[ant hill]

Originally Posted by BlueSky

I went to see the endo yesterday. I have been seeing Rick for about 10 years and we get on well. So I never miss the annual appointment, even though I know that I will most likely be told stuff I don't particularly want to hear - like I should be taking a statin and I should maintain higher blood glucose levels .

Hello Blue Sky , I too should be taking a statin and I am so against taking drugs that I would alter my eating habits instead and exercise and I am laking in doing *Slaps wrists*
My A1C is 5.8 and that's good but I should look at 6 and we should be congratulated on that.

Anyway, he agreed that perhaps I don't need to worry about the cholesterol. LDL has come down from 4.3(167) to 3.1(120) over the last 2 years, in spite of getting no treatment for it and eating lots of saturated fat. All we could attribute this reduction to was lower stress levels and improved sleep.

You should be very happy that you can do that as for me is to get active again and shake the chassis of fat!!.

The HBA1c came out at 6.0%, which to me was a pleasing result. Rick always cautions me not to try too hard because of the hypo risk. The DEs get quite edgy about it. And I have to keep on reassuring them that lowering the HBA1c is not an end in itself. It is the result of reducing variation in blood glucose levels, which means fewer and less sever hypos too. I told them emphatically that I hardly ever have hypos anymore.

Do you get a printout of your BG's to your endo BlueSky and show him that you don't get that low? I know that I get a few.

I was having some difficulty articulating all this. And Rick had noticed some perspiration while he was taking my blood pressure, which was lot higher than it usually is. So he tested my BS and it was 2.5(45) . That was very embarrassing.

Oh That is certainly embarrassing

I think I lost that round of the debate. I had had a hectic morning and over corrected a high before leaving the office. What I didn't tell them was that I had done the correction into a muscle and it had worked a bit too well. Maybe Rick is right - I shouldn't try so hard .

We are indeed human Blue Sky and I see that you are right on top of the diabetes and it is some what controlling you so just relax and don't be too critical over your BG's
I see in your posts that you are good in your control and you don't need to stress as you are like me in experience as I have had this for 37 years and I have a short fuse that I have to curb to calm down.

[Subby]

Hey bluesky, people seem to have some good things to say here (yourself included). I just wanted to point out that it seems common to feel you have to be "up to certain standards" (whether higher - or lower) for doctors - this seems especially the case with diabetics for whom their coping with the condition is intimately entwined with who they are and what they do with themselves through daily life.

Having said that, I wanted to say I know exactly what you mean when you hint at a slight (if, affable) adversarial tone, a defensiveness, with the endo, that occurs when justifying or revealing your own approach, or your own mistakes, warts and all. This should NOT be the case, try and remind yourself of that. It shows the situation as maybe being a bit too compromising and vulnerable... and I've been there with my endos many times. One sign of a good endo is when you see them reminding themselves "I don't live with this blasted thing... there is a limit I can criticise this patient's approach". And even the endo's who are excellent at maintaining the correct respect of a diabetic's philosophy, WILL have bad days when they go to far. I'm trying to say, this is not all your "bad". More, a kind of personality clash, brought on by a number of dynamics including an often innapropriate dr-patient relationship, considering the complexities and responsiblities of the condition, then perceptions on either side, compounded by a brief meeting that is supposed to "achieve" somthing.

As someone above pointed out, due to the brevity in which he has contact with your condition, the doctor simply cannot grapple with the realities of living with your condition. There is no way he can decide the best way for you to "assimilate" the ideas of living with/controlling/being alongside/being in relationship with/being at peace with your diabetes. This is different for all: for those of a more straightforward bent it is probably an easy answer of "you do this and that and get on with life". For those who find diabetes rearing it's head physically and psychologically with regularlity, and those who do think a lot about the world and themselves and how things work and how many options there are out there and how to chose your own path - doctors can hopefully respect and fit in with that, but they should never make you feel foolish for neither sticking your guns and going your own path, nor anything the blasted thing springs on you at any time.

