I Like My Patients Vertical

I like my patients vertical.  Not horizontal.
 
If I can help it, I want to make sure that nobody gets a disease that could have been prevented.  Sure, accidents happen.  And illnesses show up every day in the lives of people who did nothing to deserve them, and who could have done nothing to prevent them.  But not all illnesses.
 
Physicians know that newly diagnosed diabetic patients present to the doctor with about 10 years worth of damage to their blood vessels.  What does that mean?  That we diagnose diabetes 10 years later than the disease warrants.  It means that the symptoms we learn to identify come about 10 years after the disease begins.  
 
So, I can wait until a patient begins to complain of frequent urination, unquenchable thirst, and an infection that won’t heal.  I can spend ten years ignoring a blood pressure that continues to rise; a combination of high triglycerides and low HDL; frequent car rides to buy fast food; a lifestyle that includes almost no time for stretching, walking or other exercise; a diet consisting largely of refined carbohydrate (sugar and white flour) and omega-6 oils; and and multiple pairs of pants that can no longer be buttoned.  But at the end of those ten years, I should not be surprised when that patient shows up exhausted, and with a blood sugar of 350.
 
This past week brought with it news from the Centers for Disease Control (CDC) that 35% of American adults are now prediabetic.  Half of Americans aged 65 and older have prediabetes and just over one-fourth are diabetic.  Rates of diabetes continue to soar, particularly among racial and ethnic minorities. 
 
Diabetes is, for the most part, a preventable disease.  The key is to start preventing it ten years before your diagnosis.  When would that be?  Now.  Eat protein for breakfast and skip food-like products made from white flour.  Stop drinking soda/pop — the research shows that even people who drink diet soda have an increased risk of diabetes.  Why?  We don’t know yet, but as soon as I learn anything I’ll share it here.  And no more light, lite, quick, instant, or processed food.  Eat real food.  What’s real?  Food that your great-great-grandparents ate.
 
We must also find ways to make peace, to relax, and to manage the stress that we all feel in our hectic and busy lives.  Stress increases body weight, blood pressure, and blood sugar.  I just finished reading Traveling with Pomegranates, by Sue Monk Kidd (author of The Secret Life of Bees) and her daughter, Ann Kidd Taylor.  Sue’s hypertension evaporated once she realized how important it was to balance the time she spent writing with time she spent relaxing, walking down to the marshes near her home and sitting quietly as a part of the nature all around her.  She called it a personal recognition of the fact that “being” is of equal importance to “doing.” 
 
The stakes are high; diabetes can be dangerous.  I don’t want to see my patients in a hospital bed.  Or even in a wheelchair, if it can be helped.  I like my patients vertical.

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