-ha? moments that need to be
> frozen in time and remain connected to your initial feelings of surprise
> and unease in order to adequately learn from them and take action.
>
> In our February 25, 1998 and January 13, 2005 newsletters,(3-4) we
> suggested making a New Year?s resolution to learn from published reports
> of errors, anticipating the same risks in your organizations, and making
> substantial improvements in patient safety. We repeated this
> recommendation in our November 29, 2007, newsletter(5) after writing about
> repeated mix-ups between heparin vials of varying concentrations (10
> units/mL and 10,000 units/mL), which led to the deaths of numerous
> infants. James Conway, senior vice president of the Institute for
> Healthcare Improvement, also published a recent article in Healthcare
> Executive outlining the importance of learning from other organization?s
> errors.(6) Mr. Conway lists ISMP, FDA, The Joint Commission (TJC), the
> Pennsylvania Patient Safety Authority, and the National Quality Forum
> (NQF) as reliable sources of information on external errors. The ISMP and
> Conway articles outline the steps organizations can take to establish and
> maintain a
> system for ongoing learning from external tragic medical events. Table 1
> (in the PDF version of the newsletter) summarizes these steps.
>
> The only way to make significant safety improvements is to challenge the
> status quo, inspire and encourage all staff to track down ?bad news? about
> errors and risk?both internal and external?and to learn from the ?bad
> news? so that targeted improvements can be made. We need to shatter the
> assumption that systems are safe until proven dangerous by a tragic event.
> No news is not good news when it comes to patient safety. Each
> organization needs to accurately assess how susceptible its systems are to
> the same errors that have happened in other organizations, and acknowledge
> that the absence of similar errors is not evidence of safety. Personal
> experience is a powerful teacher, but the price is too high to learn all
> we need to know from firsthand experiences. Learning from the mistakes of
> others is imperative.
>
> References: 1) Weick KE, Sutcliffe KM. Managing the Unexpected. San
> Francisco: Jossey-Bass John Wiley & Sons, Inc. 2001. 2) Montier J. The
> limits to learning.. In: Behavioral Investing: A Practitioner?s Guide to
> Applying Behavioural Finance. New York, NY: John Wiley & Sons, Inc.; pg.
> 65-77; 2007. 3) ISMP. It?s not too late for one more New Year?s
> resolution. ISMP Medication Safety Alert! 1998;3(4):1. 4) ISMP. Looking
> forward: make pro-change your New Year?s Resolution. ISMP Medication
> Safety Alert! 2005;10(1):1-2. 5) ISMP. Another heparin error: learning
> from mistakes so we don?t repeat them. ISMP Medication Safety Alert!
> 2007;12(24):1-2. 6) Conway J. Could it happen here? Learning from other
> organization?s safety errors. Healthcare Executive. November/December
> 2008:64,66-67.
>
> Risk of IV administration of topical thrombin products
>
> In our February 8, 2007 issue, we wrote about several cases of inadvertent
> intravascular injection of topical thrombin, including two fatal cases.
> This hemostatic product is meant only for application to the surface of
> tissues to stop oozing blood and minor bleeding from capillaries and small
> venules, or from areas surrounding vascular access sites, percutaneous
> tubes, or catheters. It is also employed in the treatment of epistaxis.
> After reconstitution, topical thrombin is used in conjunction with an
> absorbable gelatin sponge or may be sprayed on with an accompanying spray
> pump or syringe spray applicator (available in kits).
>
> Topical thrombin should never be injected or otherwise allowed to enter
> large blood vessels because extensive intra-vascular clotting and death
> may result. Surprisingly, in the above cases, some practitioners were not
> aware that the product is intended for topical use only. An FDA Patient
> Safety News video, produced in cooperation with ISMP, details proper use
> of topical thrombin
> (www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/transcript.cfm?show=78#4).
>
> Earlier this year, a new topical thrombin recombinant product, RECOTHROM,
> was introduced. Unlike the other topical thrombin on the market, THROMBIN
> JMI (bovine thrombin), whose label expresses the concentration in ?units,?
> Recothrom is labeled in international units with the abbreviation ?IU?
