Wednesday, May 15, 2013

Day 104

Well yes I know your wondering.  Yes Yes and Yes.  I am still doing this.  I have decided to go 180 days.  The Navy has placed me on a Medical Board.  Of course I will fight it.  My A1c is 10.4 and holding I have lost 25 lbs.  I am sorry I have not posted in a month.  I have watched several documentaries on NETFLIX to confirm my action of plant based high nutrient diet.  (please watch "Food Matters")  I will reverse this diabetes if it the last thing I do.  So I continue the journey.  Below is my letter to the Hospital.  I am eating like a vegan to be honest one meal a day and 3 juices only.  I will go until July 31 and will move to raw foods only in a short time.


"Dear Ms. Joyce,

I appreciated your support last year on my first letter and the documentation and recap of my care in Endocrinology as it was briefed to me via email from my doctor.  It is been over one year since I have last communicated through patient administration at Balboa Hospital.  This is my second letter and response to Dr. Douglass’ email, dated March 19, 2013.

I have not been on the clinic’s scale for my weight on a regular basis, but have been on the scale at my Command since the beginning of the year, weighing in with my Command Fitness Leader, who has been carefully tracking my progress.  I take issue with the weight gain and made note of it to the Corpsman, who said they accommodate wearing a full uniform.  As soon as he added an additional 15 pounds to my weight, I immediately told him it was inconsistent and erroneous.  I currently weigh 270 pounds.  I am in line with Navy BCA standards and have never failed one PFA or BCA.  It is all documented.  It is difficult however to stay in that standard because of the drugs I am currently taking so I have worked very hard to maintain and lose weight as required, I feel good about that.

I understand that Endocrinology is doing their job and requirements as  professional Navy doctors.  Why I continue to feel very frustrated and angry is that I still do not feel adequately cared for or supported as a diabetic. All I have heard these years in Endocrinology is that more medication is the way ahead from the turnover of several doctors.  My care does not make sense anymore over these last seven years.  The tendency outside of policy and procedures is to throw more drugs at the medical condition.  I understand doctors are doing this in an attempt to lower my A1c, I am grateful and I am not against taking medications.  I have been prescribed drugs in an attempt to make me “worldwide deployable” (and healthy I hope), yet I hear “How many more years until I retire?” at every office visit.  That comment is frustrating because it makes patients feel like what about my care and they are just going to be given the open door to retirement and processed out the Navy.  Any doctor can say you need to lose weight.  But this disease is not just about weight loss; weight loss is a benefit of a healthy life which can reverse diabetes.  Any doctor can say you need to go on a diet; but with this disease, it is not just about a diet—it is seeing how I see food and how my individual body responds.  For diabetics, optimal health is not achieved by eating less to lose weight.  Rather, diabetics have to make a big commitment not only to forming better eating habits but also eating the right foods to help the body heal from the inside.  These changes include making adjustments in their thinking as well as their diet.  I do desire to have a long life expectancy.  No one wants to suffer needlessly year after year and take more and more medications with side effects and weight gain and then put on a Medical Board as the solution.

All I have heard is negative and more negative and not what I am doing well.  But no real, specific care with set goals and measured progress—only treatment for the blood work.   I was receiving this with Dr Navarrete.  No one in my care has ever said diabetes can be reversed.  No one.  I am frustrated because I was encouraged to put my concerns in writing a year ago, and when I did, I was placed on a PEB the very next day.  That is when the fiduciary trust with my care in Endocrinology was broken.  The timing of the PEB communicated to me the doctors in Endocrinology are going to do only what the institution requires.  My PEB felt like a retaliatory response and true concern and reversal have not been a part of my care.

Having been faithful to all the prescriptions but still not showing significant improvement is a failure on medicine and critical care to accompany it. Endocrinology at Balboa has failed me because I never received this support (except for a suggestion of going to a diabetes support group, which didn’t help me at all). Diabetes has progressed in me over the years.  I see how the plan I have been on continues to damage my organs and heart.  I believe much of my suffering could have been avoided had I been given more accurate dietary information (other than eat fewer carbohydrates and reduce your sugar).  So I have adopted a healthy high nutritional plant based diet all on my own. I will reverse this disease not because of medicine or the care I have received thus far. 

