Diabetes Self-Management Blog

My first ever visit to an endocrinologist was two weeks after being diagnosed with diabetes. It was an oddly comforting visit because it was in fact where Dr. Kumagai told my wife and me that I had Type 1. Long-time readers of this blog may remember that prior to that first visit, the doctors who’d determined I had diabetes — no real stumper with an HbA1c of 14.5% and a blood glucose level at my initial doctor visit of near 450 mg/dl — well, they weren’t sure whether I had Type 1 or latent autoimmune diabetes in adults — LADA.

But enough about that. Unless, of course, you want to read my diagnosis story, in which case you can return to the early days of my blog, to my first endocrinologist visit, in my three-part kickoff series, “A Diabetes Neophyte’s Prologue”.

This past Monday I had yet another endocrinologist visit. Now, if I recall correctly from something I heard early on, we (people with Type 1 diabetes) are supposed to have quarterly checkups by our endocrinologists. I don’t know if you go to your endo four times a year, but I go when I’m told to go.

And yet, Monday’s visit did not follow a March visit. It had been five months since my previous visit. Why? Well, simply put, that was when Dr. Kumagai said he wanted to see me again.

I don’t question this man’s judgment. I’ve discussed before how much my wife and I admire Dr. Kumagai and all he does for us, and what he’s done with the Family Centered Experience program at the University of Michigan. And it’s in no small part that the good care I’ve received since my diagnosis has helped me build such a great foundation of self-management.

Back in January, Dr. Kumagai was not worried about my numbers, even though I was — even though, at the time, my HbA1c was higher than it had been in the previous 18 months (6.9%), and I’d put on a few pounds. (And by the way, I wrote about that visit.)

Because my self-management has been pretty consistent since my initial diagnosis, I assume that it isn’t necessary to hit the 90-day mark each and every time. The world won’t crumble.

Still, in early May it began to feel as if I was missing something. The three-month visits are nice… hmm, how to put it — kicks in the pants, or mile markers, or patrol cars sitting out there checking my speed. Knowing there’s an upcoming HbA1c reading provides that slight nudge to help me get past the moments when I might possibly stray from the path of diabetic righteousness. Knowing that I’ll get a cholesterol check, that my blood pressure is going to be measured, that I’m going to be weighed: these events sit in the back of my mind and help to keep me focused.

Oh, sure, we don’t want to live our lives worrying that our level of control will disappoint or satisfy our doctors. That’s not healthy. It’s not healthy to perform the constant, daily, ongoing management of diabetes for someone else (well, maybe family and loved ones, sure; but a doctor: not really, no. For ourselves first of all, yes!).

I’m saying, though, that for me, to have those assessment opportunities, as well as having an endocrinologist who, although I see him maybe a total of an hour each year, I consider a friend, and whose opinion of my level of care is important to me — well, it’s all part of the bigger picture of doing everything I can to make my way through life complication-free.

And this time my HbA1c was back down to 6.2%. I also took off about 10 of those winter pounds, and with the running happening consistently now (three times in the past week), I’m hoping it continues to go down. My blood pressure was 116/72. And I hope that the cholesterol test comes back with some good numbers.

My next appointment is in September. Three months away. What a relief.

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Comments
  1. I suppose that I have Type II Diabetes and have had for at least 10 - 12 years. For a while, I would stick my finger every day until they became so sore I could not do so. AT THAT POINT, I began eating a protein with fresh fruit or celery, etc., 5 or 6 times a day. Fairly recently, I made a 3 hour one way trip, could not find anyplace to eat but got to my destination expecting to find food. Family was not ready to eat then but when we did eat, the menu was not conducive to my “style” of eating. Slept well after eating some black beans and rice. Next morning, no one was ready to eat until about 11:30 by which time I was feeling a bit sick but ate half a Rubin sandwich. About 4 hours later, I began feeling bad, bad, bad and pulled off the highway with the intention of taking a short nap but did not sleep. Started traveling again and remember absolutely nothing for about 30 miles or more when a lady honked her horn and I “woke up” just in time to prevent my car from going into a deep ditch on the left side of a two-lane, going south, side of the road. I went to my doctor who noted that I felt bad and pulled over but did nothing else for me so far as treatment except to give me an appointment for 6 months out. RECENTLY and several times, I suddenly feel really bad and especially like I am about to pass out. It is another 3 months before I am due to see the doctor again (my A1C was more than 6.5 but less than 7 - don’t remember.) What is happening and what do I need to do about it. Seems that much is written about blood sugar going up but have found almost nothing about it becoming low. Thank you kindly for any help!

