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Endo today: the good & the bad (vent)

Discussion in 'Parents of Children with Type 1' started by Mimi, Dec 20, 2010.

  1. Mimi

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    Starting with the good - A1C was right where we wanted it to be. :) A lot of credit goes to my very responsible 9 year old cwd, as she is the one who puts up with all the finger pokes and injections. So proud of her!

    Now onto the bad. :rolleyes: The endo we were assigned to at dx has recently retired. Although, he & I didn't see eye to eye on everything, we worked it out and I think he realized that I kinda knew what I was doing.

    At our appointment in September, we saw another endo in the practice. It was a short & sweet visit. He told us our A1c was great, we chatted about how Amanda was taking on more of her own care at school, got rx refills and were on our way with a "Keep up the good work!"

    Today's visit we saw a new endo to the practice. First we had the initial meeting with a resident (this is usually done with a CDE). I understand that we're at a teaching hospital etc. but sometimes - well, I'm just tired y'know. :rolleyes:

    So this resident is going over the logs, not saying anything and chooses to discuss the one entry where bg was over 300. Just kinda rubbed me the wrong way - I don't know why she went that high. We corrected and moved on. She leaves to go chat with the new endo and we wait...and wait....and wait.

    Finally, the new endo comes in, introductions all around, congratulates us on the A1c (I find that weird but, whatever). Then he begins by talking about how often we are testing her bg (6-8/day) and with an A1c like the one we have we shouldn't have to test that much and am I testing out of fear?

    He said the amount of testing we are doing is necessary in a very young child but we could "ease the burden of care" by only testing before meals and before bed.

    :eek::confused: Ummm...what?

    First I had to set him straight that taking care of my daughter's health was not a burden to me. This really upset me and dh also said he was offended by it.

    Then I told him that there is no way that Amanda's A1c would be what it is with 4 tests a day. My husband then mentioned that "if it ain't broke, don't fix it." We were both truly puzzled by this recommendation.

    Then we discussed the split Lantus does. He's never heard of such a thing or of Lantus not lasting the 24 hours as indicated. To his credit, he did say he would be doing some research on it but I was also surprised by this.

    As we were getting ready to wrap it up, I mentioned that we've used Regular insulin a few times to help with high fat foods that spike her later after the Humalog has worn off (buffets, parties etc). He was not happy about that at all. Told us bluntly that he didn't feel it was necessary and would not recommend it.

    After he left, the resident was writing the rx for strips and I asked to have the Regular put on the rx too. I can get it through insurance and only pay the co-pay. She added it on.

    On our way out I stopped at the restroom. While I was in there the resident came out to get the sheet with the rx on it because the endo did not want to give us an rx for Regular because he does not recommend it. She brought back an rx with only the strips on it! I can get the Regular without a prescrition - just have to pay full price.

    I left the visit feeling like the only reason to go is to get the A1c and script refills. I don't claim to know it all about diabetes but I sure as heck know a lot about treating my daughter's diabetes. Certainly more than an endo who just met us.

    Thanks for reading if you've gotten this far. I actually feel better getting it all out!! :cwds:
     
  2. joan

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    Wow. That sounds horrible. I never understand when an endo says we are testing too much. The only way to know what to do is to know the bs. I don't think they realize a bs test is basically nothing to most of our children. Most kids get use to it and its no big deal. I think your endo's ideas are dated and old fashioned. I would be concerned with his expertise if he didn't know that lantus may not last 24 hours. Its sad that some endos aren't up on the current practice. As far as the regular, maybe he wanted to discuss its actions before giving a rx. I would definitely consider a new endo.
     
  3. TheFormerLantusFiend

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    New endo time. It's fine to have a doctor who disagrees about things, but those are some pretty big things.
     
  4. wilf

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    I agree, I'd move right on. The good new is there are much better endos at the clinic.. :cwds:
     
  5. Andrew's Mom

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    I test as much as I want and give the endo only the information they want....before meals, before bed and 1 middle of the night check every week or so.....:D
     
  6. NomadIvy

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    Sorry that happened Mimi. I'd have been upset too. Most of us encounter these kinds of doctors. I'd have been most upset at not getting the script I wanted.
     
  7. Sarah Maddie's Mom

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    I'm sorry you had such an unpleasant experience.:(

    I guess you have two options: drop the endo a note expressing your feelings about the appointment and give him a chance to change his tone, or find a new endo. I'd be upset too.
     
