Telling the truth

Posted on May 7, 2018 by janekdickinson

wordleAt diabetes and other health-related visits, there are forms to fill out, questions to answer, numbers to report.

Do you tell the truth to health care professionals? Believe it or not there is a belief out there that people with diabetes lie to their providers.

The more important question is Are you comfortable telling the truth? Do you have a trusting relationship with your health care providers?

This is the crucial first step in any patient-provider relationship – establishing a trusting relationship. Without that we are likely to either leave important information out, or give blatantly incorrect information.

For health care professionals the question is Why is a patient not telling the truth? Are they not comfortable? Do they trust us? Have they had bad experiences in the past?

Without the whole story health care providers can’t help people with diabetes develop the best plan for managing diabetes effectively. Like I tell my kids when I remind them to check in: “I can’t help you if I don’t know where you are.”

So it takes these steps to set up an environment for the best possible health care interactions: 1) professionals establishing a trusting relationship/environment; 2) open, honest communication (free from blame, shame, and guilt); and 3) making a plan together – one that works for the person’s life and one that will lead to the best possible outcomes.

If you don’t feel comfortable telling the whole truth at provider visits, or if you suspect that patients you work with aren’t telling the whole truth at visits with you…dig a little deeper. It will definitely be worth the effort.

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diabetis vs. diabeteez

Posted on April 19, 2018 by janekdickinson

unnamed (2)From time to time I hear complaints about the way some people pronounce diabetes. They seem to really hate hearing “diabetis” instead of “diabeteez.” For me, hearing “diabetis” actually takes me back to my childhood.

When I was first diagnosed everyone around me said “diabetis.” My endocrinologist pronounced it that way, and so did my parents. So that’s how I said it for the first ten years of my diabetes life. Then I became a staff member at diabetes camp and another counselor gave me such a hard time about it that I started saying “diabeteez” and never looked back. I even asked my parents to change the way they said it!

At one point I was told that “diabetis” is the European pronunciation, which made sense to me. I let it go. Then the other day I heard that someone was offended by that pronunciation. That made me pause and think.

All I can say is there are different ways to say the same words. It happens in health care a lot. It happens in life. People have accents, dialects, speech impediments, and so on. That doesn’t make them bad people. Just like people who say “diabetic” aren’t bad people.

While I do take language and messaging very seriously and am working to change the conversation about diabetes, it’s not about being offended. Our work on language and diabetes is focused on meaning and impact. We’re working toward words that empower and help people.

In the meantime, I don’t have a problem with how different people pronounce diabetes.

Tomayto, tomahto.

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Proper use of an oxygen mask

Posted on April 18, 2018 by janekdickinson

Southwest-logo

 

Yesterday I traveled by airplane early in the morning and then back last night. On one of the legs the flight attendant announcing safety instructions made a big deal about putting the oxygen mask over both mouth and nose, not just our mouth. I remember thinking, “that’s weird, I’ve never heard them repeat that part like that” and then I promptly dismissed it.

This morning I learned about the tragic events that happened on a flight yesterday. Passengers on the plane experienced first hand the dropping of the oxygen masks and having to put them on and breathe through them.

I noticed in a couple photos and a video that (at least) one of the passengers had his oxygen mask over just his mouth. Suddenly it hit me that the crew on my flight must have known about the event, heard about or seen the photos/video, and were now making extra sure everyone knew how to properly use the mask.

Bottom line: if you ever have to use an oxygen mask on an airplane, put it over both your mouth and nose. You probably know the rest (put your own mask on first before helping others, the bag won’t necessarily inflate, etc.).

I’m thinking about all the people affected by yesterday’s frightening airplane experience and hoping the survivors are home safely. Thank you to all those brave (and calm) pilots and crew members out there!!

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Lesson(s) in flexibility

Posted on April 16, 2018 by janekdickinson

4942025_lI’m supposed to be in Minnesota right now; they are having a major Spring Blizzard, so instead I’m in Denver. I was actually supposed to fly two days ago, then yesterday. Now I’m flying tomorrow (I hope). Lessons learned: 1) be flexible, 2) get over it and move on, 3) make use of extra time, 4) get sleep while you can (very early flight tomorrow).

Bonus lesson: even when you think you have plenty of low treatment with you…bring more.

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Diabetes is boring

Posted on April 13, 2018 by janekdickinson

Except when it’s not!

There is new information almost every day. New technology, new medications, new combinations of medications, new ways to take medications, new gadgets and gizmos, new research findings.

And yet it’s the same old, same old. Numbers, numbers, numbers. Take meds, exercise, think about food. Think, think, think.

