Back to the Future...Sort of

This was originally posted to my blog, Diabetes Odyssey.

I had an endocrinology appointment today. I was kind of excited because I am now under the care of the very same endo that I had when I was in middle school all the way up through high school.

My regular readers might be whispering things like, “why would you want to see the same doctor you had as a kid when you obviously struggled so much with BG control and now have so many complications?”

Let me tell you here that I in no way blame my old endo for my problems today. I rebelled so bad as a kid, never checked my BG and left her with very little to work with. There is no way my endo could have or should have thought there were any other issues (PCOS) contributing to my BG problems other than my own behavior. I could tell then and can still tell today that she is one of the best endos out there.

Today’s appointment went very well and left me feeling very good about the future of my health and control.

We talked a lot about my BG patterns, pump settings, bad habits I need to break like relying too much on my CGM numbers and not checking my blood often enough, and not entering in all my carb and BG info into my pump and using the functions that are there to help me. We discussed my gastroparesis, neuropathy, heart, and other complications. She gave me a referral to a GI specialist and cardiologist. We adjusted my I:C (insulin to carb ratio).

She was blown away at how very insulin resistant I am. “You are super resistant! You take three times the amount of insulin in a day as an average type 1.”

“Yup.”

We talked about my PCOS and insulin resistance and weight troubles…

A happy side note here: after so much time dealing with unexplained weight gain (even though I was doing everything right to lose weight!) I am happy to report I lost 6 pounds this month! WOOT!!!

After all was almost said and done the doctor said she would like to get me a genetic test for MODY (Maturity Onset Diabetes of the Young). This is a subclass of type 1 diabetes. I have heard it loosely described as type 1 and type 2 melded, but this is not what it is at all.

I think she may be on to something here. I would be curious to know if I am MODY or not. I do have a history of type 1 in my family (6 of us total) which is a risk factor for MODY.

She first asked me to spend two weeks following the proper pump practices and also checking my blood sugar at least four times a day. Then in two weeks I’ll go back and see her again and she will decide if she wants me to go ahead with the MODY test.

The last thing she asked me before we ended the nearly hour long visit was how I am doing emotionally. This surprised me, I’ve never had a doctor ask me how I was doing emotionally.

“…I just mean…with all your health problems…you seem like a strong person…but how are you doing?” She more or less asked.

I felt really good to be asked this. I took a few minutes to tell her about my blogging and how much it has helped me to put things into perspective. And how much the DOC and TuDiabetes.org have helped me to learn so much. And just facing it all and actually working to be healthy has really given me a positive outlook.

She truly is a great doctor. She cares, she works with me, she knows her stuff. This is why I came back to her. Good doctors are hard to find.

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That is good ! You got her back. & good doctors are so hard to find,. I got the one I love back ! Last year I love her !. She know so much diabetes.

It’s amazing how great it feels to find (or in your case, re-find) a good doctor! I FINALLY found one I love! It’s a 3 hour drive and totally worth it. Here’s to better control! :slightly_smiling:

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Finding a good doctor is indeed hard. Even harder when you have to find a whole medical team that makes you feel supported. So glad that you have been able to re-find a great doctor.

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What else makes a “good” or “bad” doctor? Likewise, what makes us a “good” or “bad” diabetic?

Hi @Tamra11,

I’m totally happy for you but when I saw the title of your post, Back to the Future, the first thing that came to mind was the movie. One of my favs! :blush:
Then this came to my mind…
“Roads…where we’re going, we don’t need roads!”

:laughing:

Don’t know if you have ever seen Back to the Future, but its funny and such a great movie. Please see it if you haven’t ever. You won’t regret it.

Best wishes with your old/new endo!
Busybee

For me personally I have had many, many doctors in my life and through these experiences I have found what makes a doctor worth keeping and what makes them worthless for me.

