Endo and PA Issues..
This is probably long and drawn out.. but I would appreciate feedback if anyone has anything to add.
So, ever since I went to see the endocrinologist and the physician's assistant, I am thinking more and more that I do not need to go to that office anymore.
First, the day after my appointment I called and asked if I could decrease my I:C ratio because the 1:20 was sending it sky high. The PA basically wound up telling me I was micromanaging and not to worry so much.
The CDE that I am seeing used to work at the same endo office and knows this PA. I told the CDE about what happened, and I said maybe the PA was having a bad day but it made me feel really bad when she suggested that I was micromanaging. My CDE told me that the PA's heart was probably in the right place, basically. So I decided to just let things simmer before making a decision.
The second incident occurred a week and a half later when I sent her my BG numbers. She actually e-mailed back and told me the following: "You are testing a lot and may want to reduce it a little. Be careful with over testing. I know you are curious but you don't want to burn out
with testing." I was really shocked by that, but let it be. I was testing on average 9-10 times a day; a couple days I did more than that when I was paranoid about my sugar dropping too low. Well, I just ignored that comment and let it be.
She has been asking me when I am going to make my pump appointment off on. I've tried to schedule it several times, but whoever was at the front desk the first time I tried had no idea what I was talking about. This week after I e-mailed her my numbers, she asked me yet again. I e-mailed her back and told her that I could not make an appointment because of my schedule- I am working 85 hours a week for 4 out of the next 6 weeks and the two weeks I could potentially go, they do not have any appointments.
I don't know why she keeps pushing me to make the appointment when they are booked solid for a month and a half.
She e-mailed me back with this "Sound like you are a little busy for the pump. So best to give it a little bit more time." I'm sorry, but that came off rude to me too. I keep thinking maybe she is just not a very good people person, but these interactions have totally turned me off of going back to that endo and PA.
I told the CDE I am seeing the first day that I am probably a little too intense and she responded immediately with "That's OK, I am too." And every interaction with her has been positive and helpful. She is very supportive and does not speak negatively to me about things; instead she is informative. The CDE does set some people up with pumps; but she told me on my last visit to go through the process at the endo because they are better set up for it.
I just don't want to. Is it unreasonable to ask my CDE if she would please go through the process with me because I am not wanting to go back to that endo office? It is the only endo office in the whole region, and quite frankly not worth it to me to keep going..
Replies to This Discussion
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Permalink Reply by juliannaergrl on -
Hello Palomino!
You as the patient have the right to choose where you go. However, if you have an HMO or there's only one endo in your area then your gonna feel screwed. Ive been there. It sounds to me that your problem is with the PA. Generally PAs work underneath an endo. You can refuse to see the PA. When you make your appts let the front desk know that you would like to see the doctor not the PA. This shouldn't be an issue. If they ask why let them know you prefer the doctor over the PA and you and the PA have very different schools of thought at the moment. Also, I'll say this cause everyone has said it to me, and because I didn't listen, I ended up in a terrible predicament for the past 4 years. If you don't like or can't get along or talk to you doctor run, don't walk somewhere else. Even IF you have to leave the region, it will be worth it.
As for switching in the middle of the process of getting a pump, that to is a personal choice. I mean if you think the pump is worth waiting till you get it to switch the wait, if you think you should have a good support system from you doctors office then wait till you get it worked out. My endo said pumps were made for busy people. So, I'm busy and I'm workin towards gettin it ASAP. They should be a little more willing to work with you. I didn't even need an appt to get mine, just filled out the request and started the process myself. Animas called the doctors office to get what they needed.
Hang in there girl. We are gonna get through this together. That's right I said we cause we are gonna be peeps. And you a re my first peep with diabetes. We can share this boat. Lol.
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Permalink Reply by palomino on -
I haven't yet started the process, and am holding off to see if I can find a better option for getting one. I'm just nervous about telling the endo group that I don't want to see that endo, I feel somehow it will create issues for me there.
I'm OK not getting the pump for a while, just to not have to see or talk to her again, honestly.
