If we are going to work together,I think you should have a better idea of how I came to be an independent diabetes health coach and what it really means to me.
It started with me being a clinical pharmacist, a pretty good one too. That just means I took extra training after pharmacy school for a total of four years earning a bachelors, four years of pharmacy school and two years of residency training in order to pass the exam to become board certified in chronic disease management. (Pheww, ok the boring part is over..it gets better).
After several starter jobs in pharmacy (that proved invaluable I might add) I arrived at “The Show”. Maybe you don’t know, but pharmacists work very hard to avoid working in the chain drug stores of the world and I landed a job working in a primary care clinic. I kinda loved it. People called me Dr. Ellow and I had my own office...with a name plate. I was a very successful and respected clinician in this role. Don’t worry. This did not turn me into an arrogant ass, but I thought I knew a bit more about managing people's health. Enter rude awakening.
I did not know how much I didn’t know until I met an incredibly stubborn patient who forced me to challenge everything doctors and patients are taught about chronic disease. (In my defense, she didn’t know much either except that we were missing something).
Ironically, I actually prided myself on being great with patient care because I was able to meet people where they were instead of forcing them to buy into a treatment plan that didn’t fit them....and yet I could not help this woman with either approach.
Anyway, this was in the summer of 2017. This patient had uncontrolled diabetes and from listening to her, she had been for years. I was asked to get her started on insulin by her primary care doc and with her numbers that was a reasonably good idea. This is when I was knee deep in the clinical guidelines and following “best practices”. I gave her a treatment plan to follow as per these practices, but when she returned for her follow up in four weeks nothing had improved...not really. Her a1c went down slightly, but her symptoms were not any better. We were essentially at square one, but now also had to worry about expensive insulin and daily shots. Had I just made her situation worse? The best practices failed her and so did I. Seriously, if one patient is slightly complicated and I can't help, what the hell was all the training worth?
When she left my office, I decided to revisit everything I thought I knew. I should have been able to help her. Well, you learn some great stuff when you look at the studies that ARE NOT included in the clinical guidelines...like the research that actually helps people live without meds. I found hundreds of studies that were brushed over because the author wasn’t connected or the thesis countered that of a more prestigious clinician. In a nutshell, we knew decades ago that the nutritional guidelines were leading to the obesity problem and causing a massive diabetes epidemic, but we kept on shoving outdated and harmful recommendations up patient, student, dietician, nutritionist and provider asses anyway. I’m pretty sure the drug companies had nothing to do with this convenient system (NOT).
I wasn’t just embarrassed, I was pissed. People were going years with the wrong concept of what healthy was and despite needing more and more medication every year, were convinced they were doing “everything they could '' and “that is just how diabetes was”.
What I am basically saying is that I realized I was full of shit and so was every doctor who told patients to “get used to taking pills the rest of your life”. After that, everything was different. I started treating patients with food and learned everything I could about the deeper underlying issues of diabetes. Guess what? My patients got off meds and stayed off. Well, at least my type 2 patients. My type 1 peeps realized they did not need to eat every hour, lost weight, reduced their insulin use and appreciated that normal blood sugars were actually attainable. It was like a Christmas miracle!
The doctors stayed off my back because their HEDIS scores looked amazing (HEDIS scores are like a report card for physicians and providers).Things were looking good.
Just as I thought things were looking up and I had found renewed pride in my work, my father became acutely and seriously ill and died at age 63....on Father’s Day June 17th, 2018. I really don’t have words to express this loss...even now. He was admitted to the hospital on April 29th, got transferred twice and never came home. He had one of the worst cases of Guillain-Barre syndrome the doctors had ever seen. He went from swimming in the ocean in Florida that April to being placed on comfort care measures on June 15th. His organs failed, his lungs failed and he passed. Worse for me was that he lost the ability to communicate with us just after Mother’s Day that year on May 11th. There were no goodbyes really, just desperate crying and complete disbelief. I thought about the last time he said “I love you baby girl” and wished I had hugged him a little tighter.
Just 24 hours after my father passed, I was admitted to the hospital to have my third baby, a girl. Don’t worry, she was right on time. I bet you can imagine the huge pregnant lady walking through the ICU prior to that to visit her sick father.
On the day of his funeral, I helped push his casket down the aisle of the church holding a newborn.
When someone you love and cherish dies, that version of you dies with them, and this new version of myself turned out to be rather feisty. Just six weeks after burying my father and having another baby, I had to return to work in the clinic. No one seemed to understand. I found myself pretending I was the same and that everything was fine. I had to pretend that helping people with diabetes didn’t bother me, but it did. My father died of an unpredictable, poorly understood, barely treatable and unmanageable disease. I could not help him. Compared to that, diabetes was a breeze and I noticed even more how much the medical community complicated this disease and made it expensive to treat, when management was relatively simple. I was pissed again.
The providers in the clinic started to get to me too.
“Just give him whatever keeps the HEDIS measures in the green” was a comment from one doctor who wanted to start insulin in a particularly robust patient.
I was worried about the inevitable worsening of his obesity and worsening of everything else as this weight went up. I guess the numbers are what matter the most and again I noticed that the doctors were treating numbers and not people...but I digress.
I was soon very disenchanted by the current system and when my mother not so subtly hinted that she was not doing well (being now without her husband for the first time in 43 years), I made the executive decision to move close to her with my family. Let’s be honest, I was not doing well either.
Looking for jobs in that area was a nightmare. Apparently you can be way over-qualified for pharmacy jobs with my training. So, If I couldn’t get a job, I would make one instead and the idea of coaching people with diabetes started. That is what I did most days anyway. Again, enter rude awakening. Apparently convincing people you can help them when they are distracted by shinier ads and easier gained results is hard and super frustrating, but being successful with this is not a hope or a wish. It has to happen.
What I forgot to mention was, a year before my father died, he asked me to start my own healthcare business since I was so good at reaching people and helping them. I looked at him and said, “no”. I said no for all the expected reasons we say no; sounds like a hassle, sounds like trouble, sounds like a lot of work. He literally asked me to take what I am good at and use it to help more people. That “no” sits like rocks in my heart.
Maybe this is my way of fixing that answer. Maybe this is my way of preventing another daughter from losing her father too soon. Either way, I know it's the best thing to do.