How do you benefit from your endo visits?

We’ve had 11 years of visits. Caleb started at the Yale Diabetes Center. It was a great place at the beginning when we needed our hands held. The 75 minute drive became hard to justify when our meetings became more the clinic wanting to hear how we were able to make OmniPod work for someone so little and less about helping us since we were pretty much on autopilot. At that time, there weren’t many (any at Yale) young kids on OmniPod.

We got a great CDE (previously from Yale) right in our city. That was perfect. We were there for several years, but meetings were lengthy and little more (who am I kidding, nothing more) than a collection of Caleb’s data which I was interviewed for despite the fact I came prepared with it printed out in an orderly fashion with comparative data and analysis. We didn’t go back after she answered her cell phone during our meeting stating, “it was a client.”

My children’s GP is also an endocrinologist. Leading up to the cell phone incident mentioned above, I found Caleb’s annual check ups more useful for his diabetes care than his specialist visits with the CDE. His doctor was interested and provided insight we weren’t otherwise getting. I decided we would use him as Caleb’s endo henceforth.

This doctor has helped us through litigation with Caleb’s school district and provided guidance as Caleb has become more autonomous with his care and given good suggestions as we prepared for Caleb’s solo trip to Europe. For the last several years there has always been something out of the ordinary to ask the endo. I tend to drag out the frequency of Caleb’s visits to as few as twice per year and one of them is combined with his annual visit, so there has always been something “extra” to talk about.

Until yesterday. It had been six months since Caleb’s last visit (just prior to going to Europe) and I figured we really should check in. But I didn’t have anything to discuss. We were there for an hour - nurse updated his records and vitals (he grew two inches in six months), updated prescriptions, he had a blood draw, dr looked at dexcom, Caleb discussed current trends, no recommendations made. I asked about new insulins but he had no insight. There was nothing pressing or unusual to address. Doc suggested seeing a dietician. When I asked why, he said just to see what they have to say. I guess that couldn’t hurt, but I don’t really understand how it can help. Caleb’s A1c is great, and he eats well.

It seemed like such a waste of time.

What do you get out of your endo visits? Maybe I can get a refreshed perspective on how they can benefit Caleb rather than feeling like I’m just checking in with his drug dealer.

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I wanted to get in here before the doctor bashing starts. I must say it really depends on what you want from your visits and if you get that during each visit. I see my endo every 4 months. I send my Dexcom reports along with my list of questions or concerns a week before and I also have labs drawn a week before so we can discuss any problems. My medical team is very up to date on all the newest stuff happening and always keep me in mind for new clinical trials I might be interested in. But my biggest take away most visits, I hearing that any changes I have made and the decisions I am making are on target. It’s nice to hear a doctor understand that I the person with the diabetes has a good handle on it. And with a disease like this that can really beat down your mental welling being, it’s nice to hear, “you’ve got this” “you are making the right choices” “ you are doing a great job and call if you have any questions “. I love my doctor and feel we are a great team. Yes, he is my “drug dealer” (love that phrase, fits perfectly doesn’t it?) but we do work well together and he knows I do need those big pats on the back for all the hard work. It’s amazing how hard we work for nothing to happen! Nice when someone recognizes it.

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I only do it because it’s supposedly necessary for insurance to keep filling prescriptions. I don’t get any big insights from them.

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Thanks for mentioning this - I didn’t intend for this to go there, but can see how it could! I do like my kids’ doctor, and he’s been there for the important stuff, and he is really good about telling Caleb he’s doing a good job. :slight_smile:

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Absolutely. Your numbers tell you the story, but it can be a boost to hear a professional confirm you’re doing fine.

Also, I can tend to get tunnel vision when trying to fix a certain problem. My CDE sees at a glance the big picture and with +25 years’ pump experience can suggest a tiny tweak somewhere else that fixes the problem – something I would never have seen.

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  1. I get free insulin from doctor’s office at each visit
  2. I get my Medicare covered items such as infusions sets and Dexcom supplies by seeing my endo every 90 days.
  3. I get my Rx’s filled w/o question due to my regular visits

that’s pretty much it. My doc doesn’t need to help me keep my bg’s in control, so usually we just chat about other things.

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Getting goodie bags like this is a good incentive. :wink:

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I don’t get a lot of help from my quarterly visits to the doctor’s office. But then again, I am lucky enough not to need much help.

I just went to a quarterly visit yesterday and saw a physician’s assistant (PA). I told her that I don’t need help with blood glucose control tactics as I think I’m doing well enough. I also told her that if Medicare did not require regular 90-day visits to cover my diabetes supplies, I would likely limit my appointments to once per year with an occasional as-needed visit thrown in. She understood my sentiment and did not take offense. I like her active listening style and kind affect.

Moving forward, I’ll see the endocrinologist once per year and the other three visits will be with the PA. One thing I find helpful with these visits is to get a lab blood draw each time so that I can verify the accuracy of my blood glucose meter.

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My visits are similar to Terry, except now going only twice a year. I had a great endo a few years ago, and after she retired, switched to another endo in same practice. It’s been a slow transition to get new endo used to my expectations. Bottom line is that he and staff continue to keep my supplies / RX up to date and no delays on approvals or insurance issues. They occasionally download meter, dexcom or pump, and I get a nod, and told, all looks good.

I would turn the question around. How does your ENDO benefit ? My hope is that he realizes 5-6 A1cs are possible without lots of highs and lows, and it helps him with other patients on their journey for lower A1cs.

