Went to new Endo today

and what a waste of time. Most of them seem to be A**holes and this guy was no different. He asked me nothing about my diet, my testing, or much of anything. The only thing he recommended was to get off NPH. I could just tell he wanted me in and out of the office as quick as possible. I was actually referred to this guy by a close friend of my moms daughter who apparently worked with him at some point. I spent $125 for the visit but at least I was able to talk the nurse into giving me two vials of humalog.

Usually I give the doctors my logs before the visit, so they have time to look at them. I look at them too. If you don't have a log or meter reports of the visit, what is he supposed to talk about? I think a lot of docs will try but don't really feel the obligation to invest a lot in you unless you show that you are going to invest the time in yourself.

Did you explain any of your special symptoms that you have told us about? I would think he'd be interested in that? How old was he? If he's younger, it's possible that he may not really have a lot of experience with NPH and may not be able to offer much? Really, I'm not sure anyone could offer much with that stuff.

Yeah I did.. He said some people are sensitive and some aren't but obviously couldn't give a valid explanation as to why. I told him I don't feel well at 110 and he didn't even respond like wow I never heard that before. No compassion what so ever.. Just by the book. I really felt like just walking out the door and not paying him but his nurse was nice and I felt rather ok so I paid the schmuck. To be honest if he didn't want deal with me because I had no log he should have told me so and sent me out of the office without charging me. I need a shrink more then I need an endo.

I think too that endos probably have a "flow chart" running and patient w/o numbers= a short path on the chart. I've had appointments like that myself and fed the doctor a song and dance about what was going on but the docs sort of limited in that they can't give you any advice if you can't show them something or give them an idea what you're looking for. Maybe a lot of their patients are like that. SuFu, who is in med school and had left recently, as he didn't want to post stuff here that would get him in hot water, said that there was no way he'd consider being an endo. He didn't exactly explain why but I suspect that dealing with a sort of "unsolveable" equation would have been a big part of it? Which is not to say that my equation is any more solveable as I totally bounce along from test to test.

Yea know the feeling have not been to Endo in several years even though it is Commie here. GP actually listens to what I say.

At least the 2 vials are some compensation.

Disappointing. I have optimistic high hopes for a new doctor & those hopes are quickly dashed. Yep, the meter is running & the clock is ticking loudly. I now have lowered expectations & go armed with what I want to discuss. Smart girl to get freebie vials.

This is from a thyroid blog, but has some valid points for dealing with doctors in general. I can't imagine sending materials ahead to any doc I've seen & sure they'd eye roll & put promptly in the trash. http://thyroid.about.com/od/findlearnfromdoctors/a/Five-Things-Thyroid-Patients-Should-Never-Say-To-The-Doctor.htm?nl=1

What were you expecting, Gary?

If you don't have logs and haven't had lab tests recently, he doesn't have anything to work with. Endos think like scientists, after all. Anecdotes about how we feel that aren't accompanied by hard data just aren't useful information. Your special symptoms and conviction that you're a unique case should interest a doctor if they're accompanied by a good set of data.

I'm sorry you think this guy has no compassion, but looking at it from his standpoint, he didn't have anything to work with. He probably can't express a lot of sympathy unless he can see that something is out of whack and he can't challenge you effectively, either, without the logs and test results. You say you need a psychiatrist more than an endo. If you're expecting compassion and therapy without data about your blood glucose, how is a psychiatrist supposed to know whether there's something genuinely wrong or whether you're delusional? Psychiatrists also like real facts in terms of numbers and test results.

Would you have felt better if he'd given you a lecture about not keeping records and told you not to come back without a few weeks of logs?

Mine d/l the reports to her laptop and refers to them while we are visiting.

He didn't even ask for previous lab work or ask when the last time I had my AlC's work??? I told him my main problem was my sensitivity and he had no explanation and insisted it can't be anything other then the blood sugars which I expected anyway. His attitude made me uncomfortable to where I forgot to even describe how bad the symptoms can be. My disappointment really was more about his bedside manor and knowing I was paying out of pocket really made it obvious he had no interest spending time with me discussing much of anything. The nurse practitioner I see is a sweetheart and I will continue to go to her just for my twice a year A1C's and prescription refills. In the end I really wasn't expecting my problem to be fixed anyway.

