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18 Responses

  1. CALpumper
    CALpumper June 19, 2009 at 7:12 am | | Reply

    Well said Amy. Well said.

    I usually don’t have to wait but sans insurance I make my Endo spend at Least a half hour with me. And he knows it. I am usually his last patient of the day. ;-)
    I am ok with that. I have to get my money’s worth.

  2. kdroberts
    kdroberts June 19, 2009 at 7:41 am | | Reply

    I agree. My waits are not usually that long but after the wait I usually get to spend about 45 minutes with the CDE and we go over things, then she goes away and talks to my endo and then he comes in and we spend another 45 minutes or so going over things, current research, and the like. Always leave happy. I hear too many stories about people who hate their doctor because they bring them in, talk at them and then go without really helping with anything and it always makes me sad because when you find the right one it can make a huge difference in how well you will manage your diabetes.

    Last appointment I was at the hospital very early in the morning for other reasons and then about an hour before my appointment everything piled up and I had to leave, go home and come back. Since it takes about 45 minutes to get home I was worried about being late. So as I’m rushing to my car I see my endo. He stops and says hello then says “I’m seeing you soon aren’t I?” I just thought he meant in general so I said yes, actually today. He said he knew and told me the time of my appointment. When I explained what was going on and that I may have to change times or show up late he said no problem, just show up when I can. It’s a good sign that your doctor not only knows you personally but obviously prepares for your appointments, knows when your appointments are and will work with you on getting to that appointment.

  3. Sara
    Sara June 19, 2009 at 8:39 am | | Reply

    Nope. My doctor is not worth the wait! That is why I am trying to switch. My old one was, but then she had to go and get pregnant with twins (her 4th and 5th kids) and left the practice. Her replacement and I are not a good match.
    I do try to book the first or second appointment of the day though because, well, how far behind can they be by then?!

  4. Lauren K
    Lauren K June 19, 2009 at 1:47 pm | | Reply

    No doctor is worth that wait. That is blatantly unacceptable, rude, and absolutely unprofessional. It’s also unprofessional conduct to introduce two patients.

    Also, most doctors’ offices have such a low caliber of staff handling life and death information that it terrifies me. I am constantly explaining to the nurse that I am a TYPE 1 diabetic, therefore I take insulin. I don’t take insulin because I have “a bad case of diabetes.”

    Seeing endocrinologists is useless for me. They don’t “get it.” I know more about this than they do, because I live with it. I can read a textbook too, I don’t need them quoting a bunch of self-explanatory information to me. During my appointments, they answer my questions, not the other way around. Being a healthcare provider is the doctor’s job; but we’re dealing with my life — the patient is the one who is ultimately “in charge.”

  5. xim1970
    xim1970 June 19, 2009 at 10:08 pm | | Reply

    My endo is pretty much on time, no more than a 15 minute wait, but I was irritated that they wouldn’t allow me to email my BG results (due to “privacy concerns”). I had no personal info in my Accuchek meter that anyone would be able to use. I’m sure it’s a “lawsuit protection” thing that they were doing, but it would have saved 10 minutes (valuable time to me as a graphic designer)

  6. Sara My
    Sara My June 20, 2009 at 7:02 am | | Reply

    I never wait more than 10 minutes to see my very good endo and he is generous with his time with me. It helps that he’s a type 1 too, so he gets like no one I’ve ever seen. We actually have real conversations about medications. I’m treated as if I’m part of the equation. The really odd thing is I drive two hours out of New York City (where you’d think I’d find a doctor I liked but nooooooo) to get to this doctor. I figure the drive is so much better than the hour or two I used to spend waiting for various endos I have seen over the past 30 years, those arrogant, stingy, clueless doctors and their nasty stupid unhelpful staff.

    Actually I think most endos are weird. They are more comfortable with statistics than people and most don’t know squat about Type ! diabetes – do they know it’s different that Type 2? They are a breed unto themselves and most of them are strange beasts. So it’s nice to find a good one – but they are rare.

