Why Can't I Find a Good Endo?
I came to Mississippi just over 4 years ago. When I left Delaware, I had to leave a great endocrinologist and live the life of the uninsured for about 18 months. I was buying insulin over the counter and had friends who would supply syringes when I needed them.
Once my job here became permanent I looked for and found another great doctor. I managed to keep him for about 8 months until he made a choice to leave private practice. He left me in the care of a doctor that he thought would suit me best. My next trip in I was seen by doctor A (no names will be used). Who I guess was a student physician (although I was never told that) because she would never see me without another doctor present. It seemed that I was going to have a team of three doctors. Okay, I deal with that. Then my kidneys took a nose dive and in the aftermath I was taken off of Byetta by this team of 3 doctors. I was losing weight, something that had been so difficult was happening naturally while on the Byetta. Once I was off the medicine the weight gain started. My wife will tell you that I eat right and do not over eat. My meals did not change but I was now gaining weight.
On my next trip to the kidney specialist I was told to go back on the Byetta, that it had nothing to do with what happened with my kidneys. He was obviously right because my kidney function returned to their normal levels, for me anyway, and the weight loss resumed. Total time between being taken off Byetta and placed back on was 4 months. So I go back to the endocrinologist thinking all is well. Easy for me to say. I saw a new group of doctors who told me that if I continued to take the Byetta, they would not treat me. When pressed they told me I should wait until I could see "my real doctor". Well who are you people? I never got that question answered. My wife was furious and, by the way, she is the head of my care team.
So the search was on for another doctor. Enter doctor B (or would that be G or H?). My first visit to this doctors office all seemed great. Great office and a great staff. Then came the list of do's and don'ts. Like no fruits at all. No juice, no canned fruit, no fresh fruit. No fruit. Now I when I was in school I was taught the old food triangle and if memory serves fruit was on that list. See, I don't believe in cutting any thing out of my diet. I believe in moderation. The list of don't continued. When pressed on these about how hard these rules should be followed I was told "that is the way it shall be."
Then came the manadory classes on everything from food preparation to sliding scales. I work an early morning shift (4AM). I was supposed to drive 47 miles each way to a class I had to pay for but my insurance would not cover that would keep me up until 10:30 or 11 PM. Come on. Work with me here doc.
In the end, I could have kept on seeing him and never followed his rules or attended his classes. I could have offered lame excuses and kept right on seeing him. But the doctor patient relationship is built on trust. I knew that if I stayed with his practice that I would not be able to lie.
So I find myself with only my family doctor and my kidney specialist. It has been that way for over a year. My average A1c for the year is 5.2. I have had no lows. A few high BG but no lows that required any intervention. Makes me wonder sometimes if I really need an endo. Problem is, I know that I do. Sooner or later the wheels will come off the bus and I will find myself needing to see someone with a little more knowledge.
I just find it odd that I have one practice that will not listen to another doctor who is a specialist. Then I have another who seems to believe that diabetes is a one size fits all disease.
I have been a diabetic since 1988. I am a T2 who has been on insulin since 1996. I know my diabetes and how it responds. Why is it that these doctors refuse to let me be a part of my treatment?
Once my job here became permanent I looked for and found another great doctor. I managed to keep him for about 8 months until he made a choice to leave private practice. He left me in the care of a doctor that he thought would suit me best. My next trip in I was seen by doctor A (no names will be used). Who I guess was a student physician (although I was never told that) because she would never see me without another doctor present. It seemed that I was going to have a team of three doctors. Okay, I deal with that. Then my kidneys took a nose dive and in the aftermath I was taken off of Byetta by this team of 3 doctors. I was losing weight, something that had been so difficult was happening naturally while on the Byetta. Once I was off the medicine the weight gain started. My wife will tell you that I eat right and do not over eat. My meals did not change but I was now gaining weight.
On my next trip to the kidney specialist I was told to go back on the Byetta, that it had nothing to do with what happened with my kidneys. He was obviously right because my kidney function returned to their normal levels, for me anyway, and the weight loss resumed. Total time between being taken off Byetta and placed back on was 4 months. So I go back to the endocrinologist thinking all is well. Easy for me to say. I saw a new group of doctors who told me that if I continued to take the Byetta, they would not treat me. When pressed they told me I should wait until I could see "my real doctor". Well who are you people? I never got that question answered. My wife was furious and, by the way, she is the head of my care team.
So the search was on for another doctor. Enter doctor B (or would that be G or H?). My first visit to this doctors office all seemed great. Great office and a great staff. Then came the list of do's and don'ts. Like no fruits at all. No juice, no canned fruit, no fresh fruit. No fruit. Now I when I was in school I was taught the old food triangle and if memory serves fruit was on that list. See, I don't believe in cutting any thing out of my diet. I believe in moderation. The list of don't continued. When pressed on these about how hard these rules should be followed I was told "that is the way it shall be."
Then came the manadory classes on everything from food preparation to sliding scales. I work an early morning shift (4AM). I was supposed to drive 47 miles each way to a class I had to pay for but my insurance would not cover that would keep me up until 10:30 or 11 PM. Come on. Work with me here doc.
In the end, I could have kept on seeing him and never followed his rules or attended his classes. I could have offered lame excuses and kept right on seeing him. But the doctor patient relationship is built on trust. I knew that if I stayed with his practice that I would not be able to lie.
So I find myself with only my family doctor and my kidney specialist. It has been that way for over a year. My average A1c for the year is 5.2. I have had no lows. A few high BG but no lows that required any intervention. Makes me wonder sometimes if I really need an endo. Problem is, I know that I do. Sooner or later the wheels will come off the bus and I will find myself needing to see someone with a little more knowledge.
