My Diabetes Inklings

The COVID19 Lockdown Hokey Pokey

Just as we thought we had gotten over the worst of COVID19 here in Melbourne, we’re right back at square one. In fact I feel that this current lockdown is tougher than the first time we did it. Perhaps it was the tease of freedom we had or the frustration of people not doing the right thing. Or even just the combination of everything plus the added desolation and stress that work has thrown around. Either way it sucks.

Changing routines has had a massive impact on my diabetes management and my mental health. Working from home has meant being more sedentary during the day, meaning higher insulin resistance. My exercise and eating habits have also changed, which meant trying to figure how to manage my insulin doses around that. Stress, uncertainty and general moodiness equated to less motivation to do things, even diabetes management. Everything felt like a chore and forced.

Coming out of lockdown was something I approached with much trepidation. We started by dining out at our local cafes before venturing out to our surrounding suburbs and meeting up with other people. It was so good to be sitting down at a cafe again, catching up with friends and family over meals we didn’t cook. Everywhere we went, everyone made an effort to do the right thing by keeping their distance and sanitising everything.

Second lockdown hit me like a tonne of bricks. I am feeling incredibly worried with the rising number of COVID cases, feeling the panic and urge to sanitise everything I touch and mask up every time I’m out. I started getting a headache on day 1 of lockdown and later that night, dreamt that I had unknowingly contracted COVID and spread it to people I loved and places I often went to. By day 3, I knew I needed to take time out, rest and reset.

Today is day 4 and my stress headache has mostly subsided and I’m taking the time to focus on gratitude and kindness. I need to stop comparing myself to others, saying that I have nothing to be upset about or struggle with. Let’s start by being kind to ourselves. Each of our experiences are valid, albeit different, and we must acknowledge this. We’ve been through lockdown once, we can do it again for another six weeks. Support your local community. Do what you need to do to look after yourself.

My aim now is to prioritise my mental and physical health during this time and trust that everything else will fall into place. And thankfully, I have a cheeky kitten to keep me sane during lockdown at home.

My Diabetes Inklings

Being A Clinician Patient

Recently, I transitioned to a different diabetes clinic as I needed a team that was in one location and within the public system. The move to a new clinic felt like starting a new school. I was excited and nervous to meet my new team, while getting hopelessly lost in the hospital maze and appointment booking systems.

From the moment I stepped in the clinic the receptionists gave me a weird vibe. I was used to having a nice chat with people at the front desk who keep the clinic running smooth. However, these guys would barely break from their own conversations to say hi while checking me in. It felt weird to be almost invisible.

I recognised a few familiar faces from conferences and diabetes camps, so there was some friendly catch up on life and research. The thing I struggled with were the comments from clinicians I had never met who said “I won’t go through this with you since you should already know it” and “You probably don’t need to see the dietitian, seeing as you’re one”. Then I remembered that my referral included this little detail as part of my background. I did ask my referring doctor not to include this information in but perhaps it slipped through.

Those comments were exactly why I wanted to remain somewhat anonymous. I may know a lot about diabetes management and am good at helpful others troubleshoot things. But I usually spend so much brain space thinking about other diabetes research things for work that I sometimes just need that extra perspective. I overthink everything and am either over cautious or too blasé about my diabetes care. So having that extra guidance is extremely helpful.

Luckily I had the confidence to politely and firmly request that I did want a dietitian appointment and I did want to go through the basic knowledge even if it’s just to ensure that my knowledge is all up to date. I may have even asked a few questions that broke the system and sent clinicians trying to find appropriate print-outs and then printers. Apparently the hospital has a confusing printer system. So somewhere out there, a poor printer probably has a heap of random print outs that will never be claimed.

This experience reminded me of three things. One: that everyone in the clinic plays an important role in making the client feel comfortable. Two: that as a clinician, you need to meet a person at their own level and never make assumptions. I don’t want to be spoken down to like a child. At the same time I don’t want my clinician to skip everything, making me feel stupid if I asked a basic question with statements like “you should know this”. And three: it doesn’t matter who you are, advocating for your own health and needs is a skill you should never underestimate.

My Diabetes Inklings

Healthcare During COVID19

Part of my research interests revolves around mobile health and integrating that into mainstream healthcare system. Mobile health can include things like online peer support, online platforms used to deliver health services and telehealth. For years, there has been advocacy for telehealth subsidises and its integration into metropolitan hospitals. And for years, it’s been “too difficult” or “there isn’t a need for it”. Cue COVID19 and within a few weeks, majority of our health appointments are done via telehealth or videoconferencing.

At the same time, I find myself in a sea of appointments. I had several endo appointments trying to sort out my thyroid, my educator appointment and a few GP appointments to coordinate other referrals. Not to mention frequent visits to the pathology lab.

I have to say that even though I really appreciated the quick phone call appointments with my endo, I missed going in to catch up. With my educator, we had used a videoconferencing platform. It was awesome to see my educator at the other end but I still missed our “hang out” time and long chats. Turns out I can be a really Chatty Cathy with my diabetes team. Then I had the horror realisation that I was one of those patients who doesn’t stop talking…Eep! Sorry!

Given that I usually travel a fair distance to see my endo and educator, the time saved by using telehealth was invaluable. If they were running late, I was able to continue working while waiting for their phone call or being in the virtual waiting room. I didn’t have to wrangle public transport or pay for parking. I did miss making these appointments a bit special without my usual cafe treat experiences, but that will come back soon.

Since I was a new patient at the GP clinic, I had to attend the first appointment in person. I was excited (and slightly anxious) to have a reason to leave the house and go for a walk! Thankfully the clinic was super organised and had strict entry screening and social distancing rules. It was also so nice to speak with others in person. I didn’t realise how much I had missed it.

As much as I love telehealth professionally and personally, I think that there will always be a place for face to face consultations. I’m still really excited that practitioners around Australia are adapting to telehealth options. COVID19 seems to be the push that the healthcare system needed to keep up with the times and technology the world has got to offer. Of course, we still have a way to go to integrate this into our healthcare system as usual practice. To this, I say, bring it on!