If you have found this blog, saying Welcome does not really seem appropriate. I know you wish you weren't surfing the internet for diabetes. I felt the same.
A big part of me wishes I were not writing about diabetes, nor did I anticipate to become so opinionated or informed on the subject, but it happened. When my son was 20 months old he was diagnosed with Type 1 Diabetes.
It wasn't really part of the plan… Correction - it was not part of the plan, but it happened. He is now six. It is not always easy, but I think we are all doing okay, and I hope we continue to do so.
Why the Middle East? I happen to live in Dubai. I don't think that living in the Middle East makes mine or my son's diabetic experience any more unique or challenging than it does elsewhere in the developed world.
If you stick around, or read something you like, great. Feel free to comment and join the conversation, subscribe or follow this blog by liking the Facebook page Diabetic in the Middle East.
The one thing I ask is that you do not take this as diabetic gospel, or consider it medical advice. I am opinionated, and I will share my experiences, but the first rule of diabetes is to follow up with your doctor and/or nurse educator about your care, diagnosis or medication. If you do not have a medical practitioner that is helping you find your way through this crazy world, then do not give up until you find the right one.
Sunday, October 23, 2016
It is a complicated disease and there are several differences between the different types. There are also HUGE misconceptions about them.
As many of you probably know, November is Diabetes Awareness Month and November 14th is World Diabetes Day.
Among my many activities planned, in honor of this month, I will be sharing important diabetic facts and busting a few myths as well.
I will also share some images from a photography series I have been working on about diabetes. When I am not working on a diabetic initiative, I am a passionate travel and documentary photographer. At the advice of another photographer, I am finally putting some of those skills to use to bring light to some of the daily challenges diabetics face.
So if you are on Instagram and are not following me yet, you can find my Diapoint account here.
Hope to see you there!
Sunday, October 16, 2016
I think it can be just as difficult for the school nurse to take in. After all, they have hundreds of children to worry about and take care of. Understanding their challenges and the sometimes lack of awareness of diabetes, I wanted to do something to support them for some time.
The idea to do this started last spring before school finished. Once again, I was honored to work with Lilly Diabetes as we both felt it was such an important subject. After months of networking and collaborating I am grateful for their sponsorship of an education session last Friday just for school nurses.
It was a full house, and we even had some nurses come in from Al Ain, which is quite a drive for them. During this session, they listened to expert physicians discuss the medical details of Type 1 and how it differs from Type2 and how to manage it at school.
I was honored to be part of the agenda and shared my experiences as a parent highlighting some of my son's challenges at school as a Type 1 Diabetic and challenges that other diabetics may face.
There is a lot to think about. Having a clear Diabetes Medical Management Plan (DMMP) in place is key. Not only does it include the medical orders about how to treat a particular child, it is also a document that fosters communication between parent and school nurse about how a child should be cared for. I say particular child because each diabetic is different and each diabetic should have an individual DMMP. While there are some general guidelines to follow, DMMPs are not a one size fits all.
While I shared many stories, still, one of my most important points was a statement from the US National Association of School Nurses.
Managing diabetes at school is most effective when there is a partnership among students, parents, school nurses, health care providers, teachers, counselors, coaches, transportation, food service employees and administrators.
It is the school nurse that provides the health expertise and coordination needed to ensure cooperation from all partners in assisting the student toward self - management of diabetes.
If you are a school nurse, your role is critical in supporting our children. If something is wrong at school related to our child and their diabetes, you will likely be the first to know before anyone.
Sometimes there are not enough nurses to support a diabetic child at school, or they may be hesitant to do so as they have never dealt with a Type 1 child before. What should you do?
I never assume the school will have all the answers, so typically my son's school nurses and I partner to coordinate my son's care. Sometimes I take the lead and reach out to the teacher, or who ever needs to be reached, other times it is the nurse.
Like the DMMP, there is not exactly a one size fits all template as to how to do this. It is not easy. Ever.
Even with the best nurses it will still require work. But it is one relationship that is well worth the time and effort that you will never regret investing in.
