Waiting It Out…

It’s no secret that if you’re visiting a doctor or health care professional, waiting room times in Canada are ridiculous as a general rule. I’ve written about this before; unless you happen to be going to a private clinic and the staff are really on top of their game, you can usually expect to be waiting for well over an hour beyond your scheduled appointment before getting in to see your doctor. Some studies have shown that the average wait time in Canada can reach three to four hours.

And why is that? Common sense would dictate that if you require X amount of time to see each patient, then you’ll schedule them accordingly, right? Maybe not. I’ve been dealing with waiting rooms in various forms for almost forty years, given that I have Diabetes. And some waits can be somewhat extreme and even dangerous, depending on why you’re there.

One good example I can give is an occasion where my son fell down some stairs onto a landing in our home. He struck his head and had a nasty cut right above his eye. As parents, you can imagine our panic as we bundled him up and rushed him to our local hospital. Once we were at the ER, they asked us two questions: was he alert and had he lost consciousness? The answers were yes and no, and we were ushered to the waiting room where we waited for over three hours. I was flabbergasted! Yes, I just used the word flabbergasted!

By the end of that three hours, I had checked on our expected wait time a number of times, complained and was told that nothing could be done to expedite the wait and to take a seat. At the tail end of it, my very impatient and destructive son was beginning to get his second wind and wanted nothing to do with being at the hospital waiting room. We ended up leaving without treatment. Although some would judge that we CHOSE to leave without treatment, my son’s state f being at the moment, coupled with the fact we were well into the night and he needed to be put to bed, became important deciding factors.

This is a typical example and seems to be the norm these days. Yesterday I attended a medical appointment where I showed up forty minutes early and checked in. I totally expected to sit and wait quietly for the remaining time and beyond. Then I was taken by surprise by getting called in and being seen and out the door by the time my scheduled appointment rolled around!

I got curious, so I decided to ask a few folks I know in the medical field. It stands to reason they’d prefer I not post their names, but here’s a bit of what they had to say.

I spoke to a member in the nursing field, a medical resident and a family physician, who were able to explain some of the ins and outs of the emergency room, triage and how people are seen. One of the main aspects that was explained is that when someone comes into the emergency room, they are “triaged”. This means that they are assessed based on the immediate verbal information they provide, and are placed in order of importance.

So if you come in with a runny nose and a headache that prevents you from sleeping, you can expect to wait over the mother who just went into labour or the man who passed out from chest pains or someone who happens to be spurting blood from anywhere on their body! Further, the average emergency room in Canada only has one ER doctor on duty, so he/she is swamped! We often forget that these people need to eat, sleep and use the restroom just as we do. Although pretty trivial on their own, those little activities add up in terms of wait times.

Last but not least, the medical industry is the slowest at catching up with current technologies. Pagers and fax machines? These haven’t been a standard technology in the average residential home for over a decade, but doctors still rock the ol’ pager! And most clinics and hospitals still make frequent use of fax machines. Sometimes, the incorrect on call doctor may be paged during emergencies, and this adds up to delays.

When it comes to clinics and office settings, wait times can be attributed to the fact that although specific time slots are allotted for each patient, some patients will often CAUSE delays by bringing up several issues not originally meant for the appointment they scheduled. For example, if you book an appointment at your doctor’s clinic for a prescription renewal and you end up inquiring about a weird rash on your inner thigh “since you’re here anyway”, you’ll end up taking way more of your doctor’s time than you were scheduled for. This will cause the subsequent appointments to get bumped further down. You’ll actually see many clinics post a notice in their examination rooms that read, “One issue only”, indicating that you are only there to discuss one problem and a subsequent appointment is required if there is something else.

You’d be inclined to think that an added five minutes shouldn’t cause an issue, but imagine if all the first appointments in the morning included that added five to ten minutes. By the time your afternoon appointment rolled around, you could be looking at a minimum of a couple of hours added to the day’s roster, simply because of all the added little details patients brought up early on.

Obviously, the patient isn’t uniquely at fault. In private clinics, overbooking frequently happens as some physicians are often paid by the visit. So the more patients that are cycled through within a day, the more income the clinic generates.

