by Helen Wilde
Until Tuesday of this week I did not think of myself as a person with multiple chronic health conditions.
Like many other people, I was one of those who never took tablets – did not go to the doctor for antibiotics unless I was desperately ill, didn’t take panadol or aspirin unless I was really ill (or ok yes, or for the occasional hang over, when I was younger). In the 1990’s I started seeing my first ‘health care practitioner’, a podiatrist. I have weird feet, huge bunions inherited from my Elegant Aunt. Turned out that I walk funny, wear my shoes out lopsidedly. I needed orthotics, just little ones, especially for playing netball & basketball, & bushwalking.
That all changed after the turn of this century. I was diagnosed with high blood pressure. Coincidentally, I’d moved from the country to the city a year before. My country life included competitive sport, riding a bicycle to work, walking every day, sometimes morning and night, and incidental moving all day long in my job. I changed GP’s, changed careers, and now had a desk job with long hours and heavy responsibilities (not in Diabetes). I stopped moving, I ate biscuits, I gained weight. Easy, lose weight, the BP will normalise. I didn’t, it didn’t, so I started BP medication. That’s 1 chronic health condition.
Next I was diagnosed with- you guessed it, type 2 diabetes. This was a shock. I was the Mum of a type 1 diabetic, who was by now an autonomous adult, and a mother herself. Yes, I had a little grandson.. I should have known better, I should have done better. At this point I was taking 1 daily BP pill, a tiny little thing. Easy, lose weight, exercise, the diabetes will go away. I didn’t, it didn’t. So I added in 1 more tablet a day. My diabetes HbA1c test showed it was under control. That’s 2 chronic health conditions. I still saw myself as healthy, just that I was too fat, it was a self image thing, not a health thing.
The third diagnosis was asthma. That one was easy, ‘use this preventer, it’s a seasonal thing’, and that was all ok. That’s 3 chronic health conditions.
When I got a diagnosis of ‘chronic generalised pain + arthritis of hips, spine and knees’ I was terribly disappointed. I tried anti inflammatories, until my orthopaedic specialist and my arthritis specialist, over the course of about 3 years, said, “There is no operation that can help you, and you’re too young for that drug, it’s a risk for stomach & bowels, try this other drug.” I added in one more tablet, and also fish oil, because everyone says that’s good for arthritis. Oh and it’s supposed to be good for cholesterol too, isn’t it? Because yes, I got that diagnosis too. Another tablet, for cholesterol. So now we’re up to 6 chronic health conditions. The final diagnosis was reflux, another inherited condition. So another tablet, an awkward one, as I can only get 2 repeats, while all the others are 5 repeats, so I have to be creative to get repeats for that one. That makes 7 chronic health conditions. That’s not counting unrelated surgeries.
In the last 10 days I’ve my done my HbA1c & other chronic health conditions blood tests; seen Podiatrist; Ophthalmologist; Chiropractor; GP for my Care Plan review & prescriptions & to discuss test results; had my knees x rayed; seen my optician to get my new reading glasses; been to the Chemist, twice; went to the specialist shoe shop to buy special sandals that my (by now huge) orthotics will fit into so I don’t have to wear sports shoes with my professional outfits. Turns out podiatry is very helpful in diabetes, too! Oh, and I’m due to order new test strips for my bgl meter.
But I still didn’t see myself as chronically ill. Until this week. It was the asthma that suddenly got worse. I was seeing my GP for other things, and mentioned the pain in my chest. She upped my preventer, doubled it, and gave me an inhaler as well. The relief I got was amazing. And that’s when I realised I had a chronic health condition. Because I could feel it. And I could feel the benefit of the medication that treats it. That’s motivation enough to use it.
As people with diabetes, we are sometimes described by Health Care professionals as ‘compliant’ or ‘non compliant’. This makes me cross. It means that we either do what we’re told, or we don’t. It takes away the notion of autonomy and decision making. It removes the responsibility of managing our chronic health condition, and removes the responsibility for them to find motivation for us , other than Fear. I’m not a fan of Fear. There’s enough hysteria in the media and misinformation in the minds of the general public with out me having to find my motivation in Fear.
So what does keep me motivated to manage all 7 of my chronic health conditions?
1.I think they sort of ‘feed off’ each other. Because I’m taking one tablet with breakfast, and my puffer, it’s easy enough to take them all, and the same at bedtime. The ‘oddly timed’ ones are harder to remember, the pain medication mid-afternoon, the ‘extra’ metformin at tea time.
2.I have the motivation of watching my beautiful daughter manage her Type 1 diabetes.
3.Like everyone, I have seen good, close friends and beloved relatives die of cancer. I feel so lucky to have treatable, manageable (albeit chronic) conditions. I feel so lucky too to live in a country where medication is so reliable, strictly tested, generously subsidised.
4.I remember that diabetes is not a game of perfect, and neither is any chronic health condition.
5. I have a great Medical support team that I have refined over more than a decade of living with 7 chronic health conditions.
6. And I think it’s because I have diabetes and I work and volunteer in diabetes. It’s not all I do, I have another career. I also do other volunteering. But through working in this field I’ve been in contact with you, and so many other wonderful, brave, scared, sometimes depressed or sad people living with diabetes. I have also had opportunities to learn about my chronic conditions, some of that from the community here, to feel empowered.
7. I am driving my own life, not trying to please a doctor, not feeling I have to make excuses or make up stories about taking medication when I haven’t. Like lots of Australians, the ABC Catalyst programme last week made me question my GP about my cholesterol medication, and after thinking it over, I have decided to continue to take it. I’m too young to risk heart disease and stroke.
7 chronic health conditions: 7 strategies for managing them all.
Helen was a long term Senior Counsellor with Diabetes Counselling Online, Teacher, Counsellor. She is mother of a type 1 diabetic since 1979 and a type 2 diabetic herself for 16 years.