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How Diabetes Almost Cost me my Driver’s License

January 24, 2011

I almost lost my driver’s license today.

~

A few months ago, when I was paying my regular bi-annual license fees at the auto-bureau, the lady asked me casually if I had any new medical conditions to report.

Um, yeah. I kinda do.

That’s when I got handed a whole bunch of forms. As a diabetic, it turns out, I need to have my eyes examined by an ophthalmologist (fair enough), as well as a full medical exam from a general practitioner, in order to be deemed safe to drive.

So last week I got the eye-thing taken care of (no diabetes in my eyes yet!) and today, since my GP is on a six month leave, I went to a local drop-in clinic for the general.

She quizzed me on the usual – allergies? medications? how many units of insulin? epilepsy? heart attack? – until she asked me the most laughable question, in all sincerity, “have you ever experienced hypoglycemia?”

~

To me, that question is akin to asking an NFL quarterback, “have you ever experienced muscle soreness?”  While hypoglycemia is something to be avoided for sure, it is an inevitable side-effect of careful diabetes management. Unless you want to keep your BG chronically high (as I’m told by my endo that many “naughty” diabetics do in order to avoid testing or monitoring for lows), there will be times where your meal has less carbs than you thought, or you burned way more energy on that walk to work than you anticipated, or your metabolism today is just different because of one of some thousand possible variables.

I experience hypoglycemia a lot. Sometimes more than I’m comfortable with. My endo and I are trying to aim for no more than two lows a week. While I’ve been able to meet that quota lately, my diabetes is still so new that my dosage needs change drastically, and often, almost every week.

Last week I took one single unit of Humalog with dinner, and my blood sugar crashed so rapidly I had to knock back two pieces of fruit and three cookies to stabilize before bedtime. Yesterday, I took two units with a meal that contained no more than 1 serving of carbs, and I peaked at a post-meal reading of 12.5.

So apparently, this week I need about three-to-four times more meal-time insulin than last week, when I barely could handle any. This’ll be fine, but I’ll be pretty impressed if, when my metabolism swings back to its insulin-sensitive alter-ego of last week, I can manage that transition without a surprise hypo attack.

I can only base my insulin regimen on what happened in the past. I cannot predict the future. Sometimes, it takes a hypo episode to tell me that things in my body are changing.

Occasional hypoglycemia is a normal side-effect of type-1 diabetes management.

~

So when this doctor asked me, “have you ever experienced hypoglycemia?” I said yes. Of course.

Her pen dropped. Her face changed.  I looked at her, thinking: this lady has the power to decide whether or not I can ever drive again. “Oh,” she mused, “this is going to be a problem.”

Well, I was stunned. Every single diabetic adult I know drives, and they certainly have “experienced hypoglycemia” more than once in their lives.

“How often do you suffer hypoglycemia?” she asked doubtfully.

“About once or twice a week,” I answered, which at least this week, is true. (My endo would be proud to know that it’s down to once or twice a week!)

“Oh, this is going to be a problem,” she repeated.

As visions of my driver’s license being snatched away from me began filling my insides with dread, I took a deep breath and began to channel Sensible Sarah.

I explained calmly to this woman my situation. I’ve never passed out from hypoglycemia. I monitor my glucose regularly. I can usually feel a hypo episode right when it starts, before it gets bad. “How can you feel it?” she asked. “Do you tremble and shake?” My answer: “I feel weak and hungry, and I just know.”

Truth was, I felt like I was being punished by a general medical practitioner, who isn’t used to dealing with insulin-dependent patients, for being invested in my diabetes education. Hypoglycemic episodes are a part of the trial-and-error learning curve of insulin therapy. As a devoted student of this practice, I want my hypos to be treated as important learning experiences. Not as freak medical occurrences that threaten public safety.

I always check my glucose before getting behind the wheel, and will never drive at anything below a 5.5. I want lots of wiggle-room when on the road. I take my diabetes seriously.

It’s not her fault. She was just doing her job. Somehow I managed to assure her that things were kosher on my end – that my hypo episodes were under control, and not a threat to the road.  She signed away the papers, telling the government I’m safe to drive. I paid my forty dollars for the form.

