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 Type1Gal on -
well, congrats to you...I must say, you are doing a fantastic job! I too have had nurses and CDE's tell me I'm trying to micromanage my diabetes, testing too much. One nurse told me to only test 4 times a day, i gave her an earful..my endo has Rx'd 10 - 12 tests per day..sometimes I do less, sometimes more. Who cares how many times we test, it's how one gets good control. Next time ask her if she has this disease...cause she has no clue what a high or low blood sugar feels like and the way we correct these and TRY to stay within range, to save our bodies and feel better, is to TEST, TEST, TEST. My new endo told me, "if in doubt...just test, don't guess." Everything about diabetes has to be micromanaged on a daily, hourly basis. If you (we) don't do it, who is going to. NO ONE knows our bodies better then we do..if you're comfortable making changes, just do it..it sounds like you're very well informed, remember to make changes slowly, wait 3 days, only change one a time (basal - bolus) and there are always 1/2 units too.
As i've said before, these doctors and D team so called 'experts' work for YOU, not the other way around.
Also, do you have ideas of which pump you'd like to get...you can contact the companies directly, as someone noted, get the info, etc..then, which ever one you decide on, they, the reps will do all the work. it only took me about, maybe 2 weeks, to get a pump...they'll do all the insurance too. I think she's pushing you to make an appointment because they are so full, maybe in your best interest and she may be trying to be nice about it. Usually a pump nurse does the training.
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Permalink Reply by palomino on -
You are probably right about her just trying to be nice about it. But then that brings me to the point of why should I go somewhere that has very little time for their patients? My CDE said that when she worked there, she would see eight patients a day and only had an hour with each one. She definitely spent more than that with me the first appointment I had with her.
I'm still indecisive on which pump.
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Permalink Reply by HPNpilot on -
THe folks that say you are testing too much simply don't know the scientific literature.
There are numerous studies that show the more people test, the better their A1C.
Just a few:
http://www.ncbi.nlm.nih.gov/pubmed/20337978
http://www.ucdenver.edu/academics/colleges/medicalschool/centers/Ba...
http://abstract.t1dxresearch.org/2011/AssocFreqSMBGandHbA1cLevels.pdf(See figures 2 and 3)
Furthermore, a study just came out from the T1DExchange shgowing that people also get lower A1C from using a CGM.
The folks criticizing you are simply out of date!
The only case where the data is more equivocal is for people with T2DM who are also not using insulin.
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Permalink Reply by Leo2 on -
Get Walsh's Pumping Insulin.
Micromanage. Micromanage. Micromanage.
Keep your humor.
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Permalink Reply by palomino on
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Haha, thanks. I've already gotten the book in anticipation. And I will indeed micromanage, lol.
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Permalink Reply by kphil06 on -
Ask the CDE, I have found that nurses (NPs and CDEs) are always much more approachable and helpful than endos. I use my endo for scripts only but recently thought about changing because she told me incorrect information about a drug that I asked for. It's such an annoying process for me to switch, so who knows if I will or not.
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