Visit to Practice Nurse-Diabetic Check

[Energize]

Hi

I had a visit to the Diabetic Practice Nurse today, feeling I needed some support and encouragement to get on track dealing with Type 2, on Metformin. I have been diagnosed a couple of years but, due to other pressures and committments going on, I haven't been able to focus on dealing with this until now.

So, the nurse was very nice, told me my recent test was 'fine'. I had to ask what it actually was - 7, and was reassured this was within normal limits. I felt I was being spoken to as someone who had no intelligence or knowledge of diabetes etc. I asked her what were the previous tests, as I'd not kept a note - 7, 6.8, 7.3, 7.2. I gave up asking any further. I then asked her how valid was an 'average' reading, when the peaks/troughs could be shallow or deep. Well, her response was that it was a measure of how well controlled the diabetes was. Umm, that explains everything, doesn't it? I asked how often was this test done and told 'annually' once you were stable. So, I'm considered 'stable'!!! Well, from what I've read, I shouldn't be regarding 7 as acceptable, but should be aiming for about 6.5. However, the nurse said this level is 'fine', I don't need testing for another year, as I'm 'stable' which just gives me the message that I don't need to improve levels, everything is 'fine' and carry on. So, why do I bother at all???

We did talk about home testing of BGs. Needless to say, the nurse wasn't keen and asked me how often I checked. I told her I only checked if the result was going to give me information that was useful. She explained (as if I was stupid) that home testing only shows you the 'here and now'. Oh, isn't she clever!!! I didn't know that, did I??? Oh, how they hate the patient to have any IQ etc.

Apparently, the 'average' is a good measure, regarding peaks/troughs, unless one has symptoms or of going hypo! Oh, that's good then. As I don't have hypo situations (being Type 2 and not on glucose lowering meds), then the 'average' measurement is a good control. However, even mentioning I do have symptoms, she didn't want to know, so I just gave up.

A few prods to the soles of my feet, and checking pulses (no feedback as to whether I had any palpable pulses, of course); asked me if I knew my weight, wanted confirmation I was a non-smoker (stopped 16 yrs ago and it's on their system); how much do I drink (again, already on the system that I rarely drink - considering taking it up at the moment, though!!!).

Yes, it just ended up feeling like she was 'ticking the boxes' and not wanting to discuss anything else to do with diabetes. I have been very depressed for sometime, hence feeling I could do with some support, encouragement and guidance to get on top of the diabetes. She didn't mention a thing about my weight, in spite of me being very much overweight. She didn't mention anything about exercise, nor diet.

In spite of actually being in tears while I was with her, she didn't question anything, why I was upset, what problems I was having regarding diabetes etc. I certainly felt totally 'fobbed off', not of any importance etc.

So, the outcome of this, when I had actually said I needed some help to get to grips with it all??? Ha!!! Yes, off to Sainsbury's, into the coffee shop, Scampi and chips then for some shopping - bread, some 'nice' yoghurts, chocolate things etc. So much for her being of help.

I know it's my body and down to me but I'm in a hole, have tried to get out of it myself, can't, so ask for help. I'm not bothered about going back for further checks. They are a complete waste of time.

So, needless to say, I'm totally p'd off with it all. I'm even more depressed that I was to start with. I have other issues which contribute to depression which I can't change - just have to endure as best I can. Things are due to get more difficult in due course, a lot of family issues which are likely to come to explode in time etc. On top of that, I do have long-term depression which I have had a lot of support for but, as I say, I can't change the situation that is causing me a huge problem and diabetes is just another thing to try to deal with. I have no option but to 'hang in here' for the time being but I can't see a future.

Sorry, just needed to rant.

Cheers

 

[WhitbyJet]

(((((((((Energize))))))))) oh poor you, small wonder you felt the need to have a day off from sensible eating.
Now dont you go beating yourself up over that, life, diabetes sucks sometimes. You know when I read your post it reminded me of the Serenity Prayer, you have already accepted that there are certain situations that you cannot change, no matter how difficult they may be. At least you are not wearing yourself down any further trying to change things that cant be changed, this is actually something positive you know. There is a big difference between acceptance and giving up.

So where does it leave you, do you have friends, relatives, anyone willing to listen, someone you can talk to, counselling or therapy? Or call the Samaritans, they are not just for suicidal people but anyone who feels low and kind of abandoned.

Its good that you come in here and let off some steam, tomorrow is another day, tomorrow if you can try and work out some things that you can do to make you feel better, something that you enjoy, just teeny steps will do, anything. You do need to treat yourself, you are special and deserve it and dont let anyone tell you different.
Go put yourself first for a change.
I wish you strength and hope that you can feel better very soon.

