Doctor's Orders?

By Nonna2Three Latest Reply 2011-02-07 18:18:07 -0600
Started 2011-02-02 13:06:43 -0600

I'm just curious how many here follow the doctor's orders completely and how many are opting to do things their own way. And if you do things your own way, what parts of the doctor's orders do you follow more strictly than other parts?

I have only been working through this for a couple of weeks and the day I was diagnosed I was told to give my injections in my stomach. By the time I went back to the doctor 3 days later I had read about injections in the thighs and upper arms so I asked about giving my injections in those ares to be sure I shared the joy with all my inject-able area. My doctor told me that while those areas could be used he did not want me to because the medicine is absorbed differently in different areas. Well, my stomach now has little bruises in most of the injection spots and last night the injection was a bit more painful than most times and the injection site bled out a good bit. So, now I am considering moving to the thighs for a while to give my stomach a rest.

I have also read (not necessarily on these discussion boards) where some people give themselves additional injections if they have strayed from their diet such as when they have been to a party or other social function. This is not something I am considering, but it is just an example of another method I saw where people disregard the doctor's orders (in a strict sense of speaking).

I know we each should take ownership of our own medical well being and concern. But some things I think should not be played around with.

27 replies

RAYT721 2011-02-04 19:39:50 -0600 Report

Great point of discussion… thank you! I have been around this site enough to hear some awesome stories and some rather disturbing stories of doctors, nurses and even specialists that offer both good and bad advice. I have listened to my doctor and altered my lifestyle to what works for me, taking what he's said but making it work for me. My doctor suggested losing 5-10 pounds so I lost 30. My doctor didn't mention a meter but I got one anyone. Doctor never mentioned online support groups… but I found YOU! There are no "one size fits all" advice when it comes to an individual so the expression, "take the good with that bad" applies to all kinds of areas of life. I will continue to protest when insane advice is given but comply when things are working and I believe that true for diabetics or for anyone else with medical conditions and concerns. I once had an eye doctor point out that I am cross-eyed. I pointed out that he's a jack… anyway, be good to yourself because nobody knows your mind, body, and soul better than you. I have a problem with a non-diabetic doctor (or friend) babbling about diabetes. I have a problem with eye doctors who can't "see" the need to be professionals.

mo91108 2011-02-04 17:25:46 -0600 Report

I give my injections in my stomach my thigh my arm and in my love handles. :] I follow the docs oreders pretty strictly, but hey if you don't keep switching on and off from stomach to thigh after a while your stomach will grow callusses. And when you give yourself extra insulin and what not to do something you couldn't normally is a way to cope with your diabetes. It is normal and if you can do this without overdoing it like making your sugars too low, then it is fine. I take extra insulin if i want to have a bigger meal. But good luck and play around with it to find out what is good for you.

- Monica

kdroberts 2011-02-04 13:26:32 -0600 Report

Mostly managing diabetes is about improvising. Once you get into a routine it's very easy to keep things in check when things don't change but it's the unexpected changes, like getting sick, sudden stress, unexplained high/low blood sugars that you need to make quick choices and your doctor may not be available.

If you have an open relationship with your doctor where you tell them everything about your health, how you feel, what your goals are and what your fears and concerns are and discuss your treatment and what you are willing to do and not do then it's very easy to both manage your care and follow doctors orders. Having this kind of relationship means you will get personalized doctors orders that will most likely be flexible based on what you feel comfortable doing. If you don't have that kind of relationship the best you will get from a doctor is basic, generalized orders that may or may not be appropriate for you.

For instance, with my insulin my doctor asks me how much I'm taking rather than telling me what to take. With my mealtime it started out with a fixed dose that he told me to take, then based on results it went to a insulin to carb ratio that he prescribed and then on to me working out what works for me. With my long lasting insulin it started out on a fixed dose that he told me but then based on some guidelines he gave me I adjusted it to what I was happy with. Same thing with diet. I was given a diet plan to follow, it didn't work so I made my own. I told my doctor what I was doing and she's OK with it. I wouldn't go to a pharmacy and by over the counter insulin and randomly start using it or stop using anything without talking to my doctor but I live with this 24/7 and I don't have a doctor who knows my medical history as good as I do on call 24/7.

ston3xc 2011-02-04 13:08:26 -0600 Report

I have seen a good many drs in the 30+ years that I have been diabetic. For the most part I have always followed their treatment plans. But sometimes you have to know your own body very, very well to decide if a certain treatment is right for you. I use my hips and thighs for my injection sites, I never use my stomach. I know when my sugar goes a little high and I inject a little extra insulin accordingly. I know when my sugar is going to take a nosedive, so I always keep glucose tablets on hand. After awhile it just becomes the way you live your life. Diabetes does'nt have to be a big deal but taking care of yourself should.

