No More Sawblades
Thursday, March 3, 2011 at 11:19AM Yesterday was the day. I had an appointment with who would potentially become my new doctor. Not an endo but just a doctor.
He was not “just” a doctor at all. It was incredible to put it lightly.
When I walked into the office I saw a stack of TuDiabetes postcards on the magazine table which made me sure I was in the right place. The receptionist was very nice and as soon as I walked up she handed me a clipboard with all the paperwork I needed to fill out.
I got called back almost immediately to weigh in (3 pounds less than last appointment) and was taken to an exam room. The first thing I noticed were all the pictures on the wall. Hulk Hogan, Taylor Swift, and people I assumed were his family. His Nurse asked me why I was coming to see him and I said, “I am actually looking for a new doctor and I was referred to the Doc by a close friend.” The nurse actually guessed Jaimie’s name before I could say anything. That made me smile.
“You are going to love him.” The nurse was totally upbeat and I could just tell that she really meant it. Could this doctor be THAT different?
When the Doctor came in he asked why I was there. I told him that I have had some bad experiences in the past (i.e. Doctor F-Bomb) and heard he was a great doctor. He sincerely thanked me and said that he would take care of me. His exact words were, “We are going to get you better George.”
We went through a list of questions. Diagnosis, family history, complications, medications, and so on. The difference was it was not a questionnaire, it was the doctor asking me stuff and digging deeper to understand my complete history.
After looking at my pump and seeing my settings he said, “The way you are trying to manage your diabetes is wrong. You are taking way too much insulin and doing it in the wrong way. Now I am not telling you this to scold you are blame you. This is not your fault. You were not taught correctly and frankly I have a lot of respect for the fact that you have tried your best. It doesn’t matter how hard you try, you will not get the control you want doing it this way. The good thing is that together we are going to get all of this straightened out.”
It took everything I had in me not to cry. He meant it, he wants to help. All the while I kept catching glimpses of his pump on his belt. He gets it. He lives with it. He understands.
We changed a few of my prescriptions, had blood drawn and he checked me out from head to toe. All and all the appointment was 2 and half hours long. We talked about a lot of things and even went on to some fun tangents that had nothing to do with diabetes or health. It was a really great appointment.
At the end he showed me the A1C he took when I got there. It was 9.0.
“Don’t worry about this number. This should show you that what you were doing is not working and that we are going to get everything where it should be.” He could see my look of frustration. “From what you are telling me George, you know more about diabetes than the doctor you were seeing and no one knows your body better than you. We are going to work together and get you all fixed up. How does that sound?”
I have never wanted to give a doctor a hug before but this guy was so different. So caring and understanding. I had to reach out my hand to shake his in thanks.
Before I left the Doc gave me a spreadsheet with all my prescriptions and a game plan for how we are going to get my numbers reeled in. Then he handed me his card, “Here is my email address which I do respond to and my cell number for any emergencies.”
On the drive home I thought about the last visit I had at my last doctors. She went through the print out of all my numbers asking me why I was over 400 here and there and how could I EVER get that high!?! Then a few minutes later when she got my A1C and it was 7.0% she high fived me! HIGH FIVED ME? Right there it proved to me that she didn’t get it. My A1C means nothing if my blood sugars are from 40 to 400.
“No more saw blade BG’s. We want as smooth a line as we can get.” My new doctor’s voice echoed around in my head. This guy gets it!
Tomorrow I will get into some of the stuff we are doing to get my numbers where they should be.
Reader Comments (23)
Jumping up and down~!!~!!...this man is not just a doctor but a coach...new game plan bro! I'm so excited for both of us! <3
George! So happy for you!!!! This Dr. sounds amazing. I hate to pick on non-diabetics but if you are not one, you just can't really get it - that includes doctors.
Keep us posted on your progress and your relationship with this new Doctor!
Krista
George I am so pleased for you. After my "crisis" I have had a lot of doctors cross my path and knownow more than ever what a difference a good one makes
George. I'm crying a little as I type this. I'm sooooooooo very happy for you! It's so amazing to have the kind of experience you've had and described here, and I'm so glad that it went so splendidly. You deserve to be treated with respect--with teamwork--by someone who is credible and knowledgeable, and who knows what they don't know as well. Sounds like you found him! Whoo-ee!! Thanks for writing and sharing this with us.
