Tuesday, March 10, 2009

Olympics and Mental Health Clinics


With the budget cuts, 4 of 12 city mental health clinics in Chicago are being closed. All of these 4 are in predominantly Black or Latino neighborhoods, none are in predominantly White or "Mixed" neighborhoods. Of the clinics in predominantly Black or Latino neighborhoods, half will close. Of the clinics in predominantly White or Mixed neighborhoods, none will close. 3 of the 4 clinics being closed also just happen to be near the proposed sites for the olympics (Washington Park).

They say they can't come up with the $1.2 million to keep them open... but Chicago just spent OVER 50 MILLION on the olympic bid and also got a bunch of $$ from privatizing parking meters.

STOP (Southside Together Organizing for Power) has information about public hearings, protests and how to write the mayor on their website http://www.stopchicago.org

Friday, January 23, 2009

Dealing with messed-up-ness of medical system as a healthcare provider?

Lately I have been thinking about, or feeling like I need to think more about, becoming a healthcare provider in such a messed up system. Messed up in a lot of ways, including the lack of access and profit-driven system in the U.S. (call your congresspeople about single-payer universal healthcare, expanded/improved medicare for all, now!!), but that's a whole other post. I'm thinking about more the ways in which medicine has such a history AND present of being rooted in systems of domination and oppression such as ableism, classism, homophobia, racism, sexism, and transphobia.

How do I bring into conversation the idea that medicine is inherently a project of domination (an idea I take from discussions I've had with friends - theoretical and personal, and people I've read and heard in activist and academic contexts) with:
-the left-wing but not queer or radical in the same way doctor-activists and nurse-activists that see "good medicine" as a force for change (with whom I sometimes vehemently disagree, but sometimes think have done really good, important work)
-the objectified and rude-ranging-to-abusive way I frequently see patients get treated by providers at the free clinic where I volunteer
-the idea that even if this field is inherently fucked up and untrustworthy, there are still many things people need to get from it (sometimes because it is expertise or a skill specific to medicine, sometimes because medicine and/or government has control and acts as a gatekeeper)
-my own privileged experiences of being a patient (on the object side of the patient/doctor equation, but in a very privileged class, and racial context and a not-visibly-marked body in terms of gender variance and disability)?

What do I need to do when I am a nurse practitioner to make sure I serve the needs of the patients and/or disrupt the messed up patterns and practices of healthcare? What do I need to do now when I am interpreting or facilitating classes at the clinic? To not EVER lose sight of treating people respectfully, like people, instead of like objects to be touched (with or without consent). Or like interesting ideas to be bounced around later with colleagues (a greater danger for me, as I have noticed myself doing this)?

I have decided to go to school to be a nurse practitioner instead of a doctor. I think not entering into the old-white-boys-club (which now some women and people of color can be a part of if they play their cards right and/or have enough class privilege) of medicine, will position me a little bit differently. And when it is problematic, I will not have to have 110% of my time and energy devoted to it, so I will have time to seek out other worlds/people and take care of myself enough to not become a total pompous stressed out asshole that thinks I'm more important than everyone else, especially patients. But it still is part of a messed up, disciplining field, and it would be ridiculous to think being a nurse would escape that. Also, I am going to the top of a very hierarchical nursing field (hierarchies with strong racial and class components), and in programs that skip a lot of the grunt work and go straight to the masters or doctoral level position. Programs that are in some ways designed to position us just like primary care doctors (and that is part of what appeals to me about them).

Some of this is the mind vomit that will be irritating to look back on (and maybe for others to read). But I needed a place to work on processing, and also to be held accountable or discuss ideas if anyone has any.

Further reading (an extremely incomplete list):
Mississippi appendectomy - forced sterilizations on women of color
Ashley X petition
FRIDA on Katie Thorpe's womb to be removed
Interview with Harriet Washington, author of Medical Apartheid
Medical Apartheid book
Bad Blood book (on Tuskegee Syphilis experiments)

Friday, December 12, 2008

Insurance coverage: advocating for CGMS in a system that leaves many people out

Today I received an email from JDRF about their campaign to get continuous glucose monitoring (CGMS) covered by insurance companies. I want my insurance to cover CGMS so that I could use it. I don't think they have any business denying people coverage to this device that is helpful to our health and probably lifesaving for people with hypoglycemia unawareness. But I also don't think health insurance companies or our health care system in general as any business denying anyone coverage. It pisssed me off that this is JDRFs focus when there are more pressing issues for many people.

