Can I change consultant?

[Jane!]

Today I got the results from my second HbA1C test: 37 ( 5.5%).... my first one was 43 ( 6.1%). I was delighted but the consultant just said " you do know that you won't be able to achieve numbers like these in 10 year's time, don't you?" He was quite confrontational and then proceeded to tell me I should be on statins ( my cholesterol has risen from 4.9 to 5.7 - I think because I've been drinking red wine) & stated that the only reason for the 5.5% was that I'm still producing insulin. He then lectured me at length about how I'm high risk for heart attack and stroke ( because I'm 55). I low-carb and exercise regularly, but neither he nor the diabetes nurse seem to have any interest in how I'm maintaining stable, near normal blood sugars: they seem more concerned that I don't have highs or lows and seem to need to impress on me that this won't last. I came away feeling as if I'd done something wrong ( and couldn't work out what he wanted me to do - other than be miserable and have high blood sugar). Is it possible to change consultant? Are there consultants that understand the low carb approach (I read Dr Bernstein's book as soon as I was diagnosed - Type 1- 8 months ago and have found it invaluable. Do I have to go to the NHS diabetes clinic or can I see someone privately? I want to do all I can to be healthy ( and not be criticised for it, but supported).

 

[CarbsRok]

Sounds as if your consultant hasn't explained about your blood sugars very well. I suspect what he is trying to tell you is that you are in the honeymoon period at the moment and once that's finished things will go pair shaped number wise for a while until you can sort out extra insulin and carb ratios.
It's your choice as to whether you take statins or not, it's your body not his so remind him of this fact.
No idea why you discuss how many carbs you eat with the consultant and or nurse anyway, personally no one has ever asked me.

If you are not happy with the consultant then ask for your care! to come from your GP or a transfer to another hospital, problem solved

 

[Juicyj]

With all due respect I personally don't take much notice of what my consultant says, I have made it my case to learn as much as I can about my condition to manage this myself, when I was first diagnosed I was super sensitive and my first few consultant appointments left me deflated until I realised that I had to grasp this and take ownership. You know more now than the majority of healthcare professionals out there, so try not to feel despondent, it's all part of the learning experience of managing your type 1. You are doing an amazing job, don't left today's apt get you down

 

[Brunneria]

Hi,

Congratulations on your hard work and excellent control!

I am afraid (whether you are T1 or T2, or T1.5) a lot of consultants fail to differentiate between excellent steady control, and having a lot of hypos. Nor do they appreciate that Bernstein has maintained the same excellent control for over 40 years!

In light of this, you may want to shop around for a different consultant.
A lot depends on where you live, whether it is practical, and how many diabetes clinics within range. There are only two within realistic travel, for me.

If you are unable to change the clinic, you may find it reassuring to hear that in 6 visits to my nearest clinic, i have seen 5 different people, one consultant, 4 registrars. I guess i am not 'interesting enough' to attract the Big Cheese every time.

Equally interesting, the best, most useful and informative, helpful visits were with young Registrars. I was amazed and delighted at the extent they shared info with me and had an overview of my hormonal nonsense. Very refreshing.

 

[TorqPenderloin]

I agree with @Juicyj

While I'm very fortunate to have an awesome healthcare team, I have very simple and realistic expectations for what I need them to do.

If I can read about it online or in a book....I will do that and don't expect them to teach me.
I don't need them to create a plan for me or tell me what to eat or how to exercise.

If I have an issue and the internet won't solve it....I turn to them.
If I'm having trouble with my medication....I turn to them.
If I need an a1c test...I turn to them.

This way, the roles are clearly defined and there is little room for disappointment.

Now, if my a1c result is poor or a show signs of my management deteriorating, I would fully expect them to be more involve in my management. However, that has not been the case so far.

I think some people expect to develop a relationship with their doctors, and unfortunately that's not how the healthcare system works. I will admit that I had unrealistic expectations when I was first diagnosed, but had to learn that it was my job to take charge of my management.

 

[zand]

Well I've read that 5.6 is the cholesterol level which gives the lowest all cause mortality rate in women. My own is 5.8 and I'm happy with that.

Well done on achieving such good BG control.

