Endo Visit?

Endo appointment was interesting today. "Do you check you blood sugars?" "Oh. 10X per day is a lot." "Do you really wear a CGM all the time?" AND THEN "I guess you never have to check sugar levels with a meter, then."

But the best part of the visit was when the doctor asked me if I knew how to make her recommended basal change--if not, she would do it for me. HUH!

I had to bite my tongue. WHY would ANYONE wear a MEDICAL device they did not know how to use? Especially one that can cause death if used incorrectly. What is the point of the technology if you can't use it?

Anyway, this was my 3 month Post-Joslin visit and I am in a much better, happier and healthier place for me. It has been a ton of hard work and heart ache, but things are better.

I have only hearsay from my endo's office nurse but I have been told that some people with a pump only use the basal that the office set for them and don't bolus. I have been told that some wear the pump but are too fearful to do anything "special" with it like the square or dual wave bolus, etc.
I don't know how they got the pump or how they are allowed to keep it. So, if your endo does not know you...then I can see the questions. But I can't see the "you don't need to use the meter." My endo wears a pump and cgm and he does not do multiple meter tests, however. He only calibrates and checks when the cgm indicates a very low or high. Of course, he is in pretty good control and I envy his waistline!

I would have had trouble biting my tongue too... !!! The way I see it is this; Just because they are Medical Experts doesn't mean that they know how to live with what we do, and they also cater to a wild range of people with varying levels of technical skill so it may just be natural for them to ask questions like that without them thinking about it.

In any case, congratulations on the 3-month visit. I am happy to hear that yet another TuD Member is in a better, happier, and healthier place in their lives.

It’s so good to read of your success! If think the inferences you make from your doctor’s visit questions are correct. I am amazed and surprised that the average diabetic has such low goals and interest in their health. I sometimes wonder what goes through the doctor’s mind when we demonstrate a level of interest and knowledge so different than the average.

We do have to keep in mind though that most medical professionals who treat Diabetes, don't live with it themselves. :)

When my testing frequency is challenged by the "medically Professional" I tell them it is my body, and I am willing to do the work to stay within non-diabetic range at all times. Sometimes I get snarky and mention that not only is it easier on me to be healthy, it is easier on the economy and my physicians if I don't need to deal with complications. I did have one MD say that she thought she would bring me to "show and tell" for her patients that whine and moan about how it's too much work etc...

Wow! I'd consider firing the doc who was that odd. I don't get all that much from them but there's certain standards and 10x/ day is a lot doesn't pass...

Another thought on the endo issue. I forget that I am fortunate to have an endo who only works with PWDs. Most endo's work with clients who have a whole range of endocrine problems. Right? Is that the case with your endo? If so, clearly not all of those really may "like" working with db. I can't imagine that (!) but it could be true. It might be interesting to know how many on the forum have endo's who have specialized diabetes knowledge even if that is only a part of their practice. But don't worry, I am not starting such a survey. Best of luck with future visits, Spock.

I’m trying to find a new primary. Had an appt today with a nice enough young woman but did feel “challenged” at times, like I had to defend my concerns.

Thank you so much, Richmatik and Terry. Support, on all levels is amazingly helpful, especially from this community. You made me smile!

1. I am appalled, but not surprised, that many PWD are ambivalent about the disease.
2. I think education and information, along with the will to live forever, is key.
3. I have had GREAT endos and BAD ones. This one is in between but better than the last bad one I suffered through.

I watched folks go through the office and my heart breaks to see the lack of knowledge, the lack of compassion from the medical team, AND the total lack of patient understanding about D.
I don't normally go to the endo often--once in a few years. But after Joslin and trying to improve, I have gone more. Made no appointment today. See what happens...

I got spoiled in San Diego - for years my endo was also my primary - so not a lot of explaining to more than one person ... I also had great insurance that covered my technology. I hD TO DO A LOT OF JUMPING THROUGH HOOPS WHILE GETTING USED TO THE NEW eNDO (WE MOVED TO A NEW CITY) AND THEY GOT USED TO ME. I THINK THEY NOW BELEIVE THAT 1) I KNOW WHAT I AM TALKING ABOUT, 2)I KNOW WHAT I AM DOING AND 3) I DO HAVE THE SKILLS AND INTELLECT TO DO WELL (mY GOOD a1c'S ARE DOUE TO MY EFFORTS - NOT AN ACCIDENT NOR A RESULT OF MAJOR HIGHS AND LOWSZ ARRIVING AT A GOOD AVBERAGE). I DO FEEL THOUGH THAT THERE IS STILL A "I HAVE THE POWER SINCE I HAVE THE rX pAD" GOING ON.

Ooops sorry - hit the caps button again.Don't fel like typing things over.
As a p.s. There is a reason for the term "endork"

It's important to remember that we are a self-selected group in large part. Not everyone out there is as . . . OCD as we are regarding management and control. Doctors have to deal with many, many patients who follow instructions by rote (if they follow them at all) with limited understanding or interest, so it's understandable that they have those conditioned reactions. Doesn't make it any less irritating, of course. But everything I've seen suggests that those of us who really take this head on and deal with it forcefully are a minority. Sad, but there it is.

Which came first, the chicken or the egg? Maybe the standard medical protocols and the way patients are treated have a lot to do with their behavior and the problems the are having. If they do as they are told, and it isn't working, the doctors typically assume that they aren't. Then nothing works for them, learned helplessness sets in, and they quit trying. Then the patient gets blamed.

Had I followed doctors orders instead of doing the work myself, I'd probably still be 60 lbs overweight, and on 3 T2 type meds plus insulin. My A1C would also be out of control.

There certainly is a cause-effect dilemma here. And you touched indirectly on one of my big hot button issues -- the tendency for a doctor to assume that when desired results aren't achieved, it MUST be the patient's doing. What a lazy, irresponsible cop-out. Grrrrrr.

I've worked with many physicians and am continually astounded by how LOW the knowledge level is for most of them- even endocrinologists. You'd be surprised how many Emergency Room doctors don't even know the difference between Type 1 and Type 2 diabetes. Whenever I start to feel that a physician doesn't respect my 25 years of experience living with this every minute of every day, I immediately jettison the relationship. Mutual trust and respect is very important to me when it comes to physician-patient communication.

This has been one of the many eye opening things about this condition for me. On the one hand hearing you veteran PWD having the same difficulties finding doctors you feel comfortable and confident with makes me feel better, like its not just me because I’m not fitting neatly into a T1 or T2 box. On the other hand it worries and depresses me. Although the truth is, good compassionate medical care for chronic disease in general seems to be hard to find for many no matter what the illness.