Dr Gary
Dr GaryCA 2011-02-03 20:39:42 -0600 Report


This is a really interesting discussion that you introduced. I think that patients often do a lot of second guessing with their doctors. They wonder if the doctor is going by "best practiices" but doesn't reallly expect patients to follow their orders to the letter, or that the doctor is "erring on the side of caution," but doesn't really expect patients to follow their orders to the letter. Or, patients just find the doctor's directions to be inconvenient or unrealistic, and want to do something more reasonable. Or they follow the doctor's directions but at great inconvenience when the physician might be open to an alternate approach if the patient had simply raised the question.

It seems to me that what's important is for the patient and the physcian to communicate in an honest manner, letting the doctor know what seems reasonable, what is inconvenient if not almost impossible, and try to come to an agreement. This means not agreeing with the doctor but having no intention of followig through. At some point, the physcian knows what's best and why. But maybe he/she hasn't explained why, and, and you said so well, certan aspects of the agreement aren't negotiable.

Being a good medical consumer, in my experience, havng an open dialogue that is based on honesty and trust.

Thanks for the great post! As you can see, it's an issue that many have tought about.

slgw 2011-02-03 18:23:44 -0600 Report

Like a few of your other responders, I've been accepting the doctors words as law until i was given needles two types of insulin and told to wing it. No instructions, nothing. Within a year or so I was hospitalized with the dreaded 0300hrs drop in sugar. No matter what they did I dropped. During this time I found that many of the meds the good doctor had placed me on had done more harm than good. My pancreais (excuse the spelling) had shut down and nothing would tickle it back. I now work with my PCP and we practice together to see what is best for me. I count Carbs, I eat right and one day I cheat, I make up for it. I refuse to live without enjoyment in my life. Diabetes is not a life sentence. Since my diagnosis, my brother and sister were also diagnosed. My father now has it and I found that my grandfather on my mothers side did also. I hate taking soooooo many pills and I hate needles. After my hospitalization, I found a more understanding and proactive PCP, I take classes and try to manage my own illness/disease. I was diagnosed in about 1985 but believe I was born with the disease. i hope this gives you food for thought.

Leedemp 2011-02-03 12:30:00 -0600 Report

I have a great PCP who has helped me get my A1C in line with where it should be. I use to do it my way before my stroke but I figured the Doc knows more than me and works WITH me to make me feel better.

mdg50 2011-02-03 06:31:13 -0600 Report

I try to take all my meds that the doctor tells me to, but I also add (TCM) Traditional Chinese Medicine. Acupuncture for the most part, and it does work.

CaliKo 2011-02-04 12:21:11 -0600 Report

I have a friend who uses acupuncture therapy successfully for pain management for an otherwise untreatable chronic back condition, but I haven't heard of using it for diabetes. How does that work?

GabbyPA 2011-02-03 21:23:58 -0600 Report

Do you use the acupuncture for your diabetes or other issues? I have been given one to go and visit and am just not sure.

mdg50 2011-02-04 18:32:23 -0600 Report

Hi Gabby: Sorry that I did not get back with you sooner, I have not been feeling to well today. Yes, I use Acupuncture for my MS. I havn`t found a acupuncture point yet for my diabetes yet. But I am looking through my books. Just make sure the person you go see, knows what he is doing. And the needles, you don`t even feel them. They are about as big as a human hair. If I where you, I would try it. If you don`t like it, you don`t have to go again. Acupuncture can help with alot of things. your friend mike

GabbyPA 2011-02-07 14:57:24 -0600 Report

thanks. She is a holistic doctor and does many alternative treatments. I have been so muscle sore for months and it is making me crazy. That is one reason I was thinking of going. She charges $60 per visit, but she works on you until some reasonable resolution has been achieved. How does it help your MS?

