Diabetes Self-Management Blog

This week, Eric continues writing about his involvement as a volunteer for the University of Michigan Medical School’s Family Centered Experience (FCE) program. He’s jumping right into it, so if you want some background, please visit last week’s entry ("My Diabetes, My Family Centered Experience"). Oh, and because the program Eric’s writing about is the Family Centered Experience, he figures he may as well invite you in, just a little, so maybe you’ll feel you were sitting around the table too. Why? He’d like to see your comments on this post. Therefore, if you so choose, you can look at a few non-diabetes-related photos that may enhance your blog-reading experience. Eric’s interspersed a few links throughout this week’s entry.

Last Wednesday, Kathryn and I met Andrew and Megan at the Corner Brewery for our second FCE meeting. My wife and I love great microbrewed beer, and when you factor in that we had our wedding in the Corner’s beer garden and that the brewery is only a short, three-block walk from our home, it seemed like a nice relaxed place to have a few-hour conversation with two future doctors. The topic of conversation for most of the evening would revolve around our experiences with doctors—both the good experiences and the bad ones.

Kathryn and I got to the brewery early and grabbed a table in the tasting room. We then got a Sacred Cow IPA (for me) and a Brasserie Blonde (for her)—in our own mugs, by the way. When Andrew and Megan arrived, we gave them a chance to look over a takeout menu from Café Luwak, a delicious local deli that delivers to the Corner. (And, although I’ve never had any kopi luwak coffee, I think you really need to read about this. It’s said to be the most expensive coffee in the world.)

Andrew and Megan came prepared with questions. The first thing we discussed was loss in general. We were both asked to describe a time when we dealt with a difficult loss. My first inclination was to try and relate it to diabetes, but after hearing Kathryn talk about losing her grandmother 10 years ago, I was fumbling with how to cast my living with diabetes as a difficult loss, because to me it paled in comparison. So I started, but after a few minutes of stammering about diabetes as a loss, and during which time I probably sounded like someone trying to make up an answer on a test, I was told that my loss didn’t have to be something brought on by diabetes. I still had trouble coming up with anything concrete, but thanks to Kathryn’s prompting, I spoke of the loss I felt when I gave up custody of my black lab, April, after breaking up with a girlfriend five years ago (that’s another story for a different blog!).

The conversation then shifted to focus on experiences we’ve had with doctors that were less than ideal (uncomfortable, unethical, incompetent…between my wife and me we’ve had them all) and what it was that made those visits and interactions painful. And because I need to pick and choose what I put into this blog, I’m going to choose to leave my bad experiences out at this point and move onto the good—but please, if you’ve had bad or awful doctors, do share!

Kathryn and I both picked out my endocrinologist as the model against whom we measure all other doctors. Kathryn has accompanied me on several of my visits to Dr. Kumagai, and we’re in agreement that his level of care is beyond any we’ve ever experienced. I can’t do justice in the blog to the traits we outlined, but I know that a good physician will not make me anxious. He or she will be present at the visit and not act as if I’m another patient in an assembly line. Good physicians ask questions. They realize I’m probably overwhelmed. I don’t feel as if their answers are cookie-cutter.

Dr. Kumagai immediately established a partnership with me. Together we would figure out the best management for my diabetes. Diabetes is a chronic disease, yes, but it would not prevent me from living the kind of life I wanted to live.

I want to track back to our first topic of conversation last Wednesday night. Loss. For some reason I feel as if I should be able to rattle off what I think I’ve “lost” now that I have diabetes. But I don’t view my having diabetes or the diagnosis as a loss. Maybe I experienced some of the Kübler-Ross five stages of grief, but never to any significant degree. Yes, I continue to discover new inconveniences and hardships. And I’m not stupid—I know the dangers of diabetes, so I’m not pushing ahead blissfully unaware of what I’m living with.

Type 1 diabetes is a challenge, and these challenges are going to be lifelong if I’m to continue to maintain the high standard of self-management I’ve established. While I don’t like that when I go work out I have to keep extra carbs around, keep my monitoring kit around, check my blood glucose every 30 minutes, and worry about a second low, or that I have additional concerns when traveling, eating, working in the yard, going on a walk, shopping, visiting friends, (pretty much) anything…after time, these simply become routine and fade in their significance as an interruption or added burden.

So, what bad experiences with doctors have you had? And, conversely, if you’ve had or have a great doctor, what makes them great?

Next week, Eric talks with Megan, one of the first-year medical students, about her experience in the Family Centered Experience program.

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Comments
  1. I am so very grateful that you’ve chosen to share your experiences with doctors and the U-M medical students. I can identify so well with doctor miscommunications and dismissive attitudes so easily. Since I am profoundly deaf, adding my deafness to the mix really, really makes life difficult….for me and for the doctor. Nonetheless, I’ve managed to find one or two good doctors by interviewing them before I choose them to work on (with?) me. Thank you for choosing to share your doctor experiences with us all.

    Posted by Gayle |
  2. Hi Eric,

    I would like to share my experience when the company I was working for changed health plans. I had to find a new primary doctor from the directory the insurance company furnished. My old doctor was not listed, so I chose a gp who claimed he was experienced in diabetic care.

    As it turned out it was a terrible experience. From the start I told him I was a type 2, and I could not take enteric coated medication.

    He put me on 70/30 insulin right away. Then he prescrible some oral medication. I followed his instructions and my condition was getting worse. I was gaining weight and loosing my balance from the diaretic he prescribed.

    I checked with the pharmacist on the oral med and found out it was enteric coated. The insulin wasn’t working either.

    I went back to the doctor and told him I wanted a referral to an endocrinologist, he conceded and gave me the referral. Visited endcrinologist and everything worked out and I’m OK! Never went back to GP

    [p][/po

    Posted by David J. |

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