Diabetic Friends Action Network (DFAN)
Online Diabetes Newsletter - April 1996 Edition

This month's issue of our newsletter is a special
Marriage/Relationship & Diabetes double issue.  Diabetes can
bring many problems into a relationship.  Because of this we
thought we would devote a majority of this month's issue to this
topic.  We'd like to thank all the people who shared their
personal experiences with us.  Without them the articles in this
month's issue would just be "text book talk".  We hope these
articles help you in your own relationships.  This issue is a bit
longer than most but it's an important topic to cover.

If you need to lose weight and need motivation and support join
our weight reduction club.  It's geared toward people with
diabetes who need to shed pounds to help get their diabetes under
control.  We have weekly projects dealing with some aspect of
diabetes management along with tips on eating and exercise.  If
you'd like to receive a sample club e-mail send your request to:
belve@aol.com

This month's we're offering three more files for you to read.
This month's files include:

File 1: Neuropathy: What Is It?  How Do You Know If You Have It?

File 2: Gastroparesis (The "Other" Neuropathies): That Upset
Stomach You Have May Be A Diabetes Complication.  Also Includes
Information On Other Complications Of Diabetes Including
Diarrhea, Urinary Problems, Etc...

File 3: Diabetes & The Eyes

If you'd like to receive any (or all) of these files in your e-
mail box send a message to: belve@aol.com

Please specify that you want the "April Files" along with the
number(s) of the files you'd like to read.

We're looking for diabetes related stories for our newsletter.
The stories can be fiction or non-fiction (let us know which type
your story is) so please send them in.  We can use all the
stories you have.

_______________ARTICLE_______________

MARRIAGE & DIABETES (With Personal Advice)

The presence of diabetes in a marriage or relationship can bring
difficulties that need to be worked through.  Living with
diabetes is a strenuous task if you and your spouse/partner are
dealing with it cooperatively.  But if you and your partner are
on opposites sides of the fence the whole situation can seem
impossible.

You may feel unloved, unappreciated and misunderstood leaving you
with no energy to deal with the present and future problems that
may come along.  It's important to recognize this and work toward
relieving the stress before it turns into another argument.

George says, "I've been married twenty years.  I've only had
diabetes for nine months but my wife has come to terms with it.
My wife felt like she was abandoned when I became sick.  I was so
lethargic and that had an effect also."

When it comes to diabetes affecting his moods George shares,
"My wife sometimes blamed my mood changes on my diabetes and
many times that was the problem as I look back on the last
several months.  I think people who are married have to keep
loving each other, stay committed and try to understand."

On the physical side, the marital stress diabetes can bring to
your life can cause your blood glucose levels to rise to
dangerously high levels if you have diabetes.  In the long term
this can put you at risk for all sorts of chronic diseases such
as heart disease.

One of the most common areas of stress in a marriage occur when
the diabetic partner has diabetes related mood swings.  These
mood swings can happen when the person with diabetes has a blood
glucose that is very high or very low.  Diabetes shouldn't be
blamed for ALL mood swings but they may be the cause of some of
them.  It's not wise to try to blame all negative behavior on a
spouse's diabetes.

Peter's diabetes was diagnosed in April of 1987, "Before
diagnosis I was extremely bad-tempered, intolerant and tired.  I
still experience fatigue at times, which reduces the energy I
have to put into shared tasks."

Jason has had to deal with diabetes in his relationship for five
months.  Jason describes, "My diabetes went undiagnosed for
three months which caused stress and irritability."

Another area of stress occurs when the partner with diabetes
refuses to accept the fact that they have diabetes and go into
denial.  They may not want to accept responsibility for the
management of their diabetes.

If the diabetic spouse is in denial the non-diabetic spouse
should realize they can't make their loved one want to take care
of themselves.  It may be hard to watch someone ignore his or her
diabetes, but all they can do is offer love and support.  The
non-diabetic spouse may also need to cut down on the advice,
admonition, and criticism.

Both partners should take part in the diabetes management plan.
Otherwise the diabetic spouse can feel like they have to cope
with their diabetes alone.  If both partners have a healthy
attitude about how they will deal with diabetes in their
life it can be a shared experience that can work for both
parties.

