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Medical Forum / Diseases and Disorders / Diabetes / March 2006Endo vist. The Muffin Worked!
This was the very first endo visit I've had where I didn't have to listen to the speech about how well-controlled I am and how the doctor really doesn't know what to tell me because none of her patients have such good blood sugars, and on and on. The doctor looked at my 100% diabetic NON-fasting lab result from last November when she had asked me to test after lunch, asked me what on earth I'd eaten for lunch. When I explained that it was nothing but one 4 oz whole wheat fruit muffin from the health food place where SHE eats, she finally GOT why I need some help with my blood sugars. So today she ran through a bunch of alternatives with me. First she mentioned Byetta again, but I said if I was going to inject something twice a day I'd rather use something that a) works for sure and b) has a longer track record. She also suggested Amaryl again, but I reminded her that our family has the heart attack history so I don't want to take anything that has the slightest chance of making that worse, plus getting a dose small enough not to hypo could be a problem for me. Finally she agreed that based on my testing of UL, Lantus and Levemir over the last few months, it sounds like post-postprandial control is my main problem and Lantus is too flat to help with meals the way that the peaky UL does. She suggested using Humalog for meals rather than a basal, possibly adding a very low dose of Lantus at night if my fastings don't come down with good meal control. For the record, this is EXACTLY what Mary suggested here a while back. Over this next week I'll be trying this approach out, very, very carefully. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control The peak works for me. Where are you getting UL these days? Let's have a big round of applause for Mary. > This was the very first endo visit I've had where I didn't have to listen > to the speech about how well-controlled I am and how the doctor really [quoted text clipped - 33 lines] > http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood > Sugar Under Control > The peak works for me. Where are you getting UL these days? There are some advantages of living in obscure not heavily populated corners of the world. A couple local pharmacies still have a few vials in the fridge and I stockpiled a few, but they'll be gone soon so I need to think ahead. > Let's have a big round of applause for Mary. Indeed! --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control :: This was the very first endo visit I've had where I didn't have to :: listen to the speech about how well-controlled I am and how the [quoted text clipped - 29 lines] :: Over this next week I'll be trying this approach out, very, very :: carefully. So, you had to go through all of this to get your endo on track? What happens to the person who isn't as knowledgeable as you and who doesn't have a Mary around? They're screwed. ;-) -- Cheri >So, you had to go through all of this to get your endo on track? What >happens to the person who isn't as knowledgeable as you and who doesn't have >a Mary around? :: They're screwed. ;-) Yeah, I figured. :) :: -- :: Cheri [quoted text clipped - 4 lines] ::: What happens to the person who isn't as knowledgeable as you and ::: who doesn't have a Mary around? > So, you had to go through all of this to get your endo on track? What > happens to the person who isn't as knowledgeable as you and who doesn't have > a Mary around? They end up waiting until their blood sugar is over 7% and they've got enough diabetic complications to get taken seriously. If they don't have have a heart attack first. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control > For the record, this is EXACTLY what Mary suggested here a while back. > > Over this next week I'll be trying this approach out, very, very carefully. > > --Jenny Which Mary? dave >> For the record, this is EXACTLY what Mary suggested here a while back. >> > Which Mary? > > dave Yours. <g> --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control >>> For the record, this is EXACTLY what Mary suggested here a while back. >>> [quoted text clipped - 10 lines] > http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood > Sugar Under Control <G> she'll be pleased, I'm sure, but I don't know what you guys were discussing. I don't follow too many threads. Dave [snip] I have heard one thing long back. 2 people one should never lie to are 1) One's doctor 2) One's lawyer I assume this includes manipulating them also. Doctors spend many many years of their life studying & many more years practising. It's easy to think that by reading some websites, books & a few research papers, a layman can know more than a trained doctor. But because of their vast knowledge & experience, they can probably spot some connections, some possible bad effects etc where we may not be able to. Even if you do what you did yourself, I am not sure it's a good idea to post it here in the newsgroup where there are going to be a lot of newbies looking at it. Some newbie after reading a few websites, posts & papers may decide to eat something he doesn't eat regularly before his post-prandial tests at the doctor & the doctor would prescribe for him a higher dosage or medicine than he would normally. Wham - the newbie has a few hypos. I have read your website many times & I feel you are a great asset to the group, but this is just my 2 pennies on this matter > [snip] > I have heard one thing long back. > 2 people one should never lie to are > 1) One's doctor > 2) One's lawyer > I assume this includes manipulating them also. > Doctors spend many many years of their life studying > & many more years practising. It's easy to think that [quoted text clipped - 4 lines] > some possible bad effects etc where we may not be > able to. > Even if you do what you did yourself, I am not sure > it's a good idea to post it here in the newsgroup where [quoted text clipped - 5 lines] > or medicine than he would normally. > Wham - the newbie has a few hypos. > I have read your website many times & I feel you > are a great asset to the group, but this is just my > 2 pennies on this matter This newsgroup is an excellent and possibly unique resource for intelligent diabetics who wish to become better educated about diabetes. You think we should all censor our postings in case some passing fool misunderstands something and does something stupid?  