I’m mad.

It’s not even lunch time on the day of my appointment and already I’m looking for a new endo.

I’m mad. But mostly I think I’m homesick for Dr. C and his practice. I’m not sure I can put my thoughts together coherently, so you’re being subjected to my morning in bullet points.

• I don’t remember how I settled on this doctor, but it seems to me that his office was the closest one for a doctor whose credentials didn’t come from the University of Guatemala or University of the Phillipines.

• In the waiting room I sat. And sat. I sat too long considering my appointment was at 8 a.m. Once I got in a room I sat. And sat. I sat too long considering I barely had time to think about picking up a magazine at Dr. C’s office much less actually read several articles.

• I knew there would be a language barrier based on the doctor’s name. Again, willing to give it a go because I’ve had a number of doctors from other countries with whom I’ve had a terrific relationship.

• It’s no secret that I’m a big girl. He chose to bring up my weight and say that traditionally with obesity a person is diagnosed with type 2, but is pretty obvious after looking at my records that I’m type 1. OK, thanks for pointing out what I already knew. This is not going down a road I like.

• We chatted a bit about basal rates and carb ratios and agreed to adjust my carb ratios across the board since I’m mostly running high and since they hadn’t been adjusted since I stopped taking Symlin.

• He said he wanted to bring me back in several weeks to meet with the diabetes educator to discuss carb counting. There was the language barrier, so I asked him to clarify what he had said because I was a little shocked. Yes, he wanted me to come back to talk with the diabetes educator; it was sort of a requirement he said. I don’t want to be cocky and I understand the value of being in touch with a CDE, but I’m pretty educated and I think meeting with a CDE to discuss carb counting is a flippin’ waste of my time. I said as much, but not in those words. But this is a way to get to know you, he said, and to determine if you can continue on the pump. Wait a minute, I said. You’re saying that if I don’t see your CDE that you will determine if I should continue on the pump? That’s just downright unacceptable, I thought. Well, some people don’t really understand how the pump works, he said. Well, guess what, I do. He relented and said we could skip it.

• I asked about how he felt about a CGM. Some people have luck with them, he said, and we can send a note to your insurance company to see if they’ll cover it and take it from there. Seemed reasonable, I thought. Although not quite as aggressive as I’d like, but I’m not desperate for it right now. Plus, I already have the phone number for the Dexcom rep in my area.

• Set up an appointment for three months so we can discuss your bloodwork, he said. Stay here and we’ll be right back. I sat and sat. Too long. No surprise. The nurse came back with a sheet for my labwork and a packet about MiniMed’s Guardian CGM. I said I had already tried that one and was interested in trying the Dexcom. The packet she had wasn’t even about the CGM that’s integrated into the pump. This was the only information she had, she said, and she was sure I had MiniMed's number so I could just call them myself. Definitely not a good thing when your patient is more aware of the options than your staff.

• As for bloodwork, I am to find a lab close to me. “That blows,” I said to the nurse when she said it could be a week or two before we get the results back. I’m such an impatient person, but seriously there was an onsite lab at Dr. C’s office and I had results from my bloodwork emailed to me by Dr. C by the end of the day. This is unacceptable.

• And then, when making an appointment (even though I suspected I wouldn’t keep it) there weren’t any available in three months so they put me on standby and will call me two days ahead of when an appointment becomes available. Nothing like being on-call for your doctor's office.

This might be the difference between being in the fifth-largest city in the country and the capital of Missouri, but I have much higher expectations for my endocrinologist.