Diabetes Self-Management Blog

“Do you still write for the paper?” the bookstore clerk asked as I was checking out.

I looked up from digging through my purse to grab money to pay for a New Moon whatzit before my granddaughter (the vampire wannabe) could see me.

“We met at a diabetes support group several years ago,” she interjected. Ahhh…another member of the club nobody wants to belong to. Not to mention instant rapport between two relative strangers.

“How are you doing?” I asked. And, pulling out my continuous glucose monitor (CGM), added, “Do you have one of these yet?”

To make a long story short, her doctor — an endocrinologist yet — told her it would be impossible to get her insurance company to cover a CGM. Furthermore, she didn’t even have a pump “because my doctor says I don’t take enough insulin.” Which would be 12 units of long-acting per day plus 1 unit of rapid-acting for each 15 grams of carbohydrate.

“There are babies on pumps,” I said. “How much insulin do you think a baby takes?”

Then, as I thought about it, my back arched, my fur stood on end, and I hissed, “Plus, it’s not like it’s his money or time fighting with the insurance company.” That’s assuming the doc is even correct about her insurance company not covering what I consider to be essential equipment. I mean, the insulin pump is gold standard treatment and I hear experts are saying the CGM should be within two years or so.

Back in 1998, my doctor believed my insurance company wouldn’t approve a pump for me. On the contrary, it gave approval so fast it made heads spin in that office. And that was before insulin pumps were relatively common for people with Type 2 diabetes.

But I digress.

Shouldn’t doctors advocate for their patients instead of throwing roadblocks in their way? Don’t we have enough problems fighting everybody else, from pharmacists who think they know best to Aunt Bertha, who also thinks she knows best?

I suspect the reason is that most doctors don’t have diabetes and have no idea what it’s like to try to rein in the diabeastie darned near every moment of every day. It isn’t easy being your own pancreas, you know.

My proposal is that every health-care person who deals with diabetes, but doesn’t have it, be given a really rotten case of it. Then they’ll have to stop in the middle of whatever they’re doing to eat something when they’re not hungry and wait for their glucose to climb out of the hole. They’ll have to realize the frustration of doing everything “right,” but having their diabetes act as if they’ve done everything wrong.

I know. I’m rotten. But I’ve had a primary care doctor scream at me that insulin pumps are dangerous and that my endocrinologist should never have let me have one. (I fired him; kept the endo.) I’ve had a doctor yell at me for eating a cookie, when he didn’t have a clue that I was doing so on the advice of my dietitian to meet an insulin peak so I wouldn’t go low. He didn’t understand why I was seeing an endocrinologist. I was his diabetic, he said. Psst! I’m nobody’s “diabetic.” (Again, fired him; kept the endo.)

For the woman in the bookstore, however, I suggested she fire her endocrinologist — and get another one. One who has a clue.

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Comments
  1. I’m about ready to fire my Doc too. He told me that the only way to get my BG down is to exercise. (correct) When I asked if there was a point where my BG was too high to exercise (at the time I had been seeing 3-400’s) he said no, if I feel up to it, I should work out since it’s the only way to lower my BG. So, I almost got to experience DKA the other night. Good thing I tweeted about my nausea and difficulty breathing or I’d be typing this from a hospital room!

    I do agree that Docs should be advocates for their patients and dagnabit, they should know the basics of a disease when they insist on treating you. I seem to be HIS diabetic as well, but I’m sneaking around trying to snag me an endo. shhh. . don’t tell on me.

    Posted by Barbara Campbell |
  2. I myself am just getting going with the CGM and my pump after years of shots etc. and firing my doc. I feel we as diabetics must take a stand and stop being future job security for the doc’s and pharmacy reps. It amazes me the lack of patient education and progression in the doctors offices. We must take control, and yes fire the Dr! I have and you can too!

    Posted by Pamela Cramton |
  3. It’s great to have options!

    -Steve

    Posted by Steve Parker, M.D. |
  4. I was just told that I was eating too much. I am not on any medication and eat around 110 carbs a day in order to lose weight. In the last three months I have had a lot of stress, those I love have been really sick (seizures, brain tumors, cancer, and a 7 y/o with a an abcess on his jaw– all in six weeks) and a flaming ulcer on my toe. None of those could cause my A1c to rise from 5.7 to 6.1, only I ate too much. And then he told me not to count carbs but to count calories! He is fired. I was so depressed I wanted to commit suicide. I already am not eating anything. Where was I supposed to go? I suggested medication but my diabetes is “too well controled”> How can you have both ways?

    Posted by Lynda |
  5. Good for you! I am a type I
    diabetic for 44 years now and I
    have fired several endos over the
    years. Two for being asses and
    one for having asses on his staff
    (he was a great doctor but his
    nurses were pitiful. I also fired
    a cardiologist because his
    billing manager tried to make me
    pay a bill I didn’t owe. Good
    Luck finding a new doctor! There
    are good ones out there you
    just have to find them. I know,
    like we don’t have enough to do!!

