Gesundheit! (and LA Times Health Columnist Joins Our Club)

When I first arrived in Germany in the middle of winter about 18 years ago (ahem…), I immediately caught a bad cold. Every time I sneezed, my brother-in-law’s girlfriend would bark, “Health!” It took us a while to work out that Americans say the same thing, only in German. And maybe a little less like a command. Anyway, we had a good laugh. In recent years, I’ve come to appreciate that salutation in ways never previously imagined.

My grandmother always used to say, “if you don’t have your health, you don’t have anything.”Deinegesundheitu1

In fact, when you get a new wallet, purse, or outfit, Jewish folks will bless your acquisition by saying, “Use it in good health!” or “Wear it in good health!”

Good health, however, may be a matter of definition, and possibly personal viewpoint. Am I “sick” because I have diabetes? Or am I “healthy” because the condition I have me forces me to take such extra-careful care of myself, and because I feel pretty darn energetic and good when my condition is well-controlled?

Fellow D-blogger Bernard F said it so well:
“I’ve had diabetes for over 35 years, and it’s really taught me about the value of endurance. Even though my pancreas is broken, I’m still remarkably healthy. The insulin that I inject helps my body to absorb and process carbohydrates but it’s not a cure for diabetes. Despite the continued high and low blood sugars I’m blessed by God with very (few) complications.”

I now realize that Gesundheit is the most precious gift my family and I possess…

And btw, nothing shakes you up like facing your own mortality. I just learned that LA Times health columnist David Lazarus was diagnosed himself with Type 1 diabetes at the beginning of this month. Read his treatise called “Nation’s Healthcare Crisis Gets Personal.”

Lazarus “As of this moment, I’m completely dependent on the U.S. healthcare system to keep me alive,” he writes.

In his article, he talks about being shocked, scared, and above all, confused and anxious about the economics of his treatment costs. “The quirks and complexities of the insurance system border on madness… And what happens if I get fired tomorrow?”

Welcome to our weird and precarious world, David. Obviously, it hasn’t taken him long to catch on. When I emailed him a few days ago about the outrageous cost of glucose test strips, he promptly replied: “Test strips are the diabetes equivalent of a crack habit.”

In this case, Grandma, if we haven’t got our health, what we get instead is a costly addiction.

Still, we have to keep reminding ourselves how blessed we are with such a “treatable condition.” If it weren’t for all the finger-poking and beeping equipment constantly reminding me, I might be able to convince myself on many days that I’m a specimen of perfect Gesundheit.


8 Responses

  1. Michelle
    Michelle October 17, 2007 at 7:03 am | | Reply

    Healthy – sometimes people look at me funny when I describe my son as “a really healthy kid.” They see diabetes as something that makes him unhealthy, I don’t.

  2. Scott
    Scott October 17, 2007 at 7:31 am | | Reply

    You are right in a person’s perspective is individual, and just because your perspective on what defines “health” may differ from someone else’s doesn’t mean either of you is wrong (or right).

    My perspective is that while I may have my health, our “costly addiction” comes at a huge price that others do not incur yet is not protected by law, and that we should question exactly why it continues to be treated as an addiction if the cost to society is ballooning so?

    I’d like to see the focus of research shift away from trying to improve treatment (I’m not convinced its possible, and there is not a huge amount of clinical data to back this up in a real-world environment) and more towards eradicating the disease, but there has to be a societal imperative to do so. For that reason, the rapid growth in diabetes may finally force us to examine things (as James Hirsch’s book “Cheating Destiny” aptly notes, the U.S. doesn’t have a “health” care system, we have a “sick” care system that is geared towards treating acute illnesses and sending patients on their way) with our health/sick care system. The way things work now, we’re designed to cover only acute illnesses, not chronic conditions, which incidentally, are growing in number since we haven’t cured many diseases since TB in the 1930′s.

    Meanwhile, legislators continue talking about the issue (they’ve done little but talk about it since 1993) and progress is being made in a piecemeal fashion nationwide, which is not necessarily a bad thing because a number of approaches can be tried and Feds can then choose from those that work best but are most cost-efficient. But time is running out, and we are rapidly approaching 51% uninsured — a slight majority, so the time for clinical trials among the states is ticking fast!

