Good News Bad News

Good News Bad News

Jan 10, 2013

None of us likes getting bad news.  But everyone likes good news.  So when they come coupled together, our response is understandably mixed.

For example, finding out that you have diabetes mellitus (DM) is difficult to learn.  But catching it early and then making some big and important changes in your life because of that “bad” news can be quite positive.  That’s the “good” part.

As an eye doctor here on the Monterey Peninsula, I’m not just caring for your vision.  I’m addressing your eye health.  And many times these findings point to a bigger overall health finding, like diabetes.  Diabetes is a very serious disease and can be quite insidious.  In other words, it can really sneak up on you.

The story of one patient comes to mind that nicely reflects how getting some bad news was then changed around for the better.

“Jim” is a kindly 63 year-old retired police officer who has been coming to me for his yearly eye exams for several years now.  Each year I notice a bit more weight. He says “some doc told him years ago he had high blood pressure” but he never went back to follow up on it. Every year I stress how important it is to see a primary care physician (PCP), how is his blood sugar, what’s his blood pressure?  And each year he tells me that he “hates going to a regular doctor, hasn’t gone in years, has no idea what his blood sugar is or his blood pressure, but he’s fine, everything’s just fine.”  During his eye exams his eyes have always been healthy and his blood pressure normal.  About three years ago Jim came into my exam room slurping on a Big Gulp of Pepsi. He complained about how his vision “comes and goes” and that he’s always tired.  He now appears to be about 40 pounds overweight and is bragging about his “excessive” junk-food habits.

Jim’s right retina had a chunk of cholesterol (a plaque) blocking a critical blood vessel, and a mild cataract we’d been following in his left eye was now significantly worse, in just one year.  These were serious findings which I referred out for proper treatment as well as a complete physical evaluation. If I’m seeing it in his eyes, it’s occurring elsewhere too.

Jim’s visual symptoms, age, weight, fatigue, poor eating habits, a vague blood pressure history and now a retinal plaque and advanced cataract all pointed to a diabetes diagnosis as well as probable hypertension and cholesterol changes.

The plaque resolved and cataract surgery was performed.  Jim took his new diagnosis very seriously and began a healthy lifestyle with good food choices and he got active too.

I saw him a few months ago and he has dropped 36 pounds, his wife lost 27 pounds, his blood sugar and blood pressure are under control, and he knows what those numbers are.  He boasts that his A1C is 5.6.  A diabetic’s ideal A1C should be less than 6.0.  He has a good relationship with his physician and with his diabetic specialist and has their numbers on his cell phone.  Jim smiles a lot now.  He looks terrific and has taken up ballroom dancing.  He tells the best jokes to us and to his four grandchildren.

I’d say that’s good news.  Good news for me to see his success right in front of me, and more importantly, good news for Jim because he took control of his situation and made steps to turn it around.

Bravo Jim!

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