Some of you will know that I had a very important appointment with my GP today, where I was hoping to be able to get all my current lows/highs/ketones etc. sorted. Unfortunately, this is how it went...
I got there three minutes early, noticed surgery was running a bit behind because other people were being called in when it was more turn, eventually got in at around 10:55 (perfectly normal).
I went in with a sheet that I'ld prepared showing all my BG levels and the BG and ketone levels from the past couple of days, and had revised in my head what I wanted to say beforehand. I was high when I went to see him so I wasn't in my most lucid of states.
I started by telling him that I'm still going high/low and if anything it had got worse since I last saw him in December. He went through my notes, and pulled up the letter about Levemir and perused its contents. He looked through the sheet, grouping the results together saying it was difficuult to identify a pattern, and I said I couldn't identify any real pattern and where I had (with the evening results) I had taken action to change them (by moving to two injections a day). He then said that there was a pattern, pointing to my 6pm results, yet I saw that he was saying they were higher than they should be, yet there were several results that were definitely hypo in that column, but I really did not want to point that out.
He then told me off for not writing in when I had meals. He had told me previously to write them in a day-chronological format, which I had. I just nodded along. As far as I am concerned I need to do blood tests to work out whether I am high/low/normal if I constantly feel bad, and it would have been a waste to disregard the rest of the results and probably would have led to incorrect conclusions being made.
I told him about how I seem to randomly blank out, he wasn't really interested, didn't ask anything, and then he then went and read the letter that was sent by the diabetes nursing service, and told me I should not have 'ASKED' them for Levemir, and now its going to make it much more difficult for me to get in control, and means
we start again. And he repeated this phrase several times. Every time I change my dose etc, we must
start again. And then he looks at me like I havn't done my homework.
I explained all I had done was contact the PCT Nursing Team and
asked them about changing to two a day as I did not want to make any further changes to my regime without it being medically approved and I could not get an appointment with him. It was actually the PCT Nurses who brought up the subject of Levemir, and I then discharged my concerns to them about what Lantus was doing to my body, and we
mutually agreed that it would be better for me to try Levemir than try pussyfooting with the Lantus. I did not tell them to give me a ****ing prescription for Levemir or anything like that at all, and did not insist that they do anything - if anything I was too undemanding.
But what have we actually started? I followed his instructions and just got worse, they don't really make any sense. I really have not got six months to wait for results to get good, he seems to think I am on a quest to get perfect control, which I am not (at least not at the moment), I just want to feel good again - I don't need perfect control to do that.
He then went to say something like
'Sean, you don't understand....'
and I interrupted him and said
'Yes, I know insulin and food are connected to each other and you're supposed to count carbs and base your insulin....'
'I don't really subscribe to that theory'
Thats not what people on the forum have told me, but I didnt say anything - it seemed pretty fruitless.
He then commented that he hadn't got any information from the letter about what my dosing on the Levemir was, and I said to him I hadn't been given any information really either, only the vague instructions that 'I should reduce my insulin' and 'split it into two injections a day'. I havn't been told what times to do them, or what units to take so based on other peoples experiences I decided to cut it to 30 and do 18 at night and 12 in the morning when I first went on it, and then after two days I moved to 20 at night and 14 in the morning.
He ummed and ahhed, didn't really know, so asked me what units I was taking of the Lantus before, and decided based on that to up my morning dose to 20, despite telling me in previous appointments I should never vary my insulin by more than one or two units, and my knowledge that different insulins require different dosing.
After we had finished with all that I asked him to change my repeat prescription from Active Strips to OneTouch Ultra strips, which he did surprisingly quickly, [this is good because the OneTouch allows me to record insulin doses and food intake as well as the results, so will hopefully shut him up about that].
While that prescription was printing, he started adding notes to my records. I don't think he realized I could see what he was writing. I first corrected him when he wrote I had contacted the hospital, and saying I didn't but I contacted the diabetes nursing service, so he corrected that. He then went on and wrote that 'Presented with a lot of blood sugar results, not in correct format, Patient advised that we must start again because he changed to Levemir, advised to up morning injection to 20 units blah blah ....
problem is largely in the patients head'.
At this point I largely though along the lines of **** off, and decided to say something to him about this. I said that I did not feel that the problem was largely in my head, and if I have got a problem with my head its because I am feeling so **** because of all these problems that I am having. I cant remember what he said, but he smiled and said something, then told me to make an appointment for next week.
WTF am I supposed to do? I know I'm ill, I always thought that if its in my head I can't prove anything so theres no point, but even though I'm now getting ketotic they're still not interested.
The thing is, when I phoned the diabetes nursing service, they didn't seem all that bothered by my morning hypos either, nor the fact that I can no longer think straight. But now, I'm bothered because I cant live like this any more. To me its very worrying that because I feel constantly hypo/er I cant feel a real hypo coming on and then wander around London waiting to be mugged.
I really do not think that:
- I am a crackpot
- I am wrong for expecting to at least have been able to get some control over it by now
- that I was wrong for approaching the PCT Diabetes Nursing Service when I could not get an appointment to see him or bring forward my clinic appointment at the hospital
- That I'm an evil bastard expecting too much from them because I have NEVER contacted either the PCT or my GP specifically about diabetes related issues until I decided I had lost control and couldn't cope and needed help
PS. Ive probably missed bits out, I was in there for the full ten mins, but you get the gist and the main points of what he said.
PPS. I hope it makes vague sense - if it doesnt, its only a rant!
