How supportive is your doctor?
How supportive is your doctor?
Have you ever considered changing? Why? Why not?
I have a love/hate relationship with my doctor. Initially, I despised him, but to be fair, I am not a fan of any doctors.
The times I have hated him was when he would reply (if I questioned something he said) "Who is the doctor here. You or me?". I also wasn't fond of him when he was dismissive of my concerns about taking certain medications. I learned to say nothing and simply didn't fill those prescriptions.
He (unknowingly) is likely what turned me completely around when it came to making a DECISION to take control of my own health.
I used to have to go in every 90 days. At one of the appointments, I asked him not to yell at me this time. I told him that I already knew my numbers were going to suck because I spent the last 90 days giving up. I also asked him if any of his other diabetes patients just give up. He stopped dead in his tracks and sat down beside me. He told me that sadly, most of them give up over and over again. I have no clue what it was about that conversation that made me DECIDE to get my act together, but I just knew I wasn't going to be one of THOSE patients. I am not a quitter.
In the last year, we seem to have come to some sort of truce. I am guessing it's because of the fact that no one can argue with my results. In my last appointment, while he was talking to me, the nurse ran in with my urine test results. She was clearly upset that they detected ketones in my urine. He rolled his eyes (at her) and explained it was because I live a KETO lifestyle. I was grinning ear to ear. Ya know why? Because he said, LIFESTYLE. He didn't say, DIET.
I haven't replaced him because, well, better the devil you know than the devil you don't. Besides, he seems to be tolerating me now. Well, most of the time.
I would say I was most frustrated with my doctor last summer as the usual drill was you need more exercise and less caloric intake; follow what your diabetes educator is recommending... and so on. I was doing that but it did not get my any decent results which I tried to explain.
And the kicker was ... you need to be on a statin every diabetic patient that has HBP must be on a statin even though my cholesterol was not even close to being high. I think that is what gave me the drive to take action and do something different. I researched Keto/LCHF lifestyles; found this forum and figured lets give it a try what do I have to lose.
I saw my doctor in September and December in 2017; he saw my initial change in September and shared how I felt from our discussion at my June 2017 visit.
He was OK with low carb but not with consuming so much fat; tried to explain keto and asked if I would be harming myself and he would not answer.
At my December visit once again I pressed him am I doing anything that would be detrimental to my health by consuming 70+ percent of healthy fats in my daily diet with no response other than coconut oil is really bad for you please avoid it. However, all my blood work looked good. And he scheduled a blood draw for March 2018 and based on those results would issue new / revised medication scripts. I pressed one more time saying I needed an answer since I stopped using the diabetes educator since the summer and wanted to know in his honest opinion if following a high fat very low carb diet (keto) is not advisable. His response was I think you will be able to put your diabetes into remission; he took my hand shook it and wished me a Merry Christmas and said "keep doing what you doing".
March 2018 blood work looked even better and my doctor said "everything is going in the right direction; keep doing what you are doing". He refilled my scripts to last me through December; made some changes to dosage amounts and unless I get sick he did not request a follow up appointment.
So, in the end, Yes I will keep him he is open and supportive I guess in a non-communicative way.
My doctor visits are few & far between - usually when I need an insulin Rx, since she won't refill unless I visit - not worth it to them unless you visit - $$$$ (from either you directly or your provider). I only saw my first two doctors once - after they made it quite clear that their only interest was money. My first doctor at diagnosis wanted to hospitalize me with IV fluids - because he said, "Your blood sugar is very dangerous at 250 & you are dehydrated." Yeah...$20,000.00/day from my insurer....
Lab tests showed I was not even a little dehydrated.
When I changed doctors, the second doctor wanted to repeat ALL my lab tests from two weeks ago - for another $1,800.00. I said, "Bye."
My 3rd doctor (who I see occasionally for Rx insulin) suggested I take 10 units of insulin before each meal. After several dangerous lows (46-60) & almost ending up in the ER, I realized that the only person qualified to give me advice is ME.
All they can do is give you advice (which may or may not apply to you) based on their education
I must say that no doctor has ever pushed me hard on my T2 diagnosis. Each of them announced it and told me the clinic had resources I could use (like diabetes "educators" and support groups) and pretty much left it to me.
