Hi all,
I Just got back from what was supposed to be an appointment with a new Dr (because my previous Dr is quitting) but it didn’t turn out too well.
I briefly went over my history and asked if I should be tested for LADA. I showed her a printout regarding LADA and she asked me where I got it from. I told her the internet and she abruptly told me that she didn’t want me as her patient. I was shocked!
She said that she needed all of her patients to fully cooperate with her recommendations and diagnosis etc and not to be “looking on the internet” for their own information?
I really don’t know what to say or do at this point. This is the 3rd Dr that has looked at me like I’m some sort of idiot for thinking I might be LADA or at least get tested for it. In order to have the tests I need to be referred to a specialist but so far these 3 Drs think I’m irrational because I think I could be LADA and want to be tested?
I don’t know what to do at this point because if I mention to another Dr I feel he/she will also take a similar stand and make me feel like I’m over reacting?
Any ideas?
Thanks, Paul
You’re better off without someone so close-minded for a doctor.
Where do you live? Perhaps there are others in your area who can recommend a decent Endo.
I went to 5 GP’s before landing at an endo. Even she thought I wouldn’t EVEN be diabetic and I was a bit ‘mental’ & she gave me a referal for that!!! Huh, turns out I am diabetic, lack insulin production, insulin sensitive and she called me to tell me this on her vacation and to test me for LADA. LADA was neg thankfully for me. But I’m still where I am at.
Keep going…
My endo referal came from a diabetes RN who took one look at me, one look at my numbers quickly made me an endo appointment. Eventually if you keep banging on the door someone will open it. Don’t stay at a door that is closed (this idiot who told you about the net.) One thing that worked for me…tell them you just want labs to support or cancel out things for your own piece of mind. Silly, I know…common sense!!
Best!
Hi Shannon,
I’m in Ontario, Canada. I’m beginning to think that when a patient talks to their Dr about a certain condition/diagnosis etc which they aren’t too familiar with then this is why they seem to get upset; that I may know a little more than they do about my current medical condition.
In Ontario we have to be referred to a specialist. I cannot make an appt myself.
Thanks…
Hi Kathy,
Wow, 5 GP’s… I guess I will have to go through them all in my city until one looks at like I’m not crazy 
I’m not sure what the problem is because the tests would be covered under OHIP here (I’m pretty sure) so it would be just a matter of a Dr referring me to an Endo? At least this would put my mind at rest and stop me worrying about it.
Oh, well… Onto the next Dr I guess. This is my health and I’m not going to stop until I get an answer!!! No matter how stupid they make me feel!!!
Paul
Keep your head high. The doctor’s attitude is atrocious! I’ve encountered docs like her & sure we all have. They don’t want informed patients. They want sheep. Educated patients take more time, they ask questions, they challenge. We’re not children. I run from health care professionals who have a condescending, patriarchal view of doctor/patient relationships.
Diabetes is a disease of self-management. Good you found out right away about this woman before you wasted valuable time.
I’m sorry you experienced this. Inexcusable for her to make you feel stupid. You’re certainly not!
Any competent Doctor would want to get their diagnosis right and would welcome questions from their patients. This is a blessing for you instead of wasting your time with this Doctor you can move onto the next one. The good thing is at least she didnt string you along with multiple appointments.
The main goal no matter what Type you are is good blood sugar control and that you are entitled to normal blood sugars. How you get that should be paramount in the doctors mind. You need a partner not an adversary.
Keep pushing Paul, you will find someone out there that will listen.
When you make the appointment with the next endo, do NOT tell them which type you are. Tell them that you’ve never had a clear diagnosis. Step 1 will be for them to order a c-peptide and (hopefully) antibody panel. It would be irresponsible and (frankly) malpractice for a doctor to skip these tests when the diagnosis is unclear.
lol, what a twit. You can find a good endo, but it can be frustrating. keep looking!
Thanks guys…
These Drs are making me second guess myself now… They are supposed to be the specialists right? All 3 of them have had a problem with me suggesting I be tested for LADA. I don’t know anymore… Maybe I shouldn’t worry about it too much? But then I always have that nagging voice in me telling me to take care of myself no matter how many people make me feel I’m crazy.
Oh well, back to work… Paul
This exact thing happened to a friend who happened to blog all about it
http://babscampbell.wordpress.com/2010/01/25/the-new-diagnosis/
This has happened to me. I am type 1 and at my age (56 at the time) I am not afraid to speak my mind, this young Dr had an attitude problem. Without going into details here, my wife and I decided this wasn’t going to work. On the way out we told the receptionist that we are NOT going to pay and why and tell others to avoid him and make sure that he get this message. Type 1 is difficult to control and the more information you have the better. All GOOD Drs like a well informed patient.
Sid
While I can sympathize with all the views, my experience is very similar to Pauls and I now avoid telling any Dr I got information off “the web.” I always try to convey an attitute towards them that I am going to listen to what they say and follow their advice. If I quote any information to them, I have come to the conclusion is “must” come from a source they cannot refute, namely the medical literature that they refer to whether it be JAMA, Journal of Clinical Endochronolgy or my favorite, the guidelines from the AACE (http://www.aace.com/pub/pdf/guidelines/DMGuidelines2007.pdf). I try to pose things like, “I worry that I might not be a type 2, what do you think?” I have had a terrible time getting appropriate tests, discussing, pleading and cajoling for more than a year in order to get a c-peptide. When it came back low, I asked “What does that mean?” Unfortunately, with GPs, such adventures are generally well beyond their competencies. LADA? Unlikely you are going to find a GP to navigate you through a LADA diagnosis.
