So, I have been going to a CDE at a high risk obstetric office for about a year and a half. I was really happy with her, but I think she might be having some personal issues because she’s gone on “vacation” for the next couple months.
Today, I saw a replacement CDE unexpectedly, and it went atrociously. She didn’t listen to a word I said. She was seeing patterns where there were none (something happening vaguely similar twice in one week does not a pattern make) and her solutions for those “patterns” was illogical. She thinks I’m going high at midnight and low at 3 am, so she wants to change the basal at midnight to make it higher, and lower it at 3am. I said insulin takes a while to work, that will make me drop more at 3 am, she pretends to listen, and then insisted we do it her way.
This is the biggest problem: she just doesn’t listen. I tell her I think the insulin is taking too long to work, coupled with the gastroparesis, which is getting worse with pregnancy, and things are happening 3,4,5 hours after they are “supposed to”. She ignores me after telling me how long humalog should take to work. So, I’ve been spiking 2 or 3 hours after lunch, followed by a sharp drop 4 or 5 hours after lunch, and I’ve been trying to adjust so the food matches the insulin time with various methods, but she just wants to increase the amount of lunchtime insulin. I’m already dropping from the 170s to the 40s within an hour, and I definitely don’t want to have a seizure or chug Pepsi with a little one on board.
I mentioned I was going to ask my endocrinologist about fiasp, and she didn’t know what it was, did a Google search, and then says, “it’s the same thing as novolog; I don’t see why you’d need that.” Ummm…pretty sure it’s produced by the same company as novolog, but not the same thing. She also implied a closed loop system would fix all my problems, well, not if I’m right and it’s a delayed insulin reaction and a problem with too much insulin on board.
Basically, it was a mess. However, I want to at least pretend to be compliant because I don’t really want a label on my file as “difficult” because if the doctors have a bad opinion of me in the delivery room before we even start, it could end up being fatal. But if I follow her advice, that could also be fatal if I drop too quickly either after lunch or at 3am. She insisted we had to meet again in 3 weeks. I’m wondering if I should just wait 2 days, keep doing what I do, and then cancel all the appointments until the better CDE returns. Am I just being stubborn and overreacting? I accept that I might be more upset than usual because of hormones, but at the same time, a mistake now doesn’t just affect me, it affects baby too. I definitely want to stay with the obstetric practice. Any advice?