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Monday, July 26, 2010

No, Doc, YOU Could do Better!

It was a new doctor's office located a convenient 5 miles from the house.  I had been having problems with my right knee and wanted to get it looked at, plus I needed to find a new general practitioner.  I waited about 10 minutes before my name was called. 

Since I was a new patient, I had to fill out all the standard new patient stuff including mother's maiden name (how is that medical info?!) and previous hospitilizations (including my DKA, only 2, I got severely dehydrated once when I was 3).  They also had me fill out this survey of current health status.  Allergies, current medications, and current illnesses.  I sighed and circled "Diabetes" and thought about writing in "Type 1" in the space next to it. 

I met the nurse, dressed in hot pink scrubs with a smile just as bold as her attire.  "What brings you in today?"  "My right knee.  It hurts when I walk upstairs or cross my legs for a long time."  "OK, we'll get that X-rayed then you'll meet the doctor."  I was summoned by the X-ray tech who walked me back to the X-ray room.  I shut down Constance temporarily so he could do the scan (note:  I wasn't sure that I needed to do that, because I remember reading no MRIs and such.  So I just thought better be on the safe side.)  He scanned my right leg once laying on my back, and once on my side.  Then, I walked back to my room and waited for the doctor. 

She came in and greeted me, told me she didn't see anything on the scan but would wait to get the official word from the radiologist (who said she didn't find anything either, wasted visit).  Then she started going over my chart.  "Diabetes?  What was your last A1c?"  "6.5", I said.  "Hmmm,"  she mummed.  "That's good," she said looking down at the chart, then she looked up at me and said, "but it could be better." 

Blood . . . boiling . . .

"Well, the ADA just wants me to keep it under 7.0.  So I try to maintain that."  She went on to the next item which I don't remember what it was because all I could hear and see was RED.  All I could think about was how that number was followed my a "well done" from my endocrinologist last month.  Now, I'm getting a "it could be better"?!  Let's see, what else could I do other than: 
  • Test my blood glucose at least 6 times a day. 
  • Wear a CGM that alerts me when I go high/low. 
  • Count every single gram of carbohydrate that goes into my mouth. 
  • Try to get 30 minutes of activity in everyday after working 9-hour work days. 
  • Prepare less processed, less salty meals at home because heart disease and diabetes are BFFs. 
Could my A1c be better?  Sure, it could.  But a lower A1c means more lows, not necessarily more "in-range" numbers.  If my whole life revolved around my A1c, then I would go back to MDIs when my A1c was 5.1-5.3 where I was living in the 60s and streamlining grape juice 24/7.  That could give me a better A1c, but not a better life. 

This disease is so freakin' personal, that it's hard not to take comments like that personally.  I'm a pretty patient gal until someone starts giving me a guilt trip on my diabetes.  I already experience that everyday whenever I go over 200 mg/dL and wonder if I didn't bolus enough or go below 40 mg/dL in the middle of church and have to chomp raspberry glucose tabs putting my row into a pink fog from the dust.  Guilt--it's the ultimate complication from diabetes. 

I left the office feeling bummed out and furious at the same time.  I couldn't believe that I was treated like a number, not a person.  Then I felt silly for getting so worked up over a doctor just trying to do her job.  But then I felt like I don't want to be someone's "job", I want to be a personal patient.  If you want me to have a better A1c, how about a cure?  Because at this point, that's the only way my number is going to get any lower. 

By the way, my right knee still hurts. 


  1. I'm sorry you had to deal with that. My blood was boiling just reading that. Sounds to me like she ignorant and who knows maybe she's a D with horrible control. I know this doesn't help much.

  2. ARGH!! I'm seeing red for you! I hate the armchair quarterbacking. In fact, I had an incident a few weeks ago that got my hackles up and resulted in a long rambling blog post. Those offhand comments from medical professionals raise my ire. I always feel like "they" should know better but in reality, they don't. Some of them still think sliding scale is the ideal management technique. Ugh.

  3. Seriously Holly, when I got your text about this event made me so upset. I went on this whole soapbox conversation to Chris about how Diabetes is personal, just like you said. I feel bad when I see those numbers, because I know the only person who screwed up was me. Each of those 200s or 300s or 40s are my fault, and I would killllllll for a 6.5 A1c! You go girl! April's new A1c goal: 6.5!

  4. I'm sorry Holly! I am aiming for anything under 7.0, so I can see why that would frustrate you! I would be ecstatic with an A1c of 6.5!

  5. It's funny, because the doctor I see now gave me the same sort of lecture the first time I saw him. Boy, was I pissed.

    In the past year, though, he's brought another MD into the practice, and I guess she told him what's what, because last time I saw him, he said that she'd opened his eyes, and congratulated me profusely on my 6.6.

    Are you going back to this lady?

  6. @Jacquie: She wants me to come back soon because she thinks there might be a problem with my thyroid (still waiting on the results). I'm not sure if I want to go to her for that or my endocrinologist. Either way, I just want to go somewhere for non-D stuff.

  7. Oh. My. Goodness.

    The nerve.

    Did you ask her her A1C because that's about as much your business as yours is to her. Why not find out her weight while you're at it.

  8. Hi Holly,

    I've been there. I know that feeling of 'bummed out and furious at the same time' well. You're very right in saying that this disease is so personal, it makes it very difficult to not take any comments about diabetes personally. I struggle with this. But, I am getting better.

    If my opinion means anything, I think 6.5% is totally stellar. I say, "Go you, girl!" Stay strong.


  9. I am so sorry! Unless a person has diabetes or they care for someone with diabetes, I have found just don't "get it". You are obviously doing a great job! Keep up the good work!


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DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.