SignatureChris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] >[snip] > [quoted text clipped - 26 lines] >are a great asset to the group, but this is just my >2 pennies on this matter Jenny didn't lie to her Doc, she TOLD them what she had eaten. Jenny also explained, in detail, why she did what she did. It's very important to consider newbies when posting, but IMHO Jenny did it the right way: she supplied context, and an explanation. Should, say, a climbing group avoid discussing freeclimbing, because it can be very hazardous if newbies try it? Of course not. What you are suggesting here is that Jenny deprive us (including many of us who find ourselves in a similar situation) of information and insight, just to protect the stupid from themselves, and that I could never condone. > Should, say, a climbing group avoid discussing freeclimbing, because > it can be very hazardous if newbies try it? Of course not. What you > are suggesting here is that Jenny deprive us (including many of us who > find ourselves in a similar situation) of information and insight, > just to protect the stupid from themselves, and that I could never > condone. He also seems to be suggesting that she shouldn't use this group to share her experiences, triumphs, etc. Getting the doc to acknowledge her issues with diabetes has been a long battle for Jenny, and I appreciated hearing how she finally got the doc on her side. Very instructive for those who may have similar problems getting careful clinical attention. Susan > x-no-archive: yes > [quoted text clipped - 5 lines] > Very instructive for those who may have similar problems getting careful > clinical attention. I didn't have any problem with my endo, but I did have to explain why I wanted meds -- so that I could eat more normally --"meals" rather than lotsandlots of mini-meals. I showed her some sample bg results from the types of meals I was talking about. It's not like I was asking for help pigging out (though I did admit to wanting to participate more in certain pizza outings!). She understood that there is also a quality of life issue involved. This all took two visits at their usual 3-4 month interval -- the first one for discussion, the second for followup, agreement, rx. Later, when I wanted to increase my usage (take Prandin at more meals), I was able to get a new rx just by leaving her a phone message. She called the pharmacy, no problem. bj > I didn't have any problem with my endo, but I did have to explain why I > wanted meds -- so that I could eat more normally --"meals" rather than [quoted text clipped - 7 lines] > to get a new rx just by leaving her a phone message. She called the > pharmacy, no problem. My internist, OTOH, insisted on making sure that my request for metformin did not mean that I'd loosen up on carb restriction. In the past, any time my lipids worsened, he'd ask if I'd been eating bread, potatoes, cakes or cookies. Susan >x-no-archive: yes > [quoted text clipped - 12 lines] >Very instructive for those who may have similar problems getting careful >clinical attention. Totally agreed. I was also delighted to hear that Jenny found a way past the roadblock she was facing, and how she did it. >[snip] > [quoted text clipped - 3 lines] >2) One's lawyer >I assume this includes manipulating them also. It's your assumption that's off. You, Jenny and I are all covered by different health systems with different support levels and bureaucratic needs. Sometimes, it may be very much in the best interests of the patient to manipulate the person who controls their access to subsidised or insured treatment. Jenny id not post in a vacuum, no matter that you arrived late on the scene as a critic. If you google up the full personal history that caused the need for Jenny's action, you would not have presumed to chide her in this way. I will make the assumption that you are a fair person. Do a search and read that history before replying - to Jenny, not me. Cheers, Alan, T2, Australia. d&e, metformin 2x500mg SignatureEverything in Moderation - Except Laughter. >>[snip] >> [quoted text clipped - 10 lines] > person who controls their access to subsidised or insured > treatment. Perhaps a better way to put is would be "working the system". bj >>>I have heard one thing long back. >>>2 people one should never lie to are >>>1) One's doctor >>>2) One's lawyer >>>I assume this includes manipulating them also. >> It's your assumption that's off. You, Jenny and I are all >> covered by different health systems with different support >> levels and bureaucratic needs. Sometimes, it may be very >> much in the best interests of the patient to manipulate the >> person who controls their access to subsidised or insured >> treatment. > Perhaps a better way to put is would be "working the system". Last time I was in hospital (ulcerative colitis) I was in a GI ward which boasted its own kitchens and dietician so as to provide a specialised good diet for GI patients. However, I didn't agree. I thought there was was far too much starchy stodge, so I skipped eating the starchy stodge, and made up the difference by following the dinner trolley around and getting the nurses to give me the dinners of the people who had died. It took the kitchen bureaucracy about 3 days to stop sending up food to dead people, so there were always some to be had. I ate the veg of the dead folk's dinners to make up a more reasonable diet. No, I wasn't diabetic (or at least didn't know it) at the time, but I did know a crap diet when I saw one :-) If I'd told the nurses or docs I thought my "special GI diet" was crap I'd have antagonised them, so I simply pretended to be a weird guy who just loved eating vegetables the same way others like eating chocolate. That was something they could sympathise with, and were quite happy to indulge. Working the system :-) SignatureChris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] >It took the kitchen bureaucracy about 3 days to >stop sending up food to dead people, so there were always some to be >had. Hi Chris Totally aside from serious matters - I think you'd enjoy the movie "Terminal", if you haven't already seen it:-) Cheers, Alan, T2, Australia. d&e, metformin 2x500mg SignatureEverything in Moderation - Except Laughter. >> Perhaps a better way to put is would be "working the system". > [quoted text clipped - 15 lines] > chocolate. That was something they could sympathise with, and were > quite happy to indulge. Working the system :-) Oh my. Good story! bj >This was the very first endo visit I've had where I didn't have to >listen to the speech about how well-controlled I am and how the doctor [quoted text clipped - 6 lines] >4 oz whole wheat fruit muffin from the health food place where SHE eats, >she finally GOT why I need some help with my blood sugars. Jenny, I applaud you for your decision not to commit intellectual suicide. The "cult of doctors" should always be held up to the most exacting standards, and every intelligent person should always reserve the right to think for herself. Will, T2 |
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