> prominently listed throughout product labeling, including the carton label
> and vial (see figure 1 in the PDF version of the newsletter), package
> insert, and promotional materials. ISMP and The Joint Commission list IU
> as an abbreviation that should never be used because it has sometimes been
> misread as IV (intravenous). To cite one example, our May 4, 2006 issue
> detailed a case where a nurse misunderstood the abbreviation IU as IV in
> an order for vitamin E ?200 IU.? With Recothrom labeled using ?IU,? the
> risk of misinterpretation and a serious medication error is increased.
> We?ve contacted FDA and the company to ask that the ?international unit?
> (?IU?) designation be changed to ?units.?
>
> We have an additional concern with thrombin products. Thrombin JMI and
> Recothrom vials are accompanied by a prefilled syringe for reconstitution.
> If the reconstituted product remains in the unlabeled syringe, it can be
> confused with another product. Thus, the reconstituted product should
> never be left in the syringe as an intermediary step. A label with a
> prominent warning against intravascular injection is provided and should
> be used on any syringe that contains topical thrombin.
>
> Information about topical thrombin?including viewing the FDA Patient
> Safety News video and reviewing the indication, dose, route,
> administration, and safe storage of the drug?should be included in the
> initial and ongoing competency validation of all staff who work where this
> product might be used. It?s also a good idea for pharmacists to visit
> various surgical procedure units and other applicable patient care
> locations to see firsthand how the drug is being used and to assure proper
> labeling. Consider having pharmacy prepare and label the drug when
> possible, especially if the operating room (OR) has a satellite pharmacy
> on site (reconstituted Recothrom is stable for 24 hours). If used outside
> of an OR environment, the unreconstituted vial should not be placed at the
> bedside for reconstitution by staff because it may be confused as a
> parenteral product.
>
> ISMP gains PSO status
>
> The Agency for Healthcare Research and Quality (AHRQ) has notified us that
> our request for certification as a Patient Safety Organization (PSO) has
> been approved, effective November 5, 2008. ISMP is among the first group
> of entities granted PSO status. PSOs are organizations in which
> improvement of patient safety and quality comprise its primary mission and
> activities. They are being established under the Patient Safety and
> Quality Improvement Act of 2005. In the past, healthcare professionals and
> organizations have sometimes been reluctant to participate in external
> error- reporting programs and/or data sharing for safety and quality
> improvement purposes, for fear of legal liability. Since 1975 when our
> error-reporting program began, ISMP has never identified, or been forced
> to identify, any individual who has reported an error or an organization
> that has been involved in a reported error. Now, because reporting to a
> PSO confers both privilege and confidentiality to the information
> reported, ISMP?s PSO status will afford an even higher level of protection
> when clinicians and organizations report to ISMP. Under our PSO status,
> practitioners should continue to report medication errors to us as they
> have in the past, and patient safety and quality committees in healthcare
> organizations can work with ISMP to analyze events and aggregate data to
> help reduce risks and hazards associated with patient care. ISMP can also
> work with other PSOs to provide expert analysis on behalf of services
> offered to their clients. For information, call (215-947-7797) or send us
> an email (mmandrack at ismp.org).
>
>
> Safety Briefs
>
> On the ?do not use? list. The order below (pictured in the PDF version of
> the newsletter) for DDAVP (desmopressin) was supposed to be given
> intranasally (IN) but was given intravenously (IV) in error. The order was
> written below another drug that was ordered IV. The abbreviation ?IN? is
> on our list of abbreviations that should not be used. In addition to being
> mistaken as IV, ?IN? has been mistaken as IM. To prevent errors, use
> intranasal, nasally, or NAS.
>
> New staff intimidation. Many organizations are attempting to transform
> their culture and reverse their long-standing tolerance and indifference
> to intimidating and disruptive behaviors. In dealing with these issues,
> healthcare providers need to be sure not to overlook situations that seem
> to invite a reluctance to ask questions. To cite one instance, new staff,
> new graduates, and others may believe they need to ?prove? themselves in
> order to gain and maintain the trust and respect of their coworkers. The
> following tragic error vividly brings this issue to light. A physician had
> prescribed a 1 liter ?bicarb drip? for a hospitalized patient. The
> pharmacist who prepared the infusion was a new graduate who had just
> completed her orientation and competency verification. The prescriber?s
> order was not clear regarding the amount of sodium bicarbonate per liter,
> and the new pharmacist was too embarrassed and insecure to ask for help.
