Jumping through hoops...

[Keezheekoni]

I'm just a little depressed right now. I went to see my CDE/RN at the diabetes clinic today and she tells me that I have to do a new log for 3 days' worth of hourly bg checks, every bite of food I eat and the carbs, what I decide to give myself insulin-wise and corrections, exercise, etc.

I was told that today or tomorrow would be the day I'd be allowed to order my new pump. I'm getting very disenchanted with this clinic... She tells me that the reason they need to make me do all these things is so that they know I'm "committed" to really caring for my diabetes. C'mon, would I really be there for a pump if I didn't want to be committed to it? Sheesh!

I've already taken all the carb-counting classes, the pre-pump class, the intro to pump therapy class, my family knows how to use glucagon, I've read everything I can and wouldn't *dare* to start the pump myself...

I am really starting to feel (especially by one comment by her that was made - I don't remember it exactly) that they treat all of their patients like 2 year-olds. I mean, I have to check myself every hour??? I know that there are some people who do that, but I thought 8-12 times a day was enough!!! I have to write down every single solitary thing that I stick into my mouth? I thought I was over doing that years ago...

I practically broke down in the office... I was telling her that this is something I've been wanting to do for a long, long time. That I've been studying and taking extra classes, talking to you all, etc. That I feel I've done everything they've wanted me to...and now more hoops to jump through?!? I already did the journaling of my food, bg, corrections, etc., why do they need more than that?

Oh, and apparently their computers don't like my UltraSmart. It will only download two weeks worth of data. Oh, and she wants my records to be in handwriting...she doesn't trust those of us who use computer journals! What??? I haven't done a written record in years either!

On top of all this, I need to have surgery sometime in the next month...right now I'm on pain killers for the problem, so my bgs are higher than normal. She didn't like that at all! Oh, and pain makes your blood pressure rise, so instead of thinking that my pressure was up because of the pain, she feels that it's because I'm hypertensive...uh, yeah...whatever.

I'm so disenchanted with this clinic. I'm tempted to call my old internist and have her refer me to an endo who is pump friendly. The problem is that I like my current primary doc, she's been awesome with treating my migraines and giving notification to the hospitals that I'm not a drug seeker when I come in to the ER... But since she's affiliated with the University, just like this clinic, she won't send me to anyone but the people at this clinic. :(

I'm so frustrated... :(

[Cyborg]

Sorry you are going through such difficulties and frustration. Seems like you are almost through the last hoop. You are almost part of the pumpers club. Personally, I'd look for a new endo afterwards. Hang in there...

[gettingby]

Rikki, I am so sorry that you are having to go through this ordeal in order to get what you need and want. What you are going through is one of my biggest fears when I finally do get the insurance troubles I am having straightened. Hang in there and don't give up !!!!

[JediSkipdogg]

Sorry to hear this and here's a few additions/corrections.

Tell your doc to learn how to operate the One Touch software. It will upload all results in the meter. However, the default display for all graphs and data is 2 weeks. At the top it asks you to specify what dates to use. That's where your doc's office is an idiot.

Hourly BG checks are worthless (my opinion.) Once you have a pump and are on it to begin with fine tuning basal rates will require that, but not until then.

I definitely recommend trying to find someone new if you want to pump. If this is the trouble you have trying to begin to pump, just think of the trouble you will have while on the pump.

[duck]

Rikki, I had to do the same things for my pump. Being that I am on the "other end" and looking back--It's worth it. Don't get discouraged. And actually, looking back, I learned a lot about this disease and how it was affecting me, I would STRONGLY encourage you to not give up, and maybe embrace the process. You'll make it!

[Cyborg]

I definitely recommend trying to find someone new if you want to pump. If this is the trouble you have trying to begin to pump, just think of the trouble you will have while on the pump.

Can you imagine being micro-managed like that while pumping! I got my pump to get more control, not to jump through hoops or ask permission...

[duck]

Can you imagine being micro-managed like that while pumping! I got my pump to get more control, not to jump through hoops or ask permission...

As long as she has someone who will prescribe the needed supplies, that's all she will eventually need, as long as she is willing to learn the ins and outs of the pump and stay abreast of developments, etc.

[poodlebone]

Rikki,

Is there another clinic/doctor/CDE that you can go to? I realize that in some places there are a limited number of health care providers. I can understand the clinic wanting to make sure that you know a pump is going to take some work but it seems that they're going overboard. With me, my CDE (first time I met her) told me that I was a good candidate for a pump (she saw that I tested and kept logs, had erratic BG swings etc) and the following week I had a pump. No classes required, no follow-up demands. I read the manual, watched the CD-ROM, did the training session online and then went for my actual training with the CDE a few weeks later.

