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Yesterday I had my first appointment with a new endo. I did not have very high expectations because she is in the same clinic as my last one but I was prepared with my questions for her and I also brought in a copy of my letter to the previous endo. I went through the weigh in and blood sugar, A1C routine. I have lost 8 pounds since I was last there in May, my blood sugar was 91, and my A1C was 6.4%. I went in to the exam room and Dr. L came in and introduced herself. I introduced myself, and said, before we get started could you please just read this, and handed her the copy. When she finished reading it she said "I'm sorry" and I hope you and I can do a better job of managing your diabetes but you are in charge and I am here to help as much as I can. We spent 1 1/2 hours together. She did a complete neuro exam, thorough foot exam, and told me exactly what she was doing while she was doing it. But mostly we just talked or mostly I talked and she listened. I told her I wanted to try a fast acting insulin with a shorter tail than humalog and she suggested apridra and we went through the insulin fridge which was completely stocked with samples of every type of product available and I got a few apridra pens. The walls were lined with glucometers of every description so I grabbed some freestyle strips for the Insulinx meter. At the end of the appointment I told her I intended on getting my A1C down even further the next time I saw her, and she was very encouraging. She said if you can do it with a minimum of hypos then I would be thrilled for you.
I realize this was the first appointment, and it is unlikely she will have 90 minutes to spend with me when I see her in 3 months. But this is how healthcare should be. This is how we should all be treated and I am so happy I switched.

Views: 118

Comment by jrtpup on December 7, 2012 at 6:10pm

That's great Clare! So glad you found her ;)

Comment by BriannaM on December 7, 2012 at 6:19pm

She sounds like a wonderful and caring doctor. So glad it went well, especially since first visits set the tone for patient/doctor relationships. It's great that she is already working with you and new things you would like to try.

Comment by Clare on December 7, 2012 at 6:32pm

Thanks Brianna and pup, this is the relationship I was looking for in a doctor and I am beyond relieved.

Comment by acidrock23 on December 8, 2012 at 7:19am

I'm glad the doc seems to work! How did she do answering your questions?

Comment by catlover on December 8, 2012 at 7:59am

Glad you have found a doc you can work with, that is very gratifying. Good luck on continued positive appts.

Comment by Clare on December 8, 2012 at 8:02am

She answered the questions directly without hedging. While ADA and others consider 70 hypo, she does concede that YDMV and for some PWD that can feel perfectly normal and may in fact be perfectly normal. While she wouldn't suggest going out and driving at 70 she is not one to get all "you must treat that as a hypo". She did agree with me regarding adult T1's getting lost in the mix and her patient population is predominantly T2 but that is the case with just about every endocrinologist, save the pediatric ones. I came away with the feeling that I can work with her and she gave me not only her email address, but also her cell phone number, which is a lot more than the previous one ever divulged. What I liked is she listened and that is a skill that I think is sorely lacking in the medical community today. So I am looking forward to seeing her in 3 months.

Comment by acidrock23 on December 8, 2012 at 8:29am

I think the perspective of a 70 being "a hypo" [thus needing "treatment..."] might be as much because of limitations on test strips. If I test again in 20-30 minutes and it's still 70 (or 72 or 68...), I know that it's not a big deal. I don't see very many people reporting "I was at 70 so I had 3 Skittles..." sort of reports but I do that stuff all the time! I know doctors are limited by "safety" concern but I'd much rather play around with keeping my BG in a good spot and developing tactics to help me stay there, even if they change all the time while I cycle through various snacks.

Comment by Wren on December 8, 2012 at 8:51am

Your new endo sounds awesome! I just saw mine the other day too, and am considering looking for someone new (especially after reading this). I'm curious about your process of choosing a new doc. Was she referred, did you do research, or go in cold? Just wondering, as I only have seen one endo so far. She's competent, but her demeanor is very formal and she doesn't explain things, just asks questions and gives instructions.

Comment by Clare on December 8, 2012 at 9:35am

In my entire "diabetic" career of 37.5 years, I have seen 3 endos, the first 2 were pediatric endos from when I was a kid. The next endo was recommended by my primary care doctor. At the time he was young, probably recently out of medical school, and was generally ok, not very informative, but I didn't ask a lot of questions either. I needed him for prescriptions but beyond that I used my primary care doctor. Fast forward 20 years and a few really severe hypos from humalog overdoses, and I knew I had to change. There are 2 doctors that work in the Joslin clinic in Needham, MA and 1 nurse practioner, and 1 CDE. I had developed a really good working relationship with the CDE and asked her opinion about my new endo. Her response was "her patients seems to like her and she seems to spend more time with them, but I have worked with Dr. S for over 20 years and I have only worked with her for 3 years, but if you switch you cannot go back to Dr. S." I replied that in the 20+ years I had been his patient, I had never really made much of a connection with Dr. S and as I approach menopause I felt I would be far more comfortable working with a female doctor. So I made the switch. I am very happy I did. I wish you good luck, finding an endo who will listen, explain, allow questions, and respond because it is incredibly important.

Comment by Wren on December 8, 2012 at 11:33am

Thanks, Clare. Before my dx, I avoided doctors and hadn't had a physical in years. Now that I have T1, I am trying to be more responsible about getting healthcare. Hearing about other people's criteria for good doctor/patient relationships is helpful.


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