I can't tell you how happy this makes me George! Being able to leave an appointment feeling encouraged instead of ashamed and/or confused is such an uplifting experience.
I am so over the top happy for you George! A reason to celebraate for sure!
Sounds like you have found a good match. When we get the good matches, it matters less what the specialty on the diploma says than what the person knows and how s/he works with you to keep you healthy :)
Gah! George! This is amazing. Having a doctor who you actually feel is on your team is a HUGE life improvement. I'm so very very happy for you! I think my head's gonna explode.
Wow, this doctor sounds fantastic! I'm so happy for you. (((hugs)))
I'm so happy for you! Here's to getting better with the help of a wonderful doctor :)
Thanks for the kind words, George! Like you, I too had a smile on my face when you left the office. You, my friend, are going to be just fine.
When I give lectures on diabetes around the world, I usually stop half way through the talk and ask this question, "How many of you doctors in the audience have seen a 'non-compliant patient' in the past, oh, 2 weeks?" Not only does everyone raise their hand, but they start laughing and telling stories to the guy sitting next to them who they just met for the first time 15 minutes ago. The mood changes pretty quickly when I explain to the participants -sometimes numbering over 2000, that I too have diabetes and that in order to give you this talk I have to maintain a blood glucose of 220. Does that mean I'm non-compliant as well? I go on to ask this question, "How many of you can check your blood glucose levels 4 times daily and correctly interpret the meaning of those numbers? How many of you can count carbs? How man of you can figure out how much insulin to bolus prior to a meal? Could you wait 15 minutes after giving insulin before eating a meal? How many of you would be willing to check your blood glucose level 2 hours after a meal and give an appropriate insulin dose to correct for postprandial hyperglycemia without driving yourself into a low? Do you know what insulin stacking means? How many of you remember to get your Rxs filled every month? Do you remember to do an A1C every 4 months? How are your lipids doing these days? Are you taking your aspirin and vitamin D? Hey, when was the last time you saw your eye doctor or got screened for colon cancer? Those meds are pretty expensive. Have you ever had to stop taking those pills or shots for a while because of financial hardships? Well, welcome to the world of diabetes. If you can do all of this AND keep your A1C < 7 % please come up here and shake my hand, because you must be "compliant'. Everyone else we care for must be total loons, because they can't get it right!"
Now I've got their attention. I go on to say that there is no such thing as a non-compliant patient. The fact that someone like George simply shows up for an appointment implies that they are serious about diabetes managment. As physicians and teachers we must do our best to educate and help our patients achieve their individualized targeted goals. Let no patient be left behind. We can always find something that will work to intensify our diabetes control so that we control our lives and our destiny rather than having this chronic disease consume our entire existance.
Chris Parkin and I will be publishing a book entitled "Diabetes for the Disinterested" sometime later this year. We will let everyone know when the book will be available. For more information on the book and to reserve a copy, contact Jim Edwards at Ann Arbor publications:
JMEdwards@aaeditions.com
Dr. Unger
G-
I just want to give you and "Dr. I'm impressed As Hell" Unger a big hug and a kiss!!!!
I'm so happy for you!!!!
LYLB
Wow, color me impressed. Nicely done George, I really like this man and I'll be most interested when his book is published.
Wow!
George this post literally blew me away. So jealous yet as everyone else so excited for you.. Jaimie included. ;-)
I have a great relationship with my doc here in Spain but seeing as though he is not pancreatically challenged there will always be something missing. Not his fault mind.
Dr. Unger, dude we gotta get you some more exposure and get you over to Spain!!! :-)
Good luck George! Saludos
Very emotional over this post.
Please keep us posted over the tricks of the trade that Dr. Unger suggests.
(((hugs to both of you)))
MD envious :)
Wow! I have a new consultant who has taken over my clinic and I will meet for the first time next month. After reading this post, and your doc's comment she has a lot to live up to. Hope the 'driving manual' continues to go well.
Best
M
Dr Unger, if you ever decide to practice in Australia, I'd actually move house to wherever you are!
