MD snafu #2--Am I too critical?

Type1Lou
By Type1Lou Latest Reply 2011-11-07 16:40:08 -0600
Started 2011-11-02 17:00:16 -0500

I started on my insulin pump on August 16 and am very happy I did. I understand that getting the correct settings takes time and data. I've been testing my BG from 7 to 10 times a day to get that data and forward it to my endocrinologist every week. Two weeks into using the pump, the endo's office called me back to advise that no changes in the pump settings were indicated. I asked them to re-examine the latest BG readings because many of my BG's were too high. They called back later and had me increase/change some of the basal settings. Yesterday, I received a call after sending in my latest BG's. I had been experiencing some hypo episodes around 9 or 10 am in the morning as well as some "Dawn Phenomenon" highs upon waking. The endo's office advised me that I should decrease my 6am basal to .7; I explained to them that this would be an increase, not a decrease. They later called back to advise that I change my 6am basal to .5. My point is that I had to question their advice on two occasions and had I not done that, my control would have suffered. Am I being overly critical? Is it too much to expect the "experts" to give the correct advice? Sheesh!


25 replies

Uncle Lew
Uncle Lew 2011-11-05 14:19:16 -0500 Report

No it is not too much to expect correct advice from the experts. It is also not expecting too much that your doctor to be familiar with your case. Someone in that office is not paying attention or is mixing up patients. This points out to everyone that they need to accurately track their numbers like you did.
If the misinformation continues, switch doctors. Your well being and life depend on accurate information from your doctor.
Keep on top of it. Good luck!

RebC
RebC 2011-11-03 15:39:12 -0500 Report

I think you are perfectly fine to question your doctors. I have done that many times, and a LOT of the time I ignore what they advise and keep doing what I'm doing. However, I do know this…When I was using my pump (I'm currently not, because I find I have better control without it) I had the same thing happening, but the opposite advise. I woke up 300…they told me to increase my 5am basal by .2 units…the next day I woke up 350…again increase basal by .2…the next day woke up 400…do you see what is happening here? I was getting low in the early morning hours and my liver kicked out sugar, making me high. So I understand what your frustration is, but I would consider low blood sugar as an option, and not discount the advise you were given completely.

BUT…the fact is, you know your body better than anyone else. If you feel like you should increase instead of decrease, then that's probably your best bet. Good luck with the new doctor. It's really hard to find a good one.

Type1Lou
Type1Lou 2011-11-04 08:18:03 -0500 Report

Thank you so much for sharing your pumping experience. It is a frustrating path we travel to gain better control. My am BG's are mostly under 200 but still higher than they should be. I'm loving the pump experience after resisting going on one for years so I hope we can get this right. Thanks again!

RebC
RebC 2011-11-04 11:28:53 -0500 Report

If I remember right, my dad and little sister started out in a rough patch, just as I did, but eventually everything was worked out and their BG was under a lot more control with the pump. I am kind of impatient with bad BG, though, since I try to keep my A1C pretty tight for healthy pregnancies…I guess I just don't feel I have the time to figure it out yet. I'm planning on trying it out again after baby number 2 comes :). I hope you get everything figured out, and you continue to love the pump!

Old-n-Grey-n-Wiser
Old-n-Grey-n-Wiser 2011-11-03 09:41:13 -0500 Report

Definitely not, there always seems to be a "loose link" in most places and that link will finally break your trust, in your case you were on top of your numbers and caught the problem before any damage occurred.

Tom

Gabby
GabbyPA 2011-11-02 19:26:19 -0500 Report

Wow, I am surprised that there is such an issue. It seems that they would be paying more attention. It is good that you are, or you could have ended up in the hospital. This is why I am always harping that we MUST be our own advocate. I am glad that you are an example of that. I just hope your endo catches up.

Type1Lou
Type1Lou 2011-11-03 08:29:35 -0500 Report

I've been traveling over an hour to this endo and have decided to try one closer to home (only 1/2 hour away). I've lost confidence in the original endo's practice. The first endo I saw there left the practice in the spring and that may also be a factor in what is going on. My appt with the new endo is on December 8…meanwhile, I'll continue to send in my BG's and hope for the best. My control is getting better and I love the pump!

Mickey/CCHT
Mickey/CCHT 2011-11-02 19:06:55 -0500 Report

Hecks no you are not being to critical. They are supposed to be the professionals guiding you in your care. They should know what they are talking about. If it were me i would want a consult with the Dr. and support staff to air your concerns. We totally have to be proactive in our care. We cannot leave it to others and assume they are doing the best things for us. Always ? never take anything at face value if you are not totally sure. Good luck. Blessings

Type1Lou
Type1Lou 2011-11-03 08:49:12 -0500 Report

Thanks Mickey for these words of support! You're right, we have to be our own advocates and not fear to speak up when we have questions.

Mickey/CCHT
Mickey/CCHT 2011-11-03 22:23:57 -0500 Report

Exactly! I applaud you for being on point with what is going on in your care. I hope the new endo works out for you Also like your new pic:)

Type1Lou
Type1Lou 2011-11-04 08:19:30 -0500 Report

That was a pix of my husband and I on a punt in Christchurch, New Zealand several years ago. It was a great trip!

Type1Lou
Type1Lou 2011-11-04 18:47:55 -0500 Report

We were there in January…their summer. I especially remember the fields of blooming lupines along the rivers. It is a gorgeous country with very friendly, hospitable people.

Gabby
GabbyPA 2011-11-05 07:50:19 -0500 Report

Oh, I love to travel and New Zealand is on my bucket list. I have been to Australia in the spring and it was wonderful. I loved the people as well.

Type1Lou
Type1Lou 2011-11-05 08:52:41 -0500 Report

It was 5 years ago that my husband and I took a three week trip…the flight from Tampa to Sydney was a killer! The trip was an organized tour (SmartTours) and we spent 10 days in Australia (Sydney, Cairns, Melbourne), 6 days in New Zealand…loved the south island!..and finished up with 3 days in Tahiti! It truly was a dream trip! We're travelling now, in retirement, while our health and finances still permit.

MEGriff1950
MEGriff1950 2011-11-02 17:16:44 -0500 Report

Hi Louise I think you are not being critical. When you send in your numbers your dr should not only check your current numbers but also take time to refer to your chart for all your numbers. It is possible that your dr is not even seeing your BG's and a nurse or physicians assistant is advising you on your pump settings. If this was me I would make an appointment with my dr and discuss all of this with him.
Since this affects your health and your life it is wise to stay on top of everything like you have been doing.

Type1Lou
Type1Lou 2011-11-03 08:46:45 -0500 Report

Thanks Mary. I've decided it's time for me to change endocrinologist and one has just opened a satellite office closer to my home (30 minutes vs 1.25 hours). So I've made an appointment with him for Dec 8 after consulting with my pump rep that he supports the pump I'm using. I'll be alerting my pump rep to the concerns I have with the original endo as well. I'm trying to be rational about this but it is a matter of life and death. Thanks for the words of support!

MEGriff1950
MEGriff1950 2011-11-03 11:24:20 -0500 Report

Good for you! I have seen many here who stay with the dr they have because they trust everyone with a drs. degree. I really like that you are reporting your problems to the pump rep.

Next Discussion: Who do you talk too? »