 

[Daibell]

Hi Energize

You are not alone so don't get depressed over it; you are right to view an HBA1C of 7 as a useful limit value to stay below. My visits to my diabetes GP/Nurse over the last 8 years have usually been similar often with a patronising approach. As someone else said on the forum recently, don't bother to argue with the GP/Nurse just nod and do what you know makes sense e.g. have a meter and test and be prepared to ask for more meds if you go above 7'ish HBA1C and are already doing your best with diet and exercise. A few years back I had to suggest to my expert GP that he added Gliclazide to my Met (he agreed) and last time with another GP I suggested going onto insulin which prompted Sitagliptin being added instead which has helped. C'est la vie!

 

[Unbeliever]

Yes indeed Energise, I can empathise and sympathise., I find it very depressing that everything is aboout boxticking and targets and noone is interested in the individual. Noone who is being paid to be that is!
I have experienced high HBA1C readings because of family pressures beyond my control and although "they" knew all about it - serious situation - all that mattered was that I was messing up the
Practice targets, They put me under even more pressure to go on insulin which I couldn't have coped with either physically or mentally
Once my HBA1C dropped below THEIR target of 7.5 they were no longer interested in me. I was treated as a ddeviant becuse I wanted to know my actual result not to be fobbed off with a "Normal"

No, you are certainly not alone. I often think that the psychological aspect of many illnesses is otally ignored. Even with things like cancer. Often I am sure it would be useful just to have someone to speak o at the right time. More useful than meds.

It is very hard to ask for help when none is forthcoming. If you are feeling depressed to begin with it is soul destroying. I hope your scampi and chips {my favourite too} and your chocolate treats helped a little.

I don't know about you but I always get straight back "on the wagon" and wonder why I was so bothered about doing without them!

Still 7 isn't so bad as a reading. If you think you might be experiencing peaks and troughs then you should test and make a note of them .You might want to show w them to a GP and ask to try somet
to help. Its amazing how actually being confronted by evidence can sway them. I and others here have found sitagliptin vey helpful. It works on tthe "peaks" and does not cause weight gain.

Your nurse is wrong in assuming that peaks and troughs don't matter as you obviously know. Keeping your levels low ansd stable is the ideal. If you find that your levels are very volatile and your GP doesn't want to help you would be justified in asking for a consultant appointment.

Good luck with it all. Many of us here have had similar experiences and totally understand your concerns.
Gomeimes it all just feels like too much to cope with doesn't it?

mmm scampi and chips......

 

[Emmerdale]

Good Morning I return to the DN for my MOT results on Tuesday 30th August and i suspect another waste of time. Was put on Simvastatin 40MG sbout 3months ago and went backto the docafter 1 month legs and arms aching all the time mmh says Doc i will put you on 20MG Simsvastatin chop the 40 Mg in half and use them first then you can have 20Mg He told me my last test was 7.2 to which replied that i was trying to get it lower his immediate reply was "if you can" with a smirk, I think my time is wasted there is no help,""Dietician" will only tell you watch wat you eat "podiatrist willbe too busy to see you he has very urgent cases, so i just struggle on good old NHS

 

[Daibell]

Hi Emmerdale

Are you on any meds other than Simvastatin which has no effect on diabetes other than to keep cholesterol down? If your HBA1C is at 7.2 and you are doing your best with diet and exercise then your GP/Nurse should probably move you onto Metformin. If you want more info have a look at the NHS NICE diabetes guidelines on the web; there may be some for your local NHS area as well. You have a right to treatment that meets the guidelines so ask for some meds if necessary. Ref Simvastatin I think you will find that the more expensive Atavastatin (Lipitor) or other statins can sometimes avoid the effects of muscle ache, discuss with your nurse, but hopefully the 20mg will solve your problem

 

[Energize]

Thanks, Unbeliever

Yes, you've hit the nail on the head. It's hard when you ask for help but don't get it. I am a depressive anyway, going through a difficult patch at the moment but went to see the Diabetic Nurse because I wanted help and support to get on top of controlling the Diabetes.

What really upset me was that she didn't pick up on any clues, in spite of me having initiated the appointment. She didn't ask how I was coping etc. She ignored clear signs of me not coping. I really wonder what these DN's are supposed to do. The appointment was a complete waste of everybody's time. Yes, just tick the boxes.

I have to admit that the reason I have peaks and troughs is due to my (poor) eating. Because I am feeling so low, I find it hard to resist. However, since not finding any support from the DN last week, I am now finding I am eating even more of the wrong food, comfort eating, I suppose.

I know I'm my own worst enemy but am so fed up having tried to seek help and getting none. It just leaves me feeling my Diabetes isn't worth anyone bothering with, so why should I? I know that's stupid, as it's my body and I would be the one to benefit, but I'm sure you folks know what I mean.

Anyway, sorry to be so grouchy. I'll try to get back 'on the wagon' again and 'try harder'!!!

Cheers

 

[ClaireG 06]

Is there another nurse you could see? It sounds like you could really do with some support from your HCP's.

 

[Energize]

I have previously seen a different one but wasn't impressed with her, hence hoping for different attitude with the one last week. It's as if, apart from ticking boxes, they just aren't wanting to pick up on anything that will take any of their time.