(I paid another 30 to the ophthalmologist last week for filling out his form. Lucky us sick people, who get stuck with all these unforeseen fees. At least I live in Quebec, one of the only provinces with a public drug plan. Otherwise I’d be screwed. Like, 400+ bux-a-month-for-test-strips-alone screwed.)

I am a responsible, invested diabetic. But I saw today how lack of knowledge about diabetes can affect my freedom and rights. While I am so, so grateful I don’t have to start appealing some medical appraisal that I am unfit to drive, I am also sobered at the fact that normal side effects of diabetes could be so misunderstood.  And more than anything, I’m still just shocked that a medical doctor could ask an insulin-dependent diabetic:

Have you ever experienced hypoglycemia?

To which I say, is the pope Catholic? Or, in other words,

Diabetes is hard work. Respect, sister. Respect.

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8 Comments leave one →
  1. January 25, 2011 1:11 am

    This fills me with rage! It’s like asking a person whether they’ve ever sneezed, because sneezing forces your eyes closed and that’s dangerous. Or if they’ve ever been tired.

    PS I wish I had a public drug plan. Stupid Ontario, although stupid Ontario at least pays for my pump, if not my insulin and strips. I try to ration my strips these days because I know once I’m through my stockpile, I will have to pay through the nose, and my control of course is going to suffer as a result. If the government actually cared if it were safe for me to drive (which it’s not, but that’s because I haven’t taken lessons yet, not because I’m diabetic), it would focus on helping me be the healthiest person I can be, not ask you to pay for people to ask you bullshit questions.

    Seriously. Did she also ask you, with a finger wag, whether you’d ever eaten a cookie, or why you couldn’t just diet and exercise it away? Because that sounds like the level of knowledge here. I’ll bet you that cellphone use is more correlated with accidents than diabetes.

    Okay, better stop raging before my glucose spikes. (Also, I can’t believe how much less sensitive I am to insulin than you. It always makes me feel like it’s some sort of moral failing, that I have to take 15 units instead of, like, one.)

    • January 25, 2011 11:41 am

      Solidarity, Ilana. Also, in regards to your feelings of moral failing, I’m freakishly sensitive to insulin, and probably means that I’m still honeymooning. My last c-peptide test showed very low pancreatic activity, but still, my D-team is pretty convinced I’m still producing a bit of insulin on my own. This, like all honeymoons, will end.

  2. January 30, 2011 8:16 pm

    At least you’re in Canada, a nation with a sensible health plan. Here in the US, some people have to choose between insulin and food.

    • January 30, 2011 8:51 pm

      Luckily, QUEBEC has a sensible DRUG plan. The rest of Canada pays for their drugs themselves. Granted, they can see their endocrinologists for free. But yeah. A day rarely goes by where I’m not grateful for public health care.

      • January 30, 2011 8:56 pm

        Yeah, I have to pay for my own insulin in Ontario. Granted I am so grateful that the system pays for my doctors and my pump, but it doesn’t pay for what actually keeps me alive, nor my testing strips. The drug plan is not universal throughout Canada. Actually, before this post, I didn’t know Quebec had one, and if I had any desire to actually live in Quebec, it might make me move there (much like the general health plan in Canada made me move back here from NYC after school was done).

        The US health care system really is awful, though, and I’m so glad to have been able to escape, and feel for those who don’t have that luxury. The first time I encountered the system, I was in Trenton getting my Social Security Card, and there was some poor man at the counter of another department, in tears, yelling at the woman behind the counter because he couldn’t afford insulin and testing strips. That was my welcome to the US, and the only reason I didn’t leave for seven years was that I had a school drug plan and OHIP stil covered me as a student.

  3. Laura G. permalink
    January 31, 2011 11:20 am

    It took me many years to learn this little distinction made by medical personnel. They use the term “Severe Hypoglycemia” very specifically to mean a low BG you need the assistance of others to treat. (I used to think “severe” meant “a bad low that made me feel like crap” but it turns out that word has an exact medical meaning.) So maybe that ill-informed interrogator was trying to ask about “Severe Hypoglycemia.” To avoid being grilled and risking your license, while still responding honestly, you could have said “Severe Hypoglycemia? Oh no, fortunately I’ve never experienced that.”

Trackbacks

  1. Twenty Things I Like About Diabetes « Running with Diabetes
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