Tag Archives: medical professionals

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.

#DBlogWeek – Day One. To share or not to share?


Yay!!! Diabetes Blog Week has officially begun. Myself and many others will be posting for the next 7 (seven!) days. Haven’t heard of Diabetes Blog Week? Get the lowdown by clicking on the banner above. Now, on to the first day’s subject:

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?

Well, um… my endocrinologist already reads my blog. Not every day, but enough that if I post something about a terrible low, for instance, I’ll probably get an e-mail within the next week or so.

What do I wish she, and my primary doctor could see about my daily life with diabetes? Probably that my life isn’t perfect, but I’m living. And I’m living a pretty good life. Sure, there are tough days, but I keep on going. It’s not the tough days that define me. It’s getting back up after I’ve been knocked down by this disease that means everything. And if I’m having a hard time getting my BG up into the hundreds or down into the hundreds, it doesn’t always mean I’m screwing up. Sometimes it means I’d be even worse off if I wasn’t trying so hard.

But honestly, when it comes to me and my endo, there’s not much I don’t share. What? What’s that? You’re honest and open with your endo? In what world does this happen?

It happens in a world where your doctor speaks your language. Where your doctor wants to hear what’s going on with you… so if updates are needed in your care, you can discuss them. It happens in an atmosphere where the object of an appointment is both to measure how you’re doing and to discuss what to do in the future to make you better. Such a universe does exist, and I encourage you to find it if you haven’t already.

Now, what do I hope my medical team doesn’t see? I hope my doctors don’t see how concerned I am about my weight. I’m doing what I can to keep from gaining, but my metabolism just isn’t helping me these days. Still, I’m doing what I can. But I could use the help of a dietician. I’m still eating a lot of junk. Anyway, that’s probably the top of the list.

Other than that, my medical team pretty much knows everything. And that’s good. My doctors can help the most when they know the most. It goes without saying (but I’ll say it anyway), two-way discussion without making a patient feel guilty is worth its weight in gold. Hope your medical team is 14 karat spectacular!

DSMA Blog Carnival. Doing the best I can.

This month’s DSMA Blog Carnival subject has to do with those dreaded (sometimes) visits with the medical professionals that we rely on to help us manage our diabetes. Specifically, the questions are:

Do you get nervous or stressed when you have to go to your endo/doc appointment?
Why or why not? Be honest.

The simple answer is that I don’t stress too much about these visits anymore.

Okay, I stress a little before appointments with my physician. That’s probably because she doesn’t see too many diabetics, and she probably doesn’t have too many male clients. I’ve picked up on that, and I still have trouble talking to her, and that’s partly my fault. I’m working on it. She’s a good doc, and I think we’re both trying.

I don’t really stress at all before visits with my endocrinologist. I try to be as honest as I can, and as diligent at following her plan for me. And if I have trouble with her plan, I tell her why. And then we talk about it. That’s how it should be, I think.

Why do I seem relatively calm about these visits? Mostly that’s due to age, and the fact that I’ve been dealing with the ups and downs of this disease for 21 years. And wow, I can’t count how many of these visits I’ve made over the years, to doctors good and bad. You know what? Whether my numbers are good or bad, I feel like I’m already doing the best I can. At this point, I don’t have to apologize for anything.

But here’s the danger with that kind of logic: It only works if I’m really doing the best I can. If we’re going to expect doctors, nurses, CDEs, etc. to give us the respect we deserve, we need to show that we’re making the effort to manage our care the best we can. That does NOT mean we need to have perfect A1c numbers, that we are meeting our weight loss goals, that we are logging every BG number. It means that we need to show that we’re making the effort to reach our goals. We can’t treat our endos and docs like they’re just the customer service folks who write our prescriptions every 90 days.

However… if YOU ARE making the effort, and your numbers aren’t where you want them, and your doctor’s answer to that is to make you feel guilty for not managing your care better? Then you need to run, not walk away. Find someone who will give you solutions, not shame.

Like a lot of things, these visits are a balancing act. When we’re doing the best we can, really doing it, we can sit with our endos/docs as an equal, with less stress, ready to deal with whatever comes up. And when our medical professionals treat us as individuals, not soulless slags with the standard “how are your sugars” scripted question and answer, call and response routine, we can feel a little less stress about our next visit. Best of luck with your next appointment. Do your best… your very best leading up to it. And don’t take any crap from anyone. I always wanted to say that.

This post is my June entry in the DSMA Blog Carnival. If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2012/june-dsma-blog-carnival-2/

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