Clinic physicians are also subject to several outside interferences, such as being called to surgery, a patient at the hospital going into labour or attending meetings and appointments of their own. Plus, we need to consider the rarely recognized reality that doctors tend to get sick too! And when they do, we don’t need them breathing their pox into our throats as they make us say “ahh”…

An article posted by the Ottawa Citizen back in 2017 explains that Canada has some of the worst wait times out of 11 countries that were surveyed (https://ottawacitizen.com/opinion/columnists/barua-why-are-canadas-health-care-wait-times-the-worst). So what can we do to help alleviate some of these wait times?

Some of the things that we, as patients can do are pretty simple:

  1. Schedule your appointments well in advance. You should have intimate knowledge of your medication use, so if you know your prescription will run out in the next three weeks, schedule an appointment for your renewal right away;
  2. Avoid going to the hospital for non-life threatening illnesses. Colds and sniffles affect the best of us, but tying up the ER for something you could attend a walk-in clinic for will usually result in a longer wait for you and longer waits for the folks after you;
  3. Recognize that wait times are a continued problem, and it’s only gotten worse in recent years. Until Canada fixes or alleviates this specific problem, make sure you schedule your appointment around a healthy period of free time! If you schedule a doctor’s appointment with another important engagement happening an hour after, you may be in for some disappointment.

At the end of the day, I’ll gladly accept waiting longer for the free health care our country provides. Remember that if it is something critical and life-threatening, don’t try to attend the hospital or clinic on your own; make use of 911 and have yourself transported to the emergency room. Many people avoid this option because of the cost, but it’s a better alternative than serious debilitation or death. ☯

The “Tooth” Of The Matter…

My 4-year old son comes around the corner and I have the following dialogue with him…

ME: “Nathan, time to go brush your teeth…”

Nathan: “No, I don’t need to, Daddy…”

His voice carries a light, invisible cloud of noxious breath that causes the paint on the walls to bubble and forces the dog to retreat for cover in the basement…

Oral hygiene and dental health are extremely important. Perhaps more so than most people understand. While growing up, I remember that the standard was simply that you needed to brush regularly and floss in order to keep from losing your teeth. Since then, studies and medical advancements have proven just how serious the problems can become if you don’t pay proper attention to your mouth.

Let’s think about our mouths for a moment: it’s the entry point for your food and the air you breath. This means that you have a lot of stuff from the outside world that enters your body through your mouth. Like most surfaces on your body, your mouth is full of bacteria. Some of that bacteria is good, but the bad bacteria is what can lead to tooth decay, bacterial infections and gum disease.

Bacterial infections can be pretty serious, especially for Type 1 Diabetics. Our weakened immune systems make us more susceptible to infection and makes them worse. Just to make you grit your teeth harder, (see what I did there?) the gum disease caused by improper oral health can make it harder to control your blood sugar levels.

Even if you don’t have Diabetes, poor oral health can leave you susceptible to cardiovascular complications, pregnancy complication and pneumonia. So, what can you do to hep prevent those oral health issues?

Brushing your teeth is an obvious first step. Despite what some of us were taught as children, brushing three times a day (or after every meal, whichever is greater) is not necessary. According to the Mayo Clinic, brushing twice a day is what the current recommendation indicates. This means brushing once in the morning and once before bed. Despite this, most dentists still stick to “old faithful” and tell folks to brush three times a day. It’s not a bad thing.

Although some dentists have indicated that even once can be acceptable, you tend to run into some problems with that, including potential bad breath throughout the day and unsightly food stuck in your teeth if you’re out in public. If you only brush once a day, best to do it first thing in the morning to eliminate morning breath.

Be sure to floss. Most people overlook flossing or it bothers them. But flossing is required to eliminate the bits of food that can’t be removed by a toothbrush. Leaving that food between your teeth against the gum line can lead to an increase in bacteria.

Use an antibacterial mouthwash. Don’t forget that mouthwash is supposed to complement your dental routine and isn’t meant as a substitution for brushing.

Here are some articles posted by Colgate and WebMD that explain some of what I’ve written and can provide further insight: https://www.colgate.com/en-us/oral-health/conditions/gum-disease/how-poor-dental-care-can-affect-your-overall-health-0313 and https://www.webmd.com/oral-health/features/oral-health-the-mouth-body-connection#2

Some other small changes can also help with improved oral health, such as avoiding staining drinks such as red wine or smoking tobacco products. And don’t forget to replace your toothbrush every few months. That s&*t gets gross!

