Thursday, November 30, 2006

I Believe- therefore, I DO

Remember this?

Time flies, when you’re having fun. (And seriously, its been fun. I love blogging, whether or not it does anything for anyone else, it does for me)

Went to primary care doc’s for another script (although I’ve been studiously putting off not going, couldn’t avoid it). I need the refill RX.

“So how are you doing?” he asks, as he enters the room.
“Fine.”
“Really?”
“Uh, no, but that’s what everyone is supposed to say before they launch into the reason they came there in the first place. It’s the polite thing to do.”
“I’m a doctor- I don’t care. You can say whatever you want, ok?”
“I’ll keep that in mind, thanks.”
“And how’s the diabetes?”
“Really good.”
“How good is good?”
“It’s been pretty stable for awhile.”
“Last a1c?”
“I don’t know yet, its been a couple of weeks and I haven’t got the results yet.”
“And your numbers?”
“Mostly between 100-200.” (Now)
“Your last a1c was-“ flipping though the chart. “Pretty high. Who do you see over at X?”
“Dr. K.”
“I’m going to find out the results of your last one.”
Proceed to call over there and find out the results, in less then 5 minutes. (To my utter amazement, it must be a doctor thing, it would take me 10 years to get someone to call me back)
“Have her call me- this kid doesn’t need strokes, heart attacks, and amputations down the road.”
List 3 separate numbers as contact info. I am kind of worried- its not like my endo doesn’t do a good job or that I ever said anything negative about her. What’s she going to think? It is entirely, 100% my fault about my a1c. She’s a good endo-she attempts war on the basal rates + everything. Its not her fault I’m a hopeless case.
Hang up, turn around.
“You haven’t gone down.”
“I kind of figured.”

Push glasses up, scoot over.
“You know, you’re too young to have diabetes complications. I am seriously worried about you.”
“I try.”(put passion into voice)
“Is there anything going on?”

“You mean, besides life? I’ve been working 60 hour weeks-its not like diabetes is a huge priority right now.”
“It needs to be.”
“I know.”
“Did I ever tell you about the guy in South Carolina?”
“No.”
“Oh, I thought I had.”
Pause.
“What about the guy in South Carolina? Someone you knew?”
“During my residency.”
“Tell me the story, then.”
“He developed diabetes at 17. Started losing his vision at 25. Had two heart attacks, a stroke, kidney failure, went 80% blind, and had an amputation. Frequently ran blood sugars in the 300-500 range and spent much of the time in the hospital from DKA. He said diabetes wasn’t going to prevent him from living his life but he essentially ignored it and it cost him his life. Most of it happened when he was 30-32. Two years-in and out of the hospital-and he died.”
“I’m not saying this to make you feel bad.”
“I know.”
“It’s just- you remind me so much of the path he was taking. I don’t want this to happen to you.”
Resist urge to tell him that I DON’T run blood sugars in the 300-500 range. Just the 200.
“And I’ve got another patient, she got diabetes around 15 + has worked hard all the years to keep her blood sugars down. Checking her blood sugars before every meal, etc. She just had her 20th year eye checkup-and there are NO signs of diabetic eye disease. Had two healthy pregnancies too.”
“That’s nice. Am I the highest a1c in your practice?”
“Yes.”
“I don’t know why some patients have more motivation then others. I wish I could help you find your motivation.”
Pause.
“It’s partly a genetics game, you know.”
“Yes, but its mostly blood sugars.”
“Well, if I get my a1c down, you know you can work miracles on anybody.”
“Not necessarily.”
“Just about.”
“I want you to.”
“I want me to too. It’s just impossible, to stay motivated for that period of time.”
“Three weeks- I want to see you back in here.”
“That might help.”
(That was the condensed version, it lasted about 15 minutes)
Discuss rx matters.
Walk out to desk.
“You’re the last appointment of the day,” the nurse informs me.
Look at clock. 4:35.
“You mean, I could have gone on with the sermon for another 30 minutes?” he says jokingly.
“That’s ok. I’ve heard quite a few sermons in my life, and that was certainly long enough.”
Check out.

Why is it so hard to stay motivated? Why? And why do I feel like a failure, every single time I go there...

13 comments:

asskeeper said...

Heidi, All I want to say is what a jerk. I am loading up all the animals to come down and take care of him. Yuhoo will hump him to death. Oscar will boar into him with his horns. Sweat Pea will lick him to death. The goats will eat all his paperwork giving him a coronary. The donkeys and the horse will kick some sense into him. I would just next time explain to him that Dr. K handles the D and you WILL not discuss it with him. I'm just livid with this doctor.

cHoCoMiLkRoCkS said...

