i am so annoyed with them and their low expectations for my a1c and control in general. i keep thinking, what would they want THEIR a1c to be if they were diabetic? how much work would THEY do daily to make sure they stayed euglycemic for as much of the day as they could? what would THEY be demanding of their D team? i do not understand their lackadaisical attitude when i request things to make my control and quality of life better.
last year i went to my doc and asked for a way to pull 1/2 units of novorapid out of my pen, or to give me syringes so i could get coverage for eating the amount of carbs i wanted to eat. my i:c ratio is 1:30 and so im gonna need a lot of carbs if i need to cycle to work after injecting and eating. people suggested the novo pen junior and pulling out half units into a syringe, so i went to her with posible solutions to the problem. she said to me that no, unnecessary, we dont have 1/2 unit pens, yadda yadda yadda. just, no. the people in my neighbourhood call her la doctora house because shes like this sometimes.
now my basals are needing half units or im feeding the insulin all afternoon and evening, so now, instead of going to the doctor, i go to the nurse, thinking i might have more luck with her. she basically said no, that they dont have any, that IS IT REALLY WORTH ALL THIS CAREFUL COUNTING. really? really? um yeah, it is cuz i want to have my legs and sight and kidneys till the day i die. she asked when i see the endo next and to talk about it with her and i said that the endo didnt know anything. which kind of got her back up a bit. but she doesnt, she talks to me about analogue insulins as if they were the old nph deals, that i have to snack all the time etc! nooooo! thats not the way it is now!
i am so disgusted. i go to the endo next month and i know that my 30 or 40 minute appt will be taken up by the same routine questions. so annoying. i cant believe this crap. why do these people think ok is great? i feel that my "team" is really ok striving for mediocrity. i am so not.
i could change doctors at my health centre but it would be more of the same. you get no help from these people. they just serve to write the scrips. idiots.
oh and not to mention how i hate that theyre all up in my business with what i eat eat and dont eat and to do anything i have to show them 8.395 days of logged bg and arghh so frustrated by these people!
Maybe you should switch to syringes? Before we were married, MrsAcidRock gave me a cool syringe/ vial holder that almost as convenient as a pump to schlep around and was always fun to whip out in bars. I never counted anything but did plenty of "I'd better boost that meniscus..." draws into the works.
I agree with the medical rant stuff. On one hand, I hate logging anything but I have to sympathize w/ them that it's hard to have a meaningful conversation about diabetes management without some data. When we have threads here, we'll be sympathetic but, at some point, people generally ask for more data, although I can't think of too many threads where anyone asked for a log? I think that the doc may be saying, I can't recommend pulling 1/2 unit out of a pen for some sort of liability/ "owner's manual" issues and I have to agree with you that the smaller doses would be useful given your high activity and low carb approach which would leave you with the choice of a pump or syringes. I hope someone else comes up with something else for you!
Wow, sorry to hear of how your medical team isn't working on YOUR goals. I am even more surprised with your endo, since the reason I went to an endo was to get more focused expertise. Today, I only talk to my primary care doc for non-diabetic issues. Can you get a better endo?
U have to take care of everything....U will finally give into the fact, U R really in this alone. My first Endo was a T1 and he gave the worst clinical advise on the planet and his personal treatment plan was no better. Everyone I ran into at his office really liked him, he gave great hugs and would cosine just about anything his patents asked for. At the time I thought he was stupid...today I wish he was still my Doc.
I also have a doctor that told me one time, you don't have to quit smoking...it's probably not going to change your outcome much, I quit the next day! This Doctor is a very close friend of mine, he saved my life when I was bleeding to death internally, He was also instrumental 20 years later in getting me placed on the transplant list...I'm alive today...I would have given up long ago if he had not given me just a little bit of his time over the past 25 years. He is a great Doctor.....
If your doctor is not giving U what U need, then find another one, there are many doctors out there that really do want to help U.
Many of us use a pump because are basal needs cannot be managed well with a syringe. Many of us cant afford the pump
but we make sacrifices in other areas of are life and find a way to get a pump.
I can empathize completely. I had an Endo just like what you're describing. As you probably know, there are pens that dose in 1/2 units - Novopen Jr as well as the Novopen Echo. The latter is not yet available in the US as it was just recently approved. However, you can order it from www.amazon.co.uk and they will ship it to you in the US if that's where you live. Also, BD makes 1/2 unit syringes too. If your Endo won't prescribe them, find a sympathetic GP who will. I've done that before. Good luck!
