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Doctor doesn't agree with CGM ... Help!

Discussion in 'Parents of Children with Type 1' started by britbabi84, Jan 11, 2013.

  1. britbabi84

    britbabi84 Approved members

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    I've been trying for months to get my 4 year old on a CGM (dexcom) but his doctor is being really stubborn about it. We've only been going to this clinic since August and I have been trying since our first visit. My son does not feel or show his lows at all. It scares me how low he can go. Also I want to be able to reduce the number of checks we have. I understand its not FDA approved for kids but I know a lot of people on here have kids with them. Is there anything I can do to get this to happen??? I can't really change clinics because the next closest one is 2 hours away! There are a few doctors at this location but I'm sure they all consult one another.
     
  2. JNBryant

    JNBryant Approved members

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    I don't see any reason why a doctor would be against a child going on a CGM, especially when the child shows no signs of hypoglycemia. That would be really scary for me to deal with, too:eek:. Sometimes you just have to have a firm hand when it comes to asking for what you want/need. Be straight with him/her and say that if you can't get what you need from that particular clinic, you'll go elsewhere. The next closest clinic might be 2 hrs away, but when it comes to the health of a child, if you have to switch you should. You can always phone in to get scripts written, and I know that my child sees his endo every 3 months or so, so a 2 hour drive to and from the endo's office 4 times a year really isn't all that bad. Of course, not having to switch is the ideal scenario here, so just be firm and stand your ground! You know your child better than anyone, and don't let the endo make you think otherwise.
     
  3. nanhsot

    nanhsot Approved members

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    Look your MD or CDE in the eye and frankly and confidently say "I want a CGM for my son and I need you to write a prescription." Come armed with all the paperwork already filled out and ready to go. Contact the company you are wanting ahead of time, they will walk you through the process (do not go online, they can't send info to a child, only via phone call).

    Be confident, be forceful, your Dr. works for you, not the other way around. If he says "no", ask why, then be ready to counter all his objections. If he continues to object, say "I understand you do not agree, but this is something I need for my child." Do your research and be ready to confidently answer all his objections.

    I personally would have no problem driving 2 hours for a relationship with a MD who respects me. If your Dr. can't respect you enough to have the above conversation and support your needs, change. I drive over an hour, it's only every 3 months, not often at all.

    Good luck.
     
  4. britbabi84

    britbabi84 Approved members

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    Thanks everyone. I only see the dr about once a year.. all the others times i see a CDE or a nurse practioner. neither of which can prescribe the CGM. Its a big adjustment coming here because we use to be seen at portsmouth naval hospital in VA and they are AMAZING. We had the dr's cell number and the CDE gave me her office number, cell, home and email. I could get in touch with her no matter what question I had. Here, its a lot different. I have to call, leave a message at the front desk and wait for a call back. It might take a day or two! Unless an emergency of couse. We go on Feb 5 to the nurse practioner and im going to push it a lot. My son has dropped to 30 before showing ANY kind of sign. He goes to pre-k and it worries me he will do this at school and they wont catch it until he is almost nonresponsive. If he doesnt go with it im going to switch doctors. I need someone I feel comfortable with. I already got frustrated when I called about 2 months ago when my son woke up throwing up, with large ketones and BG in the 300's and not getting to come down. ( i knew he was catching a bug but this was getting bad, he was really pale). I did the emergency pager and it was our dr on call. His response was "well ,just keep an eye on him... and check his bg every few hours" . Forget that... I took him to the ER where he immediatly needed fluids, zofran and tested positive for the flu. He was borderline being admitted. OK sorry im venting, im just frustrated.
     
  5. momofone

    momofone Approved members

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    For what it's worth, Dexcom told me that a nurse practitioner can indeed write an Rx for a Dexcom.
     
  6. mmgirls

    mmgirls Approved members

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    i di not have this issue, But I personally fill out all of ther Dexcom paperwork and submitt it and then let the Dr look at it.

    It will show them that you mean business and that it is not just a fligh by night thought.

    Dexcom will have info, and if your endo still says no then you can try to insist upon it or you can shop around.

    I WOULD NOT make the assumption that all the endos in the group all follow the same rules/guildlines. OUr endo did not have a younge person on a CGM but that was only because noone asked. They are completely surprised that she wears it 24/7 and she is by far the most consistant child under 8 or even 10years. It is so sad that her name is one of the only ones in the under "10" club, meaning under 10. A1C.
     
  7. mmgirls

    mmgirls Approved members

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    I will add abit.

    I had no plans on geting a CGM until she was in school, but then coming here and seeing allot on it at 18months-5 years that I figured that I Should try befor school started.

    It was so easy to start and it is just like a pump in whitch you can use it as much or as little as you want. we do not down load or examine the graphs, we use it real time. We set the low alarm at 90, which is a perfecly healthy number but if that 90 s right after a meal bolus or at recess then that could be a real low. the difference between a 90 and heading low and a real low of below 75 can mean missed class of atleast 20 minutes.

    I would much rather my dd have a "alarmed low" with no symptoms than a low with syptoms anyday.
     
  8. maciasfamily

    maciasfamily Approved members

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    Sometimes you truly need to be the bear momma when you want something. I honestly don't let anyone tell me no when it comes to managing my son's diabetes care.

    If you want the Dexcom, you don't ask, but tell the dr. I agree on going to Dexcom's website and printing out their forms under getting started. There is one that is for the dr's to fill in. Print it out too and take with you to your appt. Leave for the dr to fill out if you need to, and then call everyday to check the status of it.

    I would tell the dr, I appreciate your opinion, but this will make managing our child's care much easier. Whatever his objections are (kid won't wear it, it'll hurt, it doesn't work, etc) have your answers ready.

    If you have access to an email address for them, I would email it to them now and not wait.

    We had a similar issue, except for us it was the CDE's who were against the Dexcom and also the OmniPod for our son. Saying he was too young as well. I fought the issue with them, filled out all the paperwork, and emailed it to them. I then told them I wanted to speak with the dr, who agreed with me and signed off on it the same day. Sometimes you really need to fight the issue and not stop until it's agreed on....just like a kid who keeps nagging and knows they'll get their way eventually! :D
     
  9. Brenda

    Brenda Junior Member

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    Technically, the DexCom has not been approved by the FDA for pediatric use. This may be why the doctor is reluctant to prescribe it. There are many doctors who will. Hope you can get one to help you.

    In the meantime, let's all hope the FDA approves it for children asap.
     

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