Tuesday, August 26, 2008


I had my endo appointment today and I was severely disappointed. He had ordered a thyroid blood test, but no A1c. They did it in the office again. In my finger. Instant results. I STILL don't think these can be so accurate. I just don't see how they can be. And my fears were confirmed when the results came back 6.3.

I'm sorry, but there is no WAY my A1c is that low. My blood sugars have almost been out of control for the past 2 months. Very very few lows. In fact, until today (I had 2), I hadn't had a low in weeks. And my blood sugars have been fighting highs all the time. Correcting, correcting, correcting again.

Also, I have been having some discomfort with my feet. I'm not sure if it is diabetic nerve damage or if it could be from a vitamin D deficiency.

When I mentioned to my doctor about the discomfort in my feet and asked about vitamin D he said it was a possibility, increased my vitamin D intake, and said he'd request the test to check for vitamin D deficiency. So far, so good.

When I told him I thought my A1c should be higher, based on my blood sugar readings and my CGMS readings, he asked what I thought it should be. I said high 6's or low 7's. He laughed and said, that's not that much of a difference from the 6.3. You are obsessive.

Um, yeah. I am. I should be. I've been a diabetic for 23 years and am trying to keep myself complication free for as long as possible.

Then he gave me the orders for my vitamin D test and a microalbumin test and said "see ya in 3 to 6 months". Shuffled me out the door. Next patient please. No changes to my basal rates. No changes to anything. Even when I told him about my blood sugars.

Um, okay. You aren't going to test the vitamin D now? Okay. I'm obsessive. I get it.

Usually he is running behind. I've been seeing him for almost 4 years now. He's always in a hurry, but he usually talks to me. He didn't really listen to me this time. It annoyed me. I didn't like it. It made me angry that he thinks I'm obsessive.

I realize that not everyone is as serious about their diabetic care as I am. I've not always been this way. But I realize the wear and tear this disease has on my body. I know that I am spending precious time and the better I take care of myself, the more healthy time I get.

What do I do? Do I look for another endo? That's what I want to do. But I've been with him a long time now.

Do I go back to see him in January and see what happens then? I just don't know.

What would you do? How would you handle it? I just feel like I was blown off.


Lee Ann Thill said...

I suppose you could look for a different one. It doesn't hurt to at least try if your insurance doesn't have any restrictions against it. My other suggestion is to tell them you want a lab A1c done, and tell them you want a lab slip to get it done. See if they accommodate you or not. I had been seeing an endo who saw me every 3 months, but last year I switched to one who only sees me every 6 months. I'm not so keen on that, partly because an upcoming appointment is the fire under my butt I need to go to the lab so I haven't been getting an A1c every 3 months the way I like (I hate going to the lab). I'm considering switching. You shouldn't feel obligated to your doctor though - no matter how long you've been going - if you feel your needs aren't being met.

Scott K. Johnson said...

That situation sucks. I've not really been happy with any of my endos since I left the pediatric practice.

With that being said though, it often feels like so much work for me to change that I haven't done anything about it!

I guess what I'm saying is that I don't know. :-)

Karen said...

Yeah, I'd say look for someone else. Or give him one more try, but if you get the same treatment then move on. My goodness, there is a BIG difference between low 7s and low 6s. At least, that's what I've been taught. And he certainly should have ordered a lab A1C after hearing that you've been running high for two months. AND he should have gone over those readings and, like you said, suggested new basals or something! Co-pays are expensive, and you should be getting the services you are paying for.

Minnesota Nice said...

Doctors are always in a hurry. I hate it and can tell when they've not fully present. It feels so disrespectful.
Up until about two years ago, I could always predict my AlC to within about .3 of a point (provided I had enough logging data). there were never any surprises. And then it suddenly changed and when I think I'm over 8, I'm below 7. I know there are certain types of anemia that make your AlC lower, but I've been tested. What is my body doing? When I tell him the number is not right he just looks at me over his glasses like I'm a crazywoman.
Will your insurance pay for a podiatrist? He could probably do a full evaluation of your feet and maybe it's not neuropathy.
Dang it, we have to go through so much and then to do battle with the medical system is disgusting.
Maybe the doc was just having a bad day. I guess I might give him one more chance..............sigh.
My doc is certainly not perfect but I stick with him because of the familiarity. We communicate well, and he is usually pretty receptive to ordering a new test if I explain why I want it. Also, he will refer me to almost any subspecialist without a lot of hassle.
Good luck. You are intelligent and well informed and have a lot of db experience under your belt. You will make the right decision.