Thursday, September 22, 2016
However, there are an overwhelming amount of Type 2s all over the world, and the Middle East is not immune to that trend. Type 2 and "pre-diabetes" are also seen in teens and young adults here.
So while we always see images of senior citizens in Type 2 diabetes ads, this is not always the case. Some populations are genetically prone to develop it at younger ages.
What is the difference between Type 1 and Type 2?
Type 1 is when the body stops producing insulin altogether. This is typically autoimmune related. It was not caused by food, but food has a lot to do with how it is managed. Type 1s need insulin to survive.
In Type 2, the pancreas can make insulin, but not enough of it. Or, that insulin is not able to get where it needs to in order to create energy in the body. Sometimes Type 2 patients take insulin, sometimes not. There is no cure for diabetes, but leading institutions share the belief that you can often manage your Type 2 to decrease the amount of medication you require, or delay the requirement of medication.
So if you are Type 2 and in school, or have a Type 2 going to school what should you do?
- Tell those who need to know. Of course you can advocate and share information about Type 2 with others, but at minimum, those closest to you or your child need to know. This includes the school nurse, teachers, coaches, bus drivers and any other personnel on the bus and close friends.
- Make sure you have your medical supplies with you at school, or kept in a safe place where you can easily access them when you need them. This includes your glucometer, medicine if prescribed, treatment for low blood sugars, etc.
- Speak to your doctor or nutritionist about how to handle school parties and food.
- Focus on healthy eating and learn about what food best fuels you or your child's body to help manage diabetes.
- School can be stressful, especially during exam time. It may effect blood sugars as do the hormones in our bodies that change as we grow. Ask your doctor how to manage blood sugar fluctuations that result from these. Also, do not under estimate the value of activity. Playing sports, or even going for a walk will help manage stress and blood sugars.
And whatever you do, do not be ashamed of your condition. You did not choose diabetes. It chose you. There is continued compelling research out there that indicates Type 2 diabetes is the result of genetic factors.
Do not let diabetes stop you or your child from achieving your goals!
Tuesday, August 30, 2016
Tuesday, August 23, 2016
School starts next week!
All teachers and nurses are back to my son's school today. That does not give me much time to connect with them and my son's newly assigned teacher to give them the Type 1 highlights before school starts.
Anticipating this, I sent an email to the nurses last week requesting a meeting with them and my son's home room teacher. In some cases you may have to be persistent and follow up. It is not that they do not want to meet with you, but they have many meetings in those days and are quite busy. Never be afraid to follow up or call to set a time.
I use this meeting to start the year off with open communication. It is informative, but it is equally important to enforce the message that I want to work with them and make their life easy so they can focus on the job of teaching.
For the nurses, we review all medication doses, snack timings, blood sugar checks and emergency protocols among other things. It is also important to note that my son is in the 3rd grade. If you have a high school student, the student will play a bigger role in their care. However, it is still good to request a meeting before school starts - particularly if diagnosis is new, or you are at a new school.
When meeting with the teacher, I suggest that a school nurse also join. At that time I review the basics of what Type 1 is, and how we treat it. Having the nurse there also helps open the dialogue for how they may manage certain situations with the teacher. Based on your experience, you may have ideas or suggestions for them, so do not be afraid to share your thoughts.
I typically use a template for this discussion. For example, this Guideline for Schools, I found from Australia is a good place to start. I do suggest to read everything word for word. I use various guidelines as an outline and I take the best of their information that is relevant for me here and include things specific to my son and his care.
Other guidelines to consider can be found at Diabetes UK or at this American site, The National Institute of Diabetes and Digestive and Kidney Diseases.
There is a lot of information out there, and it can be overwhelming - for both you and the school staff. I use this information as a foundation and edit it when it comes to specifics for my son and his treatment. Every diabetic is different. For example, the way one child reacts to, or feels a low blood sugar is not the same as another. Be sure to highlight information specific to your diabetic.
It is also important to note that Type 1 school guidelines often include legal information specific to a country. It may not always be relevant for you, so update it to be in alignment with your location.
