I’ve been thinking about the various doctors’ I’ve had over the years. It has occurred to me is that I’ve had a lot of poor to mediocre medical care. Is it like this everywhere? How many times have you changed doctors?
Dr. O.B.-my first ob/gyn. She had a great bedside manner, young, attractive. The kind of gyn you never minded going for those annual visits. When I got pregnant, she was patient, kind, and even tempered.
Pop quiz: Which is less stressful, a glucose tolerance test or delivering a 10lb 7oz baby? Apparently Dr. OB thought the glucose tolerance test was more stressful.
When I got pregnant the second time I pushed for glucose tolerance testing in the first trimester, full on gestational diabetes. I was on insulin for the last 12 weeks of the pregnancy. She never suggested that I see someone follow up about my diabetes, so I didn’t.
Dr. Witch–Two years after navigating gestational diabetes and successfully delivering a healthy baby I started experiencing traditional signs of diabetes; exhaustion, frequent urination, and thirst. Having been down this road for a short time I dug out my blood glucose monitor and started testing. I didn’t have a primary care doc at the time so I contacted an endocrinologist directly.
I was right, I did have diabetes, she rattled off the diagnosis over the phone with a list of directions. I was in total shock! It was emotionally wrenching to know that I had been right, but to hear it that way was rough. I didn’t do what she said because I didn’t hear her. I was criticized by her at every appointment, and at one point she gave me a sample box of glucophage and told to take it if I wanted to. She was the doctor, wasn’t she supposed to determine if I took a prescription medication or not? I only saw her for about 6 months.
Dr. Bedside manner—I found the next doctor at a Diabetes Support Meeting. He was new to town and building his practice. He was an internist, very likable, great bedside manner, and friendly staff. So now I had a primary care doc, and help with the diabetes. I controlled my diabetes with diet for several years while in this Doctor’s care, but as LADA goes eventually a good diet wasn’t enough. He started me on the rounds of the typical type 2 drugs. I didn’t complain, he always had plenty of samples and that worked because I was only taking .5 a pill at that time. As the meds became a bigger part of my reality he always had plenty of samples. I asked him to write me a prescription and save the samples for someone that didn’t have insurance. No go, he just another baggy of prescription drugs. It felt a little like I was leaving a drug deal. I also realized that he wasn’t pulling the blood work that he should; only urine samples and finger sticks they could test in the office.
Dr. Beige—after four years I switched to another internist. She listened and did everything that the ADA recommended. She had me get blood work done every 3-4 months and we would spend the visit talking about the results. The LADA proceeded, although to date it was still type 2, and more oral meds where added and tried included metformin, actos, amaryl, and januvia. I begged to go in insulin for over a year, I had been on insulin before and the side effects of the oral drugs where at times debilitating. Finally, at one visit I saw the Physician’s Assistant, and she prescribed Lantus…thank you. That’s when things changed, now every visit was about what I was doing wrong. At one point I had nail fungus in/on a toe nail…she literally looked at it from across the room, please! I started to feel like I was an insurance claim, she saw me as an income source not a patient.
I lost my aunt who was 14 years older than me to hypoglycemia. Ironically the week she died I had two overnight lows in the 40s that woke me from a sound sleep. I made sure I didn’t have lows, and of course my a1C was up the next time. She didn’t want to hear about it, and wrote me a ‘script for an ace inhibitor (which lowers blood pressure). The highest my blood pressure has ever been off meds is 120/70…does she get commission based on the number of prescriptions she writes? That was the last time I set foot in her office.
Dr. Handsome—My babies are getting older and they needed a family practice doctor, not a pedestrian any more. The first visit was just a consultation and he told me that he would be quick to refer me to a specialist, and he didn’t want to see any of my previous records. “Let’s start fresh.” He pulled an a1C, C-peptide, and an antibodies test. I love this man, he called and told me he would like for me to find an endocrinologist to manage my type 1 diabetes.
Dr. Mexico—no, I’m not going to Mexico for medical care, but my new fantastic endo is from there. He constantly apologizes for his stumbles through the English language. He still communicates his desires for good Bg control better than anyone else. He’s talked pump, and CGM from the beginning, and wasn’t surprised with the mediocre healthcare I’ve received until now. He criticizes the ADA recommendations, and told me if you think your low I’d rather you put something in your mouth than drop too low and have a problem. He not only listens to me he learns from me, while I learn from him. He praises Dr. Handsome, and attributes him to saving me from the devastating side effects of the disease. All blood work is done after the appointment, and I receive a handwritten note from him with the results, so the appointment isn’t spent defending the test results.
As I wrap up my journey through the these various Doctor’s offices, It has occurred to me that all three diagnoses occurred because I pushed to find answers. What are you doing, or have you done, to be your own health care advocate?