mdg50 2011-02-07 18:18:07 -0600 Report

My form of MS is known as Trigeminal Neuralgia. The Trigeminal nerve gives you the sense of feel in your face. The nerve starts at the base of the neck, then it branch`s around the head. My Trigeminal problem is down the left side of my face. It gives me a lot of pain, cold air will set it off, shaving will set it off, so I have to be very careful about what I do and where I go. This winter weather is just killing me. About a month ago I had surgery on that nerve. The surgery went real well. I am somewhat num from my cheek bone to my lower lip, I have no pain in that area. I`m looking to have a 2nd surgery. Because from my cheek bone to my temple still gives me a great deal of pain. My acupuncture that I use will stop the pain for about 20 to 40 min. I guess no pain for that short of a time is ok with me, then I just repeat the acupuncture again. Some day`s are better than others, some day`s I have no pain at all, and some day`s I have pain all day long, It seems I just can`t lose the pain. It also gives me a problem seeing out of my left eye. I`ve lost 10% of my sight in my left eye. Well I guess that`s it for now. your Friend Mike

GabbyPA 2011-02-02 22:57:26 -0600 Report

My protests come out in the office and we usually work a compromise out and I follow his directions from there. I am not one to just be a "yes" diabetic. I want to be involved in my treatment and he needs to be involved in my compliance. We work pretty well as a team.

CaliKo 2011-02-02 16:48:15 -0600 Report

I'm diet and exercised controlled T2, so I pretty much follow orders. Any changes I want to make I've discussed with my doctor. If I cheat, it's on portion sizes, but still healthy food. I also have found that sweets taste too sweet now, and I want to keep it that way. My injection therapy (for a different condition) has me rotate injection sites, stomach, thighs, arms, hips and the saddle bags I used to have before I lost weight for my T2.

Type1Lou 2011-02-02 16:19:50 -0600 Report

Great Question! I have been a type 1 diabetic for 34 years and most often did what my doctor advised…except for recently. During the past year, my regular internal medicine doctor kept upping my Lantus dosage and I was experiencing severe night-time and morning BG lows (high 20's and 30's). Even after I wound up in the hospital due to hypoglycemia, he maintained that I should follow his advice. I just didn't feel he was on the right track! I asked him for an endocrinologist referral and traveled 60 miles to see one. The endocrinologist has gotten me back on track by changing the time of day I take my Lantus and reducing the Lantus dosage. She also gave me a sliding scale for my Novolog that allows me to adjust the dosage before each meal based on the carbs that I will be eating and what my BG was before the meal. I test my BG a minimum of 4 to 6 times per day. I inject my Lantus in my abdomen and the Novolog in my thighs. (I tried my arms too but can't hide them as well as the thighs.) I too will frequently bruise at an injection site…so much so that once, my doctor asked me if everything was all right at home…(LOL because my husband is a sweetie but I understood with all those beautiful bruises why she had asked.)

Sounds like you're new to this disease and your doctor advised what he/she did because he/she wants to see how you react to the insulin and also did not want to introduce a variable about the injection site…arms and legs could be absorbed more rapidly, particularly if you exercise. Bottom line, trust your gut, become as knowledgeable as you can about the disease and learn what you can do to control it…then DO it (easier said than done) This site is a great resource. Also, you might want to join the American Diabetes Association. Their magazine, Diabetes Forecast comes free with your membership and also provides good, up-to-date information.

Good luck and best wishes for good control!

Nonna2Three 2011-02-02 19:30:51 -0600 Report

Thanks for the response. And yes, i am new to the disease. Diagnosed 01-17-11. I am doing my best to learn as much as I can about this disease and my nutrition. The nutrition one is the bugger since I am a [very] picky eater (I have another discussion thread where I listed some of my dislikes) and have had to give up those things that were my primary food selections. But I am learning new ways of preparing the things I do like that fit a no sugar low carb way of life.

