Terrible Doctor's Appointment!

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I’m sure most of you have seen my lost post about my ankle troubles (If not here you go)
Anyway, This weekend, I had to go to a follow-up appointment. It was the worst doctor’s appointment I’ve been to yet!

I get there and wait for 45 minutes. Eventually, the doctor finally takes me back into the room just to see me for less than 5 minutes! I had to drive 5 hours and miss an entire day of classes just so I could get rushed out! None of my concerns were taken seriously either.

She looks at my feet and asked if I’m in any pain. I said not really, but the cortisone injection she gave me a few weeks ago really messed with my bloodsugar, I had to increase my lantus by 50% to get back under control. The doctor then tells me “That’s impossible, I gave you less than a CC, theres no way it would mess with your bloodsugar that badly. You’re probably just stressed from going back to school.”

…and that was it. After that comment, the appointment was over.

I asked the lady at checkout if she could ask the doctor if she would recommend any physical therapy now that I’m not in too much pain. About 10 minutes later the doctor comes back and tells me: “No, you shouldn’t be doing anything with it, but since you are up in the mountains for school, you are probably just going to injure it again, just call us and make an appointment when you do.”

After that, I left, and I’m not going back after comments like those.
I just can’t go back to a doctor that doesn’t take any of my concerns seriously, OR recommends any preventative care. I’m done with that office for good!

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I think you may have had a CORTISONE injection; not CORTISOL. :slight_smile: OR, it could have been some other type of sterioid injection.

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Yes, that’s what I meant. I had a typo.

It still doesn’t change the fact that I drove 5 hours 1 way just to be told that my concerns are false and that I’m going to just injure it again no matter what I do.

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Even with 3X the normal amount of insulin per day, my bg’s go through the roof from either an injection or cortisone pills (prednisone). I just politely decline the pills when not necessary.

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Those injections make my sugars go through the roof. I need to increase my basal by 50-60% for a week to 10 days when I get them.

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I don’t blame you, at all. If I had any other doctor options, that doctor would be fired! In a heartbeat. Where does she get off with that condescension? Those comments were disrespectful and insulting. You don’t need this doctor!

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I just wish she would have told me. You’d think a podiatrist who specializes in “Diabetic footcare” would have warned me. Or believed me when I said I had an issue

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Podiatrists aren’t “real doctors”

they don’t go to medical school… They go to podiatry school. They have a DPM after their name instead of MD or DO (the only two real suffixes for actual physicians in the USA)… Point being, they are experts on feet but don’t have much real training on any other aspect of medicine.

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Bullshite. Every cortisone shot I’ve had played hob with my BG for weeks, and the fact that it has this effect always seems to take these guys by surprise. It’s a staple of orthopedic practice and they think they already know everything about how it works so they tend to be oblivious to its affect on PWDs.

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Hey, TimmyMac, it’s Rose. We “real” MDs/DOs call Podiatrists “Pod Docs” to distinguish the difference. I’ve always wondered why the feet in particular “walked off” and ended up being cared for by a whole separate “breed” of non-MD practitioners… Anyway, your experience sucked to high heaven and EVERYONE who knows any respectable amount of information about diabetes knows what steroids (we call 'em -roids) do to BGs in PWDs. That Pod Doc should have the term “specializes in diabetic foot care” ceremoniously stripped from her professional qualifications. Sheesh! Wanted to add that not all Pod Docs suck; I saw one once who immediately put me out of my misery by removing what I knew was an inspissated hematoma from my foot after the ER MD I saw two weeks earlier essentially told me I didn’t know what I was talking about. (Could have saved me from 13 agonizing days walking around Israel with what felt like a boulder stuck in my shoe…) Get yourself to a “real” Sports Medicine MD in your area for some preventative care. And March On! (Don’t forget about the sunscreen!)

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That’s insane! I never knew that they weren’t “real” doctors. I’ll keep that in mind if this injury flares up again.

1 more question, If I get “sock lines” on my ankles, does that mean I have swelling? The pod-doc said I should stop wearing my current socks and switch to some $20 diabetic socks. Do I actually have an issue, or was she just trying to get me to buy stuff I really don’t need? I just thought I got lines on my feet because they were tight socks.

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Might it not be possible to report this doctor?

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I doubt it, they are a private practice. I don’t think they have any higherups to report them too

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They may be a private practice…but they must nevertheless be regulated. College of physicians and surgeons or the likes.

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And what exactly is there to report? It sounds more like this podiatrist has the interpersonal skills of a rock, but aside from that what sort of professional misconduct has occurred? More importantly, how could you prove it occurred?