If you look at my numbers since starting my juicing and high nutrient plant based diet 1 FEB to reverse diabetes, you will see change.  This may in fact warrant a re-evaluation on the course of action Endocrinology continues to take.  Unfortunately, in my opinion, treating diabetes with medications and not the proper diet education gives me and other diabetics a false sense of security.  One can mistakenly think their somewhat-controlled glucose levels indicate improvement.  But this is wrong.  Going to doctors and getting every pill averts the patient’s responsibility.

I am not asking Dr Douglass to shirk his responsibilities as he stated in his email, but the doctor-patient relationship and bedside manner I have experienced is disappointing and needs improvement.  Care means so much more than prescribing medications and prescribing further medications to treat the side effects to include a Medical Board.  Care means not treating patients as a number (me) but treating them with respect as an individual and to truly care for their well-being and their outcome and partnering with them for the way ahead to be found fit for service and heal.  I need this and doctors who will partner with me; I understand that I see care differently.  I was making progress with my civilian doctor Dr Navarrete and was hoping to continue.  This course of action was terminated not at my request.


Listening to what patients need to say extends to other aspects of communication and doctor care as well.  It troubles me to see military medicine, plans, models and operational memoranda that refer to communication as some sort of weapon that can be fired downrange.  Navy medicine should not be in a business rather it is people and care for those people in the military that is the hallmark of our Navy.  Rather, it is an obligation to explain ourselves, to put into context what you are doing and why and then partner with the patient; not just quoting notes, telling the patient what you did with surprise and quoting policy and procedures.  I see it as Endocrinology has made decisions without keeping me informed and partnering with me.  I see it as the department is not taking any ownership to the breakdown of the fiduciary trust and care in the doctor oath of office and with me.

We live in a participatory culture, a post-audience world.  People don't want just access to information or be told information anymore. They want access to conversation. They want to be heard.  I do not feel heard or cared for.  To take part in that conversation doctor and guide it, at times, requires a humility that we don't always possess. It requires us to listen as well as speak, to solicit as well as inform, to admit our shortcomings and accept sometimes brutally frank feedback such as what your are receiving right now.  I know my credibility, and that of the Navy, is enhanced when I join in a discussion rather than merely lead it. It gives us a better sense of the mood and attitude in which our words and actions land. It helps us communicate more comfortably across the spectrum of caring for people and that is what we both do in our respective professions in the Navy.

I feel very capable as a Navy Chaplain and world wide deployable.  I have served at sea and with special operations commands as a diabetic over the last seven years.  I would just take the meds I needed which had no impact on my ability to serve as an active duty Navy Chaplain deployed operationally.  I still desire to serve on active duty and believe I am called to be a Navy Chaplain.  I do in fact feel discriminated against because of my care to date in Endocrinology and take issue with the way I have been treated.  It is stereotypical to think that a person with diabetes is going to have more medical issues while deployed or unsupported.  I have deployed as a diabetic at sea and with our Navy SEALs.  I do believe by October, I will be worldwide deployable and able to go to sea.  I would like to believe that a military member is judged on the unique skills they bring and not their diagnosis.  Diabetes does not have to interfere with the ability to do a job, and most of the time is doesn’t.  I would have enjoyed some more optimism and encouragement and I have never received that from Endocrinology.  I do appreciate Dr. Douglass’ kind words in his email about assisting me as I improve and what I bring as a professional as my A1c improves.  I just feel like what I am getting is more socialized institutionalized medicine.  I will show that more medication is not the solution, but a healthy life and reversal should be the focus. 

With my progress, I do not believe a Medical Board was the necessary next step in my care plan and has been forced upon me.  This Medical Board can effect my ability to be promoted.  I am going to continue this high-nutrient and plant-based diet for 180 days.  I will continue to give blood so my medications can be adjusted as needed.  My goal is to be off all my medications by October 2013.  I still need the  partnership with doctors.  Thank you in advance Dr Douglass in your assistance in stating that my condition does not interfere with my ability to perform the duties required of me as a Navy Chaplain.  I disagree that it excludes me from worldwide deployment and sea duty.  I believe I can complete the mission as a Chaplain, that I am physically fit, mentally tough, morally courageous, and spiritually connected to God to serve my country as I have these last eighteen years." 

No comments:

Post a Comment