My Endo Gets It.

Yesterday was the dreaded Endo appointment - And I knew going in what my lab results were, including the A1c of 7.4 - And I wasn't the happiest of campers.

But sometimes, diabetes or not, life gets in the way. I tried my absolute best during my mom's illness and subsequent death to stay on top of things - At least as far as my diabetes life was concerned.

I tested like a mad woman; ate when needed, and took any and all daily medications required.

I really thought I had a handle on things diabetically speaking. But sometimes it doesn't matter what you do externally, stress still plays a major factor internally speaking - And the proof is in the numbers.

As I walked into my Endo's office, I felt the dread weighing heavily on my heart.

I signed in, was weighed, and read a copy of Philadelphia Magazine while I waited in the examine room.

And then a nice Intern came in and asked me all the typical questions one would expect from an Endo visit. Questions about blood sugars, basal rates, eye-exams and the last time I saw a Podiatrist.

Then he asked if anything out of the ordinary had happened since my last visit....... And I looked him straight in the eyes and told him my mother had died 33 days earlier.

I told him in a matter-of- fact manner about taking her to the emergency room, her blocked kidney & the failed stent attempt. Her being in the intensive care unit; and being in a medically induced coma, and how she beat sepsis and woke up & was moved to a Step-Down unit, and then suffered from internal bleeding because of her cumadin, and how she beat that and was moved to a Telemetry unit. And finally I told him about her coding twice from CO2 build-up and never waking up and having her vent removed.

I told him about the funeral and all that followed, including the sleepless nights. And then I told him that I missed my mother more than I could put into words and how being an orphan absolutely sucked.

And he listened and took notes and then said how sorry he was. He asked me if I was depressed, and I told him that no, I wasn't depressed, but I was sad about losing my mom and that I missed her very much.

And then the intern told me (and I'm paraphrasing here,) that during the Adjustment Phase, (apparently, that's the name for the time after a loved one's death) being sad is normal, and that in his professional opinion I didn't look or sound depressed. I looked good and it sounded like my family and I had been through a lot.

And that quite frankly, he'd be concerned if I wasn't feeling sad. And I was like: Oh, OK, that makes me feel better, thanks. And then he went off to find Dr. J.

And a few minutes later Dr. J came in and told me how sorry he was and asked me to explain what happened with my mom from the beginning - So I did.

Dr. J: Kelly (but when he says it, it sounds like kel-lee,) I am so sorry to hear that!! You have been through so much and under a tremendous amount of stress!! I know it's been difficult and if you need anything, call us.

Me: Thanks.

Dr. J: Listen, your labs are great. Cholosterol, is good, blood pressure good, and kidneys are great! And I gotta tell you Kel-Lee, with all the stress you've been under, I fully expected an A1C in the nines or tens -At least! So listen, we're not going to change your diabetes management right now. Let's see how things are next visit before we consider playing around with your rates.

A 7.4 A.1c is really very good! Don't beat yourself up, Kel-lee.

And then we talked for another 20 minutes or so about life and discussed what direction my life was headed. Then Dr. J ran out and retrieved a large number of insulin samples for me and said: I'll see you in February/March, and call if you need anything!

We said our goodbyes and then I scheduled my next appointment and left. In the elevator I put on my sunglasses, even though it was crappy out, because I had tears in my eyes.

My Endo, his intern, CDE and amazing staff get "it," BIG TIME.

And by "IT" I mean life, and what life throws our way, diabetes and otherwise.

And I feel incredibly lucky & blessed to have such an amazing diabetes team working with me - And I am very thankful indeed~

Yo Dude, I'm a P-E-R-S-O-N.....Or Dude, Learn From The Good Dr. How To Actually Be A Good Dr.

So I went to my Endo Dr. J this morning.... But my labs did not.
The lab was called, the paperwork was found and faxed to the office 10 minutes later.

Next I was weighed -I’d lost 4 pounds.
My blood was tested. It was 107 - I’d had breakfast just an hour and a half earlier so I was pleased.

