Perhaps it'll be early in the morning for you, too. Someone will come in. An unsuspecting someone -- scared, vulnerable, looking for help. Looking to you! The world to them has changed; it's unclear, it's unfamiliar, it's blurry and it's been going on for two days. Yes, they have been urinating more frequently! Yes, they have a headache! No, they haven't been eating more, do I look fat to you?! Wait a minute -- what are you saying? Why are you asking me about my family? Medical problems will run in their family -- by the way, what an odd way to personify disease. We battle cancer, diseases ravage us, and apparently, they like to do laps through our family trees, skipping generations along the way and being passed on like batons in a relay to the newcomers by marriage or what have you. Back to our person with "the sugar." And you! Standing there with all the answers, and more importantly, the answer to this person's problem. Standing there and trying all the while to hide that smile playing about your lips because after all, you can't possibly be right about something. You're an MSIII! But how can you be wrong when this is as clear as the lungs in your chest (that's not the saying, I know), and nailing the Dx is a dense, highly glycemic piece of cake?! You're about to break the news and you're downright giddy at this point. The feelings of purpose and pride in your achievement collide in a magnificent swirl, similar to the ones this person probably indulged in -- of course, those ingredients weren't there. It was probably frozen yogurt with chocolate & vanilla flavoring. Mmm, flavoring. The emotions don't stop there, how can you be excited at a time like this? It's a conflicting feeling -- Disneyland meets Vietnam. I am sad for this person because they are not much older than me, and this could be me or anyone else I know or care about. Their road is a long one, diabetes is a war not a battle as the cliche goes. And it comes with so many other morbidities, which I don't have the time to explain and probably need to review. I compose myself, get a grip, because this person has a disease. I tell them what I think. They agree, they suspected as much. I tell them what we are going to do. They are agreeable to the plan. Accu-Check says 348 mg/dL. Shit, I'm right. I don't always hate being right, but I did right there. In my pursuit of being right, I'll make sure it's for the right reasons.
Amanda, a friend and soon-to-be rockstar PA, did a lot of work for the Native American community here and their issues with diabetes. In addition to that, she's got me interested in a site that I've passed along to a few patients during my stay at urgent care. Take a look!