I just find it odd that I have one practice that will not listen to another doctor who is a specialist. Then I have another who seems to believe that diabetes is a one size fits all disease.
I have been a diabetic since 1988. I am a T2 who has been on insulin since 1996. I know my diabetes and how it responds. Why is it that these doctors refuse to let me be a part of my treatment?
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Comment by bikette on August 23, 2011 at 9:38am
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Hi Jon
I'm one of those slow tuD members who likes to read the site a little at a time, get to know people at my own pace and I'm afraid that generally makes me tardy for just about everything that goes on here! I'm just now catching up on your blogs and wanted to congratulate you on your "featuredness" and offer a very late, but very sincere "Welcome to TuD!"
Your blog about trying to find an endo was disheartening and I can empathize in a way, but being from Canada, our health care system works quite differently. I do know what it's like to be dictated to by my "medical professionals" and have their advice pretty much ruin my life. So I would advise you to keep searching for a doctor and a 'team' who WILL allow - nay encourage - you to advocate for your own good health.
I don't know what I'd do without Dr. Google, but we can only work on our own for so long and I've been "fortunate" to have been sick enough long enough to have garnered a fairly functional rapport with a very few very talented physicians in my town. And again, it was a case of finding what/who I wanted and then campaigning for myself! The Phamily Physician I have now is one who used to treat my mother-in-law back when he was a new grad and she was ... alive. I thought it was awesome the way he would appear at her apartment just to check up on her and how his entire family was made up of various specialties in medicine, including his Dad who is a prominent neurosurgeon in this area. Since my phormer phamily physician had left town for greener pastures in Bluegrass country (clearly he was colourblind), I was looking for someone who would work with me despite my nagging fear (and with good reason) of MDeities. I'd already been badly mismanaged for about a decade and really needed someone I could trust - with the WHOLE story, not just the bits I was permitted to feed him/her.
By now, this 'new' doc was fully booked and "not taking new patients"... that's what they call the best young doctors up here. Also at that point, we lost our mother-in-law to the great beyond and, well it just so-happened she and I had the same name, sorta. Our last name was obviously the same since I married her son, and our first names were very similar. So I phoned up this busy doc's office and "applied" for a position as patient. I told them I'd heard they had a recent "opening" and that I just happened to have the same name that was on that other file and most of the same ailments - they would only have to make a couple changes to bring her file back to 'active' status. I also told them that I would be an excellent "fixer-upper" for a new young doctor eager to try out new problems and weird medical phenomena since I was apparently on the road to experiencing both of those.
The gatekeeper laughed. Gatekeeper is what I call all the (mainly) women whose first duty is to keep all of us riffraff patients AWAY from the person signing her paycheque. It is important to warm up to those individuals or you will not get anywhere near an 'audience' with the MDeity him/herself. Once I had her attention, I asked for an appointment with the doctor and she made sure that would happen - just based on my warped sense of humour. We (the young doctor and I) met. We connected. Game begins.
I know your HMO system works MUCH differently down yonder, but maybe my dumbstory will have a grain of practicality in it for you to use in your ongoing pursuit of competent medical leadership - and it should be leadership rather than control. I don't need someone to dictate my every step in maintaining or even acquiring good health. I need a guide, someone with the benefit of a bunch of years in school and who associates with other people in the know to help me to NOT screw up too badly. This doctor actually respects me - ME - the lowly know-nothing - lies all the time - patient. He believes what I tell him (and I make sure it is always Gospel) and he goes out of his way to find the help I need when I
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Comment by brokenpole on August 24, 2011 at 2:48pm -
Don't ever worry about being late with me. I am just glad people read it.
I have had nothing but trouble from most of my doctors. My first family doctor put me on glulaphage and it tore up my stomach. The clown always wanted to put me back on it even though my chart said I reacted to it. He did like me cause I knew more about diabetes then he did. Just fill my scripts you $#%%hole and leve me a lone.
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How do you know what your chart says? I sometimes get a chance to peek at mine as it flies by but it is never offerred to me for reading. If I ask to read it or get copies from it, I am only allowed the former, and I must read what I want to read there, at the doc's office, with a staff member present. Dontcha just love that mutual trust thing that goes on between most docs 'n patients?
What I hate is the lack of communication regarding tests they put me through. I figure if I'm going to wait 6 months for an MRI and sit in a waiting room at 4:30 in the morning for an hour before squeezing into a noisy crypt meant for someone half my size for another hour... I should at least get to read what the radiologist had to say. After years of NO results from myriads of tests, I just quit going to them. I took the nice requisitions home and let them sit... still do - especially all those blood tests.
One time he asked me about the prior tests and I told him why I don't bother with them anymore. Now (most of the time) he tries to get one of his incompetent staff members to fax or email me a copy of the test results but it's almost always a matter of reminding him/her a few times. I won't do that forever either, but I appreciate his efforts so I'm trying to comply.
When I was first married, I had an opportunity to enter medical school and chose nursing school instead because it was 'quicker' (and cheaper). I finished nursing school but hated it and never 'registered', and I've regretted not getting my own MDeity ever since. It sure woulda been nice to at least understand some of the garbage that has happened to me over the last 20 years and not HAVE to rely on someone else to mete out his/her little snippets of information when he/she deigns to honour my continual requests. Again, Thank God for Google.
What turned me off med school wasn't so much the hard work but the incredible competition among the students - so many minds, and so few positions in the classes/residencies. I really woulda hated that part... but I think maybe Grenada woulda been a nice place to study for a few years!
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