00:01
Let's start with the
kidneys, okay.
00:02
So high glucose
damages the kidneys.
00:06
The reason is the nephrons,
those little filtering units of the kidneys
are filled with tiny little...
00:13
you got it,
blood vessels, and we know,
that high glucose
damages blood vessels.
00:19
Also you end up with higher levels
of glucose in your blood stream.
00:23
So it's overwhelming the
kidney trying to filter it out
even has to dump
some into the urine.
00:27
So this is problematic.
00:29
Over time these high
sugar levels in the blood
can cause these vessels to
become narrow and clogged.
00:36
Now here's another
tip, you know that,
high blood glucose from
diabetes is often accompanied by
high blood pressure,
hypertension,
which can also be
brutal on kidney.
00:48
So it's very common for
client who's diabetic
to also have high
blood pressure.
00:53
Put these together.
00:56
That's a really bad combo.
00:58
So it's important
you understand,
the higher that blood sugar is
the more damage we're
going to do to the kidneys
because those nephrons,
the filtering units
are going to get
blocked up and narrowed.
01:12
So this is where
we're going to get
a little more personal
with Mr. Sanchez
and he may traditionally not be
used to talking this about anyone.
01:22
He's not,
may not be comfortable.
01:24
See how my words are stumbling
even talking about it.
01:27
That's what we don't
want you to do.
01:29
But if you find yourself doing
that, it's okay.
01:32
Stop, pause, smile,
make eye contact,
because we want to help.
Mr. Sanchez understand
that nerves are what
controller and keep us safe.
01:43
Well, it doesn't seem so hard.
01:45
But that means everything from
being able to control your bladder
to being able to have sex.
01:50
Hello now everybody's
attention, right?
So it's important that you
just stay calm and say,
Mr. Sanchez.
This may not be comfortable for you.
02:00
But I want you to understand
the impact of diabetes
in every aspect of your body.
02:05
So,
these nerves remember we
talked that high glucose
can impact your blood supply
and it can impact your nerves
and those are really important
in your ability to
control your bladder.
02:17
Now nobody wants to talk
about this Mr. Sanchez.
02:20
I understand this may
not feel comfortable
for you to talk
with me about it.
02:24
But I know that this
is really important.
02:26
So even if you're
feeling uncomfortable,
you let me know when you
want to stop or take a break
but let's share some information
with you and see if this helps.
02:34
So you stay calm,
and professional,
he'll feel more comfortable
if you appear comfortable.
02:39
So no matter what you feel like on
inside, on the outside,
you need to make eye contact and
act like this is no big deal.
02:47
This may be a conversation
you need to practice out loud
so you can be calm in
appearance when you have it.
02:55
Because here's what
we're talking about,
high glucose from diabetes
leads to bladder
problems and impotence,
see the blood vessels
and the nerves
that control the
bladder are damaged
and they can cause urine
leaking and incomplete emptying.
03:11
Well, if you'll notice Mr. Sanchez
is a little advanced in years
if he isn't having problems
with his prostate right now,
he likely is going to.
03:21
So you see the
bladder there right?
We've got the kidneys would
be just above your screen
then we got the ureters
coming down to the bladder.
03:28
And right around that that greenish
looking organ that we've colored there
is his prostate.
03:34
Is that grows, it's going to
put pressure on that exit valve
where the year and
exits the body.
03:40
So he may be having problems
because his prostate
is kind of strangulating
where urine exits the body
but also the blood
vessels and nerves
that control the
bladder are damaged
and so that can cause leaking
and incomplete emptying.
03:54
No one again I
can't say it enough
wants to talk about
this and yet they do.
04:00
Because they want to find a
resolution for this problem.
04:04
Now in addition to
the bladder problems
because we know the high blood
sugar damages those blood vessels
and those nerves they can
also cause sexual problems.
04:14
It is not uncommon
for a male to struggle
with impotence because
of the diabetes
because the nerves that control
sexual function are damaged
and that's why the patient
may experience impotence.
04:25
So this is a conversation
that you just,
gently, calmly,
and professionally bring up.
04:31
Ask him if he would like
some more information,
that's also a cue,
to know if he wants to talk more about
it, or he doesn't want to.
04:38
I think you'll be surprised,
even in what you would consider
a non-traditional setting,
like you would not expect to talk to
someone maybe older than you and a male
if you are a female or
even if you're a male
you would not expect to be
talking about sexual function,
but let them drive
the conversation.
04:55
You introduced it,
you present it.
04:58
They'll tell you how much more
information they want to have.
05:01
I think you'll be
surprised sometimes,
people are very open
and just thankful
that you asked
them the question.