> While the prescriber intended to have 1 ?amp? (8.4%, 50
> mEq/50 mL per ?amp? [which is really a vial]) of sodium bicarbonate in the
> 1 liter bag, the pharmacist dispensed a 1 liter bag of undiluted sodium
> bicarbonate solution (1 mEq/mL, 1,000 mEq/liter). The pharmacy technician
> who prepared the infusion per the pharmacist?s directions was also
> reluctant to ask questions when he had to empty a liter bag and pump 20
> vials (50 mEq each) of sodium bicarbonate into the bag.. Unfortunately,
> the nurse did not recognize the error and hung the infusion, which led to
> the patient?s death. While skills-based training and coaching in
> relationship-building and collaborative practice are certainly needed for
> leaders and managers, don?t forget to bring the frontline staff into the
> fold, particularly new staff/graduates. While our 2004 survey on
> intimidation (www.ismp.org/Newsletters/acutecare/archives/Mar04.asp#mar25)
> showed that new staff are often shielded from the intimidating behaviors
> of prescribers, we tend to forget that these staff may be
> intimidated by the very people who shield them. The code of conduct in an
> organization should promote an atmosphere where questions are expected and
> rewarded, regardless of staffs? rank, experience, or education. Other
> important steps to help reduce intimidation in the workplace can be
> found in The Joint Commission?s July 2008 Sentinel Event Alert
> (www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm) and
> the 2004 March 11 and March 25 issues of this newsletter (found at the
> survey URL listed above).
>
> ?Flag? insulin pen labels. We?ve mentioned it before, but once again, we
> heard about an insulin mix-up that happened when patient-labeled caps on
> insulin pens were accidentally switched. As a result, one patient received
> another patient?s insulin before the error was detected. Given that
> short-acting and basal insulin analogs, as well as mixtures of
> intermediate and short-acting analogs, are available in pen devices with
> caps, mix-ups among these products could be harmful. The most recent
> report of a mix-up involved Novo insulins in FLEXPEN devices, which have
> caps. However the reporter was unable to tell us which Novo insulin was
> given incorrectly. Novo manufactures LEVEMIR (insulin detemir), NOVOLOG
> (insulin aspart), and NOVOLOG MIX 70/30 (insulin aspart and insulin aspart
> protamine), which are all available in pens with caps. Other manufacturers
> also provide insulin pens with caps. For example, LANTUS (insulin
> glargine) basal insulin and the short-acting insulin APIDRA (insulin
> glulisine) are available in similar capped SOLOSTAR pens. To prevent
> errors, do not place labels on the caps. Although it?s difficult to label
> the body of the pen, it can be done using a ?flag? method (wrapping the
> label around the pen and folding the sticky ends together so the label
> looks like a flag on the pen).
>
> ISMP Events at the ASHP Clinical Midyear Meeting
>
> December 6
> Using Data Effectively to Manage the Risks to Medication Safety
> To register, visit: www.ismp.org/educational/ismpuspworkshops.asp.
> December 8
> Safe Labeling of IV Drug Products and the Role of Bar-coding and
> Outsourcing in Enhancing Patient Safety
> To register, visit: www.ismp.org/pressroom/Symposium2008.asp.
> December 9
> 11th Annual Cheers Awards Dinner
> See page 4 of the PDF version of the newsletter for details.
> December 8-10
> ISMP Exhibit at the Convention Center
> Please visit us at booth 1704.
>
> ISMP Medication Safety Alert! Acute Care (ISSN 1550-6312) ?2008 Institute
> for Safe Medication Practices (ISMP). Permission is granted to subscribers
> to reproduce material for internal communications. Other reproduction is
> prohibited without permission. Report medication errors to the USP-ISMP
> Medication Errors Reporting Program (MERP) at 1-800-FAIL-SAF(E). Unless
> noted, published errors were received through the MERP. ISMP guarantees
> confidentiality of information received and respects reporters' wishes as
> to the level of detail included in publications. Editors: Judy Smetzer,
> RN, BSN, FISMP, Michael R. Cohen, RPh, MS, ScD, Russell Jenkins, MD. ISMP,
> 200 Lakeside Drive, Horsham, PA 19044. EMAIL: ismpinfo at ismp.org; Tel.
> 215-947-7797; Fax 215-914-1492. This is a peer reviewed publication.
>
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