Wednesday, November 12, 2008

Notes from a Spinning Planet: Progress Notes

I sit, waiting, for the doctor to appear-shoes squelched tightly against tile, toes curled, sweaty hands gripping chair arms in death grip...



"Your labs look great, with the exception of your blood sugar, which is high, the last one was 185."

He fixes me with the all-knowing look.

(Not again...)

"It's very important to keep your diabetes under control."

Great. How to put this is diplomatic, physician-approved, terms. Deep breath, going off the deep end never helped one's case.

"I understand, and I do try, but I'm not your typical type 2 patient and type 1 diabetes is impossible to prevent post-meal spikes. My kidneys aren't going anywhere." (the regular function of them is perfectly fine)

He does not look convinced.

"Proper management is ESSENTIAL, you don't want those problems too."

He's a nephrologist, and I'm his type 1 diabetic patient- I guess he has the right to rag some. How many patients has he seen die because they neglected their D? probably quite a few.

I wish he would stop it though. I get that I'm at prime risk for everything under the sun. I take my health(and D) seriously, and I'm trying to manage it. Unfortunately, Doctor-Patient Communication 101 must not have been a class taught in medical school some 44 years ago and I get the feeling he thinks I'm just spouting off excuses.

"Why is it so hard for you?"

Check yes on that theory. It's not that it's consistently "hard", it's more like D has a freakin' mind of it's own and even when it's easy the insulin peaks at odd times, the hormones surge whensoever they wish and the effects of exercise hit at 4 AM, leaving the total deal somewhat of a crap shoot. And I can't explain all that, the million factors of managing bgs. I respect his expert opinion on the management of my electrolytes, but the nagging guilt parade over my bgs has got to stop. I've got to find a way to communicate that to him, because he is a very hard-nosed, do-it-my-way kind of doctor who stopped learning new info a long time ago. Finding another doctor isn't possible, the wait list for nephrologists is 1-2 months and I still have to get infusions. I need him, to manage it. It is doing much better,and I will soon only have to have it 1x/week.(on the good news front)


Colleen said...

How very, very frustrating for you.

Lili said...

Why is it so hard for you? Seriously?

Does he think it's easy to try to be your own pancreas?

A lot of doctors seem to think it's just a matter of the right inputs and then you get consistent output. Except, as we know, Type 1 diabetes isn't consistent. Can you try explaining it to him with an analogy? Or at least that many people would kill to have a bg of 185.

Scott K. Johnson said...

Wow - like Colleen says, how very frustrating.