So it may not have been a post about blood sugars or exercise, but proper oral hygiene can help prevent Diabetic complications and other issues that be aggravated by Diabetes. Why take chances when the prevention is so simple? And no, 9 out of 10 dentists did NOT ask me to write this post…☯

My Counting Sheep Fell Asleep, Why Can’t I…?

We’ve all been there, haven’t we? You reach the end of your day, change into comfy jammies and curl into a familiar sea of blankets. You lie there, staring at the ceiling or perhaps thumbing your smart device in the hopes of getting tired enough to fall asleep. Of course, using your smart phone or tablet can actually inhibit your sleep.

Image from The Simpsons

But that sleep never comes. You toss and turn, try different positions and even get up and walk around a bit but none of it helps. Then the morning comes and you feel exhausted, despite having EVENTUALLY fallen asleep.

Sound familiar? You’re not alone. Proper sleep plays an integral role in the control of blood sugar. Proper control of blood sugar also plays an integral role in getting a good night’s sleep. The two go hand in hand.

Studies have shown that blood sugar levels tend to spike during the night as we sleep. For normal people, the excess glucose can be absorbed. But for someone with Type 1 Diabetes, insulin may not be working in your favour the way it should, especially with the rise and fall of specific hormones your body produces during the night. This is why doctors will often recommend testing blood glucose at 3 am when trying to establish a pattern. So here are a couple of issues involving the important relationship between blood sugars and sleep.

High Blood Sugar: When your blood sugar spikes and rises, it places your body in a state of stress. This can make it extremely difficult to fall asleep as the stress will keep your body in an increased state of alertness. This can also be one of the causes of the “restless legs” syndrome (besides damage to the nervous system) you may experience on some nights while trying to get to sleep. I know I personally hate the feeling of being unable to settle.

Low Blood Sugar: If you have low blood sugar, your body responds by releasing adrenaline and cortisol to help you compensate. These hormones will wake you and energize you in order to ensure you can seek out food for your low. Not to mention that eating in the middle of the night causes all sorts of issues for your body as your circadian rhythm hasn’t accounted for it.

Lack Of Proper Sleep: It can very well be possible that you can’t fall asleep for reasons unrelated to Diabetes. Perhaps you have something on your mind, you’re dealing with a lot of stress, etc… Some of the things you can do to increase your chances of a good night’s rest include eating regular meals, following a consistent sleep schedule and incorporating exercise into your daily routine. Meditation is also a great tool, as the deep breathing and calming effects can help send you off to dreamland.

There needs to be a respected balance between sleep and proper blood sugar. That way, you don’t spend the majority of your day walking around in a caffeine-fuelled haze of exhaustion like I’m doing today. Diabetes UK webpage has a decent article on the subject: https://www.diabetes.co.uk/diabetes-and-sleep.html

And don’t forget that ensuring proper sleep means getting to the root cause of why you can’t sleep. And caffeine is only a band-aid and isn’t a replacement for a good night’s sleep. Sweet dreams. ☯

It’s Never Too Late…

Regret is a hell of a thing. Sometimes it can consume you, if you allow it to overcome the important aspects of your life. I’ve often written that one cannot allow oneself to have regrets as the events you might consider regretting have led you to the here and now; and if you could change those events to prevent that regret, you would seriously alter the person you’ve become.

I’ve spent the majority of my life trying to defeat every stereotype that’s been thrown at me. And having Diabetes has certainly made that challenging, let me tell you. Controlling and maintaining my health has always been a priority and I’ve worked hard to KEEP it a priority.

But in recent months I’ve begun to slip. A work out less a week here… An added beer or two a night there… Apathy and laziness have snuck up on me without even noticing. I’ve told myself, “Oh, I’m just tired, I’ll get back at it tomorrow.” Then tomorrow comes and I certainly don’t get back at it.

A good sweat and a little pain can go a long way

I think it may have been equal parts self-pity and self-generating laziness. The less you do, the less energy you have to get to where you need to be. But last night I was reminded of the importance of never stopping one’s physical development and health.

I was reminded because I saw the potential result of that laziness. Weight gain, reduced mobility, latent health issues and difficulty breathing… It’s amazing how much damage can be caused by not being physically active.