I wrote back:

I want CGM covered, but MUCH MUCH more than that, I want a single payer health care system that covers everyone in this country.

Please fight for things that will help ALL diabetics and that are much more necessary than CGM. I test 10 times a day, and sometimes wish I had CGM (for example, tonight, I am up late because I worry that my blood sugar is dropping). The diabetics that come to the free clinic I volunteer at are all uninsured, and cannot afford test strips. If they come to the clinic, wait on the waiting list for the diabetes education class, and then attend all the classes, they receive enough strips to test once a day. Though they are type 2s, this includes many people on insulin. People taking insulin that can test their blood sugar once or less a day. As for yearly dilated exams (more often if retinopathy is already present)? The waiting time to see an opthalmologist is 22 months

The millions of diabetics that are uninsured or underinsured and can't even access the basic necessities of diabetes care deserve much more help and I think it's abominable that this is your priority.


We need healthcare for EVERYONE that leaves nobody out. We need a universal single-payer system (expanded & improved Medicare for all) now.

Wednesday, September 03, 2008

Thinking back to the aftermath of Hurricane Katrina

Hurricane Gustav and the anniversary of the destruction and criminal neglect of the people in New Orleans after Hurricane Katrina had me thinking back. Katrina hit before I left home in Chicago to go back to school for the year, and the aftermath continued as I settled in on campus. One of my professors remarked that people "feel like the world is ending" with all of the recent events - Katrina, the tsunami in late 2004, even going back to September 11th.

I didn't share that sense of terror or a strong connection to events like the tsunami or September 11th (especially not September 11th, which did not seem any more tragic to me than the tens of thousands of people that die every year in the U.S. from lack of access to healthcare and other forms of violence the media is not interested in). Yes, sadness that so many were dying, frustration and disgust with the responses of people and structures that could have helped prevent tragedies of such scale or responded better, and dizziness from just trying to understand the sheer numbers of deaths, which my brain couldn't even compute. But not a sense of terror or grief that shook me to the core.

Katrina was different.

I was watching TV with my mom, and suddenly I found myself sobbing. The camera had just showed a young black woman crying and screaming that she was diabetic and she needed insulin and that she was going to die if they didn't get some insulin to her. It just got me - I reacted before I had even thought about it. It made me so upset and scared and incredulous and disgusted. It was just so wrong and so upsetting, and I did not understand how anyone or any structure could do that (deprive someone who is insulin dependent of their insulin) to another person.

Once I thought about it, I got enraged at everyone, the government especially but even all the way down to the news crew. If they had those resources (electricity and transportation and contacts and enough expensive equipment to get on national TV), how could they stand there fucking taping her screaming for her insulin and not get her some? This was not the first day after the hurricane hit either, I think it was at least day 3.

But what got me on such an immediate, visceral level was clearly the type 1 diabetes. And probably some element of seeing myself in that woman. Although I know on a rational level that my chances of being in that situation, as a wealthy white person with connections (in healthcare), are almost non-existant, it struck me. Maybe poked past some of the filters that structural racism has taught me to look through and the mainstream media perpetuates? Or perhaps I shouldn't have been surprised, I don't usually watch a lot of TV and so don't see all of the gruesome visuals on some disasters.

It also seemed much more urgent and close and part of my life because it was closer and happening in my country, a system that I am more directly part of. It was crude injustice: racism, classism and poverty laid out in such a raw, visible way. Ignoring or moving at a snail's pace to help people that are dying, in a way that just showed how little regard most of the people in power had for their lives. That stuff exists here all the time, but it was magnified and made more visible by the hurricane.

Thursday, July 10, 2008

Inventions I could actually use...

