Catching up.

Hey Dad,

A lot has happened since I last wrote!

It's funny to be reminded that Chicago was having an unseasonably warm fall just before the polar vortex brought us to a halt.  I thought I wanted to hibernate before!  I realize that temps in the 50s are rough on Floridians, but I'm seriously reconsidering living in a place where the air hurts my face.  You might have been onto something when you moved down there.  I'm sure you don't miss digging out parking spaces, but I have to say you're missing out on some seriously amusing dibs activity!

http://www.businessinsider.com/dibs-season-chicago-2014-1
These folks are classing it up!

The Affordable Care Act went live despite the government shut down.  Unfortunately, there have been problems with the insurance marketplace website launch and a lot of folks are confused about what coverage is available to them.  I've been sitting back and watching the political drama unfold and I'm discouraged to hear folks I know personally having difficulty affording health insurance even with subsidies.  I am not convinced that health insurance reform is what we need.  Time will tell whether this actually helps folks.  I'm worried about what will happen with patient assistance programs from pharmaceutical companies since they typically only help the uninsured to afford medications.  The least expensive health insurance for folks above the medicaid cut-offs almost certainly won't give them enough coverage for their drugs and/or will have too-high deductibles.

Speaking of diabetes drugs, I'm worried about you.

It's been a rough several months for you with the shoulder surgery and now more kidney problems.  I know you hate being inactive and that has created some challenges with managingyour blood sugar.  We’ve talked about this before, but it bears repeating that you really do need to take it easy because diabetes can make the healing process take longer and having an injury or illness can make it even more difficult to control your blood sugar.  A lot of stuff can come up for people withdiabetes who are also recovering from a surgery.

Your most recent news, though, is the most troubling.  I am so sad to hear that you have new kidney stones.  I know you’ve been happiest eating a low-carb diet, but the high protein diet is really causing somedamage.  I’m glad that you went to the dietician to get some advice about how to eat a low-protein diet while managingtype 2 diabetes.  I hope that you are able to keep it under control with diet, but please reconsider taking medications if the doctor thinks you need them.

In the mean time, I’m looking into some food resources for you.  I know you are not a fan of most vegetables and you aren’t all that keen on expanding your palette, but maybe there are some ways to make it easier to try new foods so you aren’t stuck eating the same bowl of lettuce every day.

Love,

Mel

Sad news and a plea.

Hey Dad,

I am sorry it's taken me a while to write.  The last thing I wrote about was trying to find public diabetes education and information events.  I did attend the Chicago ADA Diabetes Expo and collected some samples for you and got to talk to folks who do different community-based work, but I've not felt much like writing about it.  You see, just a few hours after I got home from that event, my family got the call that another one of our dads was dying and that we needed to get down to Missouri immediately.  So we packed up the car and arrived in time to sit vigil with even more family for L's last hours.  We were only home for a few days before heading back down for the memorial mass.  It's been a long couple of weeks and I'm just now trying to get back to work.

L was diagnosed with type 2 diabetes over 30 years ago and had managed the disease, when he managed it, pretty well with diet and oral medications.  He wasn't a model patient--we toasted him with bourbon, after all--but he did pretty well considering the lack of resources that were available when he was diagnosed.  In fact, it wasn't until the last year that he needed insulin, which only started after he went on dialysis for kidney failure.  L had been investigating transplant options for a kidney when he developed other complications with his gall bladder.  When his recovery from gall bladder surgery became severely complicated by the dialysis, they discovered he had liver cancer.  There was less than a month between diagnosis and his passing, nowhere near enough time to process the reality of the situation before it was time to say goodbye.  L was only 67 and he will be missed dearly.  

You would have liked L and I am so sad that you never had the chance to meet.  He had a generosity of spirit and acceptance that put the people he welcomed into his life at ease and he laughed loudly and easily.  I smiled when I heard his laugh from 3 rooms away the same way I do when I hear you laugh like that.  He reminded me of you.

So, Dad, I am so grateful that you've been doing well with keeping your blood sugar in check.  Please do what you can to spare us from suffering this kind of loss again, even if it means going in for regular checkups when you feel just fine.  Just do it, please.

Meanwhile, I'm gonna do what I can to help improve access to meaningful help for people with diabetes.

I love you.

-Mel

Fear of the known

Hey Dad,

I'm so sorry to hear that you're sick again.  It's weird for all of us that you're not running around like a crazy man since it's not like you to sit still.  I can only imagine how hard it is for you.  Thank you for talking to me about what's going on because I think I can help, if you'll let me.

I was thinking about our last visit and I get why you've been down.  You've been one of the most able bodied people I've known, always working or tinkering with something.  Lately, though, you haven't had the energy you need and your kidneys aren't doing so great.  I wish you'd slow down, but I understand that that's just not your way.  Even if you wanted to, your job won't really let you and it's not like losing that job--and your insurance--would help.  I get that and I wish it were different.  No matter what, you are still one of my heroes.

When mom called to let me know you were in the hospital again and that your A1C test came back so high, I thought about Uncle J and I was pretty sure he was on your mind, too.  I can't believe it's been almost a year since he passed.  Even though your brother had a long, devastating fight through just about every catastrophic complication that can come from diabetes, that doesn't mean that it will happen to you.  You know how important it is to bring your A1C down and to keep your blood glucose levels from fluctuating too wildly throughout the day, so I won't belabor the point.

I am worried, however, that you are going to be too hard on yourself and burn out quickly.  I know you're not new to diabetes, but it's been years since you last actively managed it and I'm going to dig up some resources to make it easier for you.  Let me know if I'm pushing too hard since that's the last thing I want to do.

Love,

Mel