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Medical Forum / Diseases and Disorders / Diabetes / March 2007Had to laugh ... (long ish)
Cos if I didn't I'd have gone mad! For those of you that don't know, I work at quite a large medical site in the NW (I'm not clinical staff but work very closely with them in an IT capacity). This gives me direct access to many doctors & specialists in various fields. Now it just so happens that yesterday we ran a conference on nutrition and several of the speakers talked about specifics to diabetes. Due to work commitments and the fact it was aimed at medical staff I was unable to attend but did speak to several of the delegates & speakers during breaks. First person (Lets say person A) I spoke to (a nurse & diabetic herself) I have known for many years and after discovering my DX started giving me the old "you need to do this that and the other" speech. This included what seems to be an almost standard NHS line of maintaining carb levels to a much higher degree than I have found are good for me. I put my decision to low carb to her and she was shocked to say the least (I may as well have suggested she went and did unspeakable things with livestock). I also told her that I am being tested for type 1.5 and she'd never heard of it. Fair enough, her area of nursing doesn't call for in depth knowledge in this area, but the fact that she is also diabetic and does need some knowledge for her job (many of our patients have diabetes) I found her apparent lack of knowledge quite strange. Must add here that she is an amazing caring person and extremely good with both patients, carers and family. I can't and wouldn't fault her on that, it's just from a medical professional and fellow diabetic I would have expected something more. Anyhow, later on I was introduced to one of the speakers (Person B) - A specialist in the field. We ended up discussing my diagnosis and she was concerned about various aspects of my tests and the results and actually suggested I put in for many of the tests that I've learnt about here - to the extent that she wanted me to attend her clinic as soon as possible. Unfortunately I am under a different PCT as I live well out of the area but she did say she'd put me in touch with some like minded professionals in my area (It's not what you know ...). She was quite positive about low carbing too which was good IMHO. Final person I will mention (C) was a GP who agreed with some of the points of (B) but didn't like the low carb idea and admitted that he wouldn't have bothered sending for type 1.5 tests and would have dealt with my case differently from my own GP. All of them agreed that less drugs are better, but when I asked (A) and (C) how I can control my BG and still eat the amount of carbs they were suggesting (same was asked of one of our pharmacists too) they all skirted round the issue but couldn't come up with anything better than adjusting medication! Fair enough they didn't use the words "increased medication" but you can draw your own conclusions. The point of this post? Well admittedly none of these people looked at my actual results, but in a single day I spoke to several professionals, all working for the same body, that gave very different advice to the exact same description of symptoms. Makes you think doesn't it? Well it does me anyway! All the best to everyone.  SignatureRenton >The point of this post? Well admittedly none of these people looked at my >actual results, but in a single day I spoke to several professionals, all >working for the same body, that gave very different advice to the exact same >description of symptoms. Makes you think doesn't it? Well it does me anyway! Makes me want to do my own reading. Almost certainly another topic where you would find a spectrum of views from the professionals - Patients? Using the INTERNET? <suck air through teeth> Problem is, we need some degree of professional support (or independent means...) to get the strips to enable the exploration. Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.5% BMI 25 > Makes me want to do my own reading. Almost certainly another topic > where you would find a spectrum of views from the professionals - > Patients? Using the INTERNET? <suck air through teeth> The internet must the the bain of the life of a GP. when I was diagnosed I was told very little about the disease and how to combat it, even about my medication, so I had to use the internet. But was warned about doing so. My conclusion is a doctors diagnosis and treatment is like a game of russian roulette > The internet must the the bain of the life of a GP. when I was diagnosed I > was told very little about the disease and how to combat it, even about my > medication, so I had to use the internet. But was warned about doing so. > My conclusion is a doctors diagnosis and treatment is like a game of > russian roulette I've come across this in so many different areas. There's that assumption that all knowledge on the internet is found by a quick Google and we will believe the first thing that we see on a web page. So few people seem to appreciate the use of other parts of the internet to actually interact with people who have experience in whatever area. SignatureRenton >> The internet must the the bain of the life of a GP. when I was diagnosed >> I was told very little about the disease and how to combat it, even about [quoted text clipped - 7 lines] > appreciate the use of other parts of the internet to actually interact > with people who have experience in whatever area. Doctors hate the interaction thing even more. Support groups? Forget about it. Informatin is passed around and DISCUSSED by "these people" who have no training and therefore no right to speak of things medical, let alone be interested in enjoying whatever is left of their lives. SignatureBeav VN 750 Zed 1000 OMF# 19 >> Makes me want to do my own reading. Almost certainly another topic >> where you would find a spectrum of views from the professionals - >> Patients? Using the INTERNET? <suck air through teeth> > > The internet must the the bain of the life of a GP. I think it's fair to say that your average doc HATES the internet. I know they hate it if they discover you know ANYTHING about your particular ailment. And god forbid you should you offer information on treatment. Feed him to the lions. SignatureBeav VN 750 Zed 1000 OMF# 19 > Cos if I didn't I'd have gone mad! [brevity snip] >The point of this post? Well admittedly none of these people looked at my >actual results, but in a single day I spoke to several professionals, all [quoted text clipped - 3 lines] > All the best to everyone. > Renton Your story is a very real one and one which I can relate to from personal experience similar in nature. This type of thing is very common all around the country and whether it involves medical staff who are diabetic or not. The reason for this is very simple, they are trained to follow the NHS policies on treatment in general terms and of course the majority have no cause or inclination to question anything in detail for a number of reasons. The simple fact is that the current teaching is inadequate