Dear Dr. S,
I wanted to first thank you for recommending I see Mary and get started with counting carbs instead of still using a sliding scale for my insulin doses. Since I started actually tailoring my insulin doses to the amount of carbs I consume, I have lost 20 pounds, started to regain my hypo awareness, lowered my LDL to 53 and my A1C from the mid 7’s to 6.1 and most recently 6.4 % and achieved a sense of control I have not had since I was pregnant with my son 22 years ago. I can also go to bed at night and not worry about whether I am going to wake up. I attribute the changes in some part to a change in diet with a more wholesome approach to what I eat and exercise, but the main reason is I am no longer overdosing on humalog at every meal and then having to counteract the hypos with a bunch of carbs. It’s a roller coaster that is not a fun ride. When I look at the sliding scale I realize it pretty much treated me like a robot, having the same thing to eat every day at every meal, the same number of carbs and the same amount of exercise, it just makes no sense at all. I now realize the only correct dose of humalog on your sliding scale for me was breakfast because I am fairly insulin resistant in the morning and I didn’t generally eat breakfast so I could get away with taking 4 units of humalog and not having to cover it with much more than my coffee with sugar laden fat free ½ and ½. I currently average about 20-25 units of humalog in an entire day, which was the dose for dinner on the sliding scale. It’s really sad that I spent so much time out of control when a simple “Clare I think carb counting would help you better tailor your insulin needs to your activity level and food intake”. It’s not as though I have ever been one of your “non-compliant” patients. I’ve shown up for every appointment, and have done what I have been told, it is just sad that what you told me was so fundamentally wrong for me.
You’re the doctor here and I respect your knowledge as far as endocrinology goes, but as far as relating to me as a person and as a type 1 diabetic of 37+ years I really think you fell short. It is for these reasons after having been your patient off and on for more than 20 years I have chosen to change to Dr. L. I am hoping a fresh start will give me the opportunity to have a teammate and mentor who will be able to help me continue to improve in my control and general health.
P.S. Even though it was not reflected in my clinic notes of May, I did in fact stop taking simvastatin as we had discussed. That is an evil drug and caused me years of muscle pain that I would have preferred to avoid. Dr. I still wanted me on a statin and since I have never had issues with Lipitor and it is now available generically I am now taking that instead. The fibromyalgia type symptoms I had been experiencing for years have completely resolved and I can now go about my day without being in constant pain.