I have never came home crying before from an appt. How do you make a doctor listen to what you say, you can do and what you can't? I can't do the bolus insulin. I can't make judgments like that safely. I am terrified of giving myself to much and having emergency. I told him other options I was given to go with this lantus that were safer and something I could do. But he kept saying we were going to bolus. I kept saying no, He finally said o.k what do YOU want? I told him what I wanted, he said o.k .......we will bolus! He also argued about giving e referral to an Endo in another city closer then where I have been going and he said I don't need specialist, he is just fine with me. I told him I wanted referral please, he saw I was almost in tears and said fine, do you have one?? I said no, you have it. He said he didn't, but would send letter off to hospital I was changing to. then he said we would bolus, see you in afew weeks.
My sugars are in 10's-20's and that is all day, he say we are going to get fasting's under control first.They are 8-9's. But for now I stay high for afew more weeks. AHHHH, very frustrated!!!, what would you do?
I'm very sorry you had this experience, hb; going to a doctor should never feel like that. Your doctor seems utterly incapable of hearing your concerns and responding to them in a reasonable let alone caring matter. I absolutely agree you should see someone else.
Having said all that, and truly believing your doctor is a jerk, I have to say, he is probably right. (In what he's saying, not how he's saying it). If You are in the 10's (180) to 20s (360) all day, you need to do something to get those numbers down and a basal/bolus regimen is the way to do that. Your fear is understandable and we've all been there. I had a bad experience when I first started insulin and it made me frightened of going low. So I started to bolus like a person with goose bumps going into cold water. I stuck a toe in at a time. One unit - still way too high - kept that up for awhile - 2 units, better but too high - did that for awhile. Then I spoke to Gerri on here who explained to me how to figure my correct bolus doses. Knowledge is power. I felt much more confident when I knew what I was doing. I was still very cautious and conservative, but after awhile I just started to swim - and you know how it is, once you get acclimated to the water, you don't feel cold!
Many of us have learned a lot from Using Insulin by John Walsh. Personally, I learned a lot more from that and being on here than any doctor. I learned how to figure my I:C ratio so I was taking the correct dose for what I was actually eating. I also learned the "law of small numbers" of Dr. Bernstein: The less carbs you eat, the less insulin you need, the less chance of screwing up badly. I don't eat true low carb for various reasons but I keep it under 100 a day and that helps. I take about 20 units of insulin a day, basal and bolus. I'm on the pump so that makes it less, but on shots it was only about 25. As far as lows are concerned, the great majority of them are easily recognizable and easily treated. Just keep glucose tabs around and learn how many you need. For me, I take 2 if I'm in the 50s, 3 if lower. You may need more or less depending on your size for one thing.
Don't let the jerk doctor get to you. Find a caring one and then, with the help of Using Insulin and 20,000 knowledgeable diabetics on here, stick your toes in the water. It will get both easier and better, I promise. Your profile is set to private so I don't know how long you've been diagnosed or which type you are, but if you want to talk 1 to 1, friend me and we can chat.
I would think that bolusing might help? It can be hair-raising but if you pay close attention to your numbers, perhaps using your concern as a "lever" to negotiate more test strips, you might feel a lot better? It's not clear if this is T1 or T2 but if it's T1, bolusing will help a lot and is sort of mandatory I think? It sounds like the doctor sort of freaked out, which is sort of lame for him professionally but I hope you can find a better doc!
Just a third vote for finding a new doc and trying to use bolus insulin. Trying to bring your numbers down just using Lantus is more likely to cause severe lows than using a basal/bolus routine. A bolus is in and out of your system in about 4 hours or less. Basal insulins like Lantus hang around 12-24 hours which means that they are much harder to fine tune. If you use enough Lantus to bring down the post meal highs you may find yourself running low between meals.
Zoe gave very good advice about starting slowly with your bolus insulin and making small adjustments until you are closer to where you want to be.
Good luck,
Maurie
You are upset for a reason. And it isn't the doctor. It is that you have a fear of hypoglycemia and it is out of control. It is so out of control it is messing with your ability to think objectively and properly take care of yourself.
And your doctor doesn't understand. And he likely won't ever understand. And chances are, seeing another endo won't help. Why? Because the problem is in your head and an endo is totally unprepared to help you fix this. Most endo's just are not trained to help you through your fear.
Your fear of hypoglycemia is more common than most people think. One review of literature found this condition actually be widespread. This study found that Cognitive Behavior Therapy (CBT) to be helpful. There are many therapists that understand this technique. You need to work with someone to face and surmount your fears and figure out how to take care of yourself. I don't know where you live, but we have a fellow member Jody in the DC area who does this sort of thing. She has a website which describes her practice.
You are brave for coming here and I hope this helps. Please think about contacting Jody, even if you aren't in the DC area, I bet she can suggest some things for you.
It is the dr.who I am upset with. I had the same dr.for 4yrs who called my endo for pretty much every change we made and ran it by her. I trusted that dr. but he moved. So now I am with the new guy and he hasn't once called the endo to see what we should do. He said we don't need specialists and we don't need anybody else, and we are fine with me being high for another few weeks!...??? I told him I don't feel good and am tired all the time, I need to get my sugars under control. I also told him at the first appt, we ever had that I had disability ( FAE). I have trouble remembering things and have to work harder then most at getting this stuff right.I write absolutely EVERYTHING down. I am scared also of having lows, VERY MUCH. But I also have my limitations and bolusi is abit much for me.
Is it true you have to be within 20min of a dr. if your on insulin? If not then is 40min o.k??? That is the next closest dr. and then I can get rid of this guy.
First thing........relax. A new doc is in order. I agree with the advice here. The one you have now is a jerk!
So let me apologize. I misunderstood you. I thought you didn't bolus because you are afraid of lows, that is not true. I am sorry. You have every reason to be upset with the Dr. Your doctor needs to understand your difficulty with learning and remembering this stuff. You need a "system" to help you with this. And your doctor should be able to help you with this.
If you are willing to have some things "fixed" in your life, you could make things simpler. It won't be perfect, but it will be better and you should feel better. For instance, would it be ok if you mostly ate the same things all the time? If you do that then you could just take the same insulin every time and not have to do all the math to figure out a bolus. I think many of us would be happy to help, but you really someone who can sit down with you and go through this.
I know you "told" your doctor that you had a disability, but he also may not have written it down or remembered. You may need to remind him. Just because doing a bolus is easy for some of his patients, it is not easy for you. And if he continues to not be helpful, then you can get another doctor even if that doctor is 40 minutes away.
Another posibility is for you to see a nurse or diabetes educator. They may be able to help you figure out your insulin and they "will" call your endo if needed.
I hope that is helpful. And I'm sorry for misunderstanding.
no one has ever told me to relax......
.......good advice :)
thank you...