Healthcare in an Ideal World that For Some Reason Hasn’t Cured Diabetes

In an ideal world, diabetes wouldn’t exist. Neither would cancer or the myriad of other medical issues. In an ideal world, we wouldn’t need healthcare.

But in an ideal healthcare situation in a world that must include diabetes, here’s what I want:

Doctors who discuss care with their patients. I never again want to see a prescription for Humalog (when I take Apidra) sent to my retail pharmacy (when I use mail order) with an unfamiliar doctor’s name on it. Continue reading

Appointments

I hate making appointments.

Two weeks ago I called the appointment setting line for my ophthalmologist’s office and asked for an appointment. After getting my information the lady asked what I needed an appointment for and I responded that I needed a dilated eye exam.

“Okay, so you need to come in for your diabetic exam,” she said. This terminology bothered me so I corrected her.

“I need to come in for a dilated eye exam,” I said.

“But you have diabetes, right?” she asked me.

“Yes, but I need to have a dilated eye exam,” I answered.

“I can get you in on September 18th for a diabetic exam,” she said.

You may be wondering why the terminology bothered me, after all the only reason I get dilated eye exams is because I have diabetes. It bothers me for three reasons:

  1. The word “diabetic” bothers me in general
  2. Even though I get the exam because I have diabetes it doesn’t mean that the exam doesn’t look at the overall health of my eyes and people who don’t have diabetes can also need/have dilated eye exams, they have pretty much the same procedure
  3. She sounded judgmental

After making my appointment for what is apparently required to be called a “diabetic exam,” I called my endocrinologist’s office to make my semi-annual appointment for what could much more appropriately be called a “diabetic exam” (but endocrinology has the sense to just call them “exams” or “appointments”).

The conversation went like this:

Appointment setter: Can I offer you a next-day appointment or help with something else?
Me: I need to make an appointment for any time in October.
Appointment setter: The first available appointment is December 3rd.

The only reason that I didn’t make my next appointment while in the office last time was because the receptionist was out to lunch when I left. The first available appointment puts 8 months, instead of 6, between the times my endocrinologist has seen me. I don’t like this.

Yes, I’m planning to call for a next-day appointment in October (after my labs have been ordered “in advance”).

My New Doctor

I haven’t seen a primary care doctor in a little while and I needed to get into see one but I had zero intention of going back to Dr. N, who scolded me for having “too high” of an a1c in less than six months after being diagnosed with diabetes. (I was happy with the 8.1 at the point in time because I was over 11 when I was diagnosed) She was abrupt with me. I didn’t feel like she listened to the whole story. And she acted like she’d never seen any insulin pump before. Plus the 40 minute drive was not desirable.

Brad likes his doctor and that means a lot because Brad doesn’t like doctors. So I got an appointment with Dr. S.

It took a bit to get over the whole having a male doctor thing, but I did. I think I still prefer my female endocrinologist and female gynecologist. One thing I noticed at my appointment was that Dr. S was thorough. He went over my chart with me, went through my lab results from March and asked about my diabetes in specific terms. One of his questions was, “Have you had it since childhood?” When my answer was no, I’ve had it for two years and my “diaversary” was a couple of weeks ago he wanted to know more. He also didn’t bat an eye at the use of the word diaversary.

We talked about the real reason for my visit (which isn’t relevant to this post) and how his first reaction for treatment would adversely affect my blood sugar levels. He’s being cautious to confirm before giving me a treatment that could wreck my careful balance. At this point, I feel like he’s acknowledging my hard work in self-management, when other doctors would probably just prescribe the number-wrecking treatment and go from there.

He also explained why I needed to get a pneumonia vaccination more than just, “hey, you should get this.” And I got it done… ouch by the way. Those burn a bit like Lantus and my arm is still kind of sore.

At the end of my appointment when going through my paperwork, he asked, “Who is Dr. N?” I explained that she was the first doctor I saw when I moved to the area and she wasn’t a good fit for me and I would like to switch.

I’m now formally a patient of Dr. S.

D-Blog Week: Share and Don’t Share

Last year, I double-timed it for D-Blog Week. This year, I’ll see what I can do.

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?  (Thanks to Melissa Lee of Sweetly Voiced for this topic suggestion.)

When I go to any of my doctors, I feel like I turn into “super patient” and answer all questions precisely as if I’m being tested and just let the medicals lead the appointment. I’m married to a man with “white coat syndrome” so I know that’s not my issue, my issue is that I need to take control of my appointments. I did better at my last endocrinologist appointment, when I started a sentence with “while we’re talking, I need to ask you about travelling.”

I try to schedule my appointments online so it’s handy that I can type into the comments/reason for appointment box what I need to talk about and it ends up on my chart… whether or not that gets seen before I do, I don’t know.

Look at that! I’ve already strayed from the prompt!

What I wish they could see.

I wish they could see the life around my numbers. I mentioned about a year ago that I had an issue with a resident fixating on a string of low numbers and kept trying to change my basal programs to avoid them and somehow she didn’t understand they were outliers (because three days with lows in a row couldn’t be an outlier when you’re painting an entire house!). I explained over, and over, and over that those were not normal numbers. At that very point in time I wished I could snap her back to those days movie style so she could watch not only how active I was, how on top of treating those lows I was.

I wish that my healthcare team could see the things that I may not think to tell them about. I’m “new” at this whole living with diabetes thing and don’t always identify things they should know about. Although I doubt they should know about my sore neck from sleeping oddly, but I bet they should know about the tingly feeling in my hands that I only get in the mornings.

What I don’t want them to see. Continue reading

Stop Scolding

As a person with a large medical team (six right now), a lot of time and careful planning goes into getting the medical stuff that I need while still having this wonderful thing people like to call “a life.”

Lately, I’ve been fed up with being scolded by medical office staff and emails from my pharmacy. Today I just need to vent.

Last year, all of my medical visits hit at the same time and I was completely overwhelmed by everything. Because of that and our insurance all of my visits needed to be spaced out. I looked at the state of my health and decided to push my annual exam back a couple of months. When I scheduled my appointment, I let the nurse know that I would run out of my current prescription a couple of weeks before my appointment. She assured me that would be fine and to just call their refill line and explain that I need an additional month to hold to my appointment. I thanked her and that was that… Until yesterday.

Yesterday, I got a voice mail from Debbie in my doctor’s office. I’m definitely paraphrasing but it said something like: We got a call from your pharmacy requesting a refill on your prescription. You haven’t been seen since February so we can’t refill your prescription unless you make an appointment. You need to call our office and make an appointment.

The message would have been fine if a few things were different: 1. If her tone were pleasant or at least not so freaking rude. 2. If she had checked to see my appointment on the books for May. 3. If she had left the office number instead of making me look it up. Continue reading