NINJABETIC – A perfect appointment?
One of my biggest challenges of the past few months has been making time for a positive change when it comes to my diabetes. I’ll happily do all of the daily activities such as blood glucose testing, carbohydrate counting, making sure I change my insulin pump cannula when needed and checking my feet for anything that may cause issues etc, but it turns out that really isn’t enough for me.
About a year and a half ago I decided that I wanted to move my diabetes care to a clinic in London where I could access combined diabetes and gastroparesis specialist advice, however, making time to follow through with that decision soon became an issue.
I was pleased to be able to have an instant HbA1c result within minutes of having the test done in the clinic. This was a really good starting point for the conversations that would follow.
Nevertheless, I recently found myself in King’s College Hospital about to take on what I hoped would be a much needed turning point in my diabetes self-management. It’s not that I’m not good at self-managing, it’s just that I know and feel that I can do better if I only tried a little harder. One of the problems that I struggle with is the constant trying, which makes me feel like I’m fighting a never ending battle, and often seeing little improvement. Recently this has caused me to become disengaged to my healthcare professionals which, admittedly, didn’t cause me much concern at the time, however I have now realised that moving away from those important people in my life has resulted in me struggling once again.
I was unsure of what to expect at the new clinic but I did feel very happy to be there. It was long overdue and I could feel in myself that it was the right time for me. I needed someone to help me uncover the answers that would put me on the right track and I needed to challenge myself to do that. My work and social life are settling down and I have been taking a lot of time for myself recently in order to concentrate on what’s important in life, and diabetes is right up there. Factor in the promise of a day out in London with the other half where we would visit a cheese store in Covent Garden and eat at multiple cheese stalls in Camden, and I was all set to make this visit to London a positive one.
I was pleased to be able to have an instant HbA1c result within minutes of having the test done in the clinic. This was a really good starting point for the conversations that would follow. I was also very impressed to be presented with a patient friendly form which would allow myself and my new consultant to discuss what is important to me, any issues I was/am having and in which areas I felt things were going well. The form was short but covered all aspects of life with diabetes such as hypoglycemia awareness, complications, psychological topics, carbohydrate counting and more. As well as being a good conversation starter it made me feel that my challenges, concerns and triumphs were important, not only to me, but also to my diabetes team.
When I think of a diabetes team I see the patient at the very heart of it, with various people working hard in the background to support that person. I realise that I feel a certain amount of pressure to perform well for my next appointment so as not to hamper the hard work that others do for me and I personally see that as a positive thing. Granted, healthcare professionals are paid to look after us, but I do not believe that my new team would do their job unless they really wanted to. If I’m a part of that team, as a patient, then I need to pull my weight as well. I wouldn’t expect to go to an appointment with someone who couldn’t give me 100 per cent so in order to not let myself (and them) down, I need to do all I can to give 100 per cent back.
Something that I found incredibly useful for myself, which isn’t something that often happens in clinic settings, is having an extra person to talk to. In this particular appointment there was a doctor from Brisbane (if my memory serves me correctly) and during the times when my consultant needed to leave the room (he’s a very popular man), I chatted to the doctor who it turned out is also a mum of a child who has type 1.
This opened up a whole new level of conversation because she got it, she really got it, and she could relate to what I was saying and what I was feeling. I soon found that I was able to open up to her, even if only for a minute or two, about the emotional side of diabetes that I often find difficult to articulate in appointments. Maybe it was because she’s involved in type 1 from personal and professional experiences, maybe it was because I knew I wouldn’t see her again or maybe it was because she had that kind motherly side to her, but having those few short moments to step away from numbers and discuss what diabetes meant to me really complimented the rest of the appointment.
Actually having those few minutes to talk to this lady was very refreshing and enabled me to translate my numbers into emotions, which is really important in helping me to understand what is going on with me.
And finally (getting back to)… HbA1c. As mentioned, this was fast, easy and almost pain free (just a small prick), which made the process for someone who is known to have a bit of an issue with having blood taken so much kinder. What I really enjoyed was that the mention of the result was just as pain free. It turns out that my result was, as expected, not where I would like it to be, but there were no lingering and painful conversations about it afterwards, the result was out there for us both to see, I acknowledged it and we moved on.
We moved towards positive goals and adjustments that would help me to reduce it and in doing so there was no further mention of the result. Both my consultant and I knew what the result meant and what it could mean in the future, but why dwell on that when we can both do something to improve it? This is what I really enjoyed about the appointment, there was no judgement, no embarrassment and no negativity.
So thank you to Kings College Hospital for making what could have been a difficult experience a good one. I can see the diabetes team have worked hard to perfect their clinic experience and I felt truly valued and welcome, as well as positive about my next appointment with them.