The Doctor who Supports Patient Choice – to the Very End

Maclean’s– “I actually felt I had done the right thing for my patient.” Gordon had gotten what he wanted, and what Buchman had done simply felt to him like helping. “It was so peaceful and loving that I said, ‘This can’t be inconsistent with who I am as a doctor’.”

Dying is as much a part of living as laughing is, but we clearly don’t embrace the former quite like we do the latter. Now with legislation allowing people to make a choice about when they die, patients and families and physicians are faced with making and respecting what can be difficult choices.

What we learn from the story about Dr. Sandy Buchman in Macleans, is that dying and living are well connected within the context of a person’s life. For healthcare professionals serving an individual at the end of their life, assistance in dying is merely another tool to treat a person’s pain and suffering. If providers are to respect what is important to the people they serve, then providing this assistance when a patient has made a clear choice, should be considered as following the care plan agreed to by the patient.

Its often been said that dying is no laughing matter, except now some people are learning that laughing and dying are not mutually exclusive. To better understand the extent of this choice we all now have, read the full story and learn how Dr. Buchman expands our understanding of compassionate care.

Read the full article…

The Type 2 Diabetes Diagnosis: Emotions

By Kathy Kastner with Zal Press

First, you grieve

A diagnosis of Type2 Diabetes means the end of life as you’ve lived it. Adding to the shock is the perception: Type2 is the ‘bad’ diabetes. The one you’ve brought on yourself by your overindulgent lifestyle. Type1 is seen as the ‘good’ diabetes: beyond your control.

Rarely is this the case: Type2 Diabetes is most often ‘written in the genes’, thus confounding even the most diligent of health efforts.

Lori became an advocate as a result of seeing the impact of this condition on her father and nephew, which evolved into her becoming a resource and Opinion Leader.

With a Type2 diagnosis, going through the stages of grief is not uncommon: denial, anger, bargaining, depression and eventually – hopefully – choosing to accept.

Anger and denial

Even for those in ethnicities at high risk of T2, acceptance of a diagnosis can be devastating. Heather is a nurse and Opinion Leader who, on a whim – and well into her career – decided to test herself: Being as she was in the hospital on the Diabetes unit. That was in 1989.

Aida (who gives an infectious giggle as she explains,’ it’s pronounced like the Opera’) is slim and fit and is certainly no slouch. When others might think of retiring, she’s embarking on new careers as a radio and tv ‘star’.

A family history of diabetes meant Aida’s genes were indeed pre-programmed but that doesn’t mean she expected her diagnosis,7 years ago. Her reaction was to go into denial. As with many T2s, she felt no differently than before being diagnosed.

When Aida’s Diabetes required an insulin injection, she felt her reality shift. “I hate needles, even tho I have the tiniest one, I hate injecting myself. And I have to do this whenever my sugars aren’t controlled.”

Aida feels education – especially from Opinion Leaders such as these ‘round the table – is one of the keys to her decision to choose to successfully managing her T2.

Depression and bargaining

Heather and Lori agree: “It’s depressing, getting a diagnosis of Type2 Diabetes”

Trying to manage is often an emotional rollercoaster. In a video produced by Northwester University’s Communication in Medicine Shoold, specifically for medical school residents to better understand the lived experience, a young woman looks into the camera, her face full of confusion and upset. “This can’t be. How can my values be so skewed? I thot I did everything right.” She rhymes off her new rituals on her fingers: “I measured the protein, I exercised, I meditated, I injected.” and as she says this, the very finger she’s using to count off her list of ‘rights’ begins to leak blood. Her shoulders sag. She shakes her head, looking at her hands. “My fingers,” she says, almost to herself, ‘Now they leak all the time.”

Acceptance

Jim’s dedication as an Opinion Leader takes many different forms: care giver for his first wife with Lupus, President (Past) of the Optimist club, he works with disabled children as one of their many projects, Canadian Diabetes Association Volunteer of the Year and a Patient Educator for people with Arthritis.

As with many trying to manage Type2 Diabetes, lives are already complicated by other health conditions. To explain his head to toe issues, Jim stands up to demonstrate starting with his balding head, ending ‘an with enlarged aorta – I’ve got a big heart.”

Changing habits is hard enough for those who don’t have Type2 Diabetes – as evidenced by an industry devoted losing weight and healthy lifestyle strategies – which always include exercise. Another tough one even for the most determined.

This group of patient and caregivers are each Opinion Leaders who are committed to improving their own lives, and the lives of others with T2D. They combine support and advocacy with a healthy dose of humour: Heather is slim, keeps a healthy diet and gets in a certain amount of activity in her job as a nurse educator at a Diabetes Management Center, and has managed her Type2 Diabetes for 22 years.