I just wish I could get "promoted" to 2x a year. It seems to med that I have enough common sense to seek help when needed. And I don't like the "you'll lose your pump" threats.
It's completely legal if you're in good control, are willing, and healthy, weigh enough and haven't ever taken beef insulin then there is nothing that would preclude you from donating. At least that has been my experience in Massachusetts. I generally don't donate within a couple months of an endo visit because that would skew the results. But it is an effective method and it could potentially save a life. I don't know what the rules are CA since they seem to vary from state to state.
I've looked at this and wondered whether my A1c is affected as I've always had a mismatch between meter readings and my A1c. I have worried about the opposite direction as I have Polycythemia. I was for the first time (medically) required to give blood last week (and I thought they stopped bleeding patients a century ago). The NGSP recognizes loss of blood as artificially lowering A1cs and says:
Factors that affect interpretation of HbA1c Results: Any condition that shortens erythrocyte survival or decreases mean erythrocyte age (e.g., recovery from acute blood loss, hemolytic anemia) will falsely lower HbA1c test results regardless of the assay method used [2]. HbA1c results from patients with HbSS, HbCC, and HbSC must be interpreted with caution given the pathological processes, including anemia, increased red cell turnover, and transfusion requirements, that adversely impact HbA1c as a marker of long-term glycemic control. Alternative forms of testing such as glycated serum protein or glycated albumin should be considered for these patients
So while you could do this, if you donate blood within a month or two before you A1c test you will render the result useless. The alternative may be to to use a fructosamine test. If I have to continue giving blood every month or two I'll probably have to switch to an alternate method.
I've donated a couple of times here, although not for a year or so, as I missed the "blood drive" at work last year. I went for a run a few hours later and was fine for 2 miles and then utterly ran out of gas the last mile, like mile 22 of a marathon, hitting the wall or whatever, with BG sailing along fine.
After re-reading my original post I can see how my attitude can be misinterpreted. I'm actually more diplomatic when I engage my doctor. I don't have very high expectations, however. My perceptions of my diabetes doctors has evolved from thinking they know everything, to suspicious mistrust that they know nothing, to a more realistic perceptions that they are just human beings with limited knowledge but a willingness to help. I also realize that my knowledge of day to day BG management dwarfs theirs.
No one really understands what were working with. I have really started to understand how diabetes is misunderstood from doing a bunch of volunteer work with Docs and nurses. The actual complexity of the system will make even your knowledge feel dwarfed. I have something I want you to read. I'm gonna send it to you.
nice! Thats a good move, Oldspook.
No one has ever suggested I would/could lose my pump, and I am always shocked when I see that. I would definitely fire the doc who made that or any sort of threat to me. I believe we need to take the power and control of our appointment schedules and management choices into our hands (we live with this 24/7 after all) and let our care team know what we can and can't / will and won't do. I feel so very fortunate in my care providers. In my decades of diabetes my doc(s) have all been about seeing that I have what I need to be a happy healthy diabetic rather than an "encounter charge service". I did have an interim provider who would not fill my RX for strips or insulin once because I refused to come in for another diabetic check up... So I said I had not found a cure since my last visit and then I threatened to keel over as soon as my last bottle of Novolog was all gone. BOOM - lol
3 years ago I was taking humalog and lantus on a sliding scale. I weighed 50 pounds more than I do today and thought my endo at the world famous Joslin Clinic knew everything about D. It is amazing when I look back that I am still alive and well considering the complete idiocy of following doctors' orders. Any one of the myriad hypos could easily have ended with a car accident or dead in bed. Now that the "doctor is God" or "always right" blinders are finally off, I can engage my new endo in a conversation and have a discussion about my concerns and desires. This also has carried over to the rest of my healthcare providers from top to bottom.