  8. wilf

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    Here's what he should have said:

    "Congratulations on the excellent work in managing the D, as reflected in the A1C. What do you think are the main things that made it possible for you to achieve so much better numbers than what I'm used to seeing here? What can I do to help you?"
     
  9. katerinas

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    Get a new endo as soon as you can!! He doesn't know AND he has an opinion?!
     
    Last edited: Dec 21, 2010
  10. emm142

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    I'm sorry. I usually feel like that after an endo appointment, but stick with them mostly because it's SO rare to find someone pro technology over here.
     
  11. MichS

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    That really sucks. Infuriates me really. And, as for shopping around for a new doctor - is that really an option for you? I would hope it is, but it really is frowned upon in Saskatchewan. We have 1 pediatric endocrinologist in Saskatchewan and he is ANTI_PUMP. So - when we met him, we started shopping around and the doctors did not like that! Basically - who are we to choose our own doctor. Anyway - we did find an internist who sees lots of children with diabetes. I agree that he might not have the diabetes knowledge that the endo has, but he is very good, and is pro-pump and pro- LIVING! He understands that lifestyle is important.
    Why can't doctors understand diabetes?? so frustrating!
     
  12. C6H12O6

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    Call patient relations - you'll have your rx for regular before you know it, and maybe consider switching to Karen McAssey.
     
  13. Lisa P.

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    The last time I saw a nurse in our endo's office, I loved her, I asked about Regular. She also very much recommended against it. Thought it was a bad idea, that I wouldn't like it, that it wouldn't work for us. Then she wrote out how I'd use it if I chose to and gave us a free sample vial. Because she had made her opinion clear, but the choice was mine! I haven't, by the way, used it, in large part because her opinion is of great value to me because of the way she freely offered it without forcing it.

    This is the worst example of gatekeeperism I've ever read. I'm so sorry you have to deal with this and I hope this new endo was some kid right out of school and all the other endos will do an intervention on his behind and straighten him out. It's not surprising, but it's shocking. I'm so sorry. You should get your money back for that visit.
     
  14. 5kids4me

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    We have been questioned about the amount of testing also...I am preparing to get it again at the next visit.

    I am sorry it was such an annoying appt. Some doctors(many) feel that their degree makes them all knowing. I have found most will not admit that they do not know something much less, admit that they learn from a patient/parent of a patient. It is really frustrating because who else knows our children better than we do?

    I hope you are able to find another dr if things do not get better with this one.
     
  15. Becky Stevens mom

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    Oh yes I agree! This new endo shouldnt be treating YOU like you are new too. Youve been doing this for awhile and should be treated that way. This is why we got rid of our former endo. She acted like we were newbies into our 4th year and was extremely condescending. Now one needs that when it comes to their childs diabetes care
     
  16. Lisa P.

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    We started with an endo out here that we liked, but Barbara Davis was available so we switched to them, because it's the gold standard, right? And they were fine, nothing horrible, nothing fabulous.

    But our previous endo, he had a habit of giving me advise based on feedback from his other patients. He'd say things like, "Do you find she goes low after a site change? Because I've had other kids that see that." The longer I was at this game, the more priceless that sort of attitude became to me. A doctor with ears can't be let go, so we switched back. Other than normal bumps in the road that are always going to happen, we've been very happy.
     
  17. Connie(BC)Type 1

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    I use Regular mixed with Novo Rapid in my pump, it works, my choice, not my endo! At least my pharmacist gives me medical receipts so I can claim everything
     
  18. SarahKelly

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    Hope you're not offended by this but..
    What an ASS.
    I mean really. He doesn't know you, your CWD, your husband...nada. He doesn't live with the diabetes and yes sometimes it is a burden, but not one that you won't take care of. Maybe burden is the wrong word, but geesh. Did he say all of this in front of your child?
    I'd be not only switching but sharing this behavior with the board at that office. Definitely not okay behavior.
    I hope you end up getting the Rx and a more responsive caring endo soon.
    And pat on the back to you guys for meeting the A1C goals you've set.
     
  19. MamaBear

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    True. I have experienced doctors like this for other problems. You have to remember you are paying good money to see these people,so find one you feel good about taking your child to. And know that obviously you are doing right with your treatment of your child, the A1C indicates that!
     

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