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Argh, sorry to hear it didn’t go well however the doc is probably going along with the SOAP process:
Subjective: What is the problem with your ankle? Is there pain? No
Objective: It wasn’t broken so they look at it and maybe compare it to the other ankle, to see if it’s swollen, bruised, etc. If it’s not, then there are no objective findings
Assessment: no pain, no other systems= the injury is better, which might have been a friendlier way to put it
Plan: The doc would conclude they don’t have any need for further plans.

I’ve been through quite a few appointments with the calf cramps I’ve run into. In 2013, my leg swelled up enormously after a race, 1/2 marathon and I got cramps 9-10 miles into it and kept running. That was Saturday, by Monday, my foot was black and blue too so I went to PCP who said “maybe it’s compartment syndrome, you’d better get xrays, and then follow up with an ultrasound…”. DO NOT look up compartment syndrome while you wait for xrays. It doesn’t seem to have been that. The ortho looks for bones and sprains, of which I had neither from the xrays but the ultrasound showed a hematoma 1x4x5cm in my calf which prompted the tech to go “that must hurt…”. The only advice was to wait. The black and blue foot was just blood oozing down from the hematoma, like a bruise inside.

I had a case at work involving interesting vascular issues and, in the course of that, I discovered that the bulgy veins on my legs can be treated by vascular surgeons. A coworker had a guy and said “you should check it out” so I did and, in a couple of weeks, I’m going to get the valves in my leg veins lasered. The valves were found not to work which makes the blood flow back and causes the bulgy veins. He’s skeptical that’ll have anything to do with the cramps but I figured I’d see what happened.

In the midst of all of this, I found (I also had an endo appt in the midst of this, A1C was fine so she was unconcerned about leg issues…) that doctors do not cross specialties, e.g. the blood sugar observations re the cortisone, asking the endo about my foot, asking any of the ortho/ podiatrist folks about my BG, NONE of the docs expressing any concern about my somewhat gross bulgy veins on my legs, etc. They do their thing and that’s it. They’ve all been to medical school but, in practice, I don’t think you can get much advice about anything that’s not the specialists specialty. And most of them will not be very well-versed in diabetes. A former member, who was in medical school, shared a pic of his med school D-education which consisted of 1 slide. I’m sure they had some reading or whatever but that was it. No “here’s how you control BG successfully” or anything like that. I have a pic of it but, since he said he was leaving because he was uncomfortable sharing it, I am waiting until the statute of limitation expires…

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This portrayal of Podiatrists is misleading. Podiatry is a medical specialty. Podiatrists are Doctors of Podiatric Medicine. They are licensed and certified just as in other medical practices. They have certain prescription privileges. There is even a subspecialty of Podiatric surgery. And furthermore Podiatry is a part of [mainstream evidence based medicine][1] (as opposed to complementary and alternative medicine which is belief based) with comparable education and certification to that required of MDs and DOs.

If you do choose to see a sports medicine specialist the most competent option is likely to be a sport podiatrist. If you go to see a general sports medicine doctor who is “certified” you may well just get a GP who has been certified by [ACSM][2] as what is essentially a “trainer.”

Doctors operate in real class system. Cardiologists are perceived as sitting at the top, the kings (or queens) of the profession. They look down on everyone else and you won’t find many doctors who will overrule the cardiologist. And this stuff filters down throughout all of general medicine and subspecialties. And don’t ever ask a mainstream doctor about a chiropractor.

ps. And most DPMs do rotate through specialties, the incompetence of this DPM in not knowing the effect of steroids on diabetes is likely due to the limited diabetes education in the entire medical field. A significant portion of patients that see DPMs have diabetes so this is not a good sign. As a patient with diabetes you should find another DPM.
[1]: Podiatry - Wikipedia
[2]: American College of Sports Medicine - Wikipedia

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@ irrational_John…Malpractice comes in many, and frequently subtle forms. The mere fact that she displayed a flippant and dismissive attitude toward TimmyMac’s concerns, constitutes as unprofessional, and uncaring
"No, you shouldn’t be doing anything with it, but since you are up in the mountains for school, you are probably just going to injure it again, just call us and make an appointment when you do." . (prickly personality aside).

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@TimmyMac - here you go! If you ever are forced to go back to this podiatrist, please refer to her as “Rock-tor” at every opportunity.

I might recommend skipping the ceremony and do the stripping un-ceremoniously!

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They are practitioners of foot care, and should be competent as such. But I maintain that they aren’t “real doctors” as they are not MD or DO. They are, instead, real podiatrists. Just as an optometrist is also not a real eye doctor, but an opththalmologist is. Just as a dentist-- a “doctor of dental medicine” is not actually a physician, they are a dentist. If you want to be a real doctor in my mind, you have to go to medical school. Chiropractors don’t even come close to the examples listed above.