I had my 3 month appointment with my endo nurse-practitioner this morning. It was, as usual, a good experience. We hear so many (legitimate) complaints about D care providers, I'd love to hear good experiences from others.
A1C is down from 5.6 to 5.5 despite eating much higher carb than usual on my cruise!
She spent a bit of time going over general stuff, then looking over my logs. She expressed some concern about my tight control, but then commented that I really don't have a lot of lows (my SD is ~20). She really doesn't want to see my A1C go lower, but only if it means more lows. Happy with my BG target of 90 (though she did say that with most people she wouldn't find it acceptable - too low because of risks of severe lows). I do have a lot of different basal rates (8), but again, her comment was that it seems to be working, and given that I feel great most of the time (D wise at least) and am hypoaware under 60 not to change anything. "If you have more lows, call. Oops... I mean make some changes and let us know." LOL. So nice to have an endo practice that acknowledges that I'm perfectly OK making my own changes.
My LDL is still well over 200, so statins were increased - I don't like it, but I'll do it. She commented that she likes that I email her articles, blogs, suggestions, etc. She likes hearing about products I use, like Opsite Flexifix, and about which sites work best for me for pump/dexcom. All the info I pass on adds to her knowledge base, and she can pass the info on to other patients.
Her last comment was that she only has one other patient who makes full use of the pump/CGM data as I do, and tweaks accordingly, and that it's another woman LOL. I'm not saying this to blow my horn, only out of surprise. There's so much info available from our devices, why not use it?? I'm reinforced in my belief that the TuD family is comprised of exceptional people, as I don't feel unusual here! You are all exceptional, thank you.
That is great news. I just saw my endo yesterday. She is very happy to let me manage my own diabetes. I feel very pleased to have found her. My previous endo experiences were a bit of a nightmare.
Yes, I have a very good working relationship with my Endo. My numbers are good so my endo pretty much gives me the green light to make whatever changes I need to make to keep my numbers good. He has expressed concern over my A1C being too low, but I completely understand the nature of his concern. We keep track of my BG profile and he is satisfied with my results.
The only issue that has surfaced my numbers were with my spot urine samples that showed high levels of microalbumin. He prescribed lisinopril, which took care of the problem but caused side effects that I did not like. When I told him I had bad side effects, he changed my script to cozaar and I have not had an issue with my spot urine tests or side effects since.
I think what makes our working relationshio good is that our expectations for each other are in line with each other.
I always have pretty good experiences with my current endo. She spends a good amount of time with me and asks me lots of questions. She's quick to admit when she doesn't know something and also quick to ask how I handle things. She has admitted that because she sees so many T2s, she often is at a loss for how to help some type 1s, especially those of us who are younger and very physically active. I think it's her willingness to admit she doesn't know something that I find the most refreshing.
As for using pumps and CGMs....among other things, I found the constant stream of data from a CGM just too much for me. I get your point about using it, but it started to make me obsessive (in addition to lazy, because then I would bolus based on the CGM, which was inaccurate most of the time on me). I'm not saying people shouldn't use them, that was just my experience.
On the one hand, if I need help, advice, or some micromanaging, he's willing and able to do it. On the other hand, if I want to handle it myself, he lets me. He's very personable.
He also promotes technology but doesn't push it. When I contacted Insulet regarding the OmniPod, the rep asked who my endo was, and when I told her, she said, "Oh, yeah. We know him. We work with him a lot." Same response when I told the Dexcom rep who my endo was.
Yeah, I had a similar experience with my endo, which kinda suprised me after my first visit. I mean, he's old school in a lot of ways. He still takes BP with a stethoscope and a mercury cuff for one thing. He seemed completly amazed by the fact that I could track my BG using an iPhone app.
My second visit though, he suggests I go on a pump, which he didn't push. He strongly suggested the Animas, which I looked at, but when I went with the pod, he just nodded, mentioned the area rep for Insulet by name, then told me he'd set it up. When I finally got everything up and running, he had no problem working through the PDM user interface, looked at the settings, then said he thought I would do well on it.
My Doc(not an endo) initially expressed surprise about the need for frequent testing in a T2, he figured once a day was good enough. But he noted the good results I've been getting and last time told me I was his star T2 patient, that he had learned a lot from me and that my treatment was a partnership between the 2 of us. My head swelled for a week or more!
It's hard to say how many medical professionals are really dispensing poor advice, I'm not sure we are a representative sample in that as a whole tuD members tend to expect better results and are willing to put in the work to get them.
Participation in tuD makes us more knowledgeable about our condition and speeds the learning curve greatly. Coupled with a health care professional who listens and observes ultimately the diabetes population in general benefits.
Glad you had a great experience. I go again on the 24th of this month. Excited to see what my A1c is going to be after being on the pump for 2 months when I go. When looking at my reports, Im averaging around 116.. Of course that includes the disaterous first few days with my pump when I was wanting to do it serious bodily injury, haha.So we shall see.
The plan : hold on to everyone on my present Team ( hope they will do same ) ... I am also very fortunate not having to deal with tooooo many insurmountable issues , 24/7 ...will know more by next A1C and other bloodwork results , 3 rd week of Jan . And I have learned a lot from you , Tu members , since 2009 !....almost celebrating 29 years with d .
Thrilled you have a good endo & a good relationship. Encouraging to be trusted to know what to do on your own. And, you clearly do! Awesome A1c. Mazel tov! I'm convinced that a cruise should be considered a management tool:)
Is your lipid ratio not good? My LDL is kind of high, but my ratio is good.
Judith , I am a cold place gal and have visited Alaska twice , both time cruises ...we are fortunate ..we have Vancouver to travel from ...never came down with anything health related ...am more concerned about flying and health !
Judith, I'm not a cold weather person, but I'd love to cruise Alaska. Been a dream of mine. Just stay out of the pool & hot tubs if you're worried about Legionaire's. No midnight skinny dipping on the ship:) Does Alaska have a high incidence of the disease? Seems that out on the water would be safe.
