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Self Adjustment

Discussion in 'Adults with Type 1' started by solobaricsrock, Sep 26, 2013.

  1. solobaricsrock

    solobaricsrock Approved members

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    So a question for all the T1's and T2's for that matter.

    A lot of doctors see a patient, and according to the info provided at the time, the doctor says "Adjustments need to be made." or "everything looks fine." They make whatever adjustments need to be made, and send the patient on their way with a warning not to make adjustments without consulting them on their insulin regimine.

    How many of you agree with this and do it? I personally do not per the fact that my situation changes daily, and i have the tools at hand to make those adjustments (CGM, etc...) I make adjustments almost daily to see if i can reign in control to that perfect 6 HbA1C. So what are your thoughts?
     
  2. KatieSue

    KatieSue Approved members

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    Our Endo team very much encourages us to make adjustments on our own. They are there and ready when there's something I'm stumped by but day to day adjustments we do ourselves.
     
  3. MomofSweetOne

    MomofSweetOne Approved members

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    I've been told I'm the specialist on my daughter, and they have not offered any advice for the past few appointments. If I get stumped, I call for help.

    I honestly don't know how they make good recommendations without knowing the story behind each number: whether carbs were counted carefully, exercise, excitement, stress, hormones, illness, whether a bolus (or food) was forgotten (my teen remembers to bolus & forgets to eat until the CGM alarms!)... I couldn't look at data and give advise to someone else the way I make changes to my daughter's management.

    I'm glad we're not micro-managed and wouldn't do well with a team that expects compliance with their recommendations.
     
  4. Megnyc

    Megnyc Approved members

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    Both my former pediatric endo and my current adult endo expect me to make all changes on my own (well my parents when I was younger). Obviously, my parents got some help in the beginning but within a few months we were making all changes on our own.

    Currently, I adjust basals every few weeks and carb ratios as needed. At each appointment my endo asks my ratios, basals, and correction factor but doesn't really comment on them. He then prints out 2-3 weeks of CGM data and will comment if he sees any patterns. His only suggestion at my last appointment was to suggest dropping my correction factor from 1:90 to 1:60. I disagreed but tried it and it turned out I was right!
     
  5. Amy C.

    Amy C. Approved members

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    After living with type 1 for nearly 16 years, no endocrinologist has ever said this to me or my son. We were expected to learn to make changes on our own.
     
  6. TheLegoRef

    TheLegoRef Approved members

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    Our endo told us to call in if we wanted to make changes, so they could tell us if they thought it was too extreme or not enough. We'd fax in the bg charts every few weeks, or whenever we wanted to make a change, then we'd call. Then after a while we just started making some and calling and saying "this is what we did, sound good?" Then after a while more, we were confident enough to not have validation, and they told us "you don't need to ask us anymore, you're doing a great job, but call, fax, email if you want to".
     
  7. misscaitp

    misscaitp Approved members

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    My endo doesn't mind me changing my ratios or rates, usually I change my pump settings every 1 to 2 weeks. I started to learn to self-adjust when I was 14 and my endo thinks I do a great job. My endo does recommend tweaks at appointments or the occasional e-mail I send, she is usually spot on with the changes that need to made.

    I don't think I could let myself run higher than comfort just because I'm waiting for an email response.
     
  8. pianoplayer4

    pianoplayer4 Approved members

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    My endo has always encouraged me to make changes on my own as long as I feel confident in what I'm doing...
     
  9. solobaricsrock

    solobaricsrock Approved members

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    Awesome responses yall! Please, keep them coming!
     
  10. cdninct

    cdninct Approved members

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    We've always been encouraged to make changes. The clinic is happy to review them with us if we ask them to, but I don't think I've called them once in the past year. If the pattern is obvious, why bother to call? If there is no obvious pattern, then all of the information that gives the numbers context is in your head, not the clinic staff's, so there really isn't a lot to say.

    I actually had an endo that I hadn't worked with before reprogram my son's pump settings while I was talking to the resident about something else. She is a big believer in 50:50 basal:bolus and didn't like our ratios. I didn't realize she had done it until I battled horrendous post-meal highs and scary lows for a week, then I took a closer look at the settings and realized what had happened. There's no way I am going back to someone who will not work collaboratively with my family.
     
  11. solobaricsrock

    solobaricsrock Approved members

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    I would have asked for that Endo's head on a platter. I had one go in and start adjusting all my basil rates without my express permission. I yanked it out of her hand and told her if she ever did that again I would be writing a letter to the hospital director asking for her termination. Shut her up pretty quick. I hate when they do that. Its a pet peeve. It keeps me alive. You don't just go messing with it without permission. That's like kissing my wife. You just don't do it.
     
  12. Connie(BC)Type 1

    Connie(BC)Type 1 Approved members

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    I haven't needed to see an Endo for over 3 years, even got my new pump without going in a couple years ago. I only need to see family doc if I need a refill(usually after getting about 18 months of refills without seeing him he calls and lectures me). I get my blood work done when I think I need it(standing prn requisition)
     
  13. Ronin1966

    Ronin1966 Approved members

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    Unless there is a dangerous problem, right in front of me.... that I just cannot solve, or must figure-out... serious infection, some kind of damage... I have no use on any level for any white-coats...

    They are completely worthless, literally.

    If I didn't require their prescriptions, hades would freeze over a million times before I ever saw one voluntarily -wg-
     
    Last edited: Oct 21, 2013

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