Can you think of any other medical condition where removal of a treatment is threatened?
I was thinking about that question a couple of nights ago, in my hotel room in Sydney, at 2.30am, getting over a hypo, after chugging OJ, messaging people, tweeting and reading pages of my book. I couldn’t fall back to sleep.
In diabetes, we (still; STILL?) hear of HCPs threatening to remove pump therapy from people who are considered to not be meeting expected results.
Let’s not even open the can of worms asking who actually has set those results, or if the PWD had any input into the decision making process around targets, or if too much focus is being given to a number.
No. Let’s instead just focus on the fact that some PWD are (still; STILL?) being told that their chosen treatment option for their life long health condition will be removed from them as punishment because they are being ‘bad’.
Now, I love my insulin pump, but let’s remember what it is. It’s a little box that delivers insulin. Okay – a little, highly-sophisticated magical box that delivers insulin, but nonetheless, it’s an insulin delivery device.
It would be the same as saying to someone who is using insulin pens that because their A1c has increased, (often the reason behind the threat of pump removal), their pens were being confiscated and they would have to use disposable syringes. Or, people using disposable syringes would have to use glass syringes with needles needing to be sharpened.
Crazy, right? There is no way that we would consider that okay. It’s actually laughable.
Of course, people with type 2 diabetes are not immune to the threats of diabetes management, however in this case, it is threatening to add treatment rather than take it away. People with type 2 are often told that if they require insulin injections to treat their diabetes it is because they have failed with other treatments.
Making threats about diabetes management options is bullying. Holding the tools we need to live well with the condition over our heads as rewards or punishment is not okay. It is scary and unfair and sends the wrong message.
Earlier this week, Aaron and I saw the Melbourne Theatre Company’s production of the play ‘Death and the Maiden’. It was fabulous – amazing performances – and if you are in Melbourne and looking for a night at the theatre, get tickets! Here is the Schubert string quartet by the same name, which is providing my background music in the office today. Have a lovely weekend.
10 comments
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July 24, 2015 at 2:33 pm
Sue
Well said Renza. I’d bet my bottom dollar that HCPs who do bullying of this sort are not even attempting to unpack the challenges the PWD is struggling with, imho therefore not doing their job properly or professionally.
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August 17, 2015 at 5:07 pm
RenzaS
I think you are right there, Sue. In fact, I think that frequently that is the issue – there isn’t enough time, or the know how, to work out exactly what is at the root of why people are struggling.
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July 24, 2015 at 5:37 pm
Heidi Lilley
very well said !!! Thanks for staying with the issues Renza, and even though we are across the world from each other these issues are the pretty much the same here in the USA as they are where you are.
As you probably know I am type 2 and I am on Medicaid, they did in fact take away my insulin pens, at first trying to put me on a second and third oral med (both of which I had used and had major problems with) and eventually put me on disposable syringes. I do a fair amount of traveling, and as I’m sure you and everyone else is aware, traveling with pens is much more convenient than with syringe and bottle, but oh well, such is life. Thankfully, as a type 2 I was able to lose a lot of weight and am currently, at least for now, off insulin and only on orals, but that could change at any time.
Thanks for your posts.
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August 17, 2015 at 5:08 pm
RenzaS
Thanks for sharing your story, Heidi. But I am so sorry that you had to go through so much trouble to get the care and use what you need to manage living with diabetes. Thanks for reading.
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July 25, 2015 at 12:04 am
lifeont1
This is how the insulin pump coverage program works in Ontario and Alberta!
You have to have an A1C below 9.0 to qualify for funding, and then if you dont achieve certain targets, your funding is pulled and you’re put on injections again.
Disgusting
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August 17, 2015 at 5:09 pm
RenzaS
That is ridiculous. Punishing – or rewarding – people for their health status/results is absolutely ridiculous.
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July 27, 2015 at 10:09 pm
Hannah
Hello Renza, when I was a teen here in Germany in the 1980s I was even told that I would no longer get any prescription for insulin, if I did not do what the HCP (?) told me to do. Problem was, I was doing what I should, but the results were “bad”. That was in times before even ICT was available. Therapy meant 7 fixed meals / snacks a day, 2 times (mixed) insulin per syringe and 1 – 2 blood sugar checks per week.
I never got rid of the fear of not getting the insulin I need until now.
Thanks for your work, your words have often touched me!
Greetings from far away – but somehow it feels close :-), Hannah
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August 17, 2015 at 5:10 pm
RenzaS
Thanks for your comment, Hannah. I really hate hearing such terrible experiences from people though. To scare you with the thought of removing insulin – that is barbaric!
Thanks for reading. And yes – blogs and the DOC make everyone seem very close!
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July 28, 2015 at 7:15 pm
Rebecca Infanti
I can’t believe this technique is even logical to HCP… I understand when a person feels their current treatment strategy is not their “cup of tea” that a HCP would advise alternatives – but to suggest it as a form of punishment for “non compliance” is just ethically and morally wrong.
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August 17, 2015 at 5:10 pm
RenzaS
I agree with you, Bec.
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