VETERANS AND DIABETES

It’s somewhat overwhelming to think that one disease can be so prevalent in American society. Over 25 million Americans have diabetes. That’s 8.3 percent of the U.S. population; seven million people don’t even know they have it.
Unfortunately, it’s worse for veterans. Approximately 5.5 million veterans receive VA health care services. Almost 20 percent of them, or 1,020,000, are diabetics. The prevalence of diabetes among veterans can be attributed to the average age of the veteran population (62), the predominance of men (97 percent), and a higher rate of smoking than the general population. None-the-less, the figures are staggering.
The Veterans Health Administration continues to expand health care services to veterans who have diabetes and the long-term complications that come with it (increased skin infections, neuropathy, eye problems, lower-extremity amputations, etc.). PTSD and other psychiatric disorders complicate matters even more. Many of the medications used to treat psychiatric disorders cause weight gain or increased insulin resistance. This affects diabetes management and requires more intense monitoring by both the veteran and his or her physician.
Some tips for taking care of yourself if you have diabetes include:
• Be an active participant in your healthcare team. Be sure to keep them informed when something is working right as well as when it isn’t.
• Monitor your blood-glucose levels daily. Your doctor will tell you how often.
• Take your medications as directed. I’m always amazed at the times people with diabetes tell me they aren’t feeling well and when I ask, they tell me they were supposed to take their medication just before they ate…but they didn’t.
• Eat a healthy diet. There really isn’t such a thing as a “diabetic diet.” Follow a balanced, healthy diet; if you’re not sure what that is, ask your healthcare team.
• Watch your weight. It’s easy to let yourself go, but it can have especially negative consequences when you’re diabetic. If you’re overweight, plan to make some changes to start getting your weight down.
• Keep an eye on your feet. Foot problems lead to serious trouble. Prevent them by checking your feet on a regular basis for ulcers or sore spots. When you find them, talk to your healthcare team!

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KEEP IT POSITIVE

If you’re a Veteran thinking about returning to work, one thing to keep in mind is to remain focused on what you can do rather than what you can’t. You have a world of experience to draw from with knowledge about survival and overcoming adversity that most people don’t have. You have skills, discipline, and courage, all proven by your ability to cope with your disability. Don’t go in ready to talk about what you can’t do. Go into an interview prepared to talk about how what you’ve learned makes you the best person for the job!

You may feel you need to discuss your disability, especially if it’s obvious, but you are not required by law to tell a potential employer you’re disabled, even if you think you may need an accommodation in order to do the work. If you’re not sure whether you should talk about your disability with your potential employer, you can go to http://www.askjan.org/topics/discl.htm for help deciding what’s best.

If you will require a reasonable accommodation to do the job, tell the person you’re interviewing with up front. An employer may ask for more medical information about your condition in order to understand what your specific needs are and what accommodation will be needed. This information must be kept confidential and separate from your normal employment records.

Studies show that employees with disabilities perform a well on the job as any other employee. Keep a smile on your face and go to that interview knowing you’re the best person for the job!

YOU CAN DO IT: THE ROLE OF A PEER SUPPORT SPECIALIST

In the VA’s Independent Living Program, a Peer Support Specialist is assigned to each veteran to act as a coach in setting and achieving specific goals that the vet chooses. That’s where Disability Network/Lakeshore (DNL) comes into the picture. There is something about knowing the person working with you has overcome some of life’s challenges too that makes it a good fit.

DNL assigns a Peer Support Specialist to each veteran. During the initial visit, we ask the veteran what the issues are that concern him or her. We look at what the veteran would like to achieve from meeting with us, and then we look at how we can best reach those goals. It’s a process we take seriously, but we want to keep things fun too. Sometimes that’s a tough balance to find.

In our work with veterans, we make a visit at least once a month. During the visit, we look at what’s been happening since the last time we were there, and if any progress has been made on moving closer to the veteran’s goals. Sometimes we can help clarify the barriers and suggest ways to get around them. Other times we act as cheerleaders and share in the pride of overcoming obstacles. In all cases, we walk with the veteran, not in front of, or behind. It is not our journey, but it is a path we’ve been down and have managed to find our way through.

