Today is the day of two pills for me, one full, one empty. I have finished my 28-day course of antibiotics for Lyme Disease, I am beginning a lifetime course of medication for diabetes. I am over the chills, fevers, sweating and aching course of Lyme, I feel strong and good, my body appreciates the farewell to Lyme, and to the antibiotics as well. If you go by what you feel – usually we are not allowed to do that – I am recovered, at least for now.
Tomorrow I start taking a medication called Metformin, supposedly the Gold Standard for diabetes medications, the next step would be insulin injections. I know there are holistic medications that work also, and I have explored them and I will probably continue using them even as I become a citizen of Diabetes World In America.
I have to be honest, this is a world of tests and procedures and warnings and big money that I have avoided for years, and happily, but one can’t generalize so completely in the morass that is health care in our country. They do some things very well, and controlling diabetes is one of them. In America, chronic illnesses like diabetes are a source of many warnings and alarms, many “concerns” about my health, but they are also huge profit centers, big business. Money is the elephant in the room, and you get the sense almost everyone you deal with is delighted to welcome you to Diabetes world even as they ask you what kind of insurance you have and warn you constantly that you are near death and disintegration at any moment.
In my doctor’s office, the walls are festooned with warnings to diabetics about sight, feet, breathing, heart and kidney trouble, amputations and aches and pains, dead nerves in feet and loss of cognitive powers. The idea seems to be to frighten people into taking a lot of tests, and buying a lot of pills. The TV channels in the waiting room sprout an endless stream of diabetic warnings to get everything in your body checked constantly, study your carbs, see every doctor there is every month there is, you can go blind and lose the feeling in your legs. These things are sometimes true, mostly not. (I have a friend in Berlin with diabetes, and he gets all of his medications and stuff for free.)
The workings of diabetes are fascinating to me. I get a glucose meter for free, and the lancet pins to poke your fingers are cheap – plastic strips with small needles all made in China. But the tiny strips that actually receive your blood are a $1 a piece, a hundred dollars a container, this is where the big money is made, I am told, that and medications. I received an armload of gear – instructions, meters, lancets, tablets – from the doctor, but then I headed for the pharmacy where the real world of Diabetes is on full display. If you follow all of these tests and warnings, write down everything you eat, poke your finger multiple times, take your classes, diabetes is pretty much a full-time job. My pharmacy has a full-time diabetes counselor shelves of meters, pills, tablets, supplements, books and pamphlets, there are posters about diabetes everywhere, special discounts for diabetics. My trip to the pharmacy triggered days of negotiations with my insurance company. Even though my payments were the subject, I was excluded from all of the conversations, which took place my via computers between the doctors, insurance companies and the pharmacy. They would pay for the lancets, but not the meter or the strips.
This required visits and phone calls and e-mails to the doctor and eventually, I had to get a different kind of meter (one the insurance companies like) in order to get the expensive strips paid for. I got a one-on-one lesson with the pharmacist on using the meter, several pamphlets and an invitation to more counseling, diabetes classes and workshops. In fact, to get my supplies, I had to sign in three places statements that I did not wish or need more counseling. It was just like Facebook.
The meter is easy to use, and I got a diary in which to write what I am eating and what my blood sugar is before and after each meal. Why did I get this feeling that the diary, published by the glucose meter pharmaceutical firm, listed many more entries for each day than is strictly necessary? More strips? With each meter, you get a handy little traveling kit, incomprehensible instructions, and a device to poke your finger (painless) and a few samples of strips and lancets. Once you get the meter, they are home.
For years, I did not consider myself a diabetic, I controlled it myself. Now I know I am a diabetic and am getting some help.
The diabetes nutritional information – I’ve studied it for years – is pretty common sense really, for me, eat lots of grains, vegetables, no sugar or processed foods, etc., pretty much what I’ve been eating for five or six years. There was nothing new for me.
Diabetes in America, like Lyme, is not just an illness, it is a gazillion-dollar business, a world unto itself, a hydra with a lot of heads, all of them leading to insurance payments and multiple doctor’s visits. The insurance companies hover over the process like the bad witch in Oz, shaping and controlling life in Diabetes World. Tomorrow I start the medication and we’ll see how it works. For all the money and bureaucracy in diabetes – a hot disease, tens of millions of Americans are getting it – the pills are the point. If the blood sugar is controlled, and it most often is, it will all be a good trade and I will remind myself that I am fortunate to have a disease that can be treated. After years of avoiding this system, I am now a citizen of Diabetes World and the truth is, I see it as a chance to stay healthy, not to be sick.
Stay tuned.