Monday, March 23, 2015
I'm Getting Older- And So Is My Diabetes
I had an appointment with my endocrinologist a couple weeks ago and it was not the best appointment. In fact, I'm still shaken by some things that were said, and in turn, felt. My A1c came back at 6.6%, which, for a seventeen year old, is pretty great. (I may be slightly bias seeing as how I am seventeen and that is my A1c.) If you based endo appointments solely on A1c results, that might lead you to believe that this appointment should have gone pretty well. But we all know that A1c's are not the only thing that doctors look at. This time, my doctor was unhappy with several things. Some of them being the percentage of my total daily dose coming from my basal (68%- eeek!), the number of times I test my blood sugar a day (about 3 times per day for the last 90 days), and me not using insulin to carb ratios effectively. These are all things I expected to be brought up at this appointment because, well, I know I've been slacking lately. The things that I did not expect to come from this appointment were the guilt and shame I felt afterwards. The one thing my doctor said that I hated the most was "Come on, you're seventeen, this is just ridiculous." Excuse me?! The anger I felt in this moment was unreal. Since when did becoming seventeen years old mean that I couldn't get tired of diabetes? Doesn't everyone slack a little now and then? Don't I know people who have had diabetes for 10, 20, 30, 50 years and still get a little overwhelmed?! I have always loved my doctor, but when she said this I almost couldn't believe it. My A1c's have been consistently in the 6% range for the past couple years. In fact, this is my first "bad" appointment in years. Sure, I've been slacking. Sure, I could be testing a couple more times a day and using my pump settings more effectively. But did my doctor ever ask how I was? What's been going on in my life? WHY I may have been a little distracted from diabetes care? No. Instead, for the first time ever, she made me feel inadequate and not good enough. I am so tired of diabetes, and I think that's normal every once and a while. I'm trying to get my diabetes care back on track, but with no help from my doctor. I'm doing this for me. My doctor's remarks did not help one bit and she barely offered any solutions to the problems she saw. This, friends, is not what a good endocrinologist looks like and I promise you I will be seriously considering this whole situation before making another appointment with her. Good things don't last forever and this good thing may be ending. I am determined to get my health back on track, with or without the support of this doctor.
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Glad to hear you're doing well (IMO); after a bit of a hiatus I was concerned. (I even tried emailing you through a link somewhere on this blog but it bounced-back).
ReplyDeleteSome doctors are medically-brilliant but lack proper social skills.Yours may fall into this category. Do you also see a nurse or CDE? Whenever I see my endo, he does all his analytical mumbo-jumbo and writes down the "doctors' orders" on a paper, and then a CDE (or sometimes not a "certified" one) comes in and takes the time to make sure I understand everything, and that I know how to put into practice the things that the doctor was speaking about.
Maybe what your doctor says has merit, maybe not. Maybe she was just having a bad day. Maybe she's a pediatric endo (I saw my peds endo through my 18th birthday) and only knows how to talk down to kids that are used to being talked-down to (when I switched from pediatric to a "regular" adult endo, the whole dynamic of the doctor-patient relationship changed). Whatever the case, I hope this form of criticism doesn't continue -- and good for you for recognizing that you're not to blame for it. Because you're not.
I never meant for my break from this blog to be so long! Life gets crazy... I'm sorry your email bounced back. I need to do some updating of my contact info!
DeleteI see a CDE, but she does not work with my doctor. Since my doctor is actually located 3 hours from where I live, I also see a local CDE every 3-4 months. Neither of them are a big help in my opinion. I am good at taking care of my diabetes and making the changes I need to- but everyone needs a little help every now and then.
My endo is still a pediatric endo but after this, I am thinking I could start looking for a "regular" adult endo, as you said.
Thanks for your comment and your encouragement! It means a lot!
Wow, good job on the A1c. When I was 17 I think mine hovered in the 11 – 12 area (I was dx at 14). I hear you too on the TDD coming mostly from basal, heck I’m 40 and 60% of my TDD comes from basal so I wouldn’t worry about it. As far as testing goes, I was testing about once a day, if at all when I was your age so good job on doing 3x a day!
ReplyDeleteWhen I was a teen and in my early 20s I was seeing an adult endo that was not the greatest. He’s berate me for my numbers and try all the scare tactics. In my early diabetic years I really didn’t care! I stayed with him because I was used to him and I was afraid of him. I would lie my way through every appointment. It wasn’t until I was in my 30s, yes 30s! that I found an endo that I respected and in turn respected me. She never gave the guilt trip or talked down to me about my control. She actually listened and once said to me “I don’t know what it is like to really have diabetes, I’m just here to help you do what you want to do to control it.” That was really a turning point for me where I realized that the only one that understands my diabetes is me. I really liked her and vowed I would never go to another endo that shamed me or wasn’t supportive, and I haven’t. My current endo is a researcher as well and is always coming up with new ways for me to try and control this diabetes ride of life. I actually have told him that I was tired of the diabetes care and all the crap that comes with it. He listened and told me he’d do all he could to help, even if it was just to listen. I really appreciated that. When I go to see him, we go over my A1c, numbers and such to use them as a tool for the future. The way we look at it now is the numbers are in the past so let’s just focus on the present and future. That has made quite a difference. He’s not blaming, shaming, or punishing me – he’s giving me advice and tools to see what else may work. This disease changes day to day, no matter what anyone says. Good luck and my suggestion would be to look for an adult endo and don’t stop until you find one that you fit well with and respects what you are going through, not just the numbers you provide.
Hi... just checking in here for the first time in a long time. Congrats on the awesome A1c! I agree with a lot of what Scott says, so I won't repeat myself here. If you need a recommendation for a good endo, let me know.
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