Gary, why not get a prescription for Lantus or Levemir (I prefer Lev. for it's low peaks), keep records of how it works for you, and go to see a doctor next time armed with some information and talking points. What's more, you might even find an improvement. I certainly found improvements over the years -- I started with NPH; Lantus was better but gave me headaches; Levemir is great.

I agree, I have finally secured a great Endo, my third one, I go to him every six or eight months and he knows I mean business. I pull out my notebook with my questions and concerns. My log book gets delivered to him one week before my appointment and he has been great. Spends the time with me and if i feel rushed, I tell him.
Oh and when I started with him, I told him what my expectations were going to be when I visit and if he didn't feel he could provide me with the time and energy, then tell me up front and I would look for another Endo.

Win / win for both and I look forward to my visits with him.

To be honest, when it comes to T1D, I don't really expect much out of endos. I have finally found one I have liked, mainly because she admits to what she doesn't know and respects me as the "expert" of this thing. She told me once that adult endocrinologists have perspectives that are so skewed to T2D, that many of them have really "lost touch" in how to deal with T1s, especially those who are young and active.

In my experience, doctors hate to admit when they don't know something.

That all said, I don't interact with my endo a whole lot. I'm usually able to troubleshoot all my issues either by talking with people here or just using past experience as my guide.

Are you going off NPH? I will admit that when I need basal insulin I do tend to prefer NPH (mostly because it's what I'm used to and I know how it works), but I know that lantus and levemir provide more stable BGs.

Also, can you get a CGM? Is that possible?

I still don't understand why you refuse to keep a log, Gary. You might actually find it reassuring! Recording your numbers at regular intervals and looking at the patterns over even a couple of weeks should either confirm your impressions of what's going on or give you some different ideas. With a log, you can also evaluate your A1c numbers because they can account for anomalies that don't appear during regular daytime testing.

Whether you go back to see this particular endo or not, having a good set of recent records will give you a good basis for getting the help you need. You can't really blame the doctor for not asking for material that you weren't in any position to provide anyway, can you? But if you could show him patterns and possible correlations between your BG numbers and how you felt at various times, there would be something to talk about.

In the end, though, whether you start to feel better or not is up to you much more than any doctor or health care provider. If you won't do what you need to do, you can't expect to get results.

Acidrock,

I was referring to suggestion in the posted link.

Unless I can get free Levemir I will continue using NPH. Its just that simple. I refuse to spend my hard earned money towards a more expensive insulin. I only use NPH while I am sleeping anyway. As we all know there are just way too many factors that effect glucose so changing my long range insulin will not fix the fact that I don't feel well. Stable blood sugars in people with diabetes are only a momentary event as we all know one goof or stressful situation and boom there she goes again. The bottom line is we each manage this sucker differently and is no right or wrong. No matter how you slice it it sucks for all of us. I really fear my mortality though somedays I really don't want to wake up anyway.

Thanks for the link, Gerri. It was really useful! It gave me a lot to think about for my next endo appointment!

marty1492

I dunno, both of my endos appreciated getting stuff ahead of time so they had an opportunity to review it? Admittedly it's a *really* small sample size but they read the stuff and bring copies of it that they've noted "here's some lows" or "here's a lot of lows..." or whatever? I don't think thyroid patients, the subject of the article, can test their thyroid levels so their "paper" isn't the same as our paper, which has actual (or actual +/- 20%...) data in it, which is what endos need to be able to formulate or at least guesstimate what's up?

Nope, thyroid patients can't test themselves. What the author was referring to was patients who show up with tons of written info & articles, not records or logs, to discuss. I said that I couldn't imagine any doctor reviewing this type of thing.

From the link (http://thyroid.about.com/od/findlearnfromdoctors/a/Five-Things-Thyr...):

The last thing many doctors want to see is a patient who walks into the examining room carrying a stack of paper -- news articles, journal references, Internet printouts -- to share during the appointment. Some doctors actively make fun of this -- calling patients the petits papiers ("little papers" in French) people. Others are threatened by knowledgeable and informed thyroid patients. Some are genuinely willing to read and explore things you want to share...but they simply don't have the time to do so in a quick appointment, while still providing provide you with a thorough office visit.

Solution: Pick a few of the most important items you want to share, and send them to the doctor at least a week or more ahead of your appointment, along with a note explaining which aspect of the material you would like to discuss, and indicating the date and time of your upcoming appointment.

Glad you found it helpful, Marty. Made me re-think my approach. Oops, I've done this & that--not effective.