You need to ask enough questions and raise enough concerns while demanding their competance that you can get the referral to an endo. “Why is my blood sugar so out of control?” “How do you know I am a type 2?” “Why are my hands numb?” “Why is this medication not effective?”
Even then understand that you will go through the same thing with an endo, but they will be even more pressed for time and subject to alarm at your waving stuff you printed off the web. Make sure you appear to be a patient who will listen and be compliant.
Unfortunately, doctors often feel threatened by informed patients. In the end, diabetes is a chronic condition. Generally, the patients that do the best are the ones that are best informed and take care of themselves. Unfortunately, for the doctor, a patient can often ask difficult questions and even worse have access to detailed information, and this can be threatening to many doctors. It is rare to find a doctor that will engage in discussion about medical matters, they are the expert and you are a lowly uninformed patient. I instead put up a front protecting the doctors frail ego and then take their advice into account. They are after all my advisor.
Hi bsc,
As usual, your post if full of great advice. I think it was a mistake letting her (the Dr) know I got the info off the web. I will put it the way you suggested “I worry that I might not be Type II”…etc etc… “Can I be referred to a specialist”…
Thanks, Paul
It is the year 2010 and I can not imagine where this doc has lived for the last 20 years. She will have a tough time to find sheepish patients anymore. Before you drop her you could phone her one last time to ask if she had changed her mind. It is possible that she never heard about LADA and was just taken by surprise. If she has gathered some information about it after your appointment you may have this last chance (but I doubt it).
I would recommend to tell a lie to the next doctor: you have a close friend (actually this community) and he has LADA. All the symptoms you have are that comparable to your friends experience that he urged you to ask to be tested. No word about the internet - just deep concerns of your friend that brought you to the appointment. This way he will understand why you already have a possible diagnosis at hand. Then step by step you can drive him to the needed tests. Maybe you can offer to pay the tests for yourself if they turn out to be unnecessary.
Hi Holger,
Thanks, but I don’t want to go back to this Dr. She pissed me off (sorry) and I don’t want to see her again! I just wan a Dr that is going to help me (their patient) but that’s easier said than done.
I wont be quoting anything from the net but I do like your suggestion regarding a college with similar symptoms…
Thanks, Paul
Some doctors are intimidated by the internet - others are wary of it because there’s a lot of snake oil there - others just don’t like patients to take control - some are just know-it-alls with a God complex. Who can tell with this one?
One approach to take with physicians if you’re not sure what their position is, is to ask questions, lots of questions, rather than telling them things you’ve learned. This requires either writing down the questions or rehearsing them ahead of time. You should even consider asking them questions to which you already know the answer. Don’t cite “the internet” as your source if asked - cite a specific source (the Mayo Clinic is always a good one and usually has something on the subject. WebMD is another good one, especially if you see copies of the magazine in the doctor’s office. Don’t forget the Canadian Diabetes Association.). To any professional, citing “the internet” is too vague - you might as well say you heard it from a guy at the convenience store who’s mother had it. Remember that many physicians are more comfortable telling YOU stuff than having you tell THEM stuff. They want to make the diagnosis. You may have to lead them to it, but you need to find a way to do it without bruising their ego.
I’m not suggesting you need to take it from a doctor like the one you just saw. But you need to test their willingness to listen first before you start suggesting things to them. Eventually you’ll find one who’s ego isn’t threatened by your knowledge - or at least one you can work with even if you have to lead her around.
Also be careful about using terms or concepts that are not widely accepted in the medical community. If you’re going to use one, ask “Have you heard about xxxx.” not “will you check whether I have xxxx.” LADA, I think, is not as widely accepted a term as Type 1.
Good luck,
Terry
PS - I just read bsc’s excellent advice and will echo it here.
Hi Paul: The sad truth is that the majority of doctors are really ignorant of adult-onset Type 1 diabetes. It is a sad commentary that so many people come to a site such as TuD, get information on adult-onset Type 1/LADA, then go back to their doctors to get the tests to get a correct diagnosis. I think you have gotten some good advice from people here on how to avoid saying you got information on the internet. I will try to get some good medical references for you, so you can cite medical journals rather than the internet (there are a few good articles out there). As it is, you can certainly say that you don’t fit the typical profile of someone with Type 2 diabetes, but you do fit the profile of someone with adult onset Type 1, and could you please get the testing to get a correct diagnosis.
Hi, Paul,
Why do you think you might have LADA? Are you on any treatment for diabetes now? How are you blood sugars? LADA should be first suspected clinically (symptoms, history), and then can be confirned by labs.
Marina
I dumped my endo 3 years ago. I was with him for about 10 years. I have retired 3 docs in the course of my T1 time frame of 52 years. My last one was “his way or no way”. Everybody is not the same. What works for you may not work for me. My new endo takes my imput very seriously. I like that. I suggest you look around.
Ray