Sometimes having someone walk with them on the journey is all it takes to help a veteran find the way through too. Those are the sweetest times!

ARTHRITIS

Arthritis is caused by inflammation in the joints. Many of the veterans I work with have arthritis in some form. Carrying large packs, holding large weapons on your shoulders, or direct injury to the joint can all result in arthritis. There are more than 100 different diseases that may have similar symptoms, so you need to be assessed by a physician who will look for pain, stiffness, and/or swelling in your joints. Arthritis symptoms can come on suddenly or gradually, and they can be present all the time or come and go.
Osteoarthritis and rheumatoid arthritis are the two most common types of arthritis. Rheumatoid arthritis is an autoimmune disease while osteoarthritis is also known as degenerative joint disease. Most people who get osteoarthritis are older than age 40.
With osteoarthritis, cartilage at the ends of bones erodes and the joint becomes inflamed. New bone and cartilage may form, creating hard swellings on the joint. Osteoarthritis usually develops in the large joints of the body that support your weight (hips, knees, and lower back), but other joints can also be affected.
Unlike osteoarthritis, rheumatoid arthritis is an autoimmune disease and may affect more than just the joints. It often starts in the hands, feet, or wrists, but it may spread to the eyes, lungs, nerves, heart, or skin.
People of any age can develop rheumatoid arthritis. But it is more common in women between ages 30 to 60.
While osteoarthritis affects cartilage, rheumatoid arthritis attacks the membrane lining of the joint. With inflammation, the joint membrane thickens and fluid begins to accumulate causing damage to cartilage, bone, or soft tissue.
Treatment for arthritis may include non-steroidal anti-inflammatory drugs called NSAIDS to treat pain and other symptoms. Rheumatoid arthritis may be treated with disease-modifying drugs. Prednisone or another corticosteroid may also be prescribed.
For more information, please see: MyHealtheVet.org.

CAUGHT IN THE WEB: DRUG ABUSE

Substance Abuse…we may cringe at the phrase, especially when it’s applied to us, but it may be just too easy to step over the line of use vs. abuse. You start out taking strong medications to control your pain. When your body begins to adjust to the drug, it takes more and more to achieve the desired result. Soon you’re taking just a half a pill extra to get the relief you so crave…then it takes a whole tablet, then one and a half, and so on and so on, and so on.

How do you know whether you’ve got a real problem or if you’re just worrying for nothing? Some of the signs of drug addiction include:
• Increasing use of the drug – any amount greater than the prescribed
• Using the drug regularly – daily or on and off throughout the day
• Inability to stop taking the drug
• Buying the drug even when you can’t afford it
• Using the drug to cope with everyday problems
• Focusing primarily on getting and using the drug

The drugs don’t have to be illegal drugs either. It’s just as easy to get into trouble with your pain medications such as Vicodin or OxyContin. It may be over-the-counter meds such as cough syrup, or cold pills. Symptoms of a drug problem can include:
• Changes in sleep patterns
• Changes in eating habits
• Loss of interest in sex
• Neglect of personal hygiene
• Depression and not caring about the future
• Anger an irritability
• Abusive behaviors toward family and friends
• Manipulative behaviors, lying or stealing

Perhaps the biggest barrier to treatment is admitting you have a problem in the first place. The VA offers a confidential and anonymous screen to help you assess the problem. While it won’t be able to tell you for sure whether or not you need treatment for drug addiction, it can indicate whether you need to consider further assessment.

Remember that addiction doesn’t mean you’re weak or sub-human. Over time the use of drugs can cause changes in the brain which lead to a need or craving for the drug. There are treatments that will help:
• Counseling or therapy
• Detoxification
• Anit-addiction medications
• Treatment of underlying issues such as PTSD, depression, chronic pain, sleep difficulties, etc.

Take charge of your life and beat the habit; you’ll be better off if you do.