Gees sorry for the wandery post. My real point is, putting aside personal feelings for a moment - did you achieve anything therapeautically with your doc apart from a bit of negative vibes hit? Maybe you guys had it great but it's a bit stale now, or maybe he is a bit sick of being "understanding" (understandable!) and prone to antagonism? If you stand back and assess this visit (not the previous ones), would you be satisfied to see it happen again in the future?

[shiftzor]

It’s like one of my tutors at university, when asked to remove words from my essay, put a line through big chunks. I had sat for hours trying to remove words and struggled. Doctors have this same outside overall picture that a patient cannot have because they are so deep in the problem, however unlike my tutor they don’t have an intimate working knowledge of the subject.

Doctor is only trying to make you take a step backwards and reflect. As long as you’re happy with the way things are going then keep going. Injecting into your arm is a calculated risk that you have consciously taken. If this helps you’re control and if you believe it is a worthwhile risk, then I can’t see anything wrong with that.

[johgn]

I'm amazed you intentionally put a correction into the muscle. Obviously you know what you are doing but I didn't think ANYONE did that, interesting. I do see the logic though.

[Alice]

We all have had these "ironic" doctor's appointments...I wouldn't worry about the 45 too much. Most important is how a doctor reacts to that number. Those that overreact and act like it's the end of the world...well, those doctors aren't for me. I think your doctor was very perceptive to notice that you were still attentive...yet something was just slightly to the "left" so to speak. I'd say good for you and good for the doctor for having a good relationship.

Don't worry, I've sat outside the lab for my quarterly A1C test waiting for my glucose to drop...just so I'd have a "perfect" number on my lab sheet. Personally, I could care less what my number is at the time of an A1C, but my last endo looked at that number first. If I hit a 190 one morning, that would be the morning I was scheduled for the A1C...never the other 6 days when I was always below 100.

I always get "white coat syndrome" in doctor's offices...with the exception of my latest venture to an ortho. Something about Type 1's especially, we tend to be overachievers and feel we are being graded...and judged...and, we often are, unfortunately.

It's just Murphy's Law.

[SharpTail]

johgn...I believe this is where intramuscular injections for corrections was first discussed. It seems with a little caution this is a good option to accelerate the action of the insulin.

High Blood Glucose, very fast correction

[Harold]

Mark, I have never figured out why things go wrong when it comes to doctor Office visits. When you figure it out please let me know.

[CrazyGramma]

Newbie, here. I am so annoyed that I am at work and cant take the time to digest all of these messages. I have found a place where people live and feel the way I do. The support shown to each other is quite overwhelming.

[shiftzor]

Originally Posted by Harold

Mark, I have never figured out why things go wrong when it comes to doctor Office visits. When you figure it out please let me know.

I think there is a big advantage to having one doctor you know and trust, which works with you and knows you. In the UK you see a different doctor each time you visit, however since there are few endos you tend to end up seeing the same one.

Originally Posted by McCaffrey

Newbie, here. I am so annoyed that I am at work and cant take the time to digest all of these messages. I have found a place where people live and feel the way I do. The support shown to each other is quite overwhelming.

We are all in it together.

[Eddy]

Originally Posted by johgn

I'm amazed you intentionally put a correction into the muscle. Obviously you know what you are doing but I didn't think ANYONE did that, interesting. I do see the logic though.

My thanks to BlueSky for mentioning that he did it. I'd wondered about IM insulin injection... but never tried it, as I'd not researched it enough to feel comfortable yet.

Since reading his post, I've attempted a couple IM shots (bicep and pectoralis). I think I just barely hit... but I can tell that it will take a needle longer than 8 mm to get a good IM.

FWIW, I believe have inadvertently shot Lantus into muscle. That is no fun... fighting hypos shortly afterward, then running high the next day. Yuck.