OH, so sorry you're having a bad experience with your DTeam. You're so right about their low 'expectations'. I use, when on MDI, either 1/2 unit syringes or Novo Junior (my endo was the one who rx'd these as well as novo junior pen, i didn't even know they existed). I also dose my basal with 1/2 units. You can buy a box or pack, I think.....which is only about $20.00 (you shouldn't need to). they should be Rx'ing this to you, makes me mad, too. ugh! I use BD Insulin Syringes 1/2 unit, 3/10 ml, 8mm, 31g. You could call your pharmacy and see if they'll order them, I do have to special order mine but it's no big deal. Find someone else, maybe.
I also like your reverse 'psychology' here; I think I might just implore this next time I see my DTeam, "well, how would YOU handle this if you had T1, what would YOUR goals be, etc..."
I'm not an insulin user, but it seems I've seen threads suggesting using a sterile solution to dilute insulin. I believe such a solution is available in drug stores. If you dilute 50 50 then 1 unit = .5 units. It would probably need to be a solution OKed for they type of insulin you use and so would take some research but it might be worth a try if you can't figure anything else out.
I traveled the full spectrum with regard to my attitude towards diabetes doctors. I once viewed them as natural competent allies in my fight with D. Seeing the endo for my once every three months appointment wore down that respect. I started to see them as simply stenographers, there to document my ultimate decline into various diabetic complications.
I have aggressive goals with regard to my glycemia. It alarmed me when I realized that the docs are way more afraid of hypos than they are of hypers. If they are part of my "team," I can't allow them into any leadership position since I do not respect that defeatist philosophy. I became cynical about the need for seeing an endo since I couldn't see any value added by them, except for writing scripts.
I went through a period where I changed endos four times in six years. For one full year I didn't see the endo at all but was scolded when I returned to renew my perscriptions.
I've learned so much about controlling my blood glucose and have had breakthrough success, all without any creative help from the doc. I've come to an agreement with my current endo, one I admire for her listening skills. She's OK with only seeing me twice per year. I could use some help from her in figuring out how to reduce my high cholesterol without statins but I've yet to propose that to her. She thinks statins are the answer and I don't. Bottom line, if she'll see me twice/year and write all the scripts I need, then I'm OK with that.
A part of me mourns the pragmatic concessions that I've had to make with my ideal conception of what a diabetes doc can do for a patient. I know that these kind of docs exist because I read what some write here about their great docs. I'm willing to accept less than the ideal. Who knows? Maybe my current relationship with my doc will someday blossom into what I consider ideal. I'm not holding my breath.
I think the best result overall is that you take full responsibility for your BG management. You know so much more about it since you have a vested interest -- skin in the game! It can focus your attention and resources like a laser, an unfair expectation of the typical doctor. Take charge but don't expect much from the doc. You are quickly becoming the world's foremost expert on your metabolism. Medical professionals are, at best, functionally inferior regarding your BG game. You're in charge and maybe once in a while, if you're lucky, the doc or CDE or nurse or dietitian will make a truly valuable suggestion. Good luck on your quest!
if only i had 8000 euros for a pump and then like another 100 euros a month for tubing and infusión sets....im a teacher. there are some days where i know im alone in this but others where i just cant believe that the doctors and nurses just wont/dont know how to help.
Terry, thanks for your thoughtful reply. i am going to request a change of endo after i see her in december if she doesnt help me out with the syringes. i got home from work tonight, thinking about it as soon as i left my job, completely perplexed at the attitude of these people. i just dont understand it.
I can't believe this.. the very least your docs should do is rx whatever you need for your care. I started using novopen junior very quickly when I figured out I needed half units and syringes came soon after to get the last doses out of my pens. I find syringes more difficult to measure with, all those lines are confusing to me and it is hard to get the right amount with air bubbles etc.= control of the plunger is not very accurate I find.
I had no problem getting these, my endo rxs whatever I want. I'm angry at your docs. Time for some new docs. Can you just insist that you want the new 1/2 unit pen? It's for novolog. Someone just posted about that.. it's available in Europe already.
Don't despair, just get what you need and get a new set of docs and be very persistent that this is what you need and right away. There is no reason you shouldn't have whatever you need to manage bg.
I see lots of writing in the US medical press that uses the term, "patient-centered care." It's one thing to give the proverbial nod to that ideal and quite another to actually embrace that sentiment.
I see nothing wrong with the attitude that you're the boss; you hire and fire; and make all the ultimate treatment decisions!
You're welcome :) I think it may be available on rx for you, you're in Spain right? Just ask them again… no reason he/she shouldn't rx this for you along with the cartridges.
It's more green too, than all the disposable pens.
Since my GP told me that anything under 10 was an ok A1C I have quietly gone my own low carb way (also non-approved). I just go for prescriptions and try to tactfully steer his point of view in line with my needs. I really did expect my 'team' to be on my side and leaders in the quest to keep my bgs down.
