Endo Appointment Today - 1st Time in Almost 2 Years

[belyro]

Well, I'm going to see my endo in about half an hour. I haven't seen her since early 2007.....before I started to make changes for the better with my diabetes. Last time she saw me, my A1C was 8.5. Now it hovers in the low 7s, and I'm expecting I may be in the 6s next time, judging by my levels lately. Not where I want it yet, but I'm getting there. She also hasn't seen me since I've been on the pump.

Some of you may remember from my prior posts that I really have a hard time with my endo. I was frustrated that she couldn't help me figure out why I couldn't get my bloodsugars down, but then after 2-3 posts on DF someone else had figured it out for me. I was also frustrated that she always seemed insensitive to the fact that I was trying and trying, but just couldn't figure out what I needed to do to make it all work. (She really lacks bedside manner.) I used to leave her office in tears. Because of all this, it's been hard for me not to blame her, at least in part, for my retinopathy this summer. I know it's not fair to blame her, but I'm still dealing with the frustration of it now....I'll get over it eventually.

I've questioned whether I should change endos, but a number of people in the medical community that I really really respect say that she is the best endo in town for a) the pump, and b) pregnancy (not pregnant yet, but hopefully within the next few years).....so I've made the choice to go back to her.

So, today I'm going to face her again. I have no idea if she's going to congratulate me for my progress or slap me on the wrist for still not being "perfect", or say "I told you so" about my retinopathy. Either way, I get a sick feeling in the pit of my stomach when I think about going back. *sigh*

We'll see what happens.

[Jan B]

Bethany,

I can't wait to hear about your appointment. Go in with confidence! I would think a decent person would appreciate the improvements you have made and help you do even better. I wish you a good and productive appointment!

Just remember, some people don't know how to properly motivate different people. They use the one solution fits all formula. I am motivated by kindness and understanding, with a diplomatic piece of tell-it-like it is. Evidently, several doctors think fear and cruelty motivate people!!

[Alice]

She sounds just like my last endo...somedays I wondered how she got through med school...other days I felt she was really watching "down the road" for me...I never looked forward to my appts., but I guess none of us do...

I've just had some really nice, funny & understanding endo's...I miss them after all my moves...

I found when I stood up to my endo and questioned some of her errors...(yes, she read old labs and such...I knew the numbers better than she did)...I had to keep an eye on such things...but we should all be doing that...they see a lot of patients.

[belyro]

I just realized that I said I hadn't seen her since early 2007....that was way off. It was early summer 2006 that I last saw her.

Well, let's just say that walking past 4 piles of vomit on the sidewalk on the way to see her was more enjoyable than the appointment itself.

Some of the lowlights:
- She made no mention of my improvement in my A1C.
- She didn't seem to have read the letter my CDE sent her in preparation for my appointment.
- She told me that if I was using more than 4 basal rates throughout the day I was probably scewing things up. (What do you think about that, John???)
- And the kicker is this (it's actually kinda hard to explain, so I'll summarize): Between folks on DF, my CDE, and a LOT of work by me, I've found something that works for me re: basals/boluses. It's unorthodox, but it works, and nothing EVER has worked for me. The suggestions she gave me prior to my temporary "dumping" of her had the OPPOSITE effect of what I needed to figure out my problems. This is why I have trouble not placing some blame on her re: retinopathy. So when I told her about what I was doing that was working, she laughed at me and told me it didn't make sense. :mad: She told me that I was either miscalculating food or had my rates wrong. I argued with her that I have 5 years of evidence to the contrary. If she pushed me much more I was going to walk out. I actually was thinking about how I was going to make an exit. Then she finally gave in and said, "Well, whatever works" (in a "you're-crazy-but-I-don't-want-to-argue-with-you-anymore kind of way"). I'm sorry, but her methods from the past made me 15 (270) at my post prandial and hypo by my next meal. My current method is allowing me to be 7 (125) at my post prandial and 5 (90) by my next meal. I'm NOT crazy. GAH!

*deep breath*

Anyway, there were some good things too:

- She told me she didn't have any suggestions for me and that I should just keep doing what I'm doing.
- She told me that, if I got pregnant today, she wouldn't be worried about my ability to make this a safe pregnancy.
- She seemed to know a LOT about diabetes and pregnancy and to be VERY committed to helping make pregnancy safe for mother and baby. I figure this is the one (and possibly only) reason that it makes sense for me to stick with her. (No...we're NOT trying to get pregnant now....just looking towards the future.)

Then to top it off, her nurse gave me a requisition form for an A1C instead of an ACR (i.e. urine test)....thanfully I noticed and corrected her. I just had an A1C done in Dec, so I didn't need one today.


Anyway....the walk back past all the vomit was kinda relieving. ;)

[Jan B]

You really are funny -- a good sense of humor can take away some of the pain! I think you did great! It almost sounds like she wasn't appreciating you challenging her, but figured out she couldn't actually argue with what was working!

I'm glad that vomit gave you some laughs for comparison (me too)!

I'm sooooooooo thankful for my current doctor.

When I lived in Kansas City, I had a mean lady endo, who was reputed to be the best around. I just couldn't take her attitude, but looking back . . . she really knew her stuff before most endos got it.

[notme]

I have my first appointment in over two years on the 12th Beth....... I like my Endo, I just had a tough two years and neglected my own health. I dread my appointment. They are treating me like a "new" patient. :(

[xMenace]

- She told me that if I was using more than 4 basal rates throughout the day I was probably scewing things up. (What do you think about that, John???)

So when I told her about what I was doing that was working, she laughed at me and told me it didn't make sense. :mad: She told me that I was either miscalculating food or had my rates wrong.

