I went to see my health care practitioner for my three month diabetes management check-up, Karen Bruce is smart,  honest and funny – she believes in patient’s making decisions, she is blunt and direct about my caring for myself, we just click. She is also a poet and writer and for a few minutes at the beginning and end of our sessions, we talk about poetry and short stories. I have found the key to dealing with American health care: stay away from all male doctors and find a nurse-practitioner, they are smart, available and generally pretty nice people.

In the waiting room, I was sitting next to a man who was staring at the scare-and-fear medical channel warning people about diabetes, obesity, etc. and peddling various medications – an ethical doctor would not have these channels selling things in the waiting room. Diabetes is a big business and it is in, in many ways, a Fear Machine of it’s own, I have had so many people send me the most outrageously alarmist and false and hysterical misinformation about diabetes that they got online or from their Uncle Harry, whose leg fell off. I joked about the diabetes reports on the waiting room channel, and the man said he was a diabetic, he was coming to the health center because his wife took his blood sample, and it was high.

How high?,I asked. Oh, 700 he said, and I almost fell off the chair and offered him my spot in the line, I thought he might need an ambulance. I’ve never had a sugar reading one third that high, and would be quite upset if I did. No, he said, he was all right, he got sleepy and dizzy sometimes,  he didn’t like to take his medications and got sick of giving himself all those insulin shots, besides he likes to eat what he likes to eat. Well, I thought, his leg will probably fall off in a few years, this is the frustration the nurses always talk about. I stopped myself from cautioning him, he wouldn’t like it any more than I do, it is his life, his choices to make.

I have not had that issue of denial and avoidance, Karen straightened me out right away. She and I have managed my diabetes well, my blood pressure is excellent, my cholesterol level is fine, my blood sugar level is consistent and exactly where we both want it to be, day after day. We had a slight dust-up, she wants me to come in every time I get sick, she wanted me to come in when I got the stomach trouble, I didn’t, and so I didn’t get a sticker today. She did mutter that I seemed to take good care of myself, so maybe it was all right this time.

Diabetes is a funny disease, colds and stress and many other things can throw it off, when I got my gastroenteritis my numbers were jumping all over the place, I’ve got it back under control, I take four injections a day, one 24 hour dose and one smaller one before each meal. When you have diabetes, viruses hang out longer in your body, they do funky things in different ways. Karen is worried that like the man in the waiting room I’ll get bored and restless with all of the needles, meters, strips, lancets, pills and cotton balls and stop taking care of myself, I keep telling her that is not likely, I am focused and determined and I see the management of my diabetes as a creative challenge. I don’t drop those.

Social media can be a nightmare for diabetics, people love nothing more than to collect the horror stories from their friends and family – amputations, kidney failures, heart attacks, diabetic comas and pass them along. One woman warned me on Facebook not to ever get a tattoo as they were dangerous for diabetics. This is quite blatantly false in my case – it can sometimes be true – and I told her I would ban her from my site if she said anything like that again. She apologized, I appreciated that. Facebook is the alarm and hysteria center of the new universe.

The mind is critical to the management of disease, living in fear and alarm is as dangerous as any chronic illness can be. I take responsibility for my health, diabetes has been good for me, it awakened me to many things I needed to deal with in my life and also installed in me the confidence that I can care for myself. Karen says I am her best patient, I am proud of that.

I don’t talk much about diabetes and don’t care to be defined by it or asked about. In the nurse’s office are all kinds of signs warning about eyesight, feet neuropathy, cuts and exercise, Karen and I laugh about those, diabetes, like everything else, is an individual disease, everyone is affected differently. It is also a vast industry now, dependent on scaring the wits out of people who have it. Managing it is complex, it takes discipline and attention, every day, much of the day – how you feel, what the blood level is, what you eat, how you move, what is happening in your life. Somethings you have to listen to, somethings you have to dismiss.  I accept it, I do not live in dread of it. We live in a world of alarms and conspiracies, that is not my world. I wish I could tell this to my friend in the waiting room, he did not look well and will not be well for long I fear.