There is this gadget I have had in my head for a few months now. I swear, it seems simple enough, and important enough, that someone should be able to create it (or should have already). They're working on continous glucose monitoring sensors, even islet cell transplants. But what about just figuring out if my bottle of insulin, right now, is still good?

I want a little device that I can inject a few units of insulin into that will tell me if it is still good or not. One that could've helped me out last weekend, when I had no idea why I was 389 after dinner. Did I really do that bad of a job counting the carbs I ate? Or was that afternoon on the beautiful Lake Michigan beach too much for my vial of insulin without an icepack, even though I was careful to keep it covered up and in the shade?

A device that could've helped narrow down the cause of several spates of ridiculous and unpredictable blood sugars I've had over the past year or two, during which I was getting my insulin from a mail order pharmacy (way cheaper) that didn't seem completely trustworthy. Like when the insulin showed up during our late-summer heatwave last September and the ice was all melted. And when I called the company pharmacist to ask, he said, "Well, it took 5 days after it left our warehouse to arrive at your post office. We aren't responsible for what happens when our shipper has it." (WTF?! I'm paying you for my insulin and you can't be responsible for whether or not it gets to me in working condition?)

Anyways, someone needs to create this little gadget. It should be totally doable... the heat just denatures (unravels) the insulin proteins, right? So something that could detect the shape/structure of the insulin could figure it out?

I want inventions and technological advances that can actually help me control my blood sugars, and make doing so less stressful, and more convenient.

I want to know if my insulin is working or not, and not have my own body be the experimental test tube taking the hit to figure it out.

I want an infusion set that delivers insulin in a way my body can absorb (as it seemed I couldn't absorb well from all the infusion sets I tried in the last round of extreme blood sugar unpredictability and highs). I don't care if my insulin pump looks like a Minimed, an OmniPod, or an iPod, as companies and some diabetics are concerned about, judging by consumer surveys I did and blogger design contests. I just want it to work.

P.S. Thanks to everyone who commented on the last post (a gajillion years ago). It was nice to hear your thoughts and experiences and have a little discussion/support/camaraderie.

Tuesday, January 08, 2008

Before and After.

Ok, so this is what I meant to post about when I wrote the last one.

So maybe it sucks that this kid's body is getting displayed everywhere, but here's a before and after picture, courtesy of the awesome "Broken & Fabulous" zine. It's a type 1 diabetic kid in the 1920's, before and after insulin was discovered (and she was one of the lucky ones to get access to it in time). I'm sure some of you fellow diabetics have seen it before:
The above is just one of many reasons I don't respond well to pictures like this:
or this:

or people telling me how I look great after I've lost some weight (which this time, is largely due to high blood sugars, since I have definitely been exercising less and eating either similarly or more food and less healthy foods). So it is definitely not from being "healthier" this time, it's from being less healthy.

I have several issues with the prevalent "weight loss is always positive" idea, but this is just a part of why it's more complicated (medically/physically and emotionally/psychologically), and what it means to disappear or not disappear part of your body, what starvation means, etc. to me.

407 at 3:29

So despite promising myself earlier today (and yesterday, and last week) that I need to get on a better schedule, I'm up posting this at 3:29 am. Last night I actually had a dream which involved getting to work late, people stealing my desk (which actually does happen a lot, but this was more severe), and then realizing I was in some pretty awkward pajamas and not work clothes. And then I woke up, waaay after my alarm had started going off.

I actually did turn off my computer earlier (before 1) tonight in an effort to get to bed at a semi-reasonable hour, but I turned it back on because I was really frustrated with blood sugar issues, so I wanted to settle down (and break me off a little piece of that diabetes OC to help) before I try to go to sleep. Basically: after working out tonight, I'm 97. I don't eat anything, I go grocery shopping (which usually drops me), and 3 hours later, I'm 397. Wash hands, repeat: 382. Yup. My site doesn't hurt, no visible blood or loose tape, and isn't due to be changed until tomorrow afternoon (I try to change it every 2 1/2 days or less). When I took it out, there was blood in the cannula - but I had no way of knowing the site was bad until my blood sugars went nuts (and for a second, I felt guilty for not having tested for 3 hours, and then I realized that is ridiculous). I gave myself a shot, fairly aggressive but not super aggressive because it's near bedtime, and 2 hours later I haven't budged - I'm 407. Don't want to give myself a lot more insulin since it's still bedtime and sometimes my body reacts really late to insulin and I bottom out, but probably I need more before I go to sleep.

