Today's class was about the standards of your medical care that your doctor SHOULD be providing. Most of our class was not receiving care anywhere near what it should be. So here are some highlights I got from the class.
1. Clear your medical records. Insurance is going to look at your records if you are applying for insurance and you want to make sure if you were tested for something (say, high cholesterol) and the labs came back negative. You need to make sure that the doctor has noted that in your records. If they don't, the insurance company will presume you have high cholesterol. So go over that paper work and make sure that any tests and questions you had do not get put down as "you have this condition".
2. Besides having your typical team of your Family Doctor, Diabetes Specialist, Pharmacist, Opthamolegist, Podiatrist and registered Dietitian (CDE preferred) you need to not overlook the need for Specialized mental health Professional. Learning to cope with a chronic illness is something that needs to be addressed often, especially in people who do not have a strong support group.
3. While the A1c is a standard used by many doctors it should NEVER be the only thing your health care team uses to monitor your control. Things that skew your A1c: other blood disorders, donating blood, a blood transfusion, and too many hypo episodes. If your doctor only uses the A1c, you may want to bring this up with them.
4. When you do visit your doctor, bring your list of questions. Also, if you have the ability to create a graph of your daily monitoring it is suggested to bring that with you to identify patterns of highs and lows to better adjust your treatments. If you don't have that, then make a summary of your daily numbers and talk to your doctor about the patterns you are seeing.
5. Blood Pressure. While our ideal is 130/80, often your health care provider does only one reading, right after you have come in. The heart association recommends the first reading to be taken after 10 min resting, no speaking and no crossed legs. Then they are to take it a second time and give you an average. So often you get one right away, don't be afraid to ask the doctor to do it again after you have relaxed.
6. Smoking doubles your risk of complications. Wow! So they highly recommend quitting. The things that smoking does are the same as diabetes, so you don't want to have both things working against you.
7. If you do have a Podiatrist, it is recommend that you get one that is a board certified surgeon and not just one who cuts your nails and files your callouses.
8. Kidney function tests are a must. Most family care doctors are ordering these now, but if yours is not, ask them to include a microalbumin and/or GFR test.
9. Always get a copy of your lab work so you can see what might be overlooked. If you have questions, make sure you ask. If you have a team, when one lab work order is put in, make sure that all of your team is coppied on that lab work, so they can look for the results that each of them are following for you.
10. BE YOUR OWN ADVOCATE. This cannot be emphasized enough. If your care team is not doing something you think they should be, let them know. If you get meds, ask them how to take them and why. If you don't understand, don't leave until you get an answer that you can understand. It is your life, make sure you are taking care of it the best you can.
I am really enjoying these classes and I hope the little bits that I can share will help you too. I am always amazed at how much I learn.
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