There are many motivators, and two powerful ones are pleasure and fear. Both of these figure into the care of ourselves and our diabetes.
The anticipated pleasure of movement, for example, often gets me up out of my chair and out the door for some exercise. Another pleasure tied to exercise is social: if I make a date with someone to walk or skate, I look forward to that person’s company. This week, for example, my daughters and I have been walking daily around a local reservoir or pond, and it’s been so enjoyable to be with them this week that every day I wake up wanting it again.
Fear — which anticipates danger, pain, or the unknown — also has some role in how I care for my diabetes. Never is this more present than when I’m in a hospital or clinic waiting room and observe extreme cases of discomfort or disease in another patient. I see a wheelchair, oxygen tether, or pallor, and I think, “That won’t be me!”
Ah, the hubris of the healthy.
Two days ago I went to a podiatrist for the first time, ever. The registration and the wait took longer than the actual time with the doctor. As my daughter Grace and I sat in the reception area, I heard one patient, an older man, tell another one: “I have foot problems because of the diabetes. It’s unfortunate. It’s unfortunate,” he intoned. (Prideful, I thought to myself, “Not me. Not me.”)
In the examining room, I met Dr. R., who checked the pulse in my calves, ankles and feet; did the filament test; and did the tuning fork test. He looked at my injured toe and proclaimed it to be healing well and not a concern. Finally he explained the physiology of diabetes and foot care, emphasizing circulation (the “plumbing” of the feet, he said) and the nervous system (the “electricity”). “And these two systems are independent of each other. You can have problems in one, and not the other,” he added.
He asked me about my recent A1C and history of them. “In the sixes and sevens,” I replied. “The last one was seven point four.”
“For someone who has had diabetes for nineteen years, your feet look great,” he said. He reminded me that research has shown than A1C’s in the “sevens or less” are key to the avoidance of complications from diabetes. “But, you know, you can do all the right things, and you can still end up with problems.” (I know that. I hate to hear it.) He described symptoms of leg and foot problems to watch out for: lower leg pain in the middle of the night, numbness in the feet, a wound that won’t heal.
“Basically, for someone like you, I only need to see you on an as-needed basis. Don’t hesitate to call.”
Dr. R. stood up and put his hand on the door. “Oh, one more thing.” He looked down at the form I had filled in during registration, which asked me questions about my shoes (practical), medications, family history, and exercise. “Why figure skating?”
“After I turned forty, I got this idea in my head that I wanted to do it. And I keep wanting to do it,” I replied.
“I would be scared,” he said. “I would need one of those bars to hold me up.”
I looked at this big man, athletic and tall, like a rugby player, and about my age and seemingly sturdier. He would be scared?
I’m scared, too, and I’ll abide with my fears: about my health, my family, job security, retirement savings, you name it. What makes it possible to live with fear is pleasure, both immediate and long term: the pleasure of good and healthy food, of a walk around the pond with my daughters, of the upcoming Homecoming Weekend at my son’s college, and of a life with strong and able — and skating — feet.