Then I was led to the exam room, where I was left to my own devices.

OK, I was dying to go through the cabinets and drawers – I didn’t of course, but who could blame me if I did? I was bored and nervous and needed something to occupy my time. There were no magazines and I’d already written my list of questions for Dr J.

So I waited.

And waited.

And waited.

I was nervous and I started to pace.


INTRODUCING.....THE DUDE

Finally, the Attending Intern (that's what you call the student Dr. in training right?) walked in and introduced himself, and quickly started to ask questions.

Right away, I could tell he hadn’t look at my chart.

And how did I know this? Elementary my dear Diabetesaliciousness reader.

1. Dr. Dude asked me how long I'd been a diabetic and if I was a type 1 or a type 2.
2. Dr. Dude didn’t know what meds I was taking.
3. When I told him I was only taking a short acting insulin; he did quite “get it.”
4. A.K.A. –Dr. Dude had no ideal I was on the pump, & between u & me, I don't think he actually knew how one worked.
5. Finally, Dr. Dude asked me if my family had a history of diabetes - In my head I thought,"Your kidding right?" This was the final huge tip off that told me he neglected to read my chart.
   

If he had read the chart, Dr. Dude would not only have known the answers to all of the questions above, but he would have total realized what medical oddities my family & I are.
"HELLO," half of my immediate family are Type 1's, not to mention a boatload of Aunts, cousins, and a nephew!

Had Dr. Dude read my chart, he probably could have written a kick-ass paper about us and maybe even be quoted in some medical journal. He could have been considered a Rock Star among his peers, and maybe even picked up a few babes in the process. But, in his eagerness to learn and impress my Endo, Dr. Dude had dropped the ball by neglecting the simple (my medical chart,) and became just another nameless Attending Intern.

Look, D2 was a really nice guy and someday he will be a good Doctor.

But, Dr. Dude needed to work on dealing with the patient as an individual. Not as a number, or some medical chart that he needed to update quickly before the real fun could begin.
Not only was I a person who had a medical issue, but I was a person who "had issues" with her medical issue. Are you following me?

I told Dr. Dude what concerns I had about my diabetes .
And to his credit, he took copious notes and was extremely polite.

He then excused himself & went off to talk with my Endo.

PART TWO - INTRODUCING THE 'ROCKIN' DR J,

A few minutes later my Endo came in - followed by D2, who was looking very serious.

Dr. J gave me a big hello and wanted to know how I was doing.
Instantly I was put at ease and I hoped that D2 was paying attention.

My Endo Dr. J is awesome! He was so on was on point and not just about my numbers, but on all issues related to Kelly K and her diabetes. He knew my concerns. He remembered my family history, my fears and all the idiosyncrasies that are part of the wonderfulness of being me.

Dr. J was genuinely happy with my numbers, and wanted to know what I'd been doing to have my A1C drop to 7 from 7.6.

He also wanted to know how I was able to drop cholesterol by 24 points, now it was well below normal. FYI - On my last visit and for the first time EVER, my cholesterol had been high by about 12 points, and it freaked me out. So I made a few changes.

To be honest, those changes were simple – I just ate more legumes; whole grains, fruits,veggies, and fish, while eating less meat. I also upped my fiber, can you say WHOLE GRAINS? It worked for me and I was both relieved and glad.

Dr J also fine tuned my Altace by 5mgs and gave me a boatload of insulin samples. YES! That man knew how to make a girl happy!

When I asked him about any upcoming studies that I might be eligible to get in, he told me that my A1C was to low to be eligible for any upcoming studies– which was a good thing.

My Endo, while being incredibly book smart, is just as incredibly people smart.
He can talk me down off my "diabetes ledge of what ifs," update me on all the latest and greatest, and never treats me like a bad diabetic.

We talked a bit more and set some goals for my next visit.

Dr J didn’t want to see me until the summer and I left feeling happy.

I was a person (one who felt happy and healthy, knock on wood,) who happened to be a patient, and that’s just how my Dr. treated me.