What Nurses Know… (And Don’t)

In a new angle on a diabetes book (or is it?) longtime type 1 PWD and registered nurse Rita Girouard Mertig has published a new guide-to-living-with-D book called, “What Nurses Know… Diabetes: the Answers You Need from the People You Trust.” Somehow the publisher found me and sent me a review copy – surprising in this case because this author seems to be oblivious to the patient/online community. But I’ll get to that in a moment. My reactions to this book fall in three simple categories: the good, the bad, and the disappointing.

The Good
True to its promise, this book does provide a solid overview of what you need to know to understand and live well with diabetes. There are some nice features, like the way Mertig begins each chapter with realistic patient questions that you know will be answered in the ensuing section. She offers some well-packaged material that you might not find elsewhere, like step-by-step instructions for measuring and injecting insulin; several good drug charts listing how the various meds work in the body; a whole section explaining how new drugs get approved; a comprehensive chapter on complications and how they’re treated; and also the most extensive diabetes glossary I’ve ever seen — 18 pages of terms from “acanthosis nigricans“ to “yoga.”  (The former means discolored skin patches from overly-high BG levels, in case you’re wondering.)

Despite covering almost exactly the same topics we wrote about in our book, Know Your Numbers, Outlive Your Diabetes, I learned a few interesting new things here, for example:

• gum chewing is good for your health (it cleans your teeth and aids digestion)
• oral decongestants raise your blood pressure
• low vitamin B12 absorption, which can be caused by taking metformin, can contribute to neuropathy (you may need supplements)
• constipation is bad for your heart (something called a valsalva maneuver increases pressure in your chest when you strain – eewww)
• on a happier note, you can buy sugar-free mixers for making cocktails at www.bajabob.com
• and create a ‘personalized’ food pyramid that takes your activity level into account at www.mypryamid.gov

The Bad
I don’t get the nurses’ title. Yes, the book is filled with highlighted text boxes containing information bits under the header “What Nurses Know…”  But other than that, plus a mention in the Forward, there’s no real reference to what nurses in particular can do for PWDs. Should we be seeing a nurse instead of a doctor or CDE? Most CDEs are nurses, of course, but the whole nurse thing left me confused. It left me to muse that the nurses’ angle is maybe just a gimmick to make a “me-too” diabetes book seem somehow fresh and new.

And here’s the thing: I think the title likely does the book a disservice. I mean, if you’re shopping for a really good down-to-earth diabetes help book, how likely are you to choose the one titled, “What Nurses Know”?

Copious references are made to the American Diabetes Association, too, almost as if Mertig worked for them… but this book wasn’t even published by the ADA.

And also: this woman needs to learn to use more paragraph breaks! OK, it’s a pet peeve of mine, but I find long, gray, text-filled pages make my eyes glaze over.  Why bury compelling information in such an archaic sleeper format?

The Disappointing
The book brags, right on the back cover and elsewhere, that it will highlight the best online tools and specific websites to help PWDs. NOT. The section in the back has a long list of federal organizations’ and company websites. But the “Online Resources” list consists of just 3 (count them, three) sites: dLife.com, the site of a small firm developing an alternative insulin pump, and this iTunes link to Diabetes Companion, dLife’s data logging iPhone app.

No mention of any other diabetes iPhone apps (there are many), and no mention of useful sites like www.ehealthme.com for looking up drug interactions — a key topic in the book. Aside from the aforementioned food pyramid link, no online tools are mentioned.

NOT ONE patient online community is mentioned — not to mention the blogosphere or the notion of grassroots web-based support and advocacy. There’s no reference whatsoever that such a thing exists!! I can’t help myself; this infuriated me.

Furthermore, in two separate places the author encourages people to subscribe to the ADA’s magazine Diabetes Forecast (free when you join) because this publication, she says, “is the best journal for people with diabetes and their family I have ever read.”  Really? Not familiar with Diabetes Health magazine, Diabetes Self-Management, the CWD website, and other core resources that we in the DOC depend on?

This confirmed to me that when it comes to the modern world of online communication, nurses don’t know that much.

On the Whole
This is a solid intro book for someone newly diagnosed, in particular — if you can get past the supposed focus on nurses. It just makes me sad that once again, new PWDs and those picking up a book for renewed resolve will not be introduced to the online world of shared patient education and patient advocacy. *sigh*

{Demos Health, February 2011, $12.20 on Amazon.com}

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