Searching for an Endo
One womans quest to manage her father-in-laws diabetes, and her own.
By By Ilene Raymond Rush
October 2007 — This August, I lost my beloved endocrinologist, who left her practice to spend quality time with her five- and three- year old. Despite my better nature, it's hard not to be a bit cranky. We'd bonded together over innumerable A1C readings and had developed a good working relationship. And, having settled on her after going through three earlier members of her team, I knew -- to paraphrase Flannery O'Connor – that a good doctor is hard to find.
Which brings me to my father-in-law, a bike-riding octogenarian who developed type 2 diabetes ten years ago. Skinny as a string bean and a regular tennis player, the diagnosis surprised the family. But, with his signature energy, within a week he found an endocrinologist, signed up for a diabetes education class, and – an inveterate techie -- connected his new blood sugar meter to his computer to forward readings to his new doctor.
At first, diet kept his sugars in line but eventually he moved to insulin. And that was when the trouble began. He simply could not get things in control. Mornings, his readings spiraled into the 300's; midnight, they dipped to scary lows. His doctor was receptive and willing to help adjust the dosages, but no matter how many times he and his doctor fiddled with the dosage, the highs and lows remained. My father-in-law grew increasingly frustrated and confused about his care.
What's wrong with this picture? Well, if a mechanic failed at finding that incessant grinding sound in a car transmission, chances are good that my father-in-law might have tried another garage. But switching medical care after a long relationship can sometimes be more difficult than changing hairdressers in the same salon. My father-in-law liked his endocrinologist and to the doctor's credit, he had tried hard to fix what was wrong. He was receptive, attentive and – unfortunately – unable to get my father-in-law stabilized.
Finally, a month or so ago, my in-laws decided – after much discussion -- to look for a second opinion. The new physician ran through my father-in-law's story and immediately changed everything from the type of insulin he was using to his diet. Within a month, the extreme lows and the highs were history.
Let me be clear -- switching doctors or getting a second opinion won't always solve a medical problem. Yet, as a pediatrician once noted as she peered into my young son's inner ear: medicine is often an art and a science. And on occasion, a fresh start may be just what the – new - doctor ordered.
As I search for my new – and I hope equally beloved -- endocrinologist, I'm going to try to keep that in mind.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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James Joyce said that “mistakes are the portals of discovery.” I wonder if insulin levels have been our mistake. Could it be that this hellish week of blood sugars were somehow meant to be? Drastic times call for drastic measures, right? Maybe we were too afraid in the past to take the plunge into drastic measures. Maybe this is oddly what we needed. We had to be truly frightened in order to make bigger, bolder changes. ...