[fgummett]

Originally Posted by gary.keith

Going against what my Endo has told me to do is one of my biggest challenges. As I've stated elsewhere, I'm at a point where I know just enough to be potentially dangerous to myself. However, when I've done the research, asked questions; as I'm doing here, and experimented a little bit to confirm my suspicions about how things affect my BG, then I'm finding growing confidence in my ability to make my own decisions, even if they contradict my Endo or her PA. And yet I still feel the need to get the PA to agree with me. Why the heck did my mother have to instill in me that I should always do what my doctors tell me to do?

DISCLAIMER: my sarcastic comment above was not meant to suggest that Doctors are idiots who are not to be trusted (my words, not anyone else's).

While of course, all Doctors are only human, the ones I see are intelligent and educated professionals who I trust and whose opinions I value. While legally they may have the final say in such matters as specialist referrals or prescriptions, I like to think that we have a collaborative/team approach where I bring at least as much to the discussion and decision making process as they do.

As an example, I was warned by my local MM rep that my Endo was against insulin pumps -- just another money-making scheme -- and would not even meet with her. At my next appointment, I presented him with printed studies, forms etc.. I explained what I wanted to do and why... he agreed and at each follow up appointment he has proudly told me how many more folks he now has on the pump.

Knowledge is indeed power, but I have so far found it useful to engender cooperation between myself and my health care team rather than becoming adversarial with them.

And I'm largely speaking about the management of my D or any other chronic condition... when I had my appendix removed, as emergency surgery a couple of years back, I was NOT sitting up on the table discussing with the surgeon how it should be done

[ShottleBop]

Originally Posted by dbaratta

That is weird about the red onion, I would question that but you are correct there are plenty of carbs in there. Do what your body tells you too. Those are even the good carbs, complex carbs! I find that a good salad keeps my BG in perfect sync. You just keep doing what you are doing.

Not necessarily "complex" carbs; onions are high in sugar, compared to other veggies. If you're following Dr. Bernstein's diet, they're on his "have a limited amount on a salad or something, but don't go crazy" list. (Of course, that doesn't stop me from eating that big 'ol slice of onion that comes on my burger, but it does stop me from having them grilled.)

[gary.keith]

Originally Posted by fgummett

And I'm largely speaking about the management of my D or any other chronic condition... when I had my appendix removed, as emergency surgery a couple of years back, I was NOT sitting up on the table discussing with the surgeon how it should be done

Once you get to the operating table, I would agree with you about your surgeon.

When it comes to my D, and the topic of this thread, I wish she would recognize when I've done my homework and, barring any reasonable medical concerns, agree that I'm informed and rational enough to make some decisions on my own now.

[fgummett]

Originally Posted by ShottleBop

Not necessarily "complex" carbs; onions are high in sugar, compared to other veggies. If you're following Dr. Bernstein's diet, they're on his "have a limited amount on a salad or something, but don't go crazy" list. (Of course, that doesn't stop me from eating that big 'ol slice of onion that comes on my burger, but it does stop me from having them grilled.)

It's another of those "perceptions" I alluded to above... all fruits and vegetables are good because they contain complex carbs

As is widely known here on DF, even so-called complex carbs can cause rapid BG spikes for at least some individuals... hence our need to test around new foods.

While I am a proponent of real whole food, and it is often suggested that Paleolithic humans ate fruit and vegetables... consider what that fruit and veg looked like compared to what is on offer in our stores today, and remember that it was seasonal back then as well. Many of the varieties we have today have been bred for size and sweetness, not necessarily for improved nutritional value.

---

Originally Posted by gary.keith

When it comes to my D, and the topic of this thread, I wish she would recognize when I've done my homework and, barring any reasonable medical concerns, agree that I'm informed and rational enough to make some decisions on my own now.

I agree Gary, but bearing in mind that some Doctors still come from a background where they are the "experts" and we are supposed to passively comply with instructions... perhaps we need to take the initiative and show them that we do in fact know what we are talking about... at least so far as the management of our own D.

[mortis505]

Originally Posted by fgummett

As an example, I was warned by my local MM rep that my Endo was against insulin pumps -- just another money-making scheme -- and would not even meet with her. At my next appointment, I presented him with printed studies, forms etc.. I explained what I wanted to do and why... he agreed and at each follow up appointment he has proudly told me how many more folks he now has on the pump.

Perhaps Gary could do something similar with the PA. Print out the nutrition info on each item as per serving size and show it to them. Hard to deny proof when its in your hounds. Also it may be useful to bring info from multiple sources.

Calorieking is excellent, but for a quick peek i also use the chart at Mikes.

[foxl]

Originally Posted by JayDee1950

Well, I would tell the PA to stuff it.
When they have MD after their name then can lecture me.