Married for ten-and-a-half-years, Helen says her husband has
concerns about eating issues, "My husband gets upset with me when
I skip meals or eat things I shouldn't.  He went to classes to
help me manage my diabetes and to learn more about it.  He's the
primary cook in our home, and he reads labels and everything."

Stress can also occur when the non-diabetic partner refuses to
take an interest in their partner's diabetes.  The diabetic
spouse can begin to feel alienated.  If your spouse has diabetes
it's a part of your life too.  You can't try to distance your
spouse from his/her diabetes.  They're a packaged deal.

Michel has dealt with diabetes in his marriage for five years.
"The absence of sex (impotency) caused stress in my marriage.  I
don't feel my wife understood my needs.  This lack of
understanding was even evident in the domain of diet/eating.  In
my opinion stress was one of the factors that brought on my
diabetes.  I have juvenile diabetes although it came on at an
advanced adult age."

Susan Hersh, married for almost two-and-a-half years had
diabetes before she got married.  When asked is diabetes
brought stress into her marriage Susan says, "Absolutely.  I
have always had difficulty with being totally compliant.  In
the beginning of our courtship, Alan had no clue as to what
diabetes really was.  So if I desired to eat sweets, he
never made a comment; never bothered me.  He never bothered
me if I chose to bake."

Susan's husband now takes an active role in her diabetes
management plan.  Susan continues, "Now that he is VERY
aware of the disease and its impact on one's quality of
life, he has taken it upon himself to be the "mini dictator"
of the house.  Sad but true.  He claims if I will not take
charge of the situation, then he has to.  Bottom line:  He
refuses to lose me to this disease."

We can see in Susan's marriage that her husband has taken
the initiative to help his wife deal with her diabetes,
emotionally, as well as with the day-to-day tasks required
to take care of Susan's diabetes.  As long as both partners
agree with this it can go a long way toward calming any
stress diabetes may have brought into the marriage.

Diabetes will be involved with every aspect of your life
including vacations, outings, going to the movies, as well as
intimate moments.  If your or your spouse's diabetes makes them
feel weak and tired you may have to alter your plans to
accommodate them.  This is a part of "living with diabetes" as
much as taking oral medications and insulin injections.

Linda has had diabetes for over five years.  "I am
frequently tired due to my diabetes.  My spouse has a hard
time understanding it.  Diabetes is hard to adjust to, especially
if you are used to being in control.  Sometimes I wonder if
permanent control of diabetes is possible."

Steve, who has been married for two-and-a-half-years, had
diabetes prior to getting married.  "Sometimes low blood glucose
levels affect my ability to have sex.  There are also times when
sticking to my meal plan can complicate vacations by having to
eat at inconvenient times or being tempted by desserts that I am
not usually around."   When it comes to coping with diabetes in
their life Steve states, "We both eat healthy foods.  We like to
take walks together and we both try to support each other by
exercising regularly."

One thing both partners can do is find out about the facts
concerning diabetes.  Learning more about diabetes can make
the falsehoods melt away and bring understanding and
compassion to the marriage.

Margie has been married three times with diabetes present in all
three marriages.  Margie says, "In all three marriages both of us
didn't understand the emotional, as well as the physical parts of
the disease.  I was open to sharing about my diabetes but they
didn't want to."

Marriage partners also need to learn how to talk about diabetes
in their life.  Discussions about your expectations and
disappointments can relieve some of the stress before it
reaches a boiling point.  If you feel overwhelmed talk it
over with your spouse.  Talk about your needs as an
individual, as well as your needs as a marital partner.  Ask
your spouse about his or her needs too.

When asked if his spouse ever blames his grumpy moods on
diabetes, Kirk, who has had diabetes for two years
responded, "Most emphatically.  I can get into a bad mood
when my blood sugar goes too low.  My wife tries her best
and we discuss it openly."

Diabetes has been in Thom's marriage six out of fifteen
years, "When I got diabetes sometimes I got treated like a
china doll that would break at any moment.  My wife does
take an active role in my diet management and exercise
program.  My diabetes is discussed when necessary but is not
the main topic of discussion *at each meal."

Here are some words of wisdom that might help you in your
relationship/marriage:

Advice #1:

"Read up seriously about diabetes and think twice before
undertaking a very difficult commitment."


Advice #2:

"Try to be understanding and encouraging.  Remember that the
diabetic doesn't like having the condition or putting up with its
management either."