I'm sad my current endo has decided she will only see patients with D and another endocrine problem not just D. I will be training a new doctor in June. He is not actually an endo his certification is internal medicine and he is the executive director of continuing medical education at the Joslin. So he teaches PCP's how to treat their PWD. Who knows maybe he will be able to teach me something ? Worst comes to worst I can always just continue to see my primary care doc who is pretty sharp herself.
Actually a lot of clinics like the Joslin use prescription extortion to make folks visit the Endo/CDE when in fact they are handling things just fine.. Refusing refills without a visit is a common practice, even for known "good" patients... Not everyone needs 2-4 visits a year...
I would still go to the doctor for the physical and yearly check ups by the way. I don't know about the RX issue I don't write in latin so who knows what might result if I were to write my own. I do need that RX for my stuff, that is what my insurance requires to cover it.
And Clare, who knows what you will teach the new doc, and that info he will then share with his students... great potential there!
^ditto^ what Jake said. The clinics are pushing the private docs off of our maps. It sucks, and this is how I lost my amazing doctor a few years ago. It took some work to find a new one but I did it. I need a doc who can deal with things beyond diabetes to keep me up and running. I got a chuckle from the "good" patients comment!
Bad things would happen if you wrote your own prescriptions. Trust me, I know. AR is not the only one with a crazy past!
Don't forget Medicare's stupid rules. They mandate 3 monthly visits for patients on pumps & clinics with Medicare contracts have to apply the same rules to all patients.
In fact when I became medicare eligible I was required to have a simultaneous bg and c-peptide to qualify for continuing pump supplies. There are ranges that the fasting bg and fasting c-peptide must satisfy before medicare will consider insulin pump supplies. Medicare still rejects sensor claims, but forwards the claim to secondary insurance as long as an advanced beneficiary notice has been signed. To me as a type 1 who has not had detectable c-peptide since my first c-peptide in the early 2000s, this exercise seemed to be an unnecessary bother, fraught with potential danger of trying to do a fasting test at a site that was about 50 miles away.
I had tried to get this done before actually going on medicare but first a simultaneous bg was not done and the test was not marked as a fasting test. So it had to be repeated even though it showed no detectable c-peptide. One has to be sure all is done properly, even though it makes no sense in the context of no detectable c-peptide.
I've been eagerly reading this thread. In conclusion, my response is that I would continue to get quarterly Labs, have them sent to the Endo dept, as well as receiving them myself and go in once a year -as long as 1) my labs are stable, my pump downloads don't show anything alarming (I don't down load from my meters - I use three different ones regularly - my pump is the data collection device) and my Dexcom data is stable.
I'm smart enough to make an apt should there be a problem - hey I noticed a problem when I went in to get Dx'd with D (of course they got it wrong - type 2 based on my age) but eventually the right Endo came along and got it right. I am perfectly suited to type 1 - anal-retentive about data, uber self-disciplined (thank you ballet career, and I tend to take pride in my good management.
Like many others, my appts are very short, but do to scheduling require a lot of time away from my regular life. I doubt any of the people who stated that they would prefer to be in the driver's seat mean they would avoid healthcare providers at all times. I know that my [personal experience - being challenged most of the time about my good control not being the "truth" or possible. I'm tired of having to prove myself at all these appts. If I could find an ENdo practice that reveled in a well-performing patient, I wouldn't be so bitter about Dr appts.
Thanks to Terry for putting this discussion out here.
Thanks, artwoman. You summarize my feelings about this issue well. I'd rather not live in a world without doctors. But I want to feel mutual respect and a relationship as peers looking to push against the same issues. And, yes, I want a doc that's willing to compliment me on a job well done.
I agree with you, I need and want doctors. I just want them and the system to not be so patronizing and self-serving and put me as the patient in the center of informed decision making.
I am reading an intriguing book right now that argues for a different model of medicine, it is called "The Patient Will See You Now" by Eric Topol
I'm gonna check that book out - thanks for the referral.
As I think on it, I think an end result of treating the patient with respect, as an equal member of the team will mean less stress and hardwork for the "system"