    Posted by Jacqueline Clepper |
  2. I just had my first visit with an endocrinologist
    and it will be my last.I have never met anyone so rude nor sarcastic. He didn’t want to see my BG Log, didn’t care if I had multiple sllergies,nor
    care one bit about why I was really there. He was on a tirade about everyone needing gastric by-
    pass surgery (which I don’t) to cure diabetes.
    He went on and on ranting at me.I will never go back to one. I’ll stick with my GP and do my best.

    Posted by Polly Westbrook |
  3. Polly, I had a bad experience with my First Endocrinologist - notice I say first. He pouted if my numbers weren’t good and let me know he was not pleased with me. Plus sometimes there was a 2 hour wait due to overbooking and he had no respect for women at all. Those were his problems - not mine - I moved on. I found a great doctor who listens to me and what I think and works with me to help me handle my diabetes. Please don’t let your first experience with an endo keep you from adding one of these professionals to your health team. Shop around for them just like you would anything else and you will be able to find one you can work with. Contact the American Diabetic Association in your area or city and ask for names and recommendations. They can be an invaluable resource for you - keep looking. My primary care physician tried for years to help me keep my diabetes in control but only after I started to my Endo guy did I really begin to see and feel the difference.

    Posted by Cathy |
  4. I HAVE NOT SEEN ONE YET ( ENDO) I MONITOR MY BS WELL, IT STILL ABOVE THE NORM (110) BUT LESS THAN 150. I WATCH MY DIET WITH SOME SLIP UPs.I LIVE IN SELMA ALABAMA AND NEED A GOOD ENDO.

    Posted by Bobby Jackson |
  5. I love reading everyone’s comments. I’ll try and make this brief. After a 10 lb 7 oz baby and the diagnosis of gestational diabetes with the second I still had my testing supplies and realized I had diabetes when the youngest was 2. Scheduled an appointment with the rudest female endocrinologist on earth. 13 years and 5 doctors later, my diagnosis just changed from type 2 to type 1 because none of the doctors along the way requested a c-peptide test. My current family MD, is young and smart enough to know he doesn’t know everything and referred me to see an endocrinologist.

    I got tired of feeling like a paycheck to my internist. Those quarterly 8 minute visits where nothing more than an opportunity to file an insurance claim. I found my two current doc’s by doing one of those free doctor rating web sites. If you are skeptical look up the doctors you know, see if others had the same/similar experiences. I know many doctors do not approve, but it’s no different than telling your story to a friend, neighbor, or stranger at the grocery store. The court of public opinion is usually valid. Be prepared to see a random negative, but multiple negatives for the same reasons I avoid. KEEP LOOKING until you find a doctor that’s the right fit for you.

    I drive 30 miles from home one direction for the MD, and 65 miles to go to the endo. Keep track of your mileage it’s tax deductible. Well, so much for brief.

    Posted by Jeannene |
  6. Is it a prerequsite for Endocrinologist to be rude and arrogant?? I just went to my first appointment, got in the room on time, had friendly nurses, and then I sat a waited for 25 minutes on the doctor. When she came in she sat on the opposite side of the room and never looked up at me, just asked questions. then she checked my neck and said go get blood work done. they will set it up for you, turned and left the room. when I got to the front desk they told me she had set me up with a diabetic management group, a bariatric surgeon, and the lab where to get the blood work done. They also gave a 3 month second appointment. This doctor challanged every test, every statement I made, and acted like I was stupid enough to lie to her about everything. I drove 120 miles to see her because she was reccomended to me as a great endo. I dont think I will go back for the second visit, at 400 dollars a visit it isnt worth it, I dont care if the insurance is paying for it. If All of then are like this one they are worthless. My GP does a better job than she did. My numbers A1cs were up to 7 but I had just had surgery about 3 weeks before, so naturally they would be up. before surgery they wer 6.2 and will be again too. TSH was good and I taake 0.2 synthroid, chlosterol and blood lipids were good also, yet she is wanting me to go to a dietian and diabetic management, as well as a surgeon. This is unbelievable. So if you ever have to see one be sure you get some better information than I did. you could wind up with someone like this one.

    Posted by Jeff |

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General Diabetes & Health Issues
How Much Do You Know About Diabetes? Six Facts to Get You Thinking (08/25/14)
Doing Your Own Research (08/06/14)
Ensuring a Successful Hospital Stay (08/15/14)
Summer of Health! (06/19/14)

Diagnosis
Free Diabetes Screenings From Sam's Club (09/12/14)
New to Diabetes: What's Next? (Part 4) (01/28/13)
New to Diabetes: What's Next? (Part 3) (01/28/13)
New to Diabetes: What's Next? (Part 2) (01/14/13)

 

 

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