JayDee, MDs rarely have much in the way of nutrition education. SOME CDEs do ... but not all of them, either. I no longer let anyone lecture me ... let alone some clown hired by my insurance co ...

[Subby]

Originally Posted by mortis505

Perhaps Gary could do something similar with the PA. Print out the nutrition info on each item as per serving size and show it to them. Hard to deny proof when its in your hounds. Also it may be useful to bring info from multiple sources.

That's the ticket. And you can practise your interpersonal skills to see if you can present it in such a way that allows them to keep face. If such a thing is impossible (they will not accept they are wrong, or move on gracefully, given a polite effort to "educate" them) then you know this person is of no use to you, you simply cannot trust them.

[gary.keith]

Originally Posted by fgummett

I agree Gary, but bearing in mind that some Doctors still come from a background where they are the "experts" and we are supposed to passively comply with instructions... perhaps we need to take the initiative and show them that we do in fact know what we are talking about... at least so far as the management of our own D.

This is what I've been doing. Hence the need for this thread. I've been telling her what my research has found and trying to convince her my salad lunch has far more carbs in it that she's willing to acknowledge.

Originally Posted by mortis505

Perhaps Gary could do something similar with the PA. Print out the nutrition info on each item as per serving size and show it to them. Hard to deny proof when its in your hounds. Also it may be useful to bring info from multiple sources.

I'm thinking your suggestion is what I need to do next so she has no wiggle-room to deny what I've been telling her. Thanks also for those links. I already had the Calorie King link, but adding Mike's to my list of paper-proof just might be helpful in persuading the PA that I am not stupid !

Originally Posted by Subby

That's the ticket. And you can practise your interpersonal skills to see if you can present it in such a way that allows them to keep face. If such a thing is impossible (they will not accept they are wrong, or move on gracefully, given a polite effort to "educate" them) then you know this person is of no use to you, you simply cannot trust them.

You mean I shouldn't just scream at her while flailing my arms about and tell her what an idiot she is? Gosh, you're no fun at all!

[jillybean]

Originally Posted by gary.keith

You mean I shouldn't just scream at her while flailing my arms about and tell her what an idiot she is?

I see no reason why you can't do both

[JayDee1950]

foxl, agree with you there.
To me, a PA is just a glorified secretary/nurse -
or a MD wannabe.
I never talked to them.
If I pay for a doctors visit - I WANT A DOCTOR!
And insurance companies that review/deny claims that are processed by bean counters just irks me.

[JayDee1950]

Ten years ago - before I moved here - I had 4 physicians who were wonderful.
GP was in the insurance 'health wellness network/program'.
Cardiologist, Pulminologist, Gastro-enterologist.

The Cardio ordered all of my labwork, forwarded results to the others and was responsible for discovering the Diabetes.
The others ordered specific procedures based upon their specialty and everyone shared results/reports as well.

Cardio started treatment for Diabetes and recommended a local Endocrinologist - oops out of network - was denied by insurance company.

The Endo (in network) was almost an hours drive away and it took me 2 months to get an appointment. I brought my labwork results (CBC from previous week), but Endo stated they were no good and they would need to run all new labwork, adding to the costs - of course.

Endo then wanted to change all my meds (as they knew better than the others) and wanted to have the leading role regarding all treatments / be primary for my case. As they were the only in-network Endo within a 2 hours drive, their office was jammed with patients. Found them arrogant, obnoxious/control freaks with a 'my way or the highway' attitude.

They made Dr. House look like Ben Casey or Dr. Kildare (if you remember them).

Needless to say after 2 visits I never went back, used the local Endo from my Cardio and paid out-of-pocket.

[Granny Shanny]

We've run into the same thing, JayDee . . . arrogant, obnoxious/control freaks, and also the business of retesting, etc. Even on referrals yet! For gosh sake we wouldn't even BE in the guy's office if another doc hadn't referred us, and yet he dismisses the first doc's tests. We said "no thanks" after only one visit . . . (can't believe it still makes me made just thinking about it! )

[SteveFromIowa]

Originally Posted by gary.keith

I'll go there tomorrow. It'll be my very first time ever inside a Walmart. Please pray for me!

So how did it go at Wal-Mart today Gary?

[Granny Shanny]

Originally Posted by SteveFromIowa

So how did it go at Wal-Mart today Gary?

(or would we be happier not knowing? hee hee)

[gary.keith]

Y'all crack me up! I ran out of time yesterday so I never made it to Walmart. The opthamalogist took two hours instead of one and the optician took two hours instead of 30 minutes. By that time it was too late and traffic too heavy to try venturing any further west than my home. The only errand I need to run Monday is the supermarket so I'll have plenty of time to venture out to Walmart.