My current PCP (actually a Nurse Practitioner, not a degreed doctor) was trying to push a statin on me for my borderline cholesterol numbers. But I was able to push that off saying I wanted to think about it; that what I'd heard about statins was not positive and asking which one she thought about putting me on since some raised BG. She offered to set me up with the diabetes "educator" and I agreed to go, thinking I might learn something useful (I didn't; it was the standard ADA "carb up and shoot up" line). While attending that class the NP's assistant told me they'd write me an Rx for metformin if I just gave them the green light to do so (I didn't).
I started LCHF and became more active. By the time I went back in three months my A1c was in the high 5s. And I knew enough to push back against the statin again, telling the NP that if I was going to donate blood to test my cholesterol, it was going to be for a pattern test, not a standard lipid panel, and that, anyway, LCHF could take up to a year to transform the cholesterol pattern, so a test now would be a waste of money.
At my most recent A1c check, I brought my spreadsheet of BG test results (6-7 tests a day for the previous three months), graphed and showing a steady decline in FBG. She asked me to guess my A1c and I hit it on the nose. "Lucky guess!" she said. "No," I replied, "I test a lot and I know." She asked me -- half-jokingly, I'm sure -- if I would talk to her other diabetes patients about how to manage BG. I told her -- also half-jokingly -- that I'd be happy to but I didn't think my way of going about it would be too popular. :biggrin:
What's won her over (aside from being young and not yet fossilized in an older education) is results and asking pertinent questions. At this point she's good with A1c intervals of six months and she'll write me for my pattern test in time for my annual physical then. So I'll say she's supportive now. Not like she was dismissive or antagonizing before. But I think she had her doubts. I don't think she has them anymore.
Statins, BP drugs & daily aspirin are pushed on everyone - especially diabetics "to lower the risk." If your numbers are "normal," they'll still push drugs to "protect" you.
Well, I've never believed drugs protect anyone when they're not necessary. And, if you're diabetic, unnecessary drugs do more harm than good because every drug you take has to be excreted through the kidneys, which are already stressed by diabetes.
It's funny - My GP or family doctor - no support what's so ever. It's got to the point where I'm years ahead of him in the treatment of Type 1 diabetes - argued with him once - big mistake. So now, the odd time I see him - I just agree with everything he says ...
My ophthalmologist - smart guy, is the first to state there is still a lot we don't know about the many variants of diabetes - enjoy the visits and the company - wish he was my GP. 1 out of 2 ain't bad I guess.
This is somewhat problematic with the Canadian Health Care System - Canada has a Doctor's shortage so most localized Health Agencies assign you a doctor. If you have a crappy one - too bad and the issue becomes worse if you live in an isolated area far from any major metropolitan center.
Having lived in both the USA and Canada - both healthcare systems have their issues so I'm not taking sides. It's just a reality.
Speaking of doctors & their "support," I've learned something about other medical specialists & their reaction to diabetes. (well, it's actually marketing).
I had a dentist I was seeing for several years. Then, when the economy started to slow down, he tried to sell me FOUR crowns to replace ONE crown that chipped. Then, he actually hired someone for marketing to patients, trying to get them to come in more often for x-rays, "cleaning," etc.
She called me with some dental advice that made me change dentists. She said, "Listen....we have many many diabetic patients & they all have gum disease. So, you need to come in every couple of months for exams, x-rays & cleaning."
Well, I asked 25 people at my diabetes support group about gum disease. Not one has any.
Anyone here have gum disease caused by diabetes?
Here's the real kicker: My 7-day hospitalization a couple of months ago was CAUSED by a dentist; he did a bad, incomplete root canal (verified by another dentist who is testifying as an expert witness). When I told him the right side of my face swelled up & I was in terrible pain, he said, "That's normal after a root canal," & gave me an Rx for Oxycodone, which didn't help. My blood sugar went to 705 & I spent 3 days in ICU & 5 more in a regular room, treated for DKA.
Yeah...I've had enough of dentists (and most doctors) for a while.....
I haven't even started on those $300.00/pair of "Diabetic Shoes," $30.00/pair of "Diabetic Socks," etc...
[I am not sure why the quote, came out like it did.]
Very well said, and I edited your post in order to be concise; but I agree with every word.
1. I am not a fan of any doctor, they have limited knowledge and zero wisdom, in most instances. Medical science is scary, because of its ignorance of things; and its presumptions, and that is a scary combo.
2. I accept a doctors advice as far as it goes, ie, if it works. If it doesn't, I toss it into the trash can, metaphorically speaking.
3. I am no quitter, but I sure am fed up with the wisdom of this world. I take most things with a grain of salt; and I am defensive.
I fixed the quote.
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