  7. LindaB
    LindaB June 20, 2009 at 2:41 pm | | Reply

    My endo and I knock heads all the time. He does not listen to anything I have to say and tells me I am combative when I question him about things that are going on. He makes me feel like all the other diabetic related issues are not as important as a perfect A1c. He spends maybe 10 minutes with me,argues about changing anything on my pump and tells me he has been an endo for years, and though I may have been diagnosed 30 plus years ago, I have no clue what I am talking about because I don’t have the diploma on the wall.
    I have been trying to find a better endo ij my town. When you start resaerching the docs in this town, It seems they are mostly proficient in T2, which does not help me at all. I am ready to plead with a pediatric endo to take me on, and I am 40 Yrs. old.
    It gets so FRUSTRATING, being dismissed out of hand, I may not be an M.D.,but, I do know quite a bit about T1 and am an expert on myself. I am willing to travel to find the right Doc, my health is too important to be poo-pooed by an ambivelant M.D.

  8. Liz A
    Liz A June 20, 2009 at 6:55 pm | | Reply

    Amy and Sara – what wonderful endo service! Congrats on finding such good endos. I live in regional Western Australia and really struggle to find an accessible endo. I use my wonderful diabetes educator and GP (general practitioner) for most of my diabetes care … but struggle with control – my latest HbA1c was 8.7%. I am 34 and have had type 1 since 1983. I dream of a 5.8% HbA1c Amy! I’ve only just found your blog, so I’ll have to search through for some ideas on getting mine down.

  9. whimsy2
    whimsy2 June 21, 2009 at 3:30 pm | | Reply

    Liz, along with Amy’s excellent blog info, an EXCELLENT book to help you get your A1C down is called “Dr. Bernstein’s Diabetes Solutions,” by Richard K. Bernstein, M.D. I know they have it on Amazon. It saved my life. I’m type 1 for 12 years now and thanks to Dr. Bernstein, my A1C has never been over 6.2 and I have no diabetic-related complications. And I’ve educated my doc.

  10. Scott K. Johnson
    Scott K. Johnson June 22, 2009 at 6:04 am | | Reply

    Great A1C Amy!

    Sounds like your doc is a winner.

  11. Jan
    Jan June 22, 2009 at 4:05 pm | | Reply

    Way to go with the 5.9 A1c! I’m impressed that you accomplished that goal without a cgms. We can get in the low 6s, but below that, only once after the honeymoon. Do you have to drastically reduce carbs to do this? (Noted the above poster’s recommendation of Dr. Bernstein’s book, but 6, 6 and 12 is not going to cut it with DN (and she is a growing child)). I’m wondering if great A1cs are possible for the adults without more extreme carb restriction.

  12. Lauren K
    Lauren K June 23, 2009 at 1:14 am | | Reply

    Jan, I am a vegetarian who eats mainly carbs. I eat veggies and tofu but no meat or eggs, and very little dairy. The carbs I eat, however, are “healthy” — whole grains, fruit. And my A1c has never been above 6 (granted I’m only 2 years past dx).

    In my opinion having an A1c of 6 is asking for blindness, dialysis, you name every horrific complication in the book, and I have vowed never to reach such a high number. With exercise and careful self-control, it’s definitely possible to achieve tight control on a carb-rich diet.

  13. Jan
    Jan June 23, 2009 at 8:04 pm | | Reply

    “Having an A1c of 6 is asking for blindness, dialysis, you name every horrific complication in the book and I have vowed never to reach such a high number.” Great, IF you can achieve it. This goal is well out of reach for most children. What you are saying is: every child with diabetes is doomed; for those with A1cs in the low 6s are VERY few, particularly during puberty and the teen years. We did have A1cs in the 5s the first year after diagnosis, but she still had functioning beta cells then. A1cs in the low 6s are as good as we can accomplish at the moment. There is not that MUCH difference between an A1c in the high 5s (our next goal) and the low 6s. Also, I wonder if adults who get Type 1 or LADA are at the same risk initially, since I believe LADA is a slower onset of Type 1, as opposed to what I chose to call “Juvenile Diabetes.” I feel I can use that label since she was diagnosed at 8. You are right in mentioning you are only 2 years past dx. You may not have such an easy time of it, although I pray you do. Or was that “6″ a typo and you meant to insert a “7″ in its place? An A1c in the low 6s puts her at very little risk, according to her endo, who is a leading researcher in the field.

