The Groups at Our September Meeting

We knew that several support groups would be present for the final with the specialist on interventions. We had 95 people present and had room for just a few more. With that many people we were happy that the air conditioning was working.

I was not prepared for the start. Dr. Tom took over and said we have had a successful intervention in the last two weeks. He explained that he had been brought up to date by several of the group and felt there was a good reason for the intervention. At that point he introduced Jerry to the group. He asked Jerry what his last A1c had been. Jerry answered 13.2%. There were several gasps and Dr. Tom asked people to be quiet as there would be more that would shake them up as they continued.

Dr. Tom explained that until last Saturday, he lived with his wife who is a dietitian. After several of our group had tried to work with him and had his wife stop them, some rather harsh information came to light. First his wife was very happy with his A1c and would not reduce the carbohydrates, had high fructose in many of the food items he ate, and would not let him reduce the carbohydrates he was eating.

He continued that when they were able to separate him from his wife, Jerry and he had about an hour's talk and a diagnosis that had been arrived at by the group. Dr. Tom said he had never had one of these, but had talked to another doctor that had experience with Munchausen Syndrome by Proxy. He saw a few hands go up and explained, Munchausen syndrome by proxy (MSP), a type of factitious disorder, is a mental illness in which a person acts as if an individual he or she is caring for has a physical or mental illness when the person is not really sick. In the case of diabetes, this can take the form of feeding the person with diabetes with too many carbohydrates.

Next he asked Jerry if he remembered what his A1c was at diagnosis, Jerry answered 8.0%, his second was 7.5%, the last was the 13.2%, and the plasma blood glucose reading from the week before was 331 mg/dl. Dr. Tom asked what medication(s) he was taking and he said he was on metformin, 500 mg 2X, and now he is taking insulin. He said that A.J was a great help in working with him.

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At that point, Dr. Tom asked the intervention specialist to talk. The specialist stated that he had been able to talk with Jerry's wife and did agree with Dr. Tom's assessment. He could not say any more, but felt that the group had come to Jerry's aid for the right reasons and this was the first case he has seen. He said that normally you see this with one parent doing this to children, but one adult can do this to another adult.

Jerry then said that the situation had gotten out of hand and he knew that his A1c was heading the wrong direction. He said that with the support group members that had worked with him, he should be able to bring his A1c back in line or at least under 7.0%. Dr. Tom said that under 7.5% would be great, but that it was possible. Jerry said this was not what he had wanted in his life, but that there was support for action when he needed it.

The specialist then spoke for another half an hour about interventions and how valuable they could be. As he concluded, he asked if James had anything to say. James stood and said no, other than to thank everyone that had helped in his intervention and the support group for forcing a few issues when he had thought to go back to denial. He even said his wife had worked to keep him away from denial. He finished by saying he felt better now that his diabetes was being managed and that his last A1c was 6.6% and hopefully would be less at the next one.

Tim then said that they doubted we could have two meetings this valuable again, but that our group was happy for the meetings and hopefully presented something of value that everyone would remember and use to manage their diabetes more effectively. The meeting ended then. Some left, but many wanted to talk to James and his wife, and to Jerry. Dr. Tom did call him away and the doctors did want to talk to him. Allen, Ben, and Barry saw to it that they were not interrupted and A.J needed to join them. It took about an hour for people to disperse.

Our March Support Groups Meeting

We heard from Dr. Tom that he had a speaker that was willing to work with us to teach us some of the things we could do for interventions. First he desired those of us that had lost friends or relatives to write as clear a picture about what our friends had done and what steps may have been taken to assist them. Tim had sent out an email to everyone asking for information from anyone that had lost someone. They were to write a detailed information description including our name and phone number for him to forward on to the speaker. This did not need to be about diabetes.

The meeting was scheduled for March 22. All the support groups were invited and we expected a full room of over 65 people. When we were ready for the meeting, we needed to delay the meeting for about 15 minutes while additional copies were produced for the overflow crowd of 82 people. Allen helped with the copying and Tim, Barry, and I passed out 3 by 5 cards. Tim asked for everyone that did not have an email address with him to complete the card with name, email address and support group name with leader. Tim explained that this was for notification of meetings and receiving information on group meetings such as this after the meeting.

As Barry and I collected the cards, Dr. Tom emphasized how important this meeting could be. Allen had asked about extra chairs while making copies and they were provided. Allen and our speaker handed out copies of the sheets our speaker would be using and Tim set up to display the sheets on the screen.

When the speaker was ready, Dr. Tom introduced him. The speaker looked at the sheet Tim had on the screen and said he appreciated that so many people were interested. He then suggested that after each sheet, he would take questions and a second meeting might be necessary if desired.

The first sheet had this:

#1. Know when to do an intervention.

#2. Know when to accept that the person did not want to prolong a treatment and wanted to die with dignity.

#3. Know what questions to ask and when.

#4. Look for clues in the answers to help guide you in providing help.

#5. Never use force or threats.

#6. Learn to read body language to know when to move forward and provide additional assistance.

#7. Make suggestions to help guide the discussion.

#8. Know when to use tough love.

#9. Know when to walk away.

Then the speaker started asking questions for the people to answer. His first question was which of these was the most important and the least important. Silence, so he picked one person to answer. The person answered that they were all equally important during an intervention. The speaker said you must have been in one and that he was right. He said that it could depend on the type of intervention and the illness, disease, or addiction that could make some of the points more or less important.

The speaker went on to say that for diabetes, all were equally important, but that number 2 was the point that most people forgot and that cancer was the same. He said that when family and other loved ones were involved, this was even more difficult.

He continued that an intervention can be done at any time, but for diabetes, the sooner the better. He asked how many had heard of denial and every hand went up. He said that as an audience of people with diabetes, he expected that. He said then that you should not be surprised when I tell you that some people stay in denial and develop varying levels depression at the same time.

He asked for a show of hands of the doctors present. There were six doctors present.

The speaker asked if any have been involved in diabetes interventions. Only two said they had been, and both people had severe depression. The speaker said those are the easiest to recognize. Those with minor depression are often able to mask this at doctor appointments.

The speaker suggested that the doctor may want to work with a group or a few of their patients that they trust and that are willing to step forward to work with patients. Then he stated that the doctors are your fist line of defense and need to help you know when an intervention or other action should be successful. Then he told the doctors he would work with them as a group, or individually, to help them recognize minor depression. He would also give them other signs to look for when a patient sees them or cancels for no reason.

The speaker said the floor was open for questions and questions he got. Even the doctors were asking questions. After over an hour of questions and answers, the speaker said I thought as much and a second session would be in order. Tim asked if April 12 would work as the following date was closer to Easter and the next was Easter weekend.

He asked for a show of hands and it was agreed. The speaker said he could do that and thanked the group for their interest. The doctors agreed and wanted everyone to be present at the next meeting. The speaker said to hang on to the handouts and read them in the coming weeks to be prepared for the next meeting. Tim ended the meeting of three plus hours. Most of our local groups wanted to talk and thanked us for including them.