That's not the best motivation is it? Not a great bed side manner. What was your last A1C? It all varies with different people. I know some one who is 84, had diabetes since they were 25 before all the mondern treatments. He still works, part time of course. He looks after himself as well as he can. He like the odd drink. He did have heart by pass surgery but he's still going strong.

It's all up to fate. Ignore that guy. The 100 - 200 range is what I'm in and my doctor called me a STAR! so f**k him.

Keep smiling don't let him get you down and can you not cut back on the 60hrs? that won't help you much.

All the best, love vic xxxxxx

Minnesota Nice said...

Oh for pity damn sake! I just don't know what to say, except dealing with the "healthcare professionals" seems to be more of a battle than the db itself.

Anonymous said...

I am going to have to disagree with the others who have commented on this. Even if this docor is not your endo, he is still your doctor too and needs to talk about all of your health issues. My gynecologist questions my A1C every time I see her! And I know that the SC guy story is horrible to hear, but I think he was just giving you a reality check. He has your best interests at heart and maybe he thought you needed to be "scared straight." That is what happened to me. For YEARS my A1C was never under 7 and my doctor was alsways upset with me. I even cried on one appointment! But one day I just realized that, like you said in your post, it 100% up to me to take care of this and even though it's hard I am only hurting myself - and eventually my family and friends down the line when other parts of my body begin to fail from my poor control. That was all the motivation I needed and it is sustained by every meter reading under 120. It really helps you see that your efforts are not for nothing. And although it doesn't get easier, you do used to it.

julia said...

I have to agree with nina. It is hard work, but you have to do it or you'll wind up like the SC guy. It's hard to hear, but it's better than being patted on the back and basically given a get out of jail free card.

Anonymous said...

man, I don't even know what to say. I would have left in tears. I would have cried at the doctor. I couldn't handle that kind of pressure.

Anonymous said...

I'll second asskeeper's comment

J E R K ! ! !

Too bad there isn't a reality tv show "try my life" where a patient and doctor can switch places. Let him live with type 1 24/7/365.

Why do they think those lectures are productive?

Be proud of yourself for going to get an A1C done and for taking insulin daily and for checking bg when you do.

Ellen

Hannah said...

I agree with Nina...this guy seems to think you needed to be "scared straight". I'm sure some people do need that, but this doc should definitely take into consideration that some of his patients may be too sensitive for that.

My A1c's are too high, too. Staying motivated can be really difficult, but that's why all these blogs come in handy. Ever since I've had a blog, I haven't felt alone.

asskeeper said...

Okay, I have to say as one who has tried working hard at getting my a1c's under control. I have never suceeded in anything that would make the endo or this idiot doc happy. Some may have D that is more easily controled but their are still some of us who will have wild fluctuations. Yes, the gyno is allowed to ask the previous A1C. Actually have a ton of docs for another medical problem and most know to keep their traps shut. Endocrinologist tries but as PA says I make no sense. I know Heidi and she does try and did not need this scare tactic. IT DOES NOT WORK!!!!

Anonymous said...

Isn't it hard to stay motivated b/c good blood glucose levels are hard to achieve. Failure breeds more failure. When I got my pump, i still had to work like mad, but I felt I could approach succes. I felt so dam good after so many years of feeling rotten. I thought - is this how healthy people feel? I have had D for 45 years, so i have been there. I know what you are dealing with. If I can help, email me or check out my blog.

Yeah I know what you mean about the first 5 minutes of fake talk with the doctor. Fine, fine, fine....

Scott K. Johnson said...

Oh Heidi,

I really feel you on this.

I know that you work hard on things. I do too. But I too struggle with high A1C's.

The thing that many docs don't understand is that a high A1C does not automatically equal a lack of effort.

My motivation levels swing up and down too. I don't have an answer on how to keep them up.

Maybe it should be more on finding little bits of improvements here and there? Or finding a balance point where you (and I) are living our lives the way we want AND maintaining decent control.

You don't have to get an A1C of 5.8 or something - just work on little bits of improvements.

Focus on progress, not perfection.

We're here to answer any questions, to help you come up with a plan, to be a virtual shoulder to cry on. Whatever you need, we can help.

Domain Names 4 Sale 24-7 said...

HI Heidi: What a great story! You should give serious consideration towards developing this into a one act comedy skit and offer it to SNL. Would probably be the hit of the season. Will you be sharing royalties? mc

Anonymous said...

^^ nice blog!! ^@^

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