Boring? Or exciting? I can relate to both. Most days it’s pretty dull. All things considered, dull is OK with me. There are enough other things in life that I don’t need to be excited about diabetes. And yet one day very soon I’m going to try something new that could be very exciting. Stay tuned…

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Non-nutritive sweetened beverages

Posted on April 12, 2018 by janekdickinson

waterI recently facilitated a discussion where a participant pointed out that he doesn’t like plain water. He drinks artificially sweetened flavored water instead. A health care provider in the room commented about a study where drinking artificially sweetened beverages led to weight gain.

What is a person with diabetes to do? Drink sweetened beverages and have high blood glucose levels? Drink non-nutritive sweetened beverages and gain weight? Drink water and hate it?

The thing is, there are studies on both sides: some research says that artificially sweetened beverages lead to weight gain, while other studies show non-nutritive sweetened beverages do not.

I drink an occasional “diet soda” and I drink a lot of water. I am fortunate that I really like water. If you can tolerate water, drink a lot of it! If you cannot tolerate water and you have diabetes, you will need to find other beverages that don’t wreak havoc on your blood glucose. If you find that when you drink artificially sweetened beverages you have a tendency to snack on (or crave) high calorie foods, you might consider cutting back on those drinks. If that isn’t happening to you, it’s probably not an issue.

Ultimately your use of non-nutritive sweeteners is your call. Many people don’t want to consume them because no one is 100% certain what we’ll find out about them years down the road. As with everything else, moderation is probably a good idea.

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Improving communication for the right reasons

Posted on April 11, 2018 by janekdickinson

unnamed (1)One really can’t avoid articles about communication in health care these days. Patient-provider communication, provider-provider communication, it’s all over the place. Communication has always been key; we just seem to be catching on finally. There are still some gaps, though.

This article is about malnutrition; the take-home message is that improved communication between providers could lower the incidence of malnourishment. That would be fabulous!

In this article, the point about improving communication seems to be missed. Improving communication is not meant to increase compliance. What? That’s basically saying, “if I communicate better with you, you’ll be better about doing what I tell you to do.”

How about looking at it from this angle: improving communication is more likely to increase patient engagement, which is more likely to improve health outcomes. In addition, improving communication is more likely to increase trust in the provider relationship, which is more likely to increase follow visits (which is more likely to improve health outcomes).

The point is not necessarily to communicate more, it’s to communicate better. The language we use and the messages we send as part of that communication are critical to improvement. First we have to figure out what we’re trying to accomplish. I think it’s safe to say that everyone wants positive health outcomes. And then work backwards from there (see above).

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Forgiveness

Posted on April 10, 2018 by janekdickinson

It turns out that when we forgive, we unlock energy.

We have to forgive to move forward and get on with experiencing life.

People with diabetes often live with anger, blame, and shame. A lot of that is self-inflicted.

Consider forgiving yourself for whatever it is you are holding blame. As long as we carry those negative thoughts and feelings, all that energy is locked up and unavailable for living.

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Relatedness, competence, and autonomy

Posted on April 9, 2018 by janekdickinson

As human beings we usually want to be happy, healthy, and successful.

We are most likely to achieve those three things if we connect with others (relate), learn to do what we need/want to do (be competent), and think for ourselves (have autonomy).

So let’s go do it!!

More about this from the expert.

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Hearing correctly

Posted on April 6, 2018 by janekdickinson

cartoon wah wahHave you ever had an experience where you heard something differently from the way someone else heard it? I’ve met with patients who, when asked what type of diabetes they have answer, “I don’t have diabetes. No one has ever told me I have diabetes.” Then they tell me the medications they take, which are for diabetes.  I always have to wonder if the health care provider didn’t tell them they have diabetes, or if they didn’t hear it. It could have been a combination of both!

I was watching an episode of Grey’s Anatomy last night (we are watching it from the beginning – currently on Season 11). There was a scene where two surgeons were “rounding” on a patient. They were in the patient’s room, next to the patient’s bed, speaking as if to the patient and her husband, yet using a language I’m guessing only they could understand. I’m a nurse and I could barely understand the words they were using. I wondered if the patient or her husband (in real life) would have asked somebody to translate what the surgeons had just said.

I strongly recommend having a family member or friend with you whenever you go to a health-related appointment, or if you are hospitalized and the providers are “rounding.” If that’s not possible, ask a nurse to come into the room and listen to what the providers say and then explain it in terms that are more understandable after they leave. If that’s not possible, take notes and ask someone to explain it later. If that’s not possible, ask the provider to slow down and use words and explanations you understand. It’s your body, your health, and your decisions, so be sure you understand what’s being said.

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