Advice #3:

"Learn all you can about it. It helps a great deal, and talk to
your spouse or intended spouse about your concerns.  There are a
lot of myths out there, and knowledge is power."


Advice #4:

"One must remember that sometimes moods and attitude are not
totally under the control of the diabetic.  I have found myself
overreacting to a situation and after all is said and done found
my blood sugar was basically shot.  It is a condition which will
require a team effort to handle.  Sometimes the non-diabetic in
the relationship must "take charge" of the diabetic for both of
their well beings.  Life is an interesting trip and diabetes is
just a little more excitement thrown in!"


Advice #5:

"Keep loving them, be committed to them and try to understand."


Advice #6:

"A simple question that can be so complex.  Both have to come to
the understanding that diabetes is not just another disease and
certainly not one that either partner can ignore.  Not only does
diabetes have an impact on the one afflicted, it has a direct
impact on the spouse and other family members.

Because it can ultimately impact on one's quality of life "down
the road," I recommend that both partners receive counseling
prior to marriage.  They must have a neutral forum in which to
voice fears, concerns, formulate  questions and prepare a plan of
action.  I honestly feel that both must agree on the type of
medical coverage to be had/shared.  Work toward obtaining a
certain amount of excellence in medical coverage that will
encompass not only the hands on treatment of diabetes but that
can offer much in the way of education, referrals and support.
Diabetes, if managed properly and approached together in a
concerted effort to control it and not let it control 'you' does
not have to mean a death sentence.  If nothing else, you have
each other "to have and to hold in sickness and in health."


Advice #7:

"Learn about it and help with preparing foods, new ideas about
eating & exercise.  Knowledge will set you free."


Advice #8:

"Support each other.  Make sure each person can deal effectively
with all aspects of diabetes and its management."


Advice #9:

"Diabetes should not really be a factor when considering
marriage.  If a person loves another person then that should be
the primary decision.  Today, diabetes is as controllable as an
allergy. One must take responsibility for ones own self and deal
with the problem realistically. A spouse should also be aware of
what to do if an emergency arises, but other than that it should
not be a factor in contemplating marriage."


Advice #10:

"Be gentle.  don't be afraid to marry someone with diabetes.
it's no different from any other medical problem and we all
have, or will have, something to deal with."


Advice #11:

"Don't take it personal if they are grouchy due to low blood
glucose levels and not to have any qualms about marrying a
diabetic since being happily married can help keep the
person on the right track and take care of the big D*."


Advice #12:

"Learn as much as possible.  Go to support groups.  It is
something that changes as new information is available."


_______________ARTICLE_______________

DYNAMICS OF DIABETES
By Susan

Susan has been married to her diabetic spouse, Richard. for
two years.   She describes him as a dynamic man who is the
"boss" at work and according to Susan, likes to be in
control of his own destiny.  Yet when it comes to diabetes,
he goes through cycles of denial.  During those cycles of
not caring for himself properly, their marriage has suffered
because she felt  so helpless.  Richard would lash out in
anger and she felt that anger on a daily basis.  Since she
was the nearest and closest person, she received  the brunt
of it.

Richard's endocrinologist felt that the anger was not from
high or low blood sugars but a kind of depression.  Susan
felt that, "He doesn't want  to have diabetes and he doesn't
want diabetes to have him.  So he wants to pretend it
doesn't exist."  Even though he takes shots, Susan reports
that he doesn't regularly check his blood sugars or watch
his diet.  He doesn't have time to exercise and this
probably compounds the problem.

Recently, she just couldn't take it anymore.  Feeling very
scared, frustrated and sad, she left him, on the advice of
doctors and therapists who were worried about her health. It
was very hard for her to leave because  she loved him so
much and has a baby.  She was just so frustrated by her
inability to help.  She recognized his worries about his
child, job security (he only recently came forward with the
fact that he is a diabetic after six years of not taking
shots at work), money worries, and health worries.  Although
she encouraged her husband to seek help, this too was
difficult for a man who didn't have the "time".  He actually
told her repeatedly that she was the source of all his
anger.  Yet she knew there was more to it.

Convinced that it was biochemical and further convinced that
she could  do little to convince him otherwise, she left
him.  He had already lost his first wife.  Admittedly, he
had been angry at her as well during most of their marriage.
 Something finally snapped inside of Richard.  First he got
angrier and then...

