Rishma: you have a life to lead as well

Canadians with type 1 and 2 diabetes write back to their younger selves, to share personal insights and reflect on their experience of living with diabetes and starting on insulin therapy. In this post, Rishma reflects on caregiving for her father who lives with diabetes.

When Rishma moved from Tanzania to Toronto at age 12, she had no idea that a huge chunk of her young adult life would be spent serving as a caretaker to her father, who has type 2 diabetes, as well as a number of other health challenges. Not surprisingly, being on the cusp of adolescence, she was most concerned about trying to make friends and fit in to her new country, so she wasn’t really paying attention to her father’s first battle with cancer, which happened when she was 13.

But she was 22 during the second bout, and it made an indelible mark on her. Midway through his treatment he landed in the ICU with pneumonia. His organs were failing, and his family had said their goodbyes and were trying to arrange his funeral. After 27 days in the ICU, a last review of her father’s bloodwork before turning off the breathing machine showed great improvement. He turned the corner and survived. That day happened to be Rishma’s birthday.

“That is when I realized how important my dad was to me, and I honestly still think God heard all our prayers and gave me a special gift,” she says.

That day also was the beginning of Rishma’s role as a caregiver, alongside her mother. A year later, her father was diagnosed with type 2 diabetes and bronchiectasis, which is a chronic lung condition unrelated to his diabetes. Today Rishma is 40 years old and writing to herself at 23, after learning that her father had these two new health problems.

Dear Rishma,

You think that your life has already been deeply affected by watching your father narrowly escape death. But now, with his two newly diagnosed conditions – type 2 diabetes and bronchiectasis – your life is going to be very tough for quite a while. Your caretaking role will intensify. And that’s not all. Because your mother has been traumatized by what your father has gone through, she often feels depressed. When your father suffers any health emergency, small or large, you are going to be the first line of defence.

In one sense, this is fine. It’s part of your culture to take care of your parents. But Rishma, unravelling your father’s health issues will be like untangling a bird’s nest.

One of the most difficult aspects of caring for your father will be his temper. His outlook will grow very dark. He will become quick to anger and refuse to talk to you. Or he’ll fight with you and be very dramatic. This hurts your feelings. His mood swings will be so intense that you will wonder if he is bipolar.

What I suggest? Educate yourself now about all of his conditions, particularly diabetes. I know that navigating the healthcare system is difficult and you won’t always find timely support. But if you keep researching, and talking to doctors and pharmacists, you’ll find more information.

Use your own power of observation, too. You will realize that your father’s mood swings are as a result of low blood sugar. He is very frightened about his health conditions, but tries to act tough. He can get angry if he doesn’t notice drops in his blood sugar levels, causing him to become mean and say hurtful things. These hypoglycemic episodes could be avoided if he tested his blood sugar more frequently, but he can be stubborn and unwilling. If you bring the testing kit over to him, he will do it. Then you can give him his tablets or fruit, and 20 minutes later he’ll be happier. Your father could choose other medication options for his diabetes, but he’s willful, worried about the cost and wants to stick with tablets. Still, keep trying.

And Rishma, you have a life to lead as well. Don’t be afraid to find your independence, move out of your parents’ home and have a boyfriend. You can still be very involved and helpful by taking your mother and father to their appointments. Being in a constant state of vigilance is wearing. It will do you a world of good to be able to confide in someone else.

With respect,

Rishma

This story has been edited by Ellyn Spragins and shared with support from Novo Nordisk Canada. The views and opinions expressed are not representative of Novo Nordisk, and should not be considered treatment advice. Novo Nordisk has permission to share this letter and included personal details.