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February 8th, 2012
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Olivia and I trekked in to Boston today, to visit her endo at Joslin. How I loathe that drive. It's two hours and the last 20 miles take at least 45 minutes. Today it took an hour. Holy god, the potholes on Route 9 could swallow a Mack truck.

Anyway. We navigated the Parking Garage Of Doom (otherwise known as Pilgrim St.) and were only (only!) 25 minutes late. I hate being late. It makes me itch.

The endo saw us right away - and Kerri, I told her you said hello. She was very happy to hear how well you're doing. The visit went well, although her A1C went from a 7.7% to an 8.1%. I hate that number. I know it's not supposed to, but it always feels like a failing grade when it gets high like that. Her doctor said it was fine, to be expected in a hormonal (and how!) teenager, but still. I don't like it. It makes my brain go down paths I'd rather they not travel, y'know?
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During the Diabetes Social Media Advocacy (#dsma) session on Twitter last Wednesday night, a lot of the discussion focused on Endocrinologists.  There were lots of great questions, and I enjoyed reading all the responses.

 

It soon dawned on me that there was a big difference between myself and many of the participants, and that being that I don't have an Endocrinologist.  I only have a Primary Care Physician/Provider (PCP) who helps manage the treatment of my type 2 diabetes.

 

So, just being curious, I asked the question: "Is it weird to not have an endo, and have everything managed through a PCP?"

 

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I want to think a fellow blogger, Carey Potash, for the idea behind this blog. It was him that I got the motivation to write this entry. Thanks man. You're a great father and you do an amazing job with your child with diabetes.
I hate going to my Endocronologist. I can't stand the overcrowdedness, the parking, some of the staff (you know who you are), the blood work (see my post entitled, "Disappointing Endo Visit"), The rookie University medical students, and the list goes on forever. (READ MORE)


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I thought seriously about postponing my endo appointment scheduled for this morning. I hadn’t seen the doc since August, when my A1C was 7.6. I didn’t think I was doing any better than I had been doing in August. In fact, I was pretty sure I was doing worse.

 

Thanks to some pretty crappy eating habits, some stress and dealing with worn out pump sites, I suspected my A1C was going to be ridiculously high. I even imagined myself telling the nurse to not tell me the number, to just write it down and let me look at it when I was ready. And then I realized that was stupid because how is the doc going to help me if we don’t talk specifically about what my A1C is.

 

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It's a shame in a way that such little things can be so influential.

 

By now you've read about my struggle to find an endocrinologist since moving to Phoenix. The first doctor I saw? What a joke. And then to Mayo where I loved the staff, but couldn't afford the out of network bills. While I've been mostly satisfied with Dr. R's office I have felt for a while that I settled on this office. And I don't really want the bad karma, but I seriously think I did settle.

 

And I think that point was driven home last week when a friend of mine saw a different doctor at Dr. R's practice. Her first experience there was much like my first endo experience here. She was completely unsatisfied and has vowed to never go back.

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A friend of mine has just found a new endo and is loving it. I'm very excited for her because I know how much trouble she went through with her last endo. I remember telling her the difference between her reluctant-to-listen-to-the-patient doctor and Dr. C: "After having never spoken to Dr. C about Symlin before, I came into his office for a regular check up, said I wanted to try Symlin and 15 minutes later the nurse was hooking me up with a sample pen."

While I had a lot of freedom when I spoke with Dr. C, I have often wondered how much latitude he gave me because he knew how involved I am in the diabetes community, knew that I was up on the latest information and technology, and was proactive. I was sad to leave him behind. (Maybe there's a little too much ego there, but I really got very little resistance from Dr. C about anything.)

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I've got that nervy, kinda sick feeling.  A type of cold feet, but all in my mind.  Maybe it's butterflies I feel, but it's not really in my tummy.  I'm dreading the stop on the scale on the way back to the tiny little interview (maybe I should call it interrogation, that seems more accurate) room.

 

It's Endo-Nerves.  Tomorrow is my endocrinologist visit.  It's only been a couple months, but with my impending insurance (maybe I should call it un-surance) upheaval, I'm going in a few weeks early.  

 

This may be the last time I go to this particular doctor (maybe I should call her Physcian's Assistant, that seems much more accurate).  Since I won't be commuting up to work following my lay-off, it's really silly to consider driving over an hour each way to see this highly rated and very popular specialist (and his minions, AKA PAs).  

 

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I know I'm not the only one to have gone through this.

 

I have an issue with my endo's office and renewing my prescriptions. I get my insulin and my thyroid medication through my endo's office. I see the nurse practitioner, K, as often as she asks me to. I get my routine blood work, I show up to my appointments on time.

 

I understand that the reason providers only give patients a certain number of refills is so that patients will check in with their providers to make sure the medication is working, is still the right one for them, that the dosage is the right one, blah, blah, blah. I GET THAT.

 

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Been having weird dreams... Guess I'm a little anxious about the endo tomorrow... So in honor of odd dreams and anxiety:
Twas the night before my endo appointment, when all through the place Not a meter was stirring, had my pump at my waist My gym clothes were tucked in my backpack with care, And I hoped that my work would show on the scale.
And I was nestled all snug in my bed, While visions of low A1Cs danced in my head. And me in my 'kerchief, and Bob in his cap, Had just settled our brains for an early fall nap.
When in a weird dream there arose such a clatter, The doctor he told me everything was the matter. He said that my A1C had risen so fast, And my weight was through the roof, I was simply aghast.
The moon it showed down as I tossed to and fro The bad news continued from my dreamland endo. When, what to my sleeping brain did appear But a 400 plus cholesterol number, and my control-loss so clear. (READ MORE)


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When I sat down in the exam room with the nurse she started asking me some typical questions but responded in a different way.

 

“So you are a type 1 right?”

 

“Yes, since I was 17.”

 

“And you are on a pump right?”

 

“Yes for just over 2 years.”

 

“Which pump?”

 

“I use a Minimed pump.” I answered although no one has ever asked me that question.

 

“Which model? The paradigm?” She asked

 

“Oh yes, the Paradigm 722,” I replied a little confused that she would even know model numbers and stuff.

 

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Julia
JuliaJulia lives behind the Tofu Curtain, in the Pioneer Valley, in Western Massachusetts. It's a nice place. She likes it there. Her eldest daughter, Olivia, has type 1 diabetes. She's also 13. It's a real toss-up as to which is more difficult -- the diabetes or the teen-age drama. (Read More)
Brenda Bell
Brenda BellBrenda was diagnosed with high blood pressure, high cholesterol, and Type 2 diabetes in July 2002. After a rocky start, her diabetes has been diet-controlled since January 2004 and she hopes to keep it that way for as long as possible. (Read More)
Our Other Bloggers: Carey Potash, Nicole Purcell, Lindsey Guerin, Michelle Kowalski, Megan, MikeDurbin, Robert Hudson, George Simmons, Scott Marvel, Kim Doty, Kerri Sparling,