Don’t be afraid to try heavier weights. If they’re comfortable to use, they’re not heavy enough

I feel it’s time to recommit and buckle down. I couldn’t believe it when I looked at my workout log and realized I only worked out once, last week. Time to up the ante and start getting back into shape. Sometimes we need to get shaken a bit and have a little reminder to bring us back on course. ☯

New Life Brings New Problems

I have certainly written often about the problems and complications associated with Diabetes. However, there’s a sneaky form of Diabetes that tends to hit ladies when they’re at the most vulnerable: Gestational Diabetes.

Basically, Gestational Diabetes is when a pregnant woman has higher blood sugars throughout her pregnancy, which can lead to a number of complications for mother and baby. Even though the symptoms are few and far between for the mother during pregnancy, untreated gestational diabetes can lead to some pretty serious complications for the baby, both during the pregnancy and once the baby is born. These can include the baby being born too large, lowered blood sugar levels and jaundice.

First and foremost, pregnant mothers can take some preventative tests to check for Gestational Diabetes. This includes a “Syrup Test” where you are expected to ingest a high-glucose syrup and then have your blood sugars verified to see how your body reacted. Someone who doesn’t suffer from Gestational Diabetes will have no effect after ingesting the syrup.

The good news is that even if you are diagnosed with Gestational Diabetes, proper diet and control, in conjunction with your medical practitioner’s guidelines will ensure the birth of a healthy baby with no complications.

The Diabetes Canada website has a good article and can direct you to some links, should any of you have questions. Here’s the page: https://www.diabetes.ca/recently-diagnosed/gestational-diabetes-toolkit

There are several different types and sub-types of Diabetes, but this one hits close to home. If you’re pregnant, be sure to speak to your medical practitioner and get tested for Gestational Diabetes. Your health and the health of your baby may depend on it. ☯

How Not To Get Your A$$ Kicked…

I’ve reached a point in my life where I’ve been doing martial arts for more years than I haven’t. In those decades, I’ve seen some pretty incredible things and have used martial arts to help deal with a number of situations. And most of those situations weren’t fighting.

Most people consider the martial arts to be a fighting art. Although this may true on some respects, this isn’t the reason why they were originally created.

Depending on who you speak to, and what their sources are, the martial arts are believed to be several thousands of years old. Their origins are believed to be rooted in China or India, although there is some debate on which of these two cultures developed it first.

Ultimately, the Shaolin monks in China originally created what is known as their version of the martial arts as a means of staying fit and in shape. It was also considered a means of defending the monasteries if it became necessary. My style of karate is a descendent of this Chinese style.

These days, thanks to mainstream cinema and other forms of media, the martial arts is often viewed strictly as a fighting art. It would be remiss of me not to mention that the concept of the Mixed Martial Arts has unfortunately deepened this view.

“Discipline is not the enemy of enthusiasm” – Joe Clark

But it is true that traditional martial arts has a deeper purpose than simply being able to clear a room of enemies in epic empty-hand battles. The martial arts has shown to improve circulation, maintain proper health and body weight and increase confidence and personal discipline.

Certainly, over the past thirty years I’ve enjoyed the increased benefits of karate in regards to my health and Diabetes. Training hard and consistently has allowed me to be the exception to the Diabetic rule. Unlike most people afflicted with Type 1 for as long as I have, I still have a clean nervous system, clean cardiovascular and renal function. My circulatory system is also clean and clear and I don’t usually have the foot and extremity problems that most type 1 Diabetics have.

Karate has certainly been good to me over the past thirty years and has provided a wide variety of benefits, health-wise and even professionally. And if I were to recount the instances where I used it for actual fighting, I can probably count the number of physical fights on one hand. I’ve come to find that once you’ve trained long enough, the need to fight actually becomes less and less.

No matter what your reasons are for being in the martial arts, make sure that those reasons are for you and and for the betterment of yourself and those around you. If one’s only desire is to fight, there are sports in which one can indulge those desires. Martial arts is not the place for it. ☯

Well, Isn’t That Sweet…?

Blood sugar testing is one of the most rudimentary steps towards preventing complications when dealing with Type 1 Diabetes. Unless you’re on some sort of continuous glucose monitoring, most health practitioners would recommend testing at least five to ten times a day to ensure that you stay as consistent as possible.