A good doctor will be knowledgeable and be willing and able to share that knowledge (explain things to you instead of just prescribing and diagnosing without any explanation). A good doctor will listen to their patient, I mean really listen, (not just hear but dismiss) and work with me to figure things out and fix problems. And they will genuinely care about the whole you and not just the science and medicine. We’re human, not inanimate objects. A good doctor does not need to be a social happy butterfly, but they do need to look me in the eye and recognize that I am a person with a brain and a life outside of my illnesses. A good doctor is geared toward finding the root of the problem and not just treating the symptoms. A good doctor works at solving problems and doesn’t just throw pills at the issues.

A bad doctor doesn’t keep up with new findings, treatments, etc… A bad doctor is dismissive of the patient and tends to make assumptions about the patients knowledge of their own health, and not be willing to work with the patient to solve problems. A bad doctor does not bother to explain diagnosis’ (what is this illness? How did I get it? What will it lead to? What is it doing to me?) and why they are prescribing what they are prescribing (what is this medication/treatment? What does it treat? How does it work in my body? etc.), A bad doctor just “goes through the motions” and is quick to throw pills at symptoms instead of trying to actually work on fixing the root.

I have never had a perfect doctor and I don’t expect to ever have one because they are human and perfection does not exist. But I hold high standards to doctors because my life and health are in their hands. I am my own advocate, I study my illnesses, I am aware of tests, treatments, medications, etc. I aim to work with my doctors and I expect them to know and understand more than I do, I rely on them to work with me to figure out my very complicated and confusing bundle of illnesses and develop the best most effective course of treatment.

Every doctor has a personality of their own and every doctor has their own style, thought process, and a million other ways of, and preferences in, treatments they recommend. Each patient must find the doctor that suits their needs, personality, etc.

A good doctor to me might not be as much to the next patient. :slightly_smiling:

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As far as good or bad diabetic… I honestly believe the one and only thing that makes a bad diabetic is a person who puts zero effort into trying to take care of their diabetes.

Not trying is the only failure.

For me ! A bad diabetic is me. I do to, many things that make me one.

@Tamra11

Tamra, I teach pre-med students patient/provider communication. The medical school where I work prepares students to be primary care physicians in underserved communities. It’s a seven year program.

I read your powerful, passionate, post and I think it would be helpful to the students if I shared your perspective. I won’t use your name but I do think it is wonderful for the students to hear at least how one patient defines “good doctor.”

Thank you for sharing your experience. I applaud you for being your own advocate and doing the homework required so that you receive the best care. I applaud you for holding yourself and your endo accountable. It is indeed YOUR LIFE and you entrust YOUR LIFE into the hands of many clinicians.

Lastly and more importantly, thank you for helping me grow.

Best,

Jo

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I’d like to add my 2 cents re good / bad doctors.

I had been seeing a NYC endo for close to 2 years. In my allotted 15 minute visit session the following took place:
*weight, b/p, feet are checked.
*uses stethoscope and has me swallow while feeling my neck (Hashimoto’s ).
She will then sit at her Mac, look at my lab report, slightly comments and tells me she’ll see me in 3 months.

Very dissatisfied, I found the most wonderful (in my opinion) NYC endo.

With every visit his receptionist takes my PDM and does a download so the doctor can view my BG stats. I leave a urine sample and his assistant takes a couple tubes of blood.

When the doctor comes in he will take my PDM and tweak it; adjusting carb ratio and basal. My feet are checked and the usual b/p, etc

First visit he spent a good 40 minutes with me (the usual visit is 30 minutes).

He asks for reports of mamo, bone dexity, and any and all tests be forwarded to him.
At last, a caring, bona fide doctor who genuinely cares about his patients. I will continually sing his praises!

Also, first visit assistant ran an EKG and a breathing test which showed that in addition to peripheral neuropathy, that I also have autonomic neuropathy.

His office put me on the Mt.Sinai site that has my history and allows me to text the doctor about any concerns.

As for how practicing doctors operate, all I can say is “Viva la difference!”

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If you are trying to improve and don’t give up, then you are a fine diabetic. Just keep trying! :slightly_smiling:

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i been doing, more stuff to try & improve ! i’m one who like to give up.