00:01
Okay, now you'll see a picture
of the blood supply on the left
and we've got the
nerves on the right.
00:07
I wanted you to have this visual
because the next thing I'm going
to talk to Mr. Sanchez about is
breaking down the complications
into two categories.
00:14
So for you, let's step aside from
Mr. Sanchez for just a minute.
00:18
I want to make this
solid in your brain first
before we teach Mr. Sanchez.
00:22
So above the
drawing on the left,
I just want you to
write in the bad news
damage to blood vessels.
00:30
Okay, so write,
damage to blood vessels.
00:34
Above the drawing on the right,
I want you to write
damage to nerves.
00:40
Okay good.
00:41
So so far my most important points
that I've taught Mr. Sanchez is
the better we can
control his blood sugar
the less complications
he'll have.
00:51
Then we started teaching
him about the complications
he could have with his mouth,
with his teeth, with his gums.
00:58
Now, we're going to do
another big category
and talk about what happens
when you have problems
with the blood supply
or problems with the nerves.
01:07
So this is a key point
I want him to understand
because when you have
damage to the blood vessel
or damage to the nerves
his quality of life is
significantly going to be impacted.
01:19
Okay,
so I put down your mind this,
I've got a big brain up there
and a big heart of there,
hey, if nobody's told you today,
your brain is pretty amazing.
01:29
Sometimes the nursing
school makes you feel like,
my brain must not work right.
01:35
It's not true.
01:36
Your brain can do
incredible things.
01:39
We just need to work together
and figure out the best way
for it to take in information,
process it and then use
it to serve other people.
01:48
So we've already helped
Mr. Sanchez understand
well high glucose is going to
give me problems with my nerves
and with my blood supply
but keep in mind,
these are really big problems
and the longer he
has the disease
and the less controlled
where of that blood sugar
the bigger problems
we're going to have.
02:08
Here's the hard truth,
people with diabetes tend to develop
heart disease at a younger age
than people without diabetes.
02:15
In adults with diabetes
like Mr. Sanchez
the most common cause of death
are heart disease and stroke.
02:22
So adults with diabetes are
nearly twice as likely to die
from heart disease or stroke,
as people who
don't have diabetes
Now do you think I'm going to
talk to Mr. Sanchez that way?
Dear Mr. Sanchez,
I just want you to know
that you have two times
the chance of dying
from heart disease or stroke,
as someone who does
not have diabetes.
02:44
That's not how I'm
going to present it.
02:46
I want them to know like
hey, if we can work together
and figure out how to
lower your blood sugar
notice I didn't say get it
perfect, get it in this range.
02:55
So if we can work together to take
steps to lower your blood sugar,
we're going to lower your risk of
having a stroke or a heart attack,
so do you know anyone
who's experienced that?
Mr. Sanchez is there anyone
in your family or your friends
that's had a heart attack
or they've had a stroke.
03:11
How did it change their life?
What was it like?
Give him something visual to
attach to that and he will think,
oh,
I remember when my
friend Bob had a stroke.
03:22
That was horrible.
03:24
His wife had to
take care of him.
03:25
He got really sad.
03:27
So help him see there's
a direct correlation
between the little choices he
makes every day about what he eats,
and how active he is
and how that ends up
looking like avoiding
what his friend went through
that was so difficult.
03:42
Because one of the main
reasons were talking about
keeping his blood
sugar closer to normal
is because we want to
keep those blood vessels
and those nerves,
the ones that help you move your body
and control your organs strong.
03:55
So make that connection for him.
03:57
You might think
doesn't he know that?
No, he really doesn't,
say he doesn't live in our world
where all we think
about is healthcare
and your body and how it works.
04:07
He doesn't live in that world,
but we can share the right
amount of our world with him.
04:13
So it makes a
difference in his life,
because we want to help
him prevent a stroke
or a heart attack.
04:20
So this is why it
is so important
for the health care team to
look at Mr. Sanchez's feet.
04:27
Wait a minute.
04:28
We were just talking about
head and heart and vessels and,
How did you get two feet?
Well, I want Mr. Sanchez
to understand,
This is an important part of
talking about that blood supply
and nerve damage.
04:44
So every day he needs
to look at his feet.
04:47
I mean at the bottoms in
betweenees, right?
He needs to look in
betweenees those toes
the bottom, the sides, the top,
because if he's
experiencing neuropathies
talk about more of those later,
but if he's experiencing problems with
his feet and he can't really feel things,
he might have a cut,
a wound or even an infection
and he would have no idea.
05:09
Now take a look at Mr. Sanchez.
05:12
We can't tell for
sure from this picture
but if it was
sitting here with us,
I could tell you he's
not really flexible.
05:19
So I cannot expect
Mr. Sanchez to
be nimble enough to look around
at the bottom of his feet.
05:25
So, you know what my job is
think through a practical plan.
05:30
Can you underline
the word practical.
05:32
Don't use some pre-processed
nursing care plan
that's printed off and says
look at your feet every day.
05:39
He can't do that physically,
so we got to get creative and we
have lots of amazing solutions.
05:45
Do you know that we have small
mirrors on an extended rod?
It's like those forks that you use
at a campfire that are really long,
and you can eat off
somebody else's plate.
05:55
Well,
we have that with the mirror.
05:58
So you extend it so
Mr. Sanchez can stand up here
or he can be seated
so he doesn't fall,
and he can actually hold that mirror at
the bottom of his foot and look at it.
06:08
Also keep in mind,
Mr. Sanchez has strong family support.
06:12
Now not everyone does,
but you know, he could put his
he could lay down on the bed,
have his bottoms of his
feet up and his wife
could look in between his toes
and really take a good
look at his feet every day.
06:26
Because if we can catch a
wound or an infection early,
we can save
what might be a
really bad outcome
we can save that from happening.