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I don't even feel like writing! Bad diabetes week. First, I took Samantha to her primary care doctor to get her school physical updated for softball. The doctor obviously didn't approve of my decision to switch Samantha from a pediatric endocrinologist group to a nurse practitioner specializing in diabetes care. "A nurse?" she said, "They have to be with a doctor!" Well, this is a practice of nurse practitioners on their own, I said. Strike one in her book. "She can't oversee that insulin pump!" she said. Sam's A1C has been rising since we started the pump, but we're still trying to understand it. "The only thing I don't agree with her on is that she doesn't think Sam should take her Synthroid at night," I said. Strike two. "I take MINE at night!" the doctor said. "There's nothing wrong with it!!" Then I had to reveal that Sam had been started on captopril to prevent kidney damage because the nurse had seen protein in her urine -- it had shown up a few times. She takes and extremely small dose which I had talked to our clinical trial doctor about & he agrees with the decision for her to take it. "Hold on!" the doctor said & left the room, coming back in with a medical book. "Captopril is not approved for use in children," she said, looking straight at me. "Samantha, you're still a child." Strike three.
I've had it. The endocrinologist's office was absolutely terrible. We never got any help. Samantha got yelled at by the CDE -- out in the waiting room -- for not using her pump correctly (she believed). That was it. We didn't go back. I did some research, considered going to Indy or Cincinnati to find a decent doctor & then decided to give the NP a try - here in Louisville. Wouldn't it be nice to have someone in town to rely on? When we first met with her, I told her we basically needed to start at the beginning because we were still at ground zero even though we'd been struggling for a year. We received pump training over the phone from Animas. We learned mostly by mistake.
Why did I have to explain any of this to the primary care doc? But I wanted to. I told her the nurse has helped us a thousand times more than the doctor's office ever did. I told her Samantha was yelled at. I do my research. She doesn't know ME. And I don't need anymore pressure. I'm dealing with enough pressure every day.
Couple days later, Samantha got a cold. Her BG started rising. We thought it was the cold. It was 300-400 on Thursday, no matter what we did. Changed the inset, tried boluses. Friday morning it was still going up & Sam really started feeling terrible. I called our nurse. She said, "Try this, call me back in an hour." We did it, nothing changed. "Do I need to take her to the hospital?" I asked the nurse. "We can do this," she said. Try another thing, call her in an hour. She said she was going out to a movie but she had her cell phone & pager. Nothing worked. BG 570, moderate ketones. Samantha was slumped on the couch. "Try 15u by injection," the nurse said. "It's the pump. We tried everything we're supposed to. Disconnect it." Whoosh! Samantha felt better within the hour. She was back in the 300s and eating a snack. She was talking again. Our nurse called to check on her, texted instructions for Lantus. She checked with us again the next day & made sure we have an appointment this week.
Diabetes keeps trying to make me look dumb, which is at the top of my HATE list. Every time something is out of whack, we have to go through a list & eliminate possibilities until we reach the real culprit. ARGH! The doctor's office was easy to eliminate. When BG is dropping or rising, it's harder for me to sort things out. I need someone to rely on in those situations. Right now, it's a nurse.