I had a lump in my throat reading your post, George. I've had almost a lifetime of incompetent idiots who just didn't get it, or didn't understand how to make me 'get it'! That apart from the 33 years of mis-diagnosis of T1 (am LADA), and being called non-compliant. Except for one Endo, who was a dream, but sadly I've since moved away, I'm at the point where I'd rather not discuss diabetes with ANY doctor, DE or practice nurse.
Just a few weeks ago I got a "diabetes sheet" from my new family doctor that looked like it was designed for a pre-diabetes T2. I made sure they saw me throw in in the bin on the way out.
Then my new DE told me - oh we don't bolus for protein or fat in Australia (ie TAG Bolusing). Er what? I learned from an Australian several years ago. And then she told me all my basal settings were wrong, WITHOUT even looking at my BGs or asking when I had the most trouble. Ah no, they're not wrong... they're working fine according to my basal testing... my boluses for dinner aren't always working... then again, neither is my self control and carb-guestimates when I'm lazy! LOL
So I plod along, learning on my own, managing on my own, making decisions that are right for me. Right or wrong, it seems I have no other choice at the moment.
George, you're lucky to have found a great doctor. The thousands of us who receive below-par diabetes care with occasional downright dangerous advice... what hope do we have?
"Ann Arbor Editions is planning to publish a consumer book on diabetes management entitled, "Diabetes Management for the Disinterested". The book should be available in November 2011. We are excited to have 3 world renown authors working on this project. Jeff Unger, MD is an international primary care thought leader in the field of diabetes and has published 2 medical textbooks on this topic. Dr. Unger, who has type 1 diabetes himself, wears an insulin pump and a sensor and uses these to his 'advantage.' One time while at an amusement park with his young daughter, Dr. Unger, who is deathly afraid of roller coasters, explained that he was unable to accompany his daughter on the Roger Rabbit Ride due to, uh...because he had diabetes." Fortunately, his daughter bought the excuse allowing the good doctor to sit on the side and eat popcorn while she rode with her unhappy Mother. In 2009, Dr. Unger was honored as the Father of the Year by the American Diabetes Association. Chris Parkin is currently helping Dr. Unger write another medical textbook on diabetes. He needs the work. After moving to Las Vegas from Indianapolis, Chris bought a new car. When the car was being delivered to the dealer, it actually fell off the transport truck! Now Chris is waiting for another car to be delivered...on a flat bed truck. Chris has written the American Association of Clinical Endocrinologists guidelines for diabetes management and many peer reviewed articles related to how patients can improve their own diabetes self-management skills. Bill Polonsky is one of the world's leading psychologists and a Certified Diabetes Educator. Bill coined the question which begs to be answered, "What is the number one complication of well-controlled diabetes?" The answer is NOTHING! Dr. Polonsky has made a career of helping patients restore their attitudes in diabetes self-management. The worse one's diabetes seems to be, the more Dr. Polonsky can help get you on track.
As we are in the process of writing this book, please tell me what you would like these authors to address which may be of benefit to you. Let me know your questions and I will pass them on to our editorial team. We will keep you all informed as to when this book becomes available. Thanks for your time and assistance with this important book.
Jim Edwards, Publisher
JMEdwards@aaeditions.com
Thanks for the offer to come to Austrailia. I want to go to a climate where there is some rain, wind and some fires. That's why I like California.
Also, if anyone out there has type 2 diabetes and a history of protein in the urine or heart disease, let me know. We are studying a drug, called Liraglutide, to see if this drug might minimize the effects of heart disease in such patients. Just let me know where you live and I will find you a study site. Thanks.
Dr. Unger
Fabulous, fabulous, fabulous!!!! I love everything you said and I loved reading Dr. U's comment. George, I could not be more thrilled for you!!!! :)
So very happy to hear that you have found a Dr. who is truly willing to be on your team!
And I loved this quote: "What is the number one complication of well-controlled diabetes?" The answer is NOTHING! Reading that aloud should be a standard prescription for all of us. Not that stuff won't happen to some of us along the way, but living life waiting for it is no way to live. Looking forward to the book.
I am so thrilled you have endo who not only gets it but cares!!
I'm so happy for you.Wow, this doctor sounds so good..
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