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Planning for a Successful Health-Care Visit
You have canceled your last two appointments with your doctor, but now the pharmacy says you need to have new prescriptions for your diabetes supplies and medicines. You can’t put it off any longer: It’s time to see your doctor about your diabetes. But this time, maybe things can be different: Maybe you can view your doctor appointment as an opportunity to get your questions answered and to get help with your diabetes care — rather than as an obligatory meeting you’ve come to dread.
Here are some tips for how to get what you need from your doctor visits for diabetes care:
Make time for it
Review your notebook one month, one week, and again one day before your appointment to make sure you haven’t forgotten anything important. At your appointment, keep your notebook out so you can refer to it, and use it to take notes on your doctor’s or other caregiver’s instructions.
Bring your meter and logbook
The numbers recorded in your logbook help your doctor see trends, or patterns, in your blood glucose levels. Seeing a pattern of highs or lows enables your doctor to recommend medication changes or changes in other parts of your diabetes regimen. Having actual numbers is much more useful than telling your physician, “My sugars are all over the place.” However, only accurate records are useful: Filling in your logbook the night before your appointment will be obvious to your doctor and won’t be helpful in improving your blood glucose control.
If your provider has not already specified what glucose ranges you should be aiming for before breakfast, lunch, and dinner and before bedtime, ask — and make sure to write it down in your notebook.
Facing the scale
If that sounds like you, consider developing a different attitude toward the scale. Regardless of the number, find something positive to say about yourself or your efforts to care for your health and your diabetes. For example, share with your doctor that you have started a walking program. Tell him you have found a lunch partner who also has diabetes and that you are eating healthy meals together at work. Really think about something positive you have been doing. Perhaps you recently enjoyed your first green vegetable ever or tried a new type of fruit. Remember that your weight is only one measure of your health. Developing healthy lifestyle habits such as being physically active and eating healthful foods can have beneficial effects beyond any effect they may have on your weight.
If you have dropped a few excess pounds since your last appointment, share how you did it, accept any positive reinforcement that is offered, and take pride in your accomplishment. If your physician chooses to respond to your weight loss with a negative comment — telling you it’s not enough, for example — respond with a positive attitude anyway. Try saying something like, “I will work on making the best food and activity choices I can for myself each day. I will update you on my progress with that at my next appointment.”
Discuss your medicines
Include any over-the-counter or herbal products on your list, and mention if you have started taking any new products since your last appointment. Ask whether these new products might interact with anything else you’re taking.
If you are not taking your prescribed medicines, tell your doctor, and say why. It is better to be candid about what’s going on than to have your provider prescribe more medicines because your blood glucose levels are too high (which they are likely to be if you’re skipping your medicines).
Are your medicines too costly? Ask your provider if there are lower-cost alternatives. If there has been a recent change in your financial situation, the doctor’s office staff can provide you with information about pharmaceutical assistance programs that may help to cover the cost of your medicines and diabetes supplies. The Partnership for Prescription Assistance Program, which can be found online at www.pparx.org or contacted by telephone at (888) 477-2669, has the application forms for many pharmaceutical assistance programs.
Money is not the only reason people don’t take their prescribed medicines. Perhaps you are not taking them because you are depressed or sick and tired of having diabetes. Just saying it out loud can be a relief, particularly if you are heard by an empathic ear. Verbalizing how you feel can also open an important dialog with your doctor about your emotional well-being. In addition to offering a supportive ear, he may be able to suggest other resources, such as a therapist or diabetes support group. Similarly, if side effects or forgetfulness are causing you to stop taking your medicines or to skip doses, your doctor may be able to help you work out solutions to these problems.
Take off your shoes and socks
Discuss your goals
If your and your doctor’s goals are different, it’s important discuss those differences and to work out a plan for going forward. You need to be clear about what you are willing and able to do to manage your diabetes. Your doctor should be willing to listen respectfully to what you have to say and also to explain the reasons behind his goals. Chances are, you can come to an agreement about steps you feel able to take that will help to manage your diabetes.
However, if your doctor is not willing to listen to what you have to say or to discuss how to achieve the goals that are important to you, it may be time to reevaluate whether this health-care provider is the best for you. If the physician does not have the time for a lengthy discussion, ask to speak to a certified diabetes educator to help you with setting and achieving goals related to your diabetes.
Bring your calendar
Even if your doctor takes a look at your feet at every visit, the American Diabetes Association recommends that everyone with diabetes have an annual comprehensive foot exam that includes an assessment of the skin on the feet, the shape of the feet and toes, the appearance of the muscles of the feet, and the pulses found on the feet. The exam should also include testing for loss of sensation on the feet using what is called a monofilament (a light, thin strand of nylon mounted on a handle), as well as one other method of testing (of which there are several options). Your doctor may wish to schedule a separate appointment for this exam or a longer appointment than usual, or he may refer you to a specialist for it.
When scheduling your lab tests, leave enough free time in your schedule before and after so no conflicts arise. Many people feel that if they miss a lab test, there’s no point in keeping an appointment with their health-care provider. This can begin a vicious cycle of missed appointments. If you miss a lab test, therefore, do your best to reschedule it quickly, and keep your appointment with your health-care provider, even if you won’t get to the lab first. Ask your health-care provider if you can check in by phone or e-mail to discuss your lab results when they’re ready.
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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.