I hurt my foot. I am, without a doubt, one of the clumsiest people on the planet. I hurt myself without even trying. My foot's been bothering myself for a while now, so I went to my Primary Care doctor. When I got there, I was told that I'd be seeing a different doctor because mine was out today. Okay, fine, whatever.
After a general check of my weight, blood pressure, and pulse rate, the doctor came in to see me. I've never met this guy in my life, so I didn't know what to expect. I looked him up on my phone while I was waiting. He is a certified family practitioner, with a specialty in family medicine. Okay. He examined my foot, said I'd be fine, gave me a prescription anti-inflammatory, and told me to get an Ace bandage. He was scrolling through my file on the computer and getting ready to send the Rx to the pharmacy. Then he brought up my diabetes, and that's where things got ugly.
"Oh, I see you're a type 1 diabetic. How's your diabetes?" he sounded conversational, so I told him I was managing. Usually doctors leave it at that. Nope. "What's your A1C?" Eight-point- "that's not managing! That is terrible! You're on a pump, there is absolutely no reason you should have an A1C above 7. What? Are you not checking your sugars? Not bolusing? Sneaking candy?" That's when I used my stern voice to tell him I test a minimum of 6 times per day, correct when needed, and bolus for everything. "Well obviously something is not right. Do you actually see an endocrinologist?" Yes. Every three months. Given my circumstances, she is okay with my progress, and- "any endocrinologist worth their salt is not going to be happy with an A1C that high. What is your BG when you wake up? When is it the highest?" Around 100, usually mid-afternoon, but I have a non-constant schedule, so finding patterns is difficult. "Well, if you're high in the afternoons you need to increase your basal rate. Your carb ratios should remain constant through the day, but if you're higher after lunch, you need to increase your basal rate." Okay, whatever. At that point, I was over it, flustered, and taken aback. So I just listened to him talk, nodded, and left as soon as I could.
I'm still finding my voice when it comes to standing up for myself. I can defend other people all day, but I'm still working on advocating for myself. I didn't want to keep going with this doctor about diabetes, mostly because he seemed to have an overly simplified view of it. He was of the opinion that diabetes is a static, formulaic disease. Input the right number of insulin, and there is ZERO reason you shouldn't get the right numbers.
If I run into this again, I don't know what I'll do. Has anyone else dealt with this?
After a general check of my weight, blood pressure, and pulse rate, the doctor came in to see me. I've never met this guy in my life, so I didn't know what to expect. I looked him up on my phone while I was waiting. He is a certified family practitioner, with a specialty in family medicine. Okay. He examined my foot, said I'd be fine, gave me a prescription anti-inflammatory, and told me to get an Ace bandage. He was scrolling through my file on the computer and getting ready to send the Rx to the pharmacy. Then he brought up my diabetes, and that's where things got ugly.
"Oh, I see you're a type 1 diabetic. How's your diabetes?" he sounded conversational, so I told him I was managing. Usually doctors leave it at that. Nope. "What's your A1C?" Eight-point- "that's not managing! That is terrible! You're on a pump, there is absolutely no reason you should have an A1C above 7. What? Are you not checking your sugars? Not bolusing? Sneaking candy?" That's when I used my stern voice to tell him I test a minimum of 6 times per day, correct when needed, and bolus for everything. "Well obviously something is not right. Do you actually see an endocrinologist?" Yes. Every three months. Given my circumstances, she is okay with my progress, and- "any endocrinologist worth their salt is not going to be happy with an A1C that high. What is your BG when you wake up? When is it the highest?" Around 100, usually mid-afternoon, but I have a non-constant schedule, so finding patterns is difficult. "Well, if you're high in the afternoons you need to increase your basal rate. Your carb ratios should remain constant through the day, but if you're higher after lunch, you need to increase your basal rate." Okay, whatever. At that point, I was over it, flustered, and taken aback. So I just listened to him talk, nodded, and left as soon as I could.
I'm still finding my voice when it comes to standing up for myself. I can defend other people all day, but I'm still working on advocating for myself. I didn't want to keep going with this doctor about diabetes, mostly because he seemed to have an overly simplified view of it. He was of the opinion that diabetes is a static, formulaic disease. Input the right number of insulin, and there is ZERO reason you shouldn't get the right numbers.
If I run into this again, I don't know what I'll do. Has anyone else dealt with this?
I think you handled it properly, and the same way I would have. Give it a minimum of effort, and after that just nod politely, let him finish up with his uneducated rant, and move on. There's a reason you see a specialist and not a PCP for your diabetes care, and I think you know whose advice and direction to take when it comes to those matters.
ReplyDeleteOftentimes, the battle just isn't worth the trouble.
Honestly, I just tell a doctor like him that my diabetes is being handled by my endocrinologist and I'd like to leave it like that. If he has any concerns, he needs to take it up with my endo. Sometimes standing up for yourself doesn't have to involve "winning" the battle, just preferring not to enter it.
ReplyDeleteWhat you did was just fine! You know you're being taken care of by your endo; another option could be, "I appreciate the concern, but my endocrinologist is helping me manage diabetes. I'm here to see you about my foot, not my diabetes. Shall we move on?" And smile. :)
ReplyDeleteI battle this issue myself. I have a hard time walking the fine line of just telling the doctor that my Diabetes isnt his concern vs having an all out explosion telling this non-Endo doctor that they dont know didly squat about type 1 Diabetes. I am really ticked off for you though, I dont think I could contain myself if he went into interrogation mode on you like that ever again.
ReplyDelete