We can definitely get through this :) Thanks for being a friend :)
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Permalink Reply by acidrock23 on -
I think the process is you call the new doc and tell them you want to see them and they call the old doc and order copies of your records. And then the old doc and the new doc fight about it. You don't have to talk to the old doc about it.
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Permalink Reply by Type1Gal on -
great reponse, AR. That's what I did Palominovet. Are these endos in the same practice, the 'new one' you want to see who helped your sister, or are they separate practices? If they're in the same practice, I found it was nearly impossible to switch to a new one. If they're not, maybe see if you can get an appointment with the endo you want to see, don't cancel yet your appointment with your current endo..as it may take a while to get in. or cancel it if you really don't want to go back. You're already getting a bad vibe there and rightfully so. I think we've all had a bad d team member and you're so right, they shouldn't make any of this difficult or make US - you feel uncomfortable especially since you're doing SO well so Quickly. Like I said, I had a nurse who said the same thing to me too, I told my endo about it..it made me so upset, I also sent an email. Funny, 2 weeks later she no longer worked there, coincidence..IDK? I eventually just found a new Endo and Team and it's been wonderful, the care, feeback has been incredible. I felt the same thing to..like, 'no one even looks at my numbers, how can they adivse anything'. does anyone download your meter when you're there?
If you want to just change to a totally new endo, you don't have to say anything to them, just follow the good advice that AR gave..you don't have to go back there or talk to them. Good luck! this is hard enough to handle, manage without the support of a good team.
Also, just thought I'd add, don't rush to go on a pump, you're still so new at this, titrating, etc...do it when YOU feel comfortable and no one can tell you when that is.
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Permalink Reply by acidrock23 on
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The new one will be happy to "steal" you away from the competition. Too bad you can't be in on the call when they ask for your records? Heh heh heh.
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Permalink Reply by palomino on
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The new one has her own clinic in another city. I just called and she isn't accepting diabetics right now, but should be in a few months... So I'll just talk to my CDE and see what she suggests. I'd prefer to have a supportive group first before I get the pump anyway...
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Permalink Reply by Type1Gal on
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like the new pic! remember too 1/2 units. Or, while still on MDI's try splitting your basal dose..have you thought about that? That was recommended to me by my Endo before I went on the pump because it gives one a better picture of basal settings, how much to do AM - PM, etc..i use 1/2 units for everything. I'm probably the only one in my endo's office who does 1/2 units for basal, but..it works for me. if 10 is not enough and 11 is too much, try 10.5, or 5.5 am and 5 pm dose, depending on if you have DP, need more in afternoon, vs. morning, vs. evening.
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Permalink Reply by palomino on
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Yeah, we split my doses a couple weeks ago because I noticed that the Lantus wasn't lasting the full 24 hours. It's better now. The PA wanted me to go up to 11 units this week from 9 units last week- I only went up to 10 units instead and am having consistent readings in the 70s for fastings.. so I'll leave it for now. I probably do need pens with 1/2 unit increments if I'm going to stay with MDI for a long time, but I'll leave it until I talk with the CDE.
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Permalink Reply by Shawnmarie on -
"I know you are curious but you don't want to burn out with testing."
That's almost exactly what the doc said to me when she told me I was testing too much. Yes, I'm curious. Curious whether my BG is going to crash, curious whether my I:C ratio is sufficient to keep me from spiking, curious whether I'm doing a good job at being my own pancreas! Arghhh!!!
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Permalink Reply by palomino on
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Amen! I'm working with horses, cattle, and other things larger than me who like to be unpredictable at the best of times! It's better to know if I'm gonna crash soon before it's too late!
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Permalink Reply by Zoe on -
I absolutely would have been out of there with those comments. Anyone that thinks a new Type 1 is testing too much or "micromanaging" is too ignorant to be of much help imho. I would ask the CDE if she is able to do it for you. Another option is to go through the pump company. I just did my training with an animas trainer and they did all the work, including hand carrying the paperwork to the doctor to sign.
I don't mind doctors that don't have much to offer, but I have little tolerance for negativity.
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