Tag Archives: endocrinologist

Endo Visit, part 1000 (or so).

Tuesday marked another quarterly visit with my super endocrinologist. Despite the fact that this was the thousandth (or so) visit with her, we still had plenty to talk about.

After going over my A1c result (still excellent, but a little low), the biggest topic of conversation was analysis of my CGM data. This is the first appointment that included a measurable amount of CGM data to look at, and that made this appointment different than most.

She’s concerned more about overnight lows than the lows I’ve had just before dinner. So we dialed back the basal on my insulin pump between midnight and 8:00 a.m. We’ll see if that does the trick.

If I really want to be honest with myself, the truth is that I’ve been a little aggressive correcting post-meal high blood sugars. So I’m getting to 80 to 100 mg/dL before bed, and going to sleep for six or seven hours while my BGs get lower and lower.

I was also honest about all that with my endocrinologist. At some point in my life, I decided that I needed to get over my feelings of what someone might say about me when I let my guard down and admitted where I might have come up short.

Now, this is where you might say, “great, everything’s perfect”. But you know what? What I really needed was to work with a doctor who would listen to what I was saying and work on a strategy to solve those shortcomings, without interjecting guilt into the conversation.

I mean, it’s one thing to let my guard down and speak the truth. But it doesn’t mean much if it doesn’t result in a plan of action put together in conjunction with my medical team.

It’s easy to take that for granted after several years with the same endo. What we really have to remember is to find a healthcare professional (or team of professionals) who will help us find the success we seek with our diabetes. When we do find that healthcare professional (or team of professionals), we have to remain grateful and let the process of working on a better life with diabetes take its course, wherever it might lead.

Both of those things can be difficult, but they are both worth the effort it takes to get there.

Other than that, I got a couple of prescriptions for things that are new (like Accu-Chek Guide strips) and things that need to be replaced (like expired backup insulin pens). We talked about the #BeyondA1c workshop a couple of weeks ago, and the upcoming Friends for Life Falls Church, Diabetes UnConference, and Diabetes Sisters Weekend for Women gatherings.

We only get so much time with our endos and diabetes educators. Precious time. If you can, it’s worth it to spend the time pursuing the best results possible, together.

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I admit it… I’ve got a great endocrinologist.

I like my endocrinologist. There, I said it.

Endos are sometimes a source of dread, or frustration, and some people wind up having to explain a lot about newer technology or drug developments to theirs because, let’s face it, diabetes changes sometimes move faster than their doctor.

But I don’t experience any of that. My last appointment a couple of weeks ago included the typical A1c, and a little blood work. Cholesterol, kidney function, that kind of thing. Vital signs, download of the pump data. Everything checked out okay, though I’m carrying around slightly more calcium than I should be. Who knew you could have too much?

We spent the rest of the time talking about a clinical trial I’m considering, about insulin pricing, and about a recent NBC Nightly News story on a family that peruses Facebook groups to find insulin their child needs, trading insulin their family’s insurance covers but their child is allergic to (“I wish some of my patients would ask about freebies… I have lots of samples!”).

Yes, she told me that she wished more of her patients would ask about insulin samples, if that’s what we’re even calling them now. Funny, I didn’t think to ask why she doesn’t suggest freebies for her patients. I’ll put that on the list to ask her next time.

We talked about starting on my Dexcom, since I was only about two weeks in when I saw her the last time. I told her, honestly, that wearing it on my arm has made it seem far less intrusive than if it were in my midsection. Which, by the way, is part of my trepidation of doing this clinical trial, because I’d be required to attach both the pump and the CGM around the middle of my body for the duration of the study.

I also mentioned that the CGM has given me real confidence that my basal rates are still very good, because once my trend graph lands in a good place, it tends to stay there for hours at a time. “But you’re going to let me know if you start training for something again, right? I remember that’s when you’ve had real trouble in the past”.

She knows me well.

We also talked about Dexcom Share. I don’t have an Apple phone, or a Pebble watch, and I’m not sure if the G5 is compatible with that anymore. We don’t agree on everything. But I trust her judgement enough that when she suggests something, even if I have questions, there’s a pretty good chance I’m going to do it and do it with gusto, because I trust her judgement that much.

Working with a medical team you can trust means a lot. The give and take between patient and doctor is a relationship that requires a fair amount of nurturing. And it’s changed over the two and a half decades I’ve been living with Type 1 diabetes.

But when it works out, the end result is terrific. It happens when both sides of the conversation engage freely and openly. It’s really great being with People With Diabetes, because they just get it. I consider myself quite lucky because I have an endo who gets it too. If you can’t talk about diabetes with another PWD, or your endocrinologist, who can you talk about it with?

I feel like I’m healthier, and making better, more well informed decisions than I’ve made under any other medical care team, endocrinologist or not. Finding people who help you with your diabetes and your diabetes knowledge are worth the effort. YOU are worth the effort. And I support you… no conditions.

Diabetes By The Numbers: Dr. Vivian Pao (Part 3)

I’m so grateful to my endocrinologist, Dr. Vivian Pao, for taking the time to speak with me on the complex relationship between a diabetes patient and their endocrinologist.

This is the third and final part of our talk, and in this episode, we talk about the importance of being honest with your endo, and what keeps her up at night.
DBTN
 
Reference Material – Click below for more information on this topic
Learn more about endocrinologists, read research and updates, and even search for an endocrinologist by clicking on one of the links below:

American Association of Clinical Endocrinologists

Endocrine Society

Pediatric Endocrine Society
 

Diabetes By The Numbers: Dr. Vivian Pao (Part 2)

Some people only get to spend about 40 minutes each year with their endo… I got to spend close to an hour with her last week. The conversation was so good that I’ve broken it up into three parts.

In this episode, we talked about how an endocrinologist considers outside factors, including depression, in treating a Person With Diabetes. Also, she talks about how she stays up on the latest and greatest in her profession, including a reference to Dr. Oz and some “raspberry, ketone thingamajiggy”.

This is part two of our conversation. We get into a lot more in part three. I hope you’ll join us for that. In the meantime, here’s Part 2.
DBTN
 
Reference Material – Click below for more information on this topic
Learn more about endocrinologists, read research and updates, and even search for an endocrinologist by clicking on one of the links below:

American Association of Clinical Endocrinologists

Endocrine Society

Pediatric Endocrine Society

Diabetes By The Numbers: Dr. Vivian Pao (part 1)

“Who is this Dr. Vivian Pao anyway?”, you might ask.

She’s my endocrinologist.

Some people only get to spend about 40 minutes each year with their endo… I got to spend close to an hour with her this week.

Together, we talked about what exactly an endocrinologist specializes in (in addition to diabetes). We also covered what she’s looking for from a diabetes patient at the quarterly appointment (and more importantly, why); and why she made me wait before allowing me to begin on my insulin pump. Hopefully, you’ll begin to understand why I believe in her the way I do. She is a huge, important part of my diabetes care team, and I value her input very much.

The best part is, this is just the first part of our conversation. We get into a lot more later on. But you’ll have to wait for that. Sorry. Our talk was just too good to cut out questions for the sake of brevity.

Part 2 is coming in the next installment. In the meantime, I hope you enjoy this view from both sides of the desk.
DBTN
 
Reference Material – Click below for more information on this topic
Learn more about endocrinologists, read research and updates, and even search for an endocrinologist by clicking on one of the links below:

American Association of Clinical Endocrinologists

Endocrine Society

Pediatric Endocrine Society

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