Tuesday, September 20, 2016

An Aching Tooth and Diabetes Stigma

I sat silent there in the dental chair, listening to the new dentist ask an array of basic questions about dental history and overall health.

Of course, diabetes came up.

Earlier, in the waiting room, there were the new patient forms to fill out everything about me. All the health and medication issues, and that typical checkbox for "diabetes."

I checked that box, but wrote in "type 1" on the line almost by instinct. I questioned that even while writing it, because I wondered if it somehow implied I was saying, "Not Type 2, or that kind of diabetes..."

Was I fueling misconception? Was I feeding into the daunting cloud of diabetes stigma that exists in the world?

Deciding it was over-thinking, I ignored my concern and wrote it on the form. And then went about completing the rest of the paperwork before seeing this new dentist for the first time.

Nice enough lady, and I was eager to get to the meat and potatoes of why I was there in the dentist chair: Discomfort in a tooth that concerned me.

As the routine goes, she went through the paperwork quickly and read off some of the health and medical related points I'd filled out. That's where she came to my checked box about diabetes.

"Oh, and diabetes... type 1, so that means you've had it since you were a child and it's OK?"

Red flags went up in my brain, but I hesitated.

"Yes, I was diagnosed at age 5, but you can be diagnosed with type 1 at any age!"

"Type 2s are being diagnosed as children more commonly, too!"

"Why the hell would it be OK at any age?!?!"

"It's not really referred to as juvenile diabetes anymore, because most of us with T1D are adults and more are being diagnosed as adults."

"What are you implying about those diagnosed as adults, or those with type 2 or gestational... no one chooses diabetes!"

But, I didn't say any of that.

I recalled writing "Type 1 diabetes" on the form in the first place, and how I'd ignored my gut instincts to just leave it as "diabetes" because distinguishing the types didn't matter at this moment.

Yep, I had pretty much brought this on.

Then I also remembered: My tooth hurt.

And that's why I was there.

So, I politely agreed with her, confirming that I was diagnosed as a young kid at age 5.

And I didn't say anything. I chose not to advocate, for whatever it might be worth.

Now a week later, I feel guilty for not raising my voice and advocating to that Healthcare Provider when I had the chance. I may not see this dentist again for a variety of reasons, but that just means I lost the chance to clarify something about diabetes that she may not have understood.

Especially in light of the latest research from the big EASD conference in Germany, in which a study showed that half of those with T1D are older than 30 years old. It's not just a kid disease, and the use of the word "juvenile" is outdated and inaccurate in many cases.

All of that makes me feel more at fault for not raising my voice to educate this dentist, especially when these folks are on the front lines in healthcare and can actually diagnose diabetes and help keep an eye (or tooth?) on D-management.

By not speaking up, I am a part of the problem in maintaining the status quo that's so saturated with stigma and misconception.

The Diabetes Community has an aching tooth in how it self-identifies and responds to the public, and that stigma is not far off from being that painful tooth that's in need of a root canal.

In retrospect, my silence feels like I just flooded the tooth with ice cold water and am now feeling the painful sensation that comes from allowing someone to continue not knowing about diabetes.

No, I don't always have to advocate in these types of situations. But then, I can't be surprised when someone doesn't know how things really are about diabetes.

And my tooth still hurts.

3 comments:

Laddie said...

I think that maybe you're being too hard on yourself. I do the same thing and always write Type 1 next to the checkmark for diabetes. It used to make absolute sense to me and now I feel guilty. At the same time I think the difference is medically significant and our doctors should be informed of our diagnosis. Even if they don't understand it. Frankly what used to be so black and white to me isn't anymore. Great post, Mike, and hope your tooth is better.

drug rehab portland said...

Thank you so much Mike!! Your post always give me some solution in my life. one of my family member suffer this disease so i know very well about it.

Kathleen Weaver said...

I always reply that I am insulin dependent. The dental community is taught to treat patients differently if they are insulin dependent vs on oral medications, especially since dental issues is a complication of both types of diabetes. I know this because I am a patient of a prominent dental school. Different outcomes are typical for insulin dependent vs on medication.