[Keezheekoni]

Thanks for the replies, everyone. I am still somewhat saddened by my experience today. The hourly checks right now, in my mind, are worthless. It's telling me nothing more than what I already know... I can understand maybe having to check that much once I have the pump, as Jedi said, but for now the information is really not necessary, IMHO.

I'm, at this point, not learning anything new. From everyone here to reading Pumping Insulin to even finding and reading one of the books that the director of this clinic wrote, I feel it's really stuff that I already knew.

It does bother me that as I said in my OP, that this is the only clinic that my primary doc will send me to. She's at a clinic run by the University of WA, the diabetes clinic is run by the UofW, so she'll only refer within their network...unless it's for something like the stupid varicose vein I have on my ovary (TMI, probably!)...then she'll send me to an OB affiliated with the hospital I had my last child at. :confused: That just mystifies me! If you're only going to refer in the UW network, why send that one out? Oh, my knee surgeon and my podiatrist...wait a minute, she refers out of their network for everything else! So, what makes this clinic so special? Well, apparently it's their success rate with pumpers. They jump through the hoops, and apparently only 1% of their patients actually stop using the pump after 1 year...

I'm rambling, sorry! I'm just frustrated....

You know the real thing that bothers me? It's like Cyborg said...the micromanagement. I could understand if I was a 4 year-old being put on it...manage the parent, whatever, but I'm an adult. I've had diabetes for a LONG time... I know how to be "good" and not binge on candy bars anytime the urge strikes.

/rant :rofl:

[Funnygrl]

Those are pretty typical hoops to jump through, hang tight, you will get it eventually.

[Tim_Roy]

Tell your PCP that you're uncomfortable with the micro-management at that clinic. If he/she puts the foot down about it, say firmly that it'd be a shame to have to change PCPs over something like this.

Or better yet, tell the endocrinologist him or herself.

[Keezheekoni]

Is there another clinic/doctor/CDE that you can go to?Well, I'm sure that there are. Unfortunately, I actually tried calling quite a few of the endos in the area (a couple who the Cozmo rep referred me to) and they all wanted a referral from my primary - even though my insurance doesn't require me to get a referral to see *anyone*. So, with one, who would have been able to get me in within a day or two of my call, I called my primary and asked her nurse to send a referral over to them as well as my last two sets of labwork (the endo wanted that). My primary called me back and told me that she would only send me to the diabetes clinic that I'm going to.

She wanted me to get all of the "education" that they offer, before getting onto the pump. Which is great...except that I've *already* had all of the education. The carb counting, advanced carb counting, intro to pump, etc. classes that were offered at the hospital close to my house. She also wanted me to see the RD who would help me with a food plan. Well, the RD didn't do that...she gave me yet *another* class on carb counting! For God's sake, how many **** carb counting classes does a person need?!?!

I told my primary, the last time I went in (for a follow up to an ER visit) that they were making me go through all of this...and her response was that it was "good" for me to be getting the refresher courses. Hello?! The last time I took the set of classes was last year...I took them for the 5th time!!! Do I really need to take the **** things again? I could TEACH the friggen classes.

So, the short answer is, no...I can't go to a different endo/CDE/etc. Unless I want to switch my primary. Until I decided I wanted to pump, she and I had a great relationship... I was very comfortable talking to her about ANYTHING. Not anymore. I almost feel like I need to find someone else, but it's such a pain getting a "new patient" appointment anywhere...takes so long, etc. Grrrr.

[condensr]

Yikes. Its so crazy how two people can have totally different experiences in the same area/locale.

When I first moved here, I saw an endo at VMC, and really liked that office. Only reason I stopped going there was that I lost insurance, and it cost too much. Several years later, when I thought it wise to seek an endo again (as did my primary doc) I went to the endo of her choice. (didn't live south anymore, so driving to VMC was out of the question.) The guy she sent me to was SO old school.. I think I went there once or twice..

I feel your frustration with the process and paperwork, but you're almost there!