I typically focus on the following topics with the teacher and nurse:
- What is Diabetes, and the difference between Type 1 and Type 2
- Hypo and Hyper Glycemia. What is the difference, signs and why are they important?
- DKA (Ketoacidosis). It is likely that a DKA would be managed at home on a sick day, but I still explain what this means as it is critical, and could happen at school.
- How the teacher can help. (This is essentially, the expectations and support your child needs to function as a normal child in the classroom)
- Diabetic Emergencies
- Other topics. For example, depending on the age of the child, you may want to discuss discipline, what to do during tests, field trips or other things.
- Thank them. Thank them all for their time and encourage them to reach out to me if they have any questions.
- Note any action items. Do they need any more information or supplies from you? Do you need more information from them?
Wednesday, August 17, 2016
Sunday, July 31, 2016
For me, it is the start of a new chapter for lack of a better analogy.
Last week I left my corporate job. I have been doing that routine for over 20 years, and I was with this company for the last 9.5 years. It was even longer than I thought!
It wasn't that it was bad. On the contrary. It was an interesting global company with a lot of internal opportunity. I had a child while I worked there and found some kind of work-life balance - even with diabetes in our lives, and my colleagues were great too. Perhaps I could have worked there the rest of my work life.
But I couldn't.
Something had been gnawing at me for almost two years or so. I wanted to do more. I was already doing a lot, but I wanted to do more to help diabetics somehow. I have over 15 years of experience in healthcare management and another five in corporate education and development. I am already active in some advocacy and share my experiences in a few presentations every year, but I need to do more.
It was not an easy decision, but it was. Yes, leaving the comfort of a regular salary and job behind is frightening, but I could not ignore my conscious any longer.
On my last day my boss gave a really nice overview of the work I had done over the last four years in my current position. One of the things that was highlighted was how even at the most stressful times when I would have every right to be going nuts, I was calm. She put it much more eloquently than that, but kept referring to my ability to smile and stay calm. I didn't expect that to be such a highlight. I mean, I can manage stress, but I didn't think I had this office zen vibe she was describing.
In the past, a few colleagues asked me how I was able to deal with certain situations or difficult people. My honest response: "Well, no one died." No one ever died from a lost deal, from an incorrect spreadsheet, reworking an agenda for the thousandth time, or redoing a powerpoint presentation until it saw a diminishing margin of return. I lived through some of those situations, and I lived to tell about it.
As I listened to my boss say these things, I kept thinking the same thing. I was calm because no one was dying as we were in the office at 10pm or as I was waiting for emails at 1am to finalize a big presentation. Furthermore, those times were temporary.
I used to work in clinics and hospitals. Medical mistakes have huge implications compared to a small mistake in a presentation. And there are so many risks that can contribute that must be considered. This is why waiting for an email until the wee hours of the morning, while not ideal, did not bother me too much.
Now I do not believe that anyone outside of healthcare should approach their jobs with a "no one died" attitude. Nor do not say this to belittle the work. This is not the case at all.
I believe we should all give 110% and work hard. Work as if you live for it when you are there. If you start thinking well, no one will die if I don't finish this report, you won't finish it. It becomes an excuse, and not a good one as that is not what you are paid for. The more you give, the more you will get. You must always deliver.
My moment of zen is that when someone gets really upset about something small, and I know I gave 110% or more, I try reframe it.
While no one was dying at my great corporate job, the sad reality that pushed me to make this move is that people do die.
As the caretaker of a diabetic, I am very well aware of the fact that adults and children die from diabetes. This was my challenge. This is what was running around in my conscious for more than a couple of years.
It is always heartbreaking to read about a diabetes related death that could have been avoided - whether that be a misdiagnosis or a mistreatment. It shouldn't happen.
So now armed with my healthcare management and education background, and the knowledge I have from managing diabetes for a child, I moved into the next phase. There is so much to do, and I am excited and overwhelmed at the same time.
I woke up today, and immediately got to work.