    Posted by Lee Ann Gray |
  6. I fired my endo when he refused to take a look at what I thought was a boil on my bum. As it turns out it a colo-rectal surgeon to inform me it was actually an ulcer.

    Posted by Harry......................... |
  7. I, too, have fired two endocrinologists. The first because he had never checked my feet, even when I was having numbness and so took off my shoes and socks before he entered. He spent 3 minutes telling me how great that was because it saved time and reminded him to check the feet. Then he finished the exam without looking at my feet and was leaving the exam room. When I called him back and asked about the feet, his answer was, “Well, when you get your sugars under control, it will go away.” and left. (My A1C at that time was 6.8)
    The next one told me that there was nothing I should eat except for a steak three times a day. I could ignore that, but then I had major foot surgery requiring that I be off it totally for two months. With no movement, and the pain and stress, I expected my next A1C to go way up. It had gone from 7.0 to 7.2. He then informed me that it was time for insulin. From that moment that he put me on insulin until 9 months later, my sugars were constanly out of control. And I could not call and talk with him. He would not call me back. He received my numbers from 4 checks a day every two weeks, but made no change. I finally wrote a letter and he did not respond. Time for a new Dr.
    My first visit with my new endocrinologist was two hours long (for the same co-pay). She listened to my stories, showed me why his plan of insulin was not working for me, created a new plan, gave me her e-mail address (which I receive answers back within a couple of hours) and her personal cell-phone to call her on a holiday weekend if I needed her. With her new plan, I started having lows, and so after trying different approaches, I am now no longer on insulin - back to pills, and doing great with my control - best ever.
    So even endocrinologists are very different and are not always understanding of you and your case of diabetes. Search until you find the one that will work WITH you.

    Posted by Mary White |
  8. To Lynda: Depression is part of being a diabetic. YOu are also under great stress for a lot of reasons. Suicide is not the answer. How about a support group of people who can relate to what is happening to you and offer a shoulder to cry on when you need it?

    Posted by Cathy A |
  9. I have fired a number of docs. One kept complaining when I was managing my insulin use and not just taking the same amount each meal no matter what!! The educator was wonderful however and agreed that the doc was an ass. She also agreed that he had problems working with patients who had multiple chronic conditions. I fired him.
    I moved to a new state. Used the military clinic, which meant they kept switching who I saw. Took myself off of insulin after losing 60 pounds-on purpose- and having the docs say that since my A1c was great that I should keep on using it at the same levels. My A1c was at 5.5. I left.
    Now instead of an MD I hired an OD and he listens and asks me what I think before he adds his opinion. We seem to be working well together.

    Posted by Kate B |
  10. I Have a 10 yr old daughter who is type 1. For almost two years now. Before she was Dx we were taking her to her regular Doc, Who did not think she had diabetes because she was to young, So we took her to a Driscoll Childerens Hospital,where they put her in ICU right away did blood work. They said it was a good thing that we brought her in,Her bg was 468 went up to 788 in the next hour. The Silver Lineing Here is that we meet the Most Wonderful Doctor! Dr. Stephen Ponder,who happens to be TYPE 1 as well! He had her on 3-shots aday at first,with in six months she was pumping and DOING GREAT! Now almost two years later My Insurance won’t Pay for a CGM they say she is two young? I say any child who can deal with Diabetes and her pump and keep up with it all is not to young? After all I am paying for It as well?

    Posted by John Taylor |
  11. I too fired two of them because I do have renal insufficiency and I am not suppose to take metformine due to a problem increasing the creatinine level.

    Posted by mynor e garcia |
  12. I have fired two doctors, one was a PA who happened to be my niece!! I had complaints, but was told I was getting old, slow down, I exercised and ate heart healthy so I was fine, but when I started to go blind, I called her and said I think am diabetic, she said no, she knew my family history, come see her in a week if still concerned!! Well she knew diabetes ran in my family but because I did not have the standard symptoms she thought something else..I was just in control all those years without even knowing it, but then the body decided to let me know full force diabetes was running amuck.

    Then I just had to fire the next one who told me “congratulations you have cured your diabetes” you don’t need medication now or testing…And when I called and said a veggie salad (diet dressing) made me spike to 297 and then I crashed at 40, he tells me “so your A1C” was good…

    Dang and here I thought I could go out and have a triple bannana split with marshmellow cream and hot fudge!!

    Posted by gayle |
  13. Thank you, Cathy. I am still a bit depressed but I am not suicidal any more. Seeing articles in two different email magazines telling me stress could raise my blood glucose help immensly. I see a new MD tomorrow and am hoping for some direction. At this time, two years into my diagnosis, I have never seen a diabtic educator, a dietician or an endocrinologist. I had no insurance for a long, long time and that limited everything. I do have insurance now and am looking forward to a new Doctor that I have heard good things about.

