September 21, 2014

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.
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.

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