  3. Anne
    Anne October 17, 2007 at 8:54 am | | Reply

    I consider myself healthier than most of America. I can run, swim, and bike for hours; my cholesterol and blood pressure are excellent and I don’t get sick often. But I do have a chronic disease and the future is therefore a little more uncertain. Still, I am fortunate, I realize, since many others who’ve had type 1 for as long as me (19 years), are not doing as well.

    I cling onto the hope that keeping a very active life as well as minding my BGs as much as possible, will somehow help me avoid or delay serious complications as long as possible. We shall see.

    And to David Lazarus: I’m really sorry to hear that you were diagnosed with type 1. It is disappointing that we don’t have a way to cure or prevent it yet. But for some inspiration, look up “Team Type 1.” Type 1 will inconvenience you but shouldn’t prevent you from reaching your goals.

    And regarding being dependent on the healthcare system for our lives, this is why I’m rooting for insulin produced in sunflowers or lettuce (or some other plant). I’d sure like to have some backup to the pharmaceutical companies. (Of course I’d have to figure out how to get the insulin from the plant into my body…) Wouldn’t it be nice to have a windowbox insulin garden?? :)


  4. Chuck McKay
    Chuck McKay October 17, 2007 at 2:37 pm | | Reply

    Test strips are closer to cigarettes than to crack. To get the same effect you don’t require more of them tomorrow than you used today.

  5. Angela
    Angela October 17, 2007 at 4:03 pm | | Reply

    I liked this post, because when you blogged about the “World in Your Hand” contest last week, the first word I thought was, “Empowered.” Shortly after I married a few years ago, I began realizing how fortunate I was to have such a thorough, diabetes-imparted understanding of nutrition. I can take excellent care of my husband because of my access to nutritionists and my understanding of how the human body responds to food. While his friends are filling up and puffing out on tater tot casserole, my husband is enjoying a dinner of peach-glazed grilled pork chops, roasted garlic asparagus, and corn on the cob. Diabetes is not a picnic. But it does have its silver lining – and I don’t usually _feel_ sick.

    I wonder if Dr. D told Mr. Lazarus about insulin pumps? The way the poor man wrote, “As of Friday, I was injecting myself with insulin, something I’ll be doing four or five times a day, every day, for the rest of my life,” really brought me back to my fatalistic attitude for the first… oh… three years of my life with diabetes. For me, getting an insulin pump ten months after diagnosis was the first step toward snatching my life back from this disease. That was a quick initiation to the pump five years ago, but do they even make you wait that long now?

  6. Jim
    Jim October 17, 2007 at 4:11 pm | | Reply

    The analogy of test strips to cigarettes or crack is really insulting – diabetics (like me) don’t use test strips to modify our brain chemistry to get high. We use test strips to get information about blood sugar levels, which happens to be a life or death issue. There is nothing pleasurable about constant finger pricks, having to carry around a blood meter, etc.

    Mr. Lazarus – Sooner or later the press is going to realize that it is not in the best interest of pharmaceutical companies to create a genuine cure for diabetes, when they can continue to milk the enormous multi-billion $$ cash cow of symptom treatments and coping products.

    One company would benefit in the very short term from such a product/cure, and then the diabetic products industry would essentially cease to exist.

    Does anyone who works for a company think that non-diabetic execs would do something so foolish to endanger their company’s quarterly financial outlook?

  7. Jim
    Jim October 17, 2007 at 4:14 pm | | Reply

    In other words, to really understand what the interests are of the medical research community regarding diabetes, simply “follow the money.”

  8. Rosalind Joffe
    Rosalind Joffe October 17, 2007 at 4:30 pm | | Reply

    I think it’s great to try to change big business’s priorities (fat chance) but frankly I’m more interested in the question: Can you be healthy while living with a chronic illness? Yes, it is possible. You are, Amy (at least most of the time) and so are others who posted — as am I. You’re managing this disease effectively — and when it’s not, you feel like a sick person, because you are. I don’t think we have to make this any more complicated than: we’re healthy until we become sick. Just like “healthy people”. Rosalind

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