    Posted by Lynda |
  14. My Internest DR took over my diabetes dr when I thought the the diabetes DR was too slow in treating me. When I went to the diabetic DR, it was like he would move the insulin up to a little more (like .5%) at a time (every 3 months).
    The Internest DR was more aggressive with jumps up to 10 or more for thr insulin. I think it is a money thing for the dr,s.
    The internest DR said he could do everything the diabetic dr could.
    How do you pick a good diabetic dr.?

    Posted by David Keener |
  15. David talk to others who have diabetes in your area and ask them if they are getting good treatment. Go to your local ER and ask the nurses for a recommendation. In the end, it is up to you to go out and interview some docs. Ask them about how they treat diabetes. How do the see their patients- as participants or as ones who are to be told how to act. You must rely on your instincts. If after switching docs it doesn’t go well, switch again. YOU are the one paying them for their service’

    Posted by Kate B |
  16. David if you can try to find a Endocrinologist who is Diabetic of someone in there family is,I think that makes a HUGE difference on how they treat you! Plus they have first hand knowlege of what it take to work.

    Posted by John Taylor |
  17. This is an obvious reminder that just because someone is a doctor, we shouldn’t assume they are a *good* doctor. Just like any other profession, there are incompetent doctors, lazy doctors, prejudiced doctors, over-confident doctors, cowardly doctors, bullying doctors, and doctors who believe in nonsense instead of valid science. Most people are much more selective about choosing their friends than the people they put in charge of their health. Especially when dealing with a life-long illness, it’s wise to choose a doctor who is willing and able to partner with you in maintaining your health.

    Posted by Still too fat |
  18. I would like to know why Insurance companies will only pay for one test/day. I have ups and downs. I am a type 2 diabetic. I take metformin. Sometimes, I just drop and get weak, sweaty etc. I feel that if I could test more often, this would be less apt to happen.
    Please give me your input.
    Another diabetic too!

    Posted by Peggy Squires |
  19. I am on the verge of firing my second endocrinologist.
    The first one I got along very well with his Nurse Practioner, she would sit and listen to me but he seemed to make me “jump through so many hoops” that I got tired of it.
    On one ocaission I was seeing my Gastroenterologist a week before seeing the Endocrinologist. They are in the same medical group.
    The Gastroenterlogist ordered that Labs be drawn on me, I suggested that he might as well go ahead and order the labs that the Endo. was going to order a week later.
    When I went to see the endo a week later, he was irate with me for having his labs ordered a week ahead of time. He told me that had better not happen again.
    He then ordered labs to be drawn on me, I refused to go to the lab and he ordered staff to escort me to the lab. I was so mad that I came close to using my cell phone to call 911 that I was being held against my free will.
    The following time that I saw him, he ended up “firing” me as a patient. He was one step ahead of me firing him. to this day everytime I see his Nurse practioner, we get along greatly.

    Fast forward some three-fours years, I am now seeing a different Endcrinologist for the same problems.
    At first when I was referred to this doctor I was on Byetta, which was prescribed by my PCP. I was also on reglan as prescribed by my Gastroenterologist. All the physicians that I see have a list of meds that I take.
    this Endocrinologist did not notice that Byetta and Reglan are counter productive to each other.
    Byetta slows down the digestive system and reglan speeds up the digestive system. It took reseach on my behalf to show this to the Endo. in order for me to get taken off of that awful Byetta.
    Fast forward 6 month, the endo is now placing me on insulin (novolog) and I am resisting taking it.
    I don’t mind oral medication. I was on a combination of glyburide/metformin. I was told I was on the highest dosage I could take.
    I get left on glyburide and the metformin is taken away from me under the pretext that the metformin is now causing me to have kidney disease.
    I started taking this gawd awful novolog, I hate injections, and no matter what they endos say the needles do hurt.
    I go back to the endo and really raise “caine” at his office. He then tells me that he could let me double my glyburide does, even though the previous time he tells me I can’t increase it because I am at the maximum dose. If he did that I could go off of the Novolog but if it doesn’t work out they way he would like, I would have to be on something else later.
    I lost it in that office that day, I took what they call the “pen” and i proceeded to show then that it was a syringe and not a pen. I pointed out that out that you write with a pen and this so called pen has nothing to write with.
    Needless to say, the Office Manager and the tech in the office were asking for me to leave and never darken there door again.
    All I want is to be taken off of the needle or I might just take myself off of the needle on my own.
    Should I look for yet a third endo and while I am at it, should I look for a third PCP.

    Posted by George Evans |

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Living With Diabetes
An Introduction (06/25/14)
Wink at Diabetes (07/10/14)
The Foibles of Dealing with Diabetes (06/17/14)
Enjoy Your Life! (06/12/14)

 

 

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