Its odd they had trouble downloading your ultrasmart. Last time I was there with mine (before I switched to an Ultra2) they downloaded some 2500 readings off it. Maybe their database overflowed due to folks like me! :)

[Cyborg]

They probably micromanaged their database... :rofl:

[Dewey]

Rikki,

I'm sorry you've been having so much trouble trying to start pump therapy. Before I began using the MiniMed 506, I had some of the very same issues. The doctor that I was referred to was the very same way - he treated me like a 2 year old, & made me jump through all the very same hoops you're now going through. He & his nurse buddy also wanted to throw me in the hospital for 2 weeks to regulate on the new pump (at 23 years of age, what the he** for!? I Don't think so!!). Of course, my insurance at the time denied it, due to the high hospital bill they would have incurred. After they denied, the doctor & his little buddy got rude with me, saying I wasn't being enthusiastic enough! Meanwhile, I had A1Cs in the 9s & was doing quite poorly overall (with MDIs)....I had enough of their garbage (after all, this is MY life), left them and went over to a doctor that treated me like a person & (although we're now in different states) is still a good friend.

Funny enough, the stupid insurance approved it After I dropped the other doctor (& right before we switched insurance carriers). Of course I didn't go, cause I already saw the new endo, and was very pleased with him (despite the other doctor & his cronie nurse badmouthing him - something which is very unprofessional anyway!!). At any rate, within 3 months & a couple of visits, I was on the MM506. He personally told me that he felt I was logical & intelligent, & could do it on my own without being in a "controlled environment" such as a hospital (am not trying to offend those who had to go in the hospital to start, am just telling what My doctor said to Me).

You need to get a new endo, ASAP. And if it takes getting a new primary, so be it. It's Your health & Your life, so they should only do as you ask of them (which is what they're paid for in the first place). I found a great endo while living in Seattle! If you'd like his name & the name of his clinic, I'll be more than happy to provide it (in a PM, of course ;)). :thumbsup:

Sorry for the long-winded post....just wanted to let you know that you're not alone.

[Sharps]

So, the short answer is, no...I can't go to a different endo/CDE/etc. Unless I want to switch my primary. Until I decided I wanted to pump, she and I had a great relationship... I was very comfortable talking to her about ANYTHING. Not anymore. I almost feel like I need to find someone else, but it's such a pain getting a "new patient" appointment anywhere...takes so long, etc. Grrrr.


It really sounds that the Diabetes clinic is trying to make you give up on pumping, as you said earlier that only 1% quit pumping -- the other 99% probably gave up long before they got the pump. Education is great but you already know what they have to teach and it is wasting your time and money. Maybe you should change Primary care Doctors, or at least threaten to do so. You also might want to challenge the clinic to get them to actually state whether this is futile or it is actually leading to a pump. I really hope that this ordeal comes to a close soon and you can get your pump.

[lelggren]

I personally think that it is so stupid that they want you to do all that extra stuff. You should tell them that you will do it with a glad and happy heart if and only if, they provide all the test strips needed to test each hour, as well as any others you may need to do because of hypo's or hyper's, the paper and pencil to keep the handwritten log because they can't figure out how the very simple software works for your meter (which is sad. If I can understand it, anybody should be able to...lol), and also if they will take care of all the stuff in your life that you could have been doing while you were writing down every little move you make.

I know that was extremely sarcastic, but really, that is a lot of things that you just don't need to do before hooking up. I really recommend that you take dewey up on her offer to give you that doc's information. Granted, the pump is worth all of this, but it is just not necessary to go through all of this.

I wish you much luck! and hopefully we will be hearing your hooked up story soon! :)

[Vic L]

Wow, I can totally relate to your issue. I can only say, have patience and when you get the pump, have a sincere and honest conversation with the Endo. Tell him why you are choosing another doctor / staff and how his policies can improve.

I recently went through some hassles getting a pump upgrade and I swore I would kill someone if they continued to treat me in that fashion. If it wasn't for my wife, my tongue would have gotten the better of me and I would be without an upgrade I needed badly. Long story short, my insulin to carb ratio changed and my reservoir would last a day & 1/2 (MM512). Now using a MM722.

Hang in there. Look for a new doctor as you wait and know that it is well worth the wait but not the hassle they are giving you. It also irks them when you ask for written documentation concerning their pump policies / upgrade. I bet you they have no step by step procedure for getting on a pump just what they think and how much they want you to pay for the entire process.

Vic L

[June91]

I am really sorry for what you're going through! They should have remembered that you are in fact, a CUSTOMER :stupid: hmmm... and jumping on that train of thought, our doctors should treat us at least a bit more like customers - everything would go much smoother.