I never thought I'd say this but I was downright excited and giddy to see an endocrinologist today. Why? Because it's been eight years since I've been able to see one. I went nearly seven years without insurance and then once I regained insurance it took a year and a half before I was able to get a referral for an endocrinologist to go through.
So what happened at my appointment today? A lot of extremely good things. First I filled out a bunch of forms giving a detailed medical history and family medical history. With six type 1's in the family this took a bit of time. Then I was weighed, I gained five pounds this week...this is getting seriously worrisome. Then my blood pressure, 128/83. Blood sugar, 103. The nurse asked a few questions like why am I no longer taking the low dose aspirin. I explained that it was causing too much bruising and unstoppable bleeding. So I am now only on Plavix.
I was then taken in to an exam room and a few minutes later the doctor came in. She explained that she was not the actual endocrinologist I will be officially under the care of, but a diabetes educator. She asked me a few questions regarding my health history.
"How long have you been type one?"
I told her I asked to be referred to this doctor because my brother (who is also a type 1) is a patient of hers. She was pleased to here this. After some more routine questions and answers, she asked me what my expectations for diabetes care are right now. I explained I obviously want to gain tight control and one thing I hope will help is to get a CGM (continuous glucose monitor).
"You are definitely an excellent candidate for a CGM. We will start the process today."
She asked me why I am on such old insulin. I explained that it is the only insulin I could buy over the counter when I didn't have insurance and once I got insurance my primary just kept me on it. She said the first thing she wants to do for me is to put me on Lantus and Humalog.
We talked some more and the conversation moved on to my neuropathy. She asked if I have been seeing a neurologist. I said no. She probably would have gone on to suggest I see one but somehow the conversation went on to discussing my toe fracture and swelling. She wanted to examine it so I got up on the table and she first listened to my heart and then examined my toe. She was concerned about the redness and said she was going to prescribe an antibiotic. I told her an x-ray was taken but I don't know what it showed because they wouldn't tell me until I see my primary later this week. She said she would call and request the results and call me with them as soon as she gets them.
At this point I am loving her so far.
The conversation moved on to me telling her I think I may have PCOS because I can't lose weight, I have hair where only men should have hair, I think I'm insulin resistant, and I've never gotten pregnant. She said I might just have PCOS and she would order a lab test for it. I asked if she thought it was a good idea for me to go on Metformin and she said yes but let's do the lab work first.
We discussed diet and insulin some more. She asked how comfortable I was with my carb counting. I said I think I'm getting by but could use some one on one discussion on it. She immediately called in the dietitian. Right then and there I had a wonderful talk with the dietitian (who is a type 1 herself) on how to balance healthy meals and count carbs for blood sugar control. She gave me several print outs with information and tips for healthy diabetic eating and carb counting.
I am feeling awful bright about my future now. :)
After the dietitian, the diabetes educator returned and gave me some insulin samples, pen injector samples, and a new meter (Accu-Chek Nano). She also gave me a Dexcom booklet with a form to fill out to get the process started. I filled out the form right then and there and turned it in to the front desk to fax out.
The educator asked to see me back in three weeks to follow-up on how the new insulin is working for me, turn in three weeks worth of blood sugars, and follow-up on my lab work. I left with prescriptions for an antibiotic, Humalog, Lantus, and test strips. I also left with a lab slip for A1c, DHEA-Sulfate, Follicle Stimulating Hormone, Luteinizing Hormone, Prolactin, Testosterone, Lipid Panel, Microalbumin (random).
I am so very happy with this visit. I feel like I am finally getting things truly moving with my diabetes care. I am feeling very optimistic about the future now.