I know sites fail occasionally, but I just am frustrated and worried cuz it's happening all the time, again (this happened to me last winter/spring, I took a pumping break and tried some new sites). It seems like my pump isn't dependable anymore again. Or I don't even know. I have been in the 300s routinely in the last few weeks, despite not being sick, testing 12+ times a day, and not drinking much at holiday festivities. I started paying less attention because I was exhausted/burned out from paying so much attention and having things still not work out. Sometimes I am eating crappy or underbolusing or needing an adjustment in my insulin rates because I've been exercising less, but I don't even know how to sort out what's what, changes I need to make or bad sites any more. Between not trusting my pump and being burned out, I sometimes can't figure it out or just don't have the energy to. You know it's bad when you're going through ketone strips like crazy just to try to figure out if your pump is working... (hey, at least walgreens started making the generic ones now!)

Tuesday, November 20, 2007

I'm it! Here are my seven.

Jonah and Beth both tagged me for the seven random/weird things meme. Thanks! This is good, my exam today is done and I wanna get back to blogging. I feel like I already write here some of the weird things about me, but I'll try to cook up a few more.
  1. When I was little, I used to shave every morning. I would get really really jealous of my dad shaving, so he'd give me a plastic spoon and some shaving cream (the kind with an orange top that comes out as awesome turquoise gel and turns into creamy white foam when you rub it). I would stand next to him in the bathroom mirror and shave my face almost every day (except when I got out of bed too late, which yes, I was doing even at 5 or 6 years old). Kind of funny for someone who doesn't shave her legs or pits at all now. Or... maybe it makes perfect sense.
  2. I love thunderstorms.
  3. Sometimes when I have a really intense yawn or nose-blowing, I feel like I can breathe in air through my ears.
  4. I am kind of in love the idea of my body being pregnant. Not with the idea of having a kid, I really want nothing to do with having any kids right now (or possibly ever). Just the idea of my body being physically pregnant. This is the opposite of how most people feel I think - they want the kid without all the icky physical things about a pregnancy. And I am well aware of how ridiculous this may seem, especially considering the actual reality and the extra mental/emotional and physical burden that would come with a diabetic pregnancy. And I should know better, considering that what I do all day at work is review medical records of pregnancy, scary complications and all. And even scarier/more painful, labor and delivery records (can you say, episiotomy? how 'bout 2nd degree vaginal laceration? contractions at a pain level of 10 out of 10?). But that's why this is just a fantasy, and it's about the beauty and roundness and just the general physical idea of being pregnant.
  5. Speaking of being pregnant, people think I am all the time. I get people giving up seats for me on the train for no apparent reason except that they are looking at my belly and smiling sweetly at me/it. I get asked about it my strangers and less socially conscious/inhibited family members (most recently, my grandmother and a cashier in a cafeteria). I wrote about it a long time ago - I just have a belly on me, which isn't that proportional to the rest of me I guess. Haha, or maybe my thoughts from #4 cause me to give off some kind of vibe?
  6. My ring finger is my favorite for checking blood sugar.
  7. I eat apples from the bottom up instead of around the sides. Since I eat more of the apple than most people, usually a little tiny core, it's the best way to go at it.
I'm tagging bsom, estrogenmoment, Claire, misscripchick, Liz, Kameron, FatlyYours, Jes, and Hannah. (yes, that's 9... see below how I feel about rules! or above, how I feel about decisions...) I don't know if all of you do memes, but it's worth a try.

Rules (but I'm all about bending/breaking 'em if ya want):

1. Link to the person’s blog who tagged you.
2. Post these rules on your blog.
3. List seven random and/or weird facts about yourself.
4. Tag seven random people at the end of your post and include links to their blogs.
5. Let each person know that they have been tagged by posting a comment on their blog.