for those who have the charachter and ability to do better. The policies are designed for the majority who sadly, are for the most part incapable of looking after themselves and have no alternative but to rely soley upon medication. For these people, the current view may be valid because essentially it is saying just carry on as before but try to eat more sensibly and we will counter the result with medication. For the likes of you and I and others in here that is a laughable policy simply because we are capable of doing better and managing as best we can with the minimum of meds. > Your story is a very real one and one which I can relate to from personal > experience [quoted text clipped - 24 lines] > because we are capable of doing better and managing as best we can with > the minimum of meds. Totally agree with you Pete, although Peter C's comments in another thread certainly made me think about things differently. The NHS can be a strange beast from a patients point of view, and is certainly even stranger when you are working within it. I've seen really good people with great ideas (IMO) be drummed down just because they were thinking differently. SignatureRenton > First person (Lets say person A) I spoke to (a nurse & diabetic herself) I > have known for many years and after discovering my DX started giving me [quoted text clipped - 4 lines] > have suggested she went and did unspeakable things with livestock). I also > told her that I am being tested for type 1.5 and she'd never heard of it. Type 1.5 Diabetes isn't actually a bone fide type; it's just an unofficial, jokey name given to slow developing Type 1. If you have the GAD tests etc they will just confirm you as Type 1 or Type 2. Your nurse might have come across it as LADA or another name. > Must add here that she is an amazing caring person and extremely good with > both patients, carers and family. I can't and wouldn't fault her on that, > it's just from a medical professional and fellow diabetic I would have > expected something more. You mean - agreement with your new-found opinions ? > Anyhow, later on I was introduced to one of the speakers (Person B) - A > specialist in the field. We ended up discussing my diagnosis and she was > concerned about various aspects of my tests and the results and actually > suggested I put in for many of the tests that I've learnt about here - to > the extent that she wanted me to attend her clinic as soon as possible. To what end ? Your treatment won't change for now if you were confirmed as "Type 1.5". You would still be on oral meds, but with the sword of Damocles hanging over you, until the honeymoon period ended, and the sh.t hits the fan. There's just an outside chance they would want you to jack in the diet and meds approach and switch to insulin right now. > Final person I will mention (C) was a GP who agreed with some of the > points of (B) but didn't like the low carb idea and admitted that he > wouldn't have bothered sending for type 1.5 tests and would have dealt > with my case differently from my own GP. Practical approach ? The GAD antibody and C-Peptide tests are expensive. All they will show ( if positive for Type 1 diabetes ) is that, at some point in the not too distant future, the meds will stop working, your bgs will start to rise and you will have to go onto insulin injections. Carry on as normal with the meds - it might never happen. > All of them agreed that less drugs are better, I prefer Oldal's approach and that of the medics he favours, Type 2 Diabetes is so damaging, in so many ways and all we have is preventative measures. So we come out with all guns blazing ... --a couple of meds to control bgs, metformin, TZDs, sulfs -- one to control blood pressure -- an ACE or ARB inhibitor to protect the kidneys -- a statin to control cholesterol -- a baby aspirin for the blood "thinning" ( remember stroke is your second enemy after heart disease ) Good control is going to be gained by a judicious mix of diet, exercise, medication, insulin. Thta's going to vary from person to person and there is plenty of room for the kind of different judgements that you encountered. > Type 1.5 Diabetes isn't actually a bone fide type; it's just an > unofficial, jokey name given to slow developing Type 1. > If you have the GAD tests etc they will just confirm you as Type 1 or Type > 2. > Your nurse might have come across it as LADA or another name. Didn't know that! >> Must add here that she is an amazing caring person and extremely good >> with both patients, carers and family. I can't and wouldn't fault her on >> that, it's just from a medical professional and fellow diabetic I would >> have expected something more. > > You mean - agreement with your new-found opinions ? Partially I must admit, yes - but also she seemed to just be anoyingly set in her belief that she knew all she needed to know and that was all anybody else needed to know. It works for her so it would work for everybody else and from what I have read here there is just so much more to know before you make up your mind how to deal with the situation. Maybe she has already gone down the route of learning more, maybe not. What wound me up most was her lack of ability to accept that I might want to look at alternative ways. >> Anyhow, later on I was introduced to one of the speakers (Person B) - A >> specialist in the field. We ended up discussing my diagnosis and she was [quoted text clipped - 8 lines] > There's just an outside chance they would want you to jack in the diet and > meds approach and switch to insulin right now. Don't know to what end to be honest - just reporting on what was said. It also just seemed to me to highlight the differences of opinion between healthcare professionals. My GP seemed only slightly concerned about my keytone's whereas (B) was very concerned. Maybe just because of not seeing the actual results, maybe not - just how I percieved the difference in opinion. >> Final person I will mention (C) was a GP who agreed with some of the >> points of (B) but didn't like the low carb idea and admitted that he [quoted text clipped - 6 lines] > will start to rise and you will have to go onto insulin injections. > Carry on as normal with the meds - it might never happen. Makes sense >> All of them agreed that less drugs are better, > [quoted text clipped - 12 lines] > Thta's going to vary from person to person and there is plenty of room for > the kind of different judgements that you encountered. Very interesting point of view and it does go a long way to explain the differences in judgement. Thanks for your comments Peter - makes me look at things from a different angle too! SignatureRenton > Cos if I didn't I'd have gone mad! <snip a good post> > The point of this post? Well admittedly none of these people looked at my > actual results, but in a single day I spoke to several professionals, all > working for the same body, that gave very different advice to the exact > same description of symptoms. Makes you think doesn't it? Ask 4 doctors for an opinion and you'll get 6 different answers. SignatureBeav VN 750 Zed 1000 OMF# 19 |
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