The separation was truly painful for Susan and the baby as
well as her husband, Richard.  Her husband finally
recognized the need for professional help.  Although a
thyroid problem had been diagnosed (and treated) six months
earlier, it wasn't until the depression was treated that the
anger disappeared.  Richard takes the antidepressant,
Bupropion Hydrochloride, which allows him to manage the
superficial anger even now.  He also goes to a therapist and
is learning new ways to control his internal anger so he
won't have to be on Bupropion forever.


Susan sees a wonderful change in  her husband's behavior,
"He is such a warm, wonderful, energetic person.  We still
have differences in philosophies, he is still incredibly
strong  willed and energetic but he is not angry all the
time.  He is a wonderful father  and husband now.  So giving
and kind."   A side benefit that she can see is a beginning.
A recognition of his diabetes and the beginning of a plan to
take control of that as well.

Now that her husband is more responsive and less angry all
the time, Susan has taken his lead and begun to cook meals
that he enjoys but are low fat and well balanced.  He is
starting to eat in a more conscientious fashion but she
knows, being the man he is, he is the only one who can make
choices for himself.  "Facing up to diabetes is such a
difficult road.  I want to be there for him but ultimately,
he is the only one who can chose his own path.  Sometimes
being a spouse is as painful as the person doing the walking
because you can't walk in their shoes.  All you can do is
walk by their side, (assuming they are going in the right
direction and not throwing rocks at you along the way!)"

Susan may need to keep that sense of humor since no one said
the road wouldn't be pretty rocky!>


_______________POLL QUESTION_______________

Some people think humor can play an important role in coping with
a chronic illness like diabetes.  Other people think the subject
of diabetes should never be used in humor.  Do you think people
should tell jokes about diabetes?  Or do you think diabetes is a
serious illness that should not be joked about in any way?


_______________ARTICLE (Fiction)_______________

Sam let out a depressive sigh as he got ready to take his
evening injection.  Thinking back to when his doctor told
him that he had diabetes a few years ago,  he didn't even
need medications, "Just lose about 15 pounds and with
regular exercise,  you may never need to take any meds !"
His doctor's words kept coming back to haunt him;  Sam made
the choice to keep eating as he always did.  "Choices," he
thought to himself,  "then I had plenty and now I have none."

It was his choice to go off his diet repeatedly and then get
mad with the glucose meter for always reminding him of that.
How he longed for those days when it seemed so simple!
Doctor Jones had warned him not to have a false sense of
security about being diet controlled.  Eating "forbidden
foods" then thinking to himself, "I got away with it before
and I will this time."  Then came the day when his body said
enough was enough !

Sam found himself awakening at the hospital emergency room
after fainting at work: a concerned co-worker had alerted
his boss, calling the paramedics and informing them of his
diabetes.  When the emergency room docs had checked his blood
glucose it
was an amazing 560!  Laying there, he was embarrassed about
how he had made the wrong choices and now he had no one to
blame but himself.  Sam's doc came into his room telling him
he now must take insulin for the rest of his life.
"Shucks," Sam thought to himself,  as his doc's voice seemed
to be disappearing into evergrowing distance.   "NO !" he
thought, "I can't be like this. If only I had the choice to
go back. If only!"

Just then, his trusty alarm clock went off, waking him as it
did everyday.  Sam awoke with a shudder, taking a deep
breath, relieved that it was only a bad dream.   I am going
to make the right choices from now on!!!   Knowing that if
he didn't the nightmare could easily become true,  he
resolved from that day to take control of his diabetes.

_______________ANNOUNCEMENT_______________

What would you do if you read these headlines?

          "TURN YOUR TRASH INTO NEW METERS!"
          "METER BANK DEPOSITS 72 METERS!"
          "HELP A FRIEND!  HELP THE METER BANK!"

Headlines like that might sell a lot of diabetes related
newspapers but they would all be true.  To date the Meter
Bank run by Richard Thornton has given away *77* meters!
Yes your donated Lifepoints and fulfillment coupons have
been responsible for giving 77 people with diabetes new
Lifescan meters.

The Meter Bank is STILL helping people and you can help too
if you use Lifescan Blood Glucose Testing Strips.  If you
use this brand of strips you can send your Lifepoints (on
the bottom of your box of strips) to the Meter Bank.