I think I might try to talk with a GP next week. I do feel I need to do something but don't feel I can do it on my own.

Thanks for all your support. It certainly does help to know you are out there!!!

Cheers

 

[ClaireG 06]

Yes, hopefully you will be able to find someone who is more helpful to you. Have you considered changing Dr's surgeries if there is another near you that you could use? When i was first diagnosed i had to do this.

 

[Energize]

Bless you, Clare. You must have read my mind.

Yes, I have thought of changing surgerys. There are several in my town. However, I just worry that I'll just have the same problem again, taking all my 'baggage' with me!!!

I think I need to give it another go, and maybe write down what it is I feel I need to say/ask. Perhaps that might work.

Thanks again

 

[Unbeliever]

Bless you, Clare. You must have read my mind.

Yes, I have thought of changing surgerys. There are several in my town. However, I just worry that I'll just have the same problem again, taking all my 'baggage' with me!!!

I think I need to give it another go, and maybe write down what it is I feel I need to say/ask. Perhaps that might work.

Thanks again

I really don't have much choice about Gp's where I live but I knw what you mean about thinking it might be useless to change. It is knowing what they are like ifor diabetic treament that is the difficulty.
Someone{may have been Sid} posted a link o as ite where Gps and the prcices could be rated by paients. Noone had commented on any of the practices in my area or anywhere near . I suppose people are suspicious of the confidentiality aspecs or just unaware of the site. Pity as i could be useful.

Wriing down what you want o say is a really good idea. Gets it all clear in your mind to begin with
and you have it here wih you to prevent you being side tracked. Good luck with it all. I am sure you will get a result now that you are determind not to be fobbed off.

 

[Emmerdale]

God Morning Hope everyone is OK ,forgot to mention yesterday that appoinments with DN have been cut from 6 monthly to annually, wonder what DN is going to fill her time with?Is the signs of the cutbacks in our Health Service..

 

[ClaireG 06]

Writing a list of questions is a very good idea It's something i always do now. Mainly, incase i forget something.

 

[catherinecherub]

You can rate your G.P. here but the problem is that good G.P.'s are not usually rated as human nature being what it is there will only be comments on the bad ones and subjective views.. I was speaking to my HC Team who had some bad comments on this site and yet I would rate them as excellent. Only people who cannot get what they want immediately seem to have commented there. One case in point was a family who wanted a home visit because their mother had a sore finger and got upset when it was suggested that she attend the surgery.
http://www.nhs.uk/NHSEngland/AboutNHSse ... HSGPs.aspx

 

[Unbeliever]

Yes I am sure you are right catherinecherub. All those sort of sites are he same. As you say only the disgruntled tend to comment. It is easy to see this on hotel sites etc.

Even asking people you may know who are paients at a particular practice isn't always helpful unless they have the same condition as yourself.

In my present practice I had one particular doctor recommended to me . I was quite pleased when I heard he was doing my annual diabetic review. Wihout going into details his lack of experience led to me suffering another haemoerrhage in my eye . Since then while sitting in the waiting room I have heard several paients complain about some quite serious failings - and the people were I live end to be very placid and uncritical. He is fairly young abd quite pleasant in his manner and this is how he makes a good impression on those only seeing him for minor problems.

As is often the case it is all about he web site. Patients can't really judge a whole pracice so quesions should be framed differently perhaps. Its very difficul.

I think it is just another case of making it appear hat the views of the public are sought when ,in reality , it means very little.

 

[Virginia]

So sorry you had such a miserable time.I'm in exactly the same situation and due for my check up in 2 weeks.At my last the Nurse still refuses to give me strips etc,"no need you're border anyway"( 7.05)
I take Metformin and have been buying my own strips and after eating I'm sometimes 12.02 or 14.0,most of the time I'm 9.05.I also mentioned my blurred vision,even wearing new glasses and I was told to see my optician.I've finally plucked up the courage to tell her on my visit that it's my right to have the strips if I have Type 2 and if I'm on Metformin.I've even downloaded the paper that says this and will take it with me.I hope you can get sorted out and feel better on your next visit,or even change Practises!! Take care,Ginnie

 

[trand]

I recently had a phone call from my surgery, telling me that my yearly appointed needed to made, I explained that my complaint a year ago had not been followed up, and when they replace the existing d/n, and get one that knows what he/she, is talking about then they can phone me, for an appointment,...

 

[smidge]

Hiya!

I also have a Practice DSN that doesn't know what she's talking about. At a recent appointment with the hospital consultant, he wanted to discharge me back to her care, but luckily when I explained to him that I know more aboout diabetes than she does, he asked me a load of questions and then agreed that I really did know more. So he kept me on his books for another year. I saw this as a very good result! I still have to go and have my feet checked and blood tested by her though, so I'll just have to smile, bite my tongue and say as little as possible! No matter what your DSN is like, you need your annual checks, so don't miss them to avoid the nurse, it's not worth risking your health over.

Smidge