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To Give Your Patients Hope, Listen Well to The Stories They Tell Themselves

Feb 20, 2018
 

I recently met a patient whose life is alternative medicine. Not complementary medicine but alternative medicine.

A young woman in her early 30’s who was diagnosed with type 1 diabetes 10 years ago. Besides having an A1C of 10.5%, I could tell she was struggling. Her career is in alternative medicine. For years she has been looking for a way to stop taking insulin. She is looking for the cure, but as with many, has difficulty believing it’s not here yet. She has had diabetes education, but because she hasn’t really met the hcp she can relate to or who has given her the answer she wants to hear, she’s not really put things together yet.

I asked her if she thought she caused her diabetes. She confessed that prior to being diagnosed, she read about the raw food diet and how that can prevent/cure diabetes. She hadn’t really heard much about diabetes before that, so yes, she thought her thoughts caused her to have diabetes. Although she’s been taught that is not possible, I realized that she still believes it. She agreed with me. I tried to assure her again this is not and can not be so. I told her I did not think she was crazy for thinking what she was thinking and I was glad we could talk about it. She told me other “Western” health care professionals rolled their eyes at her as if she was, or at least she felt they were telling her, she’s crazy.

She then asked me if I could give her information that can help her. She seemed to trust me. I think it was my words and body language that allowed her to ask. I started with teaching her the basics of type 1 diabetes; that it is not something she can bring on herself, how and why she needs to take insulin, and how best to match the insulin she takes with her body’s needs.

For some reason, it seemed to click in her mind. She told me she was relieved and would use the tools we discussed.

My plan is to introduce her to some people I know who have type 1 diabetes and I know will give her correct information. I have more thoughts of how to introduce her to get more involved in the type 1 diabetes community, but as she said, and I agree, she’s confused and only trusts working with me at this time. She said she would stop looking for diets and potions at this time that promise her the plan will heal her type 1 diabetes.

I also warned her that with type 1 diabetes, there will be those times she’ll get a number she won’t be able to make sense of and that’s okay. I gave her info re: when to be concerned and reach out to me or her endocrinologist.

She left feeling, or at least she said she felt, she now understood better and was more hopeful.

Lessons Learned:

  • Listen to your patients. Listening is not just listening to the recent glucose level(s), but listening to them, learning more about their lifestyle, beliefs and disbeliefs can help in guiding their treatments.
  • Be open and be careful about your body language when patients tell you their stories.
  • Losing glucose “control” or having wide variations of glucose levels can be disastrous but so can losing hope. If one doesn’t have hope, some stop trying. For others some try everything they hear and some of those things can hurt them.
  • When a person has hope, they may become more open-minded to learning, which can help better manage their diabetes and their quality of life.
  • When the time is right, connect people with other people you can trust who have well managed type 1 diabetes and are living a full life. That can give your patients more hope.

Joy Pape, FNP-C, CDE
Diabetes In Control Medical Editor

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