Daily Bread - A Patient’s Story
Gordon first came to us in 2017. There would sometimes be prolonged periods in between appointments and visits as he worked not only locally as a day laborer, but often drove as far away as Southern California for work. Gordon’s top medical conditions are typical for many of our patients: diabetes mellitus type 2, hyperlipidemia and acute gastritis. To top it off, anemia and chronic weight loss. What is particularly concerning is that his diabetes is uncontrolled and chronic due to poor management of this disease during long absences away from medical care and follow-up.
A year ago, when he was 53, Gordon lost the tip of his right great toe when it became gangrenous due to a wound/injury. He had emergency care and surgery in the Los Angeles area while he was working down there at the time. Gordon came back to the Bay Area and the Clinic as he was told to follow-up and have his stitches removed. Fortunately, the wound healed cleanly and he his ability to walk and work were unimpeded after recovery. And it was even more fortunate that Gordon sought care early enough on with his foot. Over 60% of the non-traumatic amputations are related to the consequences of diabetes, and of those 80% of foot amputations start with a foot wound or ulcer left untreated.
Of course, Dr. Thomas Wallace ordered a full panel of lab tests and follow-up with the Clinic’s Diabetes Nurse Educators (DNE). Even with phone call reminders and follow-up, we knew there may be some time, actually months before Gordon would finally go in to get his laboratory tests done. Five months later in December 2023, Dr. Wallace called Gordon and left multiple messages concerned about his high A1c levels (blood glucose/sugar) and his anemia. A10.4 A1c indicates poor, suboptimal control and management of his diabetes.
The problem is Gordon has worked very little since January 2024. We found out when he finally came in July for a Clinic appointment. He was gaunt and sallow-looking. A finger-stick, manual glucometer test done in Clinic showed a blood sugar level of 484. Gordon hadn’t eaten the day of his appointment, only drinking some lemonade as it was a pretty warm day. He had not been checking his blood sugars; he related losing his glucometer a couple months ago. With the help of a translator and our volunteer DNE Sharon Palmer, RN, we learned that Gordon basically bought food and ate when he worked. Getting food and meals, eating was uncertain and sporadic when not working. He lived a life of “feast or famine.”
At the Clinic, Gordon received information on local food banks/pantries and where to go for a daily hot meal and more. Locations that he could get to such as Loaves and Fishes and St. Vincent de Paul. With continued help and reinforcement from our DNE, Gordon was counseled how to optimize the right food choices of vegetables and protein and avoid the immediate gratification of carb heavy options. The Clinic provided a grocery gift card to stock up on basic healthy food items, as well as a new manual glucometer, test strips and supplies made possible and supported by the John Muir Health Community Partner Grant.
Most of us cannot fathom or begin to understand eating only on the days you work. It is written on his face, the face of so many. Gordon’s story, a story of the working poor here in the expensive Bay Area, is one of where to find his daily bread while managing his diabetes and other chronic medical conditions. He has four follow-up appointments in the coming weeks including an all-important diabetic retinopathy eye screening. Gordon knows that the Order of Malta Clinic of Northern California has always been there to provide the compassionate health care and follow-up that he needs. Our prayer is that he will keep his appointments.
“For I was hungry and you gave me something to eat…I was sick and you looked after me.” – Matthew 25:35-36
By Anne Brussok, DM