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What benefit?

Check into a hospital with a major issue. The benefit of having an Endo can be good. Check into a hospital where the Endo is on staff? Priceless.

I am with you Sally, i base my choice of providers on the emotional and mental support as much as the medical. When it is optimized it is a true partnership. I have been listening to Radical Candor podcasts and find their approach to improving relationships masterful. Perhaps employing some of their feedback techniques with our Doc would help the original poster.

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My visits are generally nothing more than a general health-check and data collection, and I’m okay with that. I think of it as more that I’m managing things well. I know that they’re there if I need them - like when I had to challenge my work insurance to cover CGM supplies. It’s also nice to have that secondary review to make sure you haven’t missed something, or to bounce a new idea off of.

To be honest, I mostly go because it’s an excuse to go get blood drawn and then have an additional comparison point to the data I’m already collecting from finger tests and my CGM. If it weren’t for the appointment I probably wouldn’t make the time to do it, I travel a lot for work and my schedule is hard to juggle at times. (I could be away for 2-3 weeks in the US at a time, or other times a month overseas in the Middle East/North Africa, only to get home and fly out again a few days later…)

Often times, whether it’s because I like to keep up on trends or because of things I read on this forum, I am more up-to-date on things than the team is so our conversation will be about things coming and thoughts on them.

Sometimes I walk away with a new meter, or some other freebie from my Diabetes care team, but generally these are things that I could have obtained myself elsewhere and it was just opportune to grab it from them instead while I was already there.

I guess I should also mention that I do have to see them a minimum number of times a year in order to keep my pump coverage from the provincial government. So there’s always that aspect of it too. :smiley:

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I can understand how you feel. When it comes to my diabetes I know all there is to know and I am on top of my own diabetes care, so it’s not like I’m going to get ‘taught’. But I do find that my endo can and does put things into another perspective for me when I get stuck in ruts or on one point of view that may be making things more difficult for me than they need to be, etc… Also, this may not be something you’ve experienced yet because of youth, but my endo is on top of labs and examinations and has caught, on many occasions, complications that I had yet to notice symptoms of (complications can happen to any diabetic, even well controlled ones). It can feel tedious, monotonous, and even worthless to see the doctor on a regular basis, but a good endo is keeping track and eyes on things you are probably not even thinking about or aware of. I find seeing my endo helps to keep me on track and keep things in proper perspective, and she helps me keep my priorities straight and in sight. And then, as you mentioned, there are the prescriptions, LOL.

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My endo is my cheerleader. Most of the time she emotionally pats me on the head and reinforces that I am doing a good job. But I know that she is there if I ever need her expertise medically. Now that I am on Medicare, I must see her every 3 months after years of very 6 months. I always leave my appointments feeling better than when I walked in.

This is a blogpost that I wrote two years ago. It is one of my favorites.

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At our visits, my endo goes over all my bloodwork, we talk about my thyroid medication (and he periodically mentions other treatments) and my pump settings. He goes over my records and usually says that I know as much about diabetes as he does (he’s T1 himself). He checks my blood pressure and weight. At my last appointment my blood pressure was very high, so I was prescribed medication for that.

We usually spend a good chunk of the appointment talking about new diabetes treatments, studies, and technologies. This past year has been really busy in that regard, because I’ve had lots of things I want to try and some of which I want to get insurance coverage for. I often also need prescriptions renewed and referrals to other doctors, like my ophthalmologist.

I almost always feel great and healthy and extra confident after appointments, with the exception of some non-diabetes stuff like thyroid or blood pressure where I end up needing a new medication and feeling like I have yet another health issue to deal with. But seeing my endo is by far my favourite medical appointment, and I don’t think it’s a bad thing. I see my endo every three to four months, but if it weren’t for my thyroid (and now blood pressure) concerns, I’d only be seeing him every six months.

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That’s quite an accomplishment … for both you and your doctor!

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I guess there’s also the added benefit of someone other than you having up-to-date records in case they’re ever needed. (Hopefully not though!)

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You guys gave me exactly what I needed. We’re independent. We do all our adjustments on our own. We could send in our numbers weekly for suggestions, but there’s no need. I should be content with the fact there there isn’t much to talk about - that’s good news, right?

Caleb’s doctor is great, but we’ve sacrificed something because he is not fully dedicated to endocrinology. There are benefits to having him as our primary care and endo, but also the other side of the coin. This balance we have does work for us, particularly since picking up the phone for another patient during our visit does not work for me. :slight_smile:

Thanks for all the feedback. I’m inspired by your relationships with your medical professionals. You’re all so responsible! Kudos!

We see a Pediatric Endocrinologist and I am already nervous about when we get the boot from the practice for being too old.
Wondering if we can get a faked birth certificate online and buy ourselves a few more years…

lol

Although we see quite the handful of specialists, we tend to use our Ped Endo as the focal point and make sure any other care is coordinated. I have asked our Endo for suggestions on obviously non-Endo matters as sometimes it is just not clear for a Parent (non-doctor) which specialist is the proper one to request to see for a given issue.
We rotate between a (specific) Endo Nurse Practitioner (three times per year) and our Pediatric Endocrinologist Doc (once per year) and love them both. Once we did have a different NP with whom neither me nor my daughter clicked with at all. (My daughter and I were giving each other “looks” during the appointment - it was kinda funny.) I simply never made an appointment with that person again.

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Do you know what age limit is imposed at this practice?