I was first diagnosed with Type 1 Diabetes in 1982 (I know, I know… no need to point out how I’m aging myself…) and at that time, the belief was simply “don’t eat sugar.” Although that’s pretty accurate in some respects, there is far more to controlling Diabetes than JUST sugar.

As a child, I did everything I could to avoid sugary foods (with my parents’ support, of course). Staying away from desserts, juices and sugared products was all I assumed was needed. My parents knew no better either. If I were hungry, bread, crackers, milk… These were acceptable foods that weren’t “sugary” and were therefore safe for me to eat.

From the age 4 until about the age of 10, I suffered through a number of Diabetic comas resulting from extreme blood sugar levels. The worst of these comas lasted for a number of days. I can’t begin to explain how disorienting it is to go to sleep on one day, only to wake up several days later in a hospital bed. I often thank my lucky stars for having shared a bedroom with my older brother, as he was the one who ran to get my parents when he’d wake to find me frothing at the mouth. Without his intervention, I’m quite certain I wouldn’t be here today…

My point is, my family and I didn’t really have a firm understanding many of my Diabetic symptoms throughout my childhood. And the terminology of the time, “avoid sugar”, didn’t help. It wouldn’t be until twenty five years later that I would learn about carbohydrates and how they relate to Diabetes.

An example of a typical Nutrition Label found on most commercially sold food items.

Carb counting is not an OLD concept, per se… But it’s one I didn’t learn about until I started on my insulin pump in 2015. When I started consulting with my pump educators and dieticians, they began asking me about how I was carb counting. I was at a loss. I had become one of those people who focused so much on avoiding sugar and exercising, that I had never really bothered to learn anything new. That meant I had no idea what they were talking about.

Blood glucose levels are affected based on the consumption of carbohydrates. This includes sugar of course, but encompasses so much more. If you look at the nutritional label I included above, you’ll notice the portion I’ve encircled.

The Total Carbohydrate line includes all carbs, sugars and fibers included in the food. That being said, dietary fiber does not affect blood sugar. So if we look at the numbers on this label, you would need to subtract 4 grams of fiber from 37 grams of total carbs. This means you would need to take an insulin dose for 33 grams of carbs, not 37.

A 4 gram difference isn’t extreme, the difference over time can result in serious blood sugar fluctuations and all the symptoms and side effects that follow.

Although the medical definition of Type 1 Diabetes doesn’t change, treatment and proper care is a constantly evolving creature. It becomes important to continue learning and studying, and don’t be afraid to do some research of your own.

I know that doctors absolutely hate knowing we check Google and WebMD, but no information is bad information. Don’t be afraid to do whatever is necessary to ensure your proper health. And keep checking those blood sugar levels… ☯

Sometimes, Laziness Is A Good Thing…

You know, it’s been a long week. I painted and renovated our upstairs bathroom, laid flooring in the downstairs bathroom, eliminated a bunch of stuff we were no longer using and loads of weeds pulled in the yard and laundry.

I usually have a great deal of difficulty sitting still, and any of my coworkers and my family would concur with that. Between my annoying need to keep moving and always be doing SOMETHING and my compulsive need to clean, a day where I simply sit back and relax is usually quite rare.

I had just such a day today. Today is a civic holiday in Saskatchewan, meaning that most people had the day off. I started my day the way I usually do; with a healthy dose of caffeine to supplement the fact that my son woke me up far earlier than I planned on getting up.

A light breakfast and a few dishes later, I found myself sitting in a comfortable rocker watching some television. No chores, no errands… Then, the whole family partook of a short nap. After a short respite, we decided to take our son Nathan to a splash park to get some fun in the sun and play in the water.

We spent the better part of almost two hours playing in the sun. It was quite warm out today, and Nathan had an absolute blast until he managed to hurt himself and decided he wanted to go home.

Once we got home and were shielded from the sun, we all cooled down and had another bite to eat. This was followed by another nap. Now that we’re all fed and refreshed, I’m currently typing and my son is playing with a Uno deck on the floor. Although “playing” may be a very loose term; he’s mostly scattering the cards all over the floor.

Not exactly an exciting day, right? Was this a lazy day? A wasted day? What do you think? Realistically, in today’s busy world of non-stop hustle and bustle, a lazy day where one does nothing is often needed in order to reset your clock and get proper rest. This is almost as important as getting a full night’s sleep or meditating regularly. ☯

Let’s Lighten The Mood, Shall We?