There is also an urgent need for Lifescan Free Meter
Fulfillment coupons (in specially marked boxes of Lifescan
strips).  If you run across these fulfillment coupons please
send them to Richard so he can use them to help more
diabetics get free meters.  If any of your family members or
friends use Lifescan strips please let them know about the
Meter Bank and the need for these fulfillment coupons.

The Meter Bank also needs the following:

Meter Coupons that sometimes can be obtained from Lifescan.
These coupons are for the meter itself and are blue in
color.

New Unused Meter Information (to be added to the New Meter
Database)  This information will be used to match new unused
meters with people who need them.

Used Meter Information (to be added to the Used Meter
Database)  This information will be used to match used
meters up with trade-in allowances and rebates offered by
companies.

Stamps & Envelopes

There is also a "Meter Bank FAQ" available for the asking.
This Frequently Asked Questions file will give you
background information about the Meter Bank and the person
who runs it.  If you'd like to read this FAQ send a request
to:

          xjmv62a@prodigy.com   -or-  belve@aol.com


We'll get the FAQ right out to you (or your family and/or
friends) so you can start participating!

or if you'd like to write Richard directly send an e-mail
to:

          batman@phoenix.net   -or-   arthur@tenet.edu

The Meter Bank is using 50/50 Pharmacy to have the meters
delivered to people.  This pharmacy donates fifty percent of
it's profits toward diabetes research.

The Meter Bank is a way for you to help people with diabetes
get new meters to help them with their diabetes management
plan.  Having a blood glucose testing meter plays a critical
role in someone being able to control their blood glucose
level.  So why not help someone in a meaningful worthwhile
way and donate to the Meter Bank.



_______________POLL RESPONSES_______________

Last month's poll question asked:

Do you feel that diabetes should be kept as a personal
issue, only to be discussed with close family and friends?
Keeping diabetes as a close secret is one way some people
deal with having this disease in their life.  Do you think
discussing diabetes only with family and friends makes it
easier to cope with diabetes?

Here are some of the responses we received.  I want to thank
everyone who shared their opinions.


Response #1:

"I haven't told many people yet, (it's been under 6 months).
One friend says I don't match with her experience, so I'm
not really diabetic (I have more hypoglycemic episodes than
high blood glucose readings).  I don't discuss it at work
because I don't want everyone watching everything I eat and
constantly analyzing it.   They also have very strict rules
about any items that have blood on them, so I would feel
like a freak handling test strips and such using their
"biohazard" rules (I smuggle them home and dispose of them
there).  They also have lots of special treats at work, and
I do feel left out (somewhat).  Some of my friends know, and
they are supportive but uninformed.  I think some people are
beginning to wonder why my eating and exercising have
changed dramatically (and my weight some too!) but don't
want to ask (mostly because I think they are afraid of the
answer).



Response #2:

"Keeping it only in the family may be an easier way to cope
with the "beast" but in the long run it's best to let
friends and co-workers know too.  Diabetes is far from being
a rare disease  nowadays and those undiagnosed as yet, may
realize symptoms in themselves and then go to their own
doctors for a checkup."



Response #3:

"In response to the question about being open about
diabetes, my opinion is that it's nothing to be ashamed of.
While I don't often bring up the subject out of the blue,
when the situation warrants, I speak up without hesitation.
When I started a new job, my co-workers had the custom of
having cake whenever one of us had a birthday.  As I am
insulin dependent and trying to keep my blood glucose on an
even keel, I don't eat the cake, but toast the honoree with
a diet Pepsi.  The first time this occurred, I simply and
matter-of-factly explained why.  When my birthday came, I
was asked what they could do to allow me to celebrate - how
thoughtful!  We had bagels and coffee in the morning instead
of cake, and everyone enjoyed the change. My feelings are
that while you need not wear your diabetes on your sleeve,
you should not be afraid to admit to it."



Response #4:

"I believe it is absolutely essential that people talk about
being diabetic.  I'm not saying that we must divulge
intimate information about ourselves, just that we try to
eliminate some of the myths, fears and often ignorance about
this disease.  This can be accomplished by accepting the
disease as a part of our lives and by being willing to deal
with it in constructive ways.  One of those ways in which
this can be done is by dialogue.  I believe we have a
"responsibility" to educate, whether it be ourselves, our
family, the public at large.  It is time to stand up and
take charge.  We have nothing to be ashamed about and have
everything to live for."