  14. Lauren K
    Lauren K July 7, 2009 at 7:58 pm | | Reply

    Jan, there was no typo. I won’t let myself have an A1c over 6. I have seen diabetics in “good control” with years of reasonable A1c’s (between 6 and 7, only the occasional 8) who have horrible, horrible complications. This is a personal opinion based on my personal experiences and observations only, but I don’t buy the current standards of “good control.” I think they are based on fear, maybe a reasonable fear for some people, of tightly controlled diabetics having hypoglycemic episodes.

    I can tell you that my body does not like a glucose above 180. I don’t feel well. It does not seem like a good idea to have a high glucose for any length of time, even hours, when my body is responding to it as if I am sick. That indicates to me that it’s not healthy to spend any amount of time at a high number.

    My little brother was diagnosed with type 1 as a child and I was diagnosed as an adult. I can’t claim to have had my brother’s experience, but after watching the consequences of his management (again, mostly “good management” by current standards, until recently), I am not going to fool around with my own disease.

  15. Lauren K
    Lauren K July 7, 2009 at 7:59 pm | | Reply

    Sorry, that emoticon above is supposed to be the number 8.

  16. claire
    claire August 17, 2009 at 7:22 pm | | Reply

    Lauren K: not to try to mess with any T1′s control freakiness, but I’ve never had an A1C BELOW 7 in 30 years, and have had no horrible, horrible complications so far. I still show no signs of neuropathy, kidney problems, retinopathy, etc.

    We’re all different. These things work differently on us. Some of us don’t have the personality, the life, or the simple human capacity to maintain as tight control as you do. And some of us, frankly, don’t have the body chemistry. Some of us go high just looking at a carb. Our metabolisms are different, the way we respond to exercise is different. We all do what we have to do to get through life.

    I’m also sorry to note from your comment above that you don’t seem to have ever had a decent endo. I’ve only had one, one out of nine and counting, but that made all the difference in the world. A good endo — even a halfway decent one — is a clearinghouse of information about your disease in all its permutations. You only have the time and inclination to explore one permutation: your own.

    I would strongly encourage you to keep looking for that decent doc and when you find her/him, let go of your control freakiness and be prepared to wait for a long time. Good docs always take on more patients than they can handle, trying to help as many as they can. Good docs take sudden panicked phone calls, wanting to deal with their patients personally. Good docs will talk a patient through all the details of sudden, unexpected symptoms, extending what was expected to be a routine visit. Good docs give you as much time as you need. That’s why you’re waiting longer, and that’s what you’re waiting for.

  17. Tom smish
    Tom smish November 30, 2009 at 11:43 pm | | Reply

    I would strongly encourage you to keep looking for that decent doc and when you find her/him, let go of your control freakiness and be prepared to wait for a long time. Good docs always take on more patients than they can handle, trying to help as many as they can. Good docs take sudden panicked phone calls, wanting to deal with their patients personally.

  18. courtney
    courtney March 30, 2010 at 10:56 pm | | Reply

    I wish i could get into an endo! you all should just be thankful you are fortunate enough to see a Dr. Im 22 and have been diabetic since I was 6. I have a very low income and cant afford to see a dr and often find myself lowering my dose just so i have enough lantus to get me through the month. I am trying to support my 6yr old and figure out away to go back to school without missing important events in his life because i honestly dont know how long i will be around. Im also in debt with medical due to DKA, so much so that the local hospital told me next time i would have to drive an hour into dallas to go to parkland hospital next time im addmitted, unless i start making payments. Guess they dont realize when you are passed out from DKA you are seriously out! I mean i dont see myself directing the driver to the appropriate hospital. Anyway my point is to just appriciate your Dr., nurse, CDE, A1C, and the fact that you have all that available to you. The last A1C I had was an 11 and 14 before that.

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