When I first came up with the idea to pair up a person with diabetes (PWD) with a health care provider (HCP) living with fakebetes (fake diabetes) back in April 2014, I had to make sure the concept worked (you can see the first real pairing of a PWD and HCP here and here). I asked Troy, one of the star medical assistants at my office at the time. He was just weeks away from leaving the clinic to attend PA school. I knew fakebetes would be a great learning opportunity for him. I also knew it would allow me to foresee any bugs in the project as I moved forward. I acted as the PWD, texting Troy photos of glucose readings found on instagram using #bgnow. I did my best to have this relate to what he was actually doing (he was working full time while attending school full time, plus it was finals week). Here is his guest post of the experience.
It’s a lazy Sunday evening in April and I’m lounging at the dinner table, enjoying the feeling of after-dinner comfort. My phone buzzes with an incoming text, and across the dinner table my young daughter’s eyes light up in anticipation. I read the text and groan, and she bolts for the insulin kit, giggling. She holds up a syringe and asks, “Ok Daddy, where do you want me to shoot you?” At least someone is enjoying this.
When Michelle approached my desk a few months ago and declared that I had been “diagnosed” with type 1 diabetes as part of her Fakeabetes diabetes awareness challenge, I was hesitant. I knew whatever she was asking me to do would be intense, but I also knew it would be worth it. Her previous health challenge had revamped my life and I had lost 60 pounds. I thought this new challenge over but decided against participating. I was simply too busy. Michelle gave me her no-nonsense look and asked “Troy, will your future patients be able to tell diabetes to hold off because they are too busy?” The guilt trip worked. She then proceeded to hand me a bag full of needles, some fake insulin (saline), a blood glucose monitor kit (which had even more needles) and wished me luck. I stared at the bag, clueless of what to do with it all and asked “What do I do with all this?” Michelle smiled and replied simply, “See you at your next appointment.”
Millions of Americans get diagnosed with diabetes and have no clue even what it is or how to control it. Their doctor hands them a bag of supplies and says “see you at your next appointment.” No wonder millions of Americans have uncontrolled diabetes. For the next couple of weeks I tested my blood sugar at least 6 times a day, gave myself saline shots every morning night and after every meal. I was in very close contact with Michelle about everything I ate (sending her pictures and how many carbs were in each meal), activities I was doing, stress levels throughout the day, and my physical health. She would text me back a picture of my “blood glucose reading” according to the way my body would react to all of the above. There lies the shock value in doing this experiment. I had no clue how much the smallest changes in my health, stress, exercise, diet, and compliance had on blood glucose levels and that even the smallest thing could cause a drastic change in those levels. Here is an example. I ride my bike 24 miles a day, (going to and from school/work). I did not know that I had to keep my blood glucose up by eating carbs to prevent a hypoglycemic episode.
One morning, Michelle shocked me by reporting that due to my stress levels, the soda I had consumed while studying the night before, and the fact that I had fallen asleep without taking any insulin, I was “currently” at risk for ketoacidosis with a BG level of almost 600. I quickly learned there is no room for forgetfulness, laziness, and noncompliance.
Being diabetic was not only physically difficult, but psychologically difficult. I was not able to eat my “comfort foods” or a piece of candy, not able to even try to lose weight the way I had been (in fear of having a hypoglycemic episode), not able to eat a meal that someone spent time making for me. I began to fear needles more because of how sore I was getting, and much more. Again I marveled “NO WONDER millions of Americans have uncontrolled diabetes”.
Then there was the financial factor. Michelle didn’t require me to invest money in this experiment (luckily) but through my own personal research and calculations, the financial responsibility for diabetics was daunting. A list of expenses I compiled talking to some diabetics includes:
Supplies, Medications, and Estimated Cost for 3 Months: $1071
Everyday Nutritional Pack – $81
Diabetes Monitoring Kit – $70
Test Strips – $60
Medical Bracelet – $15
Sterile Tip Lancets – $7
Medicated Lotion – $8
Insulin Injection Pen – $40
Insulin – $90 per vial
Medication to control blood glucose taken prophylactically – $700 (depending on insurance)
Other costs, such as the cost of eating healthier, increased doctor visits, and specialized foot and personal hygiene items add to this total. As diabetes progresses it can affect other body systems, the costs will continue to climb because of these complications.
As hard as just a couple of weeks were in doing this, I can clearly see the struggle that a person with diabetes has their entire life. As a future healthcare provider I will have more sympathy for patients with diabetes and also know how to educate a patient with more understanding and knowledge of the difficulties they face.
If you are a patient with diabetes, stick in there and find help and motivation from those who understand. If you are a healthcare provider, you can read testimonials and articles all day long, but until you truly put yourself in your patient’s shoes you will lack an understanding of the illness and the battle your patients go through. And that is what we are here for, to make life easier, healthier, and happier for your patients.
I am grateful to Michelle Litchman for her dedication in bringing an awareness of diabetes to me, patients, healthcare providers and thousands of others. Keep up the hard work in making a difference in this world.
Troy Richardson is a current PA student at Wichita State University and a former employee of Wasatch Internal Medicine & Family Practice.
If you are a healthcare provider or are living with diabetes and would like to volunteer for the Fakebetes Challenge, please to contact me.