Think back to a time when you’ve dealt with someone exhibiting a bad mood or a temper. How did you deal with what person? How did their mood affect your interaction with them? Did you do the typical thing and tell them to calm down?

That’s usually the worst thing you can do. Never, in the history of humanity has that ever worked. If anything, telling a person to calm down usually just fuels the fire and makes things worse.

Anger, frustration and rage are symptoms that are all too common to someone suffering from type 1 Diabetes. Fluctuating blood sugar levels can cause sudden and violent mood swings, which can often be misunderstood by those around you.

I can remember times when I was a teenager, that I was a real a$$hole. Those who know me personally who are reading this may wonder, What’s changed? Don’t get me started…

But seriously, there were times in my youth where my anger outweighed my ability to control it. And this is one of the lesser knowns symptoms of Type 1 Diabetes.

Depending on what source you look into, low and/or high blood sugar will affect different people in different ways. For example, most medical sources will say that low blood sugar will lead to aggression and irritability. For me, high blood sugar has always led to my bad tempers. In fact, I’ve damaged and even ended relationships in my youth because of my temper. In hindsight, I wish I had been aware of these symptoms back then.

According to an article posted by HealthyPlace.com, severe drops or spikes in blood sugar levels can cause several emotional responses including but not limited to, increased doses of cortisol within the brain, which affects the level of adrenaline in the body as well as a number of systems in the brain that affect things like fight-or-flight and self-control.

This is an effect known as “Diabetic Rage“. As most people would agree, feeling anxious, depressed or angry are normal human responses. Things get a little dicey when that anger intensifies and starts being projected on others. Here’s the article, if you wish to peruse: https://www.healthyplace.com/diabetes/mental-health/diabetic-rage-can-diabetes-cause-aggressive-behavior

The first and most obvious step in preventing such mood swings is the proper and frequent checking of your blood glucose levels. Preventing severe highs and lows will help to stem the symptoms. The deeper issue is learning the difference between what’s caused by Diabetes and what’s caused by normal mood and emotion.

Needless to say, it may be difficult to control oneself in the face of these mood swings but if you feel a sudden fit of rage, it may be in your best interest to test your blood glucose and adjusting your levels as needed. Barring Diabetic symptoms, deep breathing exercises and meditation often works for me although having someone tell me to calm down usually sets me off… ☯

Channel Your Inner Vila…

I remember sitting through many an episode of “This Old House” when I was a kid. My father loved the show, despite having never lifted a tool in his life. I guess it’s a bit like watching wrestling or boxing and never being in a fight.

I absolutely despised home improvement shows at that age, as any kid would. If I’m being honest, I was way more partial to Star Trek, Star Wars or Lost In Space.

I’m a little behind on getting some writing done. Yesterday morning started like any other day. I went into work, then came home to take my son outside to get him out of his mother’s hair. Usually that only includes keeping him busy until lunchtime so she can work, but yesterday I decided to take a drive to Home Depot.

Home Depot is an evil place, because they’re really good at making you believe that you can fix or build ANYTHING. I went in to buy some caulking for my upstairs bathtub, and ended up leaving with flooring, caulking, paint and tools.

What started as a quick shopping visit ended with redoing the bathroom floors and painting all the walls and floorboards. I worked diligently from about ten in the morning yesterday and finished just shortly after lunch this morning. Needless to say, I’m exhausted and I could never do home improvement for a living.

In order to turn my bragging about my renovating prowess into something that qualifies as content for this blog, I should mention my blood sugar levels. I spent almost 36 hours running low.

The idea is that many hours of consistent work tends to make my blood sugar levels drop. It’s not like anything I was doing was intensely rigorous, but even light work stretched over long hours without stopping will have an adverse effect.

I passed out hard last night, after eating reasonable amounts of glucose. When I got back at it this morning, I watched my levels a bit more carefully. It didn’t help that I painted the baseboards outside, with the summer heated quickly rounding the corner on 30 degrees, causing some mild dehydration and blood sugar drops.

This is just another example of how just about EVERYTHING affects you when you have Type 1 Diabetes. It’s important to take this into consideration when doing any sort of activity, especially in the high heat of summer. Drink plenty of fluids and stay hydrated, and test your blood often. ☯