I believe theres an almost complete lack of understanding of basal rate behavior by 99+% of the medical community. There is a widespread assumption that basal requirements are flat with little bumps along the way: night time dips, DPs, and afternoon dips, but that these are minor and overall rates are pretty flat and consistent. Pffft! Of course many if not a majority of diabetics fit into this mold. I don't and I don't think you do either. As a Chartered Accountant you understand that the assumptions you've made are backed up by evidence. This is not a hack selling job by some eBay phishing sob crooks.

I'd be tempted to use your professional credentials in any arguments.

Then she finally gave in and said, "Well, whatever works" (in a "you're-crazy-but-I-don't-want-to-argue-with-you-anymore kind of way"). I'm sorry, but her methods from the past made me 15 (270) at my post prandial and hypo by my next meal. My current method is allowing me to be 7 (125) at my post prandial and 5 (90) by my next meal. I'm NOT crazy. GAH!


A good endo should say this. Mine certainly understands that if my A1C is good and I'm not dropping like a drunk diabetic fly every other day, that whatever I'm doing must be ok. There are no arguments against results.


- She told me she didn't have any suggestions for me and that I should just keep doing what I'm doing.


I have lots of suggestions for you ;) :eek: :evil:

[Gangrel]

At this point in my life, I see my endo as the person I need to tolerate in order to see my nurse..... (who is far, far more in tune with me)

I have to admit she's never pulled THIS type of thing to me, but given that she sees oodles of patients a day, I feel like something on a factory assembly line.... in, out, lickety split!

I agree with the fact she probably doesn't like that you challenge her. I mean, after all, SHE'S a certified doctor!!!!!! You're only a well respected Manager who's been a diabetic for 25 years after all........ [/sarcasm off]

You could always sic Murphy on her!

[belyro]

You're only a well respected Manager who's been a diabetic for 25 years after all........

26, actually....but who's counting? ;)

[tanyatype1]

Hi B, I'm glad to here that the appointment wasn't as bad as you feared, but it also makes me frustrated! I think it sucks being treated like that. Grrrr. I'd still put some thought into changing endos if I were you. Can you meet with another endo, just to get a "feel" for them, without actually taking them on right away as your new endo? I think that bedside manner's really important and so is trust ~ especially when you're pregnant! Blood sugar isn't the only thing bad for a fetus ~ so is stress! You have to periodically see your endo for the rest of your life so don't just settle. I think you should try to find one that treats you the way you deserve to be treated. (Shwew! I think my cheeks are burning!):-

[belyro]

I think it sucks being treated like that. Grrrr. I'd still put some thought into changing endos if I were you. Can you meet with another endo, just to get a "feel" for them, without actually taking them on right away as your new endo?

Thanks T. :) Maybe should have you come here and give her a talking to. ;)

The thing is, we don't have a ton of endos in town. A diabetic friend of mine knows at least one patient of each of them, and says that they all have complaints....if it's not one thing it's another. I don't know that I want to go through all that hassle of changing just to have something different go wrong at the next endo's.

[Gangrel]

26, actually....but who's counting? ;)


I was trying to make you look younger..... ;)

[Injecto]

Beth, that really sucks. If you've found what works for you, even if only for now, then THAT is the right choice, plain and simple.

I believe theres an almost complete lack of understanding of basal rate behavior by 99+% of the medical community. There is a widespread assumption that basal requirements are flat with little bumps along the way: night time dips, DPs, and afternoon dips, but that these are minor and overall rates are pretty flat and consistent.


I just don't get this, but I agree with you. If oh so many diabetics understand that there can be more basal needs during the day (I have 8 myself), then WHY oh WHY can't some "Doctors" who are so highly superior to us little sick people understand it? :mad:

Beth, you are on the right track for you. Your track isn't the same as mine, nor John's, nor Aarons (well, since WHEN is beer a proper treatment I'll never know :T ), and shouldn't be because you are a different person. I say good on you for finding your way now.

[gettingby]

B,
I think you are doing a wonderful job. You have found what works for you and are implementing it into your care plan. No doctor should laugh at you just because your way isn't the "proper" way.
I have to say that my endo is a good guy. We had our problems with my first visit to him (his bad bedside manner is what caused me to not go back to him for 2 years). Now, when I see him, he asks if I have any idea how to correct my problems. If my ideas aren't the norm, he has the decency about him to listen and not ridicule me. I think you handled this appt with the upmost dignity. Bravo !!! :top: :congrats:

[kgm0612]

Beth..........keep on doing what you're doing........It's working for you!

Karen

[gambi]

Beth..........keep on doing what you're doing........It's working for you!

Karen

I agree Beth, an endo should know that everyone is different and unfortuanately there is no one way street to treating this disease.

Look at my signature and my meds - does it make any sense? Heck no! But it works. If something it's working for you that's all that counts.

I'm acutally seeing a new endo on Monday, I was seeing PAC at the office but she wanted me to have a follow up with the Doctor - I guess legally they have to do that. I love the PAC, she's awesome! Sometimes I think they are more understanding. I am excited though to see this new endo, she a recent grad and very young so she I'm interested to see what her cutting edge treatment methods are.

Good luck Beth, you are doing fine!

[soso]

I wonder how she would feel to know her bedside manner compares unfavorably with 4 piles of vomit? lol......

Actually Beth, given enough time and a little attention paid on her part, she might start to learn something from you.... for myself, I congratulate you on your restraint.
I might have been tempted to make her a personal gift of one of the piles of vomit....have you ever considered a career in the diplomatic service?