Response #5:

"I do not keep my diabetes a secret from anyone. I am in the
entertainment field and sometimes when I am auditioning a
prospective  client I will have a low blood sugar reaction
(I am a Type one with very tight control).  I excuse myself
to get a small juice from my office refrigerator and tell
the performer why I did so. If the person is not familiar
with diabetes and its symptoms, I take a few minutes to
dispel a misconception that they usually have about
diabetics.  My openness about "my friend" has saved my life
on more than one occasion.  I don't think that diabetes is
something to hide away and be ashamed of.  The more informed
the public is about this disease the more aware they will
become when someone is having an adverse reaction near them.
If everyone that had diabetes were to be open about it with
their friends, neighbors, and acquaintances then we wouldn't
hear about so many tragedies caused due to someone not
knowing how to react when a diabetic next to them has a low
sugar reaction or goes into insulin shock."



Response #6:

"I think that diabetic must assess the individual they are
talking to.  Some people react rather strangely when told I
am diabetic, at least in my opinion.  It is necessary that
some people know for the diabetics own welfare, but I really
have an intense dislike of people who are overly sympathetic
about the disease/condition.  Hey, in reality I will
probably die one day from something which the diabetes
contributed to but as long as I take adequate care of myself
that won't happen soon.  Open discussion can be an aid to
survival if the other parties are receptive and will try to
understand what you are trying to tell them."



Response #7:

"I don't tell everyone, but I do inform key people I come in
contact with in case I have an emergency.  This is very
similar to the fact that I don't tell lots of people about
my personal life.  If people ask, I will tell them.  I have
a support network of close friends and family and I also
have volunteered to speak with other diabetics and help them
cope with the disease or tell them how I have handled
certain situations.

Years ago, I worked at a company where a gentleman kept his
conditions a secret and he had a medical emergency and
almost died as no one was aware of his health condition.  He
was diabetic, had heart and kidney problems."



Response #8:

"My belief is that there should be no impediment to
informing others outside the immediate family of the
condition.  I have yet to find anybody who appeared to be
upset at being informed of my diabetes - in contrast most
appear interested.  Informed acquaintances are more likely
to respond appropriately if a serious hypoglycemic reaction
occurs.  They are more likely to offer appropriate food in
social situations and to accept refusal of food if
necessary.  After all, what excuse could I have for refusing
a sugary desert if my hosts were not told of my condition?

The other aspect of informing others is that of increasing
overall public awareness of diabetes, its consequences and
treatments.  I believe that greater levels of knowledge must
work in the interests of diabetics when matters of
government/health/insurance/etc. policies are being debated
and set."



Response #9:


"I find that talking about my diabetes is very cathartic.
While not the first thing (or even the second) that I bring
up, I usually try to mention my diabetes early to any
frequent acquaintance. I find that this tends to bring up
questions which I am happy to answer, and forestalls many
curiosities concerning diet, needle marks, bruises, my
confusion, sweats, shakes, grouchiness and other possibly
disturbing reactions I may exhibit.  This also feeds my need
to be an early disclosur-er. I have also had a tremendous
amount of feedback concerning so many people who have, or
know of someone who has, diabetes.  So many people seem
afraid to talk about it (shhhh - she has the big *D).  When
I bring it up in passing, many seem to be relieved to talk
about a father, brother, or mother who has it. The emotional
baggage for them (and myself) appears to be lessened by the
open discussion. I can't imagine not talking about it. It is
now an integral part of my life. It is not who I am, but I
have it. Discussing my diabetes is one of my main coping
strategies. I have found that as long as it is discussed
when appropriate, and is only one of many topics of
discussion it is useful to me."



Response #10:

 I try to learn all I can about diabetes.  I also find that
some times I encounter other diabetics when I or the other
person was willing to say something.  We have been able to
encourage each other when, for example, large pieces of cake
were being passed out.  I don't always mention it, but I'm
not afraid or ashamed to mention it, either.



Response #11:

No, I don't think you should keep your diabetes a secret.  I
have had several episodes of low sugar and the quick
thinking of people who knew me, but not closely, saved me
more serious complications.



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