Sunday, January 2, 2011

Destiny's Dance

Curiously astounding at times, when circumstances align, bad breaks reveal their silver lining, and I find myself precisely in the right place, at the right time, with the proper skill set, and a nose that knows.

I had that very thought after the initial shock with the Bean, my Bean.

“No more chocolate, very little meat, no preserved meats, no sodas, no NSAIDs, low salt,” Dr. Patel said.

“No problem,” I responded. “I don’t eat chocolate, don’t eat much meat, I never use a salt shaker, I quit sodas about fifteen years ago, and NSAIDs about ten years ago.”

His eyes grew wide, his nose crinkled, and brow wrinkled. “Why’d you do that?”

“I dunno doc. Sometimes I would just stop and say out loud, ‘This isn’t good for my kidneys. I’m not gonna do this anymore.’” Ah, those were the days, when I thought I had two that worked.

“I’m so lucky,” I said over lunch this year. “If ever there was a problem I should have, it should be this one; one that I so naturally and unconsciously manage. To a large degree, I’ve been on a renal diet since I left my father’s home. And I am so lucky because it has saved me; I’d be in a world of hurt had I not listened to my body and responded to its wants.”

Circumstances align and a bad break becomes its silver lining.

Several years pass, my job with the internal medicine service is eliminated – a devastating blow – and I return to ED nursing. My manager leaves for Chronic Conditions and I follow to become a diabetes care manager. I learn more about diabetes than I ever thought possible. As I gain knowledge and skill, the cardiothoracic NP team at Mercy subsumes the diabetes management of all post-op open-heart patients. It is tedious work at which we out-perform cardiologists, bar-none.

I volunteer to teach the DM Type-1 class to gain new knowledge, to increase my skill in serving a minuscule patient population. I’ve learned more than I ever knew existed regarding Type-1 diabetes: how to calculate insulin:carbohydrate ratios, manage sick days, calculate unused boluses, the consequence of insulin stacking, and overlapping action curves. I’m no expert but I can aim someone down the right path with a pretty high degree of efficacy and safety.

Where is this going lb? A big boy has been losing weight. But he was obese and needed to lose weight. No one ever asks an obese 26 year-old if the weight loss is intentional… or not. Unintentional weight loss, lots of it. My nephew was hospitalized today. Diagnosis: type-1 diabetes. I will be in Honolulu by lunchtime tomorrow, for ten days. If this kid sticks to me like glue, I can get him down the right path. Perhaps together, we can lead our family toward food choices that convey better health. We are what we eat.

Circumstances align, a bad break - compound and comminuted - reveals its silver lining, and I find myself in precisely the right place, at the right time, with the proper skill set, and a nose that knows.