Terry, are you my long lost twin brother? My sentiments exactly. Sometimes it is hard to go in "there" with a good attitude when for a long time (until I hooked up with a great CDE in the practice) I was accused of blatant D mis-mgt (he didn't believe good A1c's are possible by mere non-MD people). But I am as cheerful as possible and try to go in with at least one new good joke or anecdote.
The last 2 times I needed my Rx's renewed, I used an online doctor service. I filled out the medical history, then connected with the doctor. He asked what he could do for me, I told him I was running out of insulin and meds and needed my Rx's renewed. He asked me about 3 questions, the last one was what pharmacy I wanted the Rx's sent to. I emailed him a list of Rx's. He called them to my local pharmacy and I had my granddaughter pick them up than evening. I never left my room.
I wasn't aware of such a service. I'll have to file that one away for later reference.
I don't think they appreciate that some of us work pretty hard to do what we do. That's an impressive A1c! Is it your lowest to date?
I'm working hard to get mine down, too. I'll get it tested in the next few weeks. My cgm shows a 103 mg/dl monthly average with an 86% time in range and a 110 mg/dl quarterly average with 78% time in range. My meter is showing a 102 mg/dl 30-day average. If those numbers predicted A1c well, that would come in at 5.3%. I think it'll come in higher, we'll see. Maybe my red blood cells live a little longer than average.
Also type 1 is often treated as being more serious "If you don't take insulin, and dose it exactly right, you WILL die. no questions asked" Where type two is often treated with "Just take this pill and check your bloodsugar once a week." Some doctors seem to put it in the same category as high cholesterol. If a patient just hears that from their doctor, they wouldnt try to look for a support group.
yeah that would actually be pretty useful
I was "demoted" years ago with my doc when my A1c stayed in the 5 to 5.2 range and the BGs remained in the "normal" ranges for most readings. I prefer a doc who is interested in the meter, not the 3 month which we learned in the early years was skewed with ups and downs and a dx of hypounaware.
Anyway, I don't have Medica** anything coverage and my insurance pays for ONE wellness visit each year. Doc writes RX for a year because she's pretty smart and knows my diabetes isn't going to go away. So....I will say again I am fortunate in my diabetes care providers.
If Medica** pays for 4 visits a year and a lab draw then okay. What harm is there to go other than a hassle. I don't have a choice in going for a blood test and visit with a NP every month or so as I wear another thing that needs testing that can't be done on a home meter, and not knowing the numbers in this gig could be very harmful. These simple tests and visits are not inexpensive and I hope when I get to Medica** they are paid for!
The CMS is an excellent resource, so thanks Shadow Dragon for the link and reminder.
I've had like 2x 5.1s and 2x 5.0s since I did the big basal brouhaha, with the 1/2 hour intervals. Before that, I'd run 5.2-5.4 since I'd had the CGM and then 5.8 w/ the pump and paying attention to what I was doing.
I got a formula from Dr. Ponder, multiply your average by 1.03, then add 46.7 and divide by 28.7 to get your A1C.
I think that we should be able to get what we need without rx and doctors should be consulted for advice/council/diagnosis. I've believed that for a long time, even more so now that I need insulin and other materials just to survive.
I would still visit my doctor for council/advice maybe 2-3x per year would be better than 4, but with diabetes and all of the complications I have already had I won't take chances with too long in between blood work and some council. Since I've started on a pump, things are monitored more closely and I think I'm actually required now to go 4x per year, which is what I have been doing, at first I was going more frequently as I recovered. I read the 4x per year requirement somewhere in the Tandem info I think. I'm uploading my pump data weekly for advice from my cde who is helping me a lot. We usually communicate via email.
I say this also being fed up with having to go to way too many docs lately with other issues..I only visit my endo twice a year. She writes the rx for a year so in reality I could avoid going for an entire year. But she is smart and I appreciate her input and always feel like I'm part of my team not just following "orders". I also see my CDE twice a year. We go over the various reports from the various devices I have and then chat about great recipes for low carb treats. I have hand picked my providers and all of them from endo, CDE, opthalmologist, PCP, podiatrist, etc are people I respect and who respect me. In general I do write my own prescriptions, I just need the endo or doc to sign them and fax them to the mail order pharmacy.
Hey Terry - try donating blood before your next one :). Sure fire way to lower your A1C.
I forgot to say that my rx have refills that last around a year, so I don't feel I have to go exactly every 3 months and sometimes I have delayed appointments for various reasons.
I'd still go to the doctor , because there's physical exams and lab tests I can't do to myself. Rather be safe than sorry on that even if I could prescribe my own stuff. I mean I know a lot about my own body but I don't have a lab and I don't know everything .
I have also thought that the stuff we're told at Dx (PWD1's) usually scares the hell out of us. PWD2's get "lose weight, eat better, get more exercise" Well, shoes doctor doesn't tell them that? I mean, D or non-D everybody's doctor has that in their script - how is anyone supposed to take that seriously since it's the same old same old
Ha! I didn't know that. Makes sense. If you're down a pint then your body will ramp up to make some new red blood cells. Is that legal??!
My dog had a cancer scare this last month. (He's fine. No cancer; so relieved.) So between all his appointments and my dental work, and foot doctor, it fills the calendar quickly.
I think I could manage my scripts quite well, thank-you.
Sounds like a great group of medical providers. You are lucky.
Things like reading the lab tests and hands-on exams have no patient equivalent.
This is an interesting observation. I do not make enough insulin. I am a Type 2 but insulin dependent...on top of that I take cholesterol medicine too and Janumet daily. I tried to go without my cholesterol meds but that did not work to my favor. I tried to take Metformin and Sitagliptin separately but could not remember if I took it due to being so many pills daily. I went from taking no medicines to a lot in a few years. Only medicine can make me better and I am so thankful for great insurance coverage and great medical care.
Ahh...I have someone in my family in denial that those pills give him the right to do whatever he wishes. Sadly, those few heart attacks have not spoken loud enough to him.