Jab 10 times daily for better results.

Am back in PG! Was actually a bit weird to be back at first - I was only here for a couple weeks, and then I was gone for almost 2 months. Will have to get some pictures up of my lovely neighbourhood and the hospital here; bear with me, PG seems less novel than the northier north. In fact, to most people in BC, PG is positively southern.

So right now, I'm starting Clinical 2. Sounds impressive, yeah? I'm doing diabetes ed - something I did quite a bit of in my last two rotations by total fluke, so I figured this would be a snap.

Right?

WRONG!

Don't get me wrong, some parts of it are much easier. For example, on my very first day, I got there at 8:30, and was putting on a group class on eating for diabetes by 10:30. Sort of badass, don't you think? I was pleased with myself. I'd never even seen the PowerPoint before, but I admittedly tend to do better in group settings so I breezed through it. Naturally, there were things I could've done differently, but then I gave a class the following 2 mornings and am starting to feel I've got the hang of it. There was a group for brand new type 2 diagnoses, an impaired glucose tolerance group (pre-diabetes!), and a Senior's Survival group. I enjoyed the crap out of it. To be fair, it was partly luck; if you have a lousy group, you could be the awesomest awesome who ever awesomed, and your class will still bomb. My groups were awesome and talkative and at least half of them really wanted to KNOW. You must realize how rare that can be. So many people are just shunted off for diabetes ed by their doctor when really, they have no interest. So what if they should eat more fibre? Changing eating habits is one of the harder habits to change, and sometimes the results are so subtle (man, my kidney feels WAY better today) that it can seem pretty thankless.

That said, type 1 diabetes was still a bit of an enigma at the beginning of this week.
A) You have no insulin. No matter what I tell you to eat, you will still have no insulin. Dietary changes can only go so far.
B) The vast majority of the clientele are kidlets, and all the ones I've seen  are about 10-14. It's an...interesting age.
C) Teenage boys. Ugh.

I think I'm starting to get the hang of it, though. It seems like the hardest part is really for the parents. I mean, yes, the kid is getting poked with needles several times a day (I have one of the pens! See previous post!), but mum and/or dad is worrying CONSTANTLY. Kid, for the most part, at least in a lot of cases, is not overly concerned with their blood sugar level. I don't know if you can really grasp potential nephropathy at age 10.

Think about it. How many foods can you think of that DON'T have any sugar?

Even things that don't taste sweet converts into sugar in the body. ALL carbohydrates - that includes some veggies, mes amis! Bread, cereal, fruit, potatoes, rice, pasta, yogurt, milk, granola bars, chips - that doesn't even include the really sweet stuff. (Don't even get me started on some of the myths, 'organic potatoes don't have sugar.' PLEASE.) Counting carbs, poking your kid with insulin or getting them to do it 4 times per day PLUS the blood glucose checks before AND after supper. SO MUCH POKING.

This is a pretty good video for just a glimpse of how much of an ordeal it can be. It takes 6 minutes just to explain how they figure out breakfast for this little nipper.

Kids will be kids. We had a teenage boy who ate...well...like a teenage boy. Fibre? WHAT? WHERE? And vegetables: you've got to be kidding. Ridonculous amounts of protein and refined flour without a carrot in sight. Another problem especially with older kids is missing meals *guh*. This is one of the worse things you can do, since your body runs a lot better if it has regular energy and carbohydrate coming in.

***Feel an eating-breakfast-sermon coming on? DAMN STRAIGHT. DO IT. For reals, just have a smoothie or something, it doesn't have to be the whole shebang with eggs and pancakes and so on. I don't care if you have diabetes, I may just poke you until you get my drift. Also the first thing we recommend for weight loss, just saying!***

Anyway, back to the kidlets. Sometimes, you get one in who is rather depressed. Think of sending your kid to school every  day, coming in 2-3 times to check their blood sugar if they're little, or them having to check their blood sugar before and after meals. They probably don't have all the stuff the other kids have; not like I think kids SHOULD have chocolate bars and chips in their bags, but it's got to suck a bit being the odd one out. And having your parents fuss about your sugars and nag you constantly about them, and always having to analyze everything you eat until you're not sure a 2nd helping is even worth it? It's not like it's ever going to go away, either. If you're lucky, you'll get on a pump so less poking, but you still have all the other hassle. Sometimes the kid just says 'I don't want diabetes today.' They don't want to check or inject, and they just want to eat every doughnut and chocolate bar in sight. Burnout is the sort-of technical term for it, when the person is just so tired out of the counting carbs and calculating insulin and insulin pens or beeping pumps that they hit a wall. Even if you let them take a day off (not recommended, for the record), it'll still be there tomorrow.

Bit depressing, this, isn't it? One of my very good friends is coming to visit this weekend, so will try to get out and take some pictures so I can talk a little less :P.