And, I have already signed up at the ADA site and signed up for the Diabetes Forecast magazine also.

vgarrison 2011-02-02 23:49:37 -0600 Report

Might I just add my opinion here…I am by no means and expert at this, but one thing I have learned is that if you tell yourself that your not "allowed" to eat something then you will eat loads of it!!! I eat ice cream, cup cakes, bread, pasta and everything else that I want…I just had to learn how to balance the carbs on my plate…If I eat a really good salad then I know that I can have some pasta…or whatever else you want. I make sure I factor in all carbs thru out the day…

Just a little tid bit..


Harlen 2011-02-02 15:12:13 -0600 Report

I tried to do it my way and that was a flop all the way lol
As I got better at taking care of D I did start doing things a little difrent
so that it worked better for me I dont take extra shots I am on the pump lol I do give a bit more if I need it lol
Best wishes

Bunny Cakes
Bunny Cakes 2011-02-02 14:31:51 -0600 Report

I follow my doctor's orders pretty well, though right now I don't have many to follow other than testing once a day (I only get so many strips through the program I'm on) and I don't have my meter or strips yet so I have not been doing that. I plan on trying to add to my allotted supply with my own money as well.

I didn't get a lot of instruction but that was probably more my fault than his, I was sort of in shock because I was told I have type two diabetes, hypothyroidism and high cholesterol all on the same day which was added to my prior diagnosis of high blood pressure. He offered help and I just sort of freaked out and ran home.

Since I calmed down I've been studying diabetes like it's the SATs, taking notes and writing down questions. I plan on taking any questions I can't find the answers to with me on my next appointment.

I've made a lot of diet changes like cutting carbs and sugar to try to help my blood sugar as well as taking my meds. I'm a work in proress.

Nonna2Three 2011-02-02 14:44:11 -0600 Report

I can so relate to the shock and running home, only I couldn't run as quick as I wanted to. My BG was 612 the day I was in the doctors office & he told me I was Diabetic. He sent me downstairs for urine and a blood draw and then kept me in an examining room for almost 3 hours with him & his nurse playing tag team coming to check on me and adding one more piece of information at a time. He said the delay was to wait for some lab results but I've had a couple of people suggest that he was stalling to be sure the insulin they gave me in his office brought my BG down enough. But, yeah, I was kind of in shock & had no idea of what questions to ask on that first day. I did ask several when I went back 3 days later. And I will ask more next week.

I too have made a lot of diet changes, the same as you, I have cut out as much sugar as possible and reduced the carbs as much as I can by eliminating potatoes, rice, pasta and eating bread in limited amounts. We use to have sandwiches 4 or 5 days a week for lunch and now we only have them once a week. It's probably not enough, but it's a start and hopefully one day it will all be second nature for me.

Bunny Cakes
Bunny Cakes 2011-02-02 15:00:21 -0600 Report

On most days I have no sugar at all besides what is naturally in fruit and other foods. I cut back to no more than 60 carbs a meal and no more than 20-30 carbs for a snack, if my snack has carbs at all.

I don't know what my blood sugar is doing but I feel better and I think I'm at least laying the ground work for the bigger changes I'll be making once I can test.

It's been about a month now and I cheated once, just the other day and learned I just don't like regular sweets anymore. It's just too sweet for me now but even though I cheated and ate that brownie I count it as a win because now that I know that stuff tastes gross to me I don't want it at all and I won't cheat again with sweets.

re1ndeer 2011-02-02 14:06:25 -0600 Report

I follow just about all of my doctors orders (sometimes I fudge on the items I am eating), I normally stay true.

Now insulin shots, I take several a day, I f I took that many shots in my stomach I would be black and blue.

True it is better to give your shots in the stomach, but after a while, you will form Fat pockets if you inject in the same area over and over again. I was told both by my doctor and my CDE to rotate my shots. So, I give my shots in my arms, thighs, buttocks, hips, and stomach.

Yes, giving your shots in the other areas, it will take longer for the insulin to work.

But, please make sure you don't inject into your muscles or your insulin will never work. Find the fatest area in those other places to inject.

Never give your self more medicine than what is prescribed for you, you won't know what the reaction will be like, and you could go into a coma.

Nonna2Three 2011-02-02 14:44:44 -0600 Report

Thanks for the reply. And, for the record - I have adhered strictly to what he has said. The only thing I am considering wavering on is the injection site simply because I would like a less painful place to inject.