Monday, January 23, 2012

Paging Nurse Ratched!!!


Blarrrrrf. That’s the sound of the puking I did this weekend after mixing gluten AND alcohol this weekend. No bueno, ya’ll. I have an inkling that this was also a side effect of mixing the alcohol with the medication given to me by the Rheumatologist. I may never know. All I know is that I was miserable, and had only devoured 2 drinks over 3 hours…so for those of you thinking I was drizzle, WRONG. I even counseled with a pharmacist prior to my GNO to make SURE I wasn’t going to drink and then crap my pants, and I was given the go-ahead to “pace myself”. I thought I was doing a noble job at it, too. Lucky me. I see the Dr this Friday to discuss further medication options.

This brings up an interesting point. I have had MANY questions about the gluten-free diet, and would totally love to chat with a dietitian about the changes I have already made, and the further changes I am open to making. For gluten seems to sneak its way into everything. It’s a sneaky lil bastard. Now. Would I want said dietitian to counsel me on the state of my diabetes. NEGATORY. Carb counting. Check. Fats. Check. Being able to identify fruits & veggies….ehhhh CHECK. Why do we HAVE to meet with a dietitian JUST because we have diabetes? Why can’t a CDE learn you about advanced pump features {typically used with fatty or protein rich foods} just as well as a dietitian? I mean they cross train us educators to do both. Why do you need both? Dietitians do pump starts and teach injections, why can’t nurses teach carb counting & dietary needs???

Growing up, I was part of the Texas Children’s Hospital {TCH} assembly line. Appointments lasted 4-5 hours, we met with a nurse, endo, dietitian, had labs drawn and did a lot of sitting around. I remember loathing my time with the dietitan. Was I exchanging starches? Was I eating fiber and drinking water? Did I ever consume candy or junk food? It made me want to SCREAM. My CDE in college, who was also a dietitian, sent me to the “office dietitian” in charge of carb counting, because she was JUST going to do my pump start. Uhhhhh excuse me? How efficient is that for anyone?

Don’t get me wrong, I can see why a newly diagnosed type 1 could benefit from seeing a dietitian, but what if one isn’t available….like in my office? I think I do a pretty phenomenal job of getting my patients off on the right {dietary} foot. Why would I then, also, waste my patient’s time AND money and send them to a dietitian (who in this area, mostly condone exchange counting and cutting out sweets a la Type 2)?? Now for those in the diabetic community that need assistance with renal diets or putting on weight, then yes, a dietitian consult can help. But for normal, Joe Schmo type 1 diabetes management, I just don’t see the need to see a dietitian ALL THE TIME.

Maybe I just need to lay off the haterade?? Maybe TCH & ADC cultivated this “Debbie Downer” feeling I have against RD/LDs? And don’t GET me started on non-licensed/registered {so-called} Nutritionists. I’m sorry, but the internet does not make you a “nutritionist”, and someone should never pay for services from someone not in the field…so BEWARE. In the state of Texas dietitians must be licensed AND registered, so always look for those letters behind their name!

Now…DJ…please don’t punch me! Love ya!

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