 

[Mrs Vimes]

My cholesterol last checked was 7.3. BUT the consultant said that I didn't need to be on statins. That was written on the letter to my GP.
You have done brilliantly. They are used to being exasperated by people with poor control - this control being caused by trying to eat ' normally' but not quite matching up the insulin with the food spike.
The most helpful comment from my consultant last time? You eat lots of broccoli? Doesn't that make you fart a lot?

Ha ha ha, but I got the new insulin I wanted and some free cgm sensors.
@Jane! Ive messaged you.

 

[Mrs Vimes]

Ooo sorry @Jane! i can't seem to message you. But if you are on Facebook try Typeonegrit. We aim for 5% or less. Bernstein is God - bless him!
Mostly parents of t1s but lots of us adults.

 

[Jane!]

Ooo sorry @Jane! i can't seem to message you. But if you are on Facebook try Typeonegrit. We aim for 5% or less. Bernstein is God - bless him!
Mostly parents of t1s but lots of us adults.

Thank you...I don't know where I'd be without Bernstein, the internet and this website! I'll find Typeonegrit - thankyou.

 

[Robin_H]

Today I got the results from my second HbA1C test: 37 ( 5.5%).... my first one was 43 ( 6.1%). I was delighted but the consultant just said " you do know that you won't be able to achieve numbers like these in 10 year's time, don't you?" He was quite confrontational and then proceeded to tell me I should be on statins ( my cholesterol has risen from 4.9 to 5.7 - I think because I've been drinking red wine) & stated that the only reason for the 5.5% was that I'm still producing insulin. He then lectured me at length about how I'm high risk for heart attack and stroke ( because I'm 55). I low-carb and exercise regularly, but neither he nor the diabetes nurse seem to have any interest in how I'm maintaining stable, near normal blood sugars: they seem more concerned that I don't have highs or lows and seem to need to impress on me that this won't last. I came away feeling as if I'd done something wrong ( and couldn't work out what he wanted me to do - other than be miserable and have high blood sugar). Is it possible to change consultant? Are there consultants that understand the low carb approach (I read Dr Bernstein's book as soon as I was diagnosed - Type 1- 8 months ago and have found it invaluable. Do I have to go to the NHS diabetes clinic or can I see someone privately? I want to do all I can to be healthy ( and not be criticised for it, but supported).

I feel for you Jane. Well done on your results. I had halved my a1c since diagnosis but this went totally unacknowledged at my last appointment. I don't need a pat on the back from anyone but this SHOULD demonstrate to anyone with their head half screwed on that I'm being responsible and taking care. Assuming that the consultant had read my file before seeing me (I'm not convinced) she felt that the time was best used criticising my food choices and exercise patterns. Not once did she look make eye contact or smile. I turned up with reading history and food diary in hand and left disappointed feeling that I hadn't benefited at all. I have an appointment in a few weeks but I'm reluctant to return and don't hold out much hope of it being time well spent.

I do agree with others who say that if you're educating yourself and results are favourable, you should be able to ask for consultations if you feel it necessary. However if you do show commitment by dutifully turning up to see them, they have to know your history and recent developments otherwise it's a waste of time.

If you feel you would benefit by seeing someone else, then ask for that. You're the one most responsible for looking after your care. The hospital won't do anything unless you tell them about it unfortunately.

 

[CarbsRok]

Not once did she look make eye contact or smile. I turned up with reading history and food diary in hand and left disappointed feeling that I hadn't benefited at all. I have an appointment in a few weeks but I'm reluctant to return and don't hold out much hope of it being time well spent.

Hi Robin, if you feel the same after your next apt., do ask the consultant straight out exactly why you are there and explain how you feel.
You need to remember these consultants came into the world exactly as you did and will go out the same way i.e. they are human so perhaps the consultant has no idea how she comes over.

 

[Robin_H]

Hi Robin, if you feel the same after your next apt., do ask the consultant straight out exactly why you are there and explain how you feel.
You need to remember these consultants came into the world exactly as you did and will go out the same way i.e. they are human so perhaps the consultant has no idea how she comes over.

You're absolutely right. Maybe it had been a bad day for whatever reason. I will give it another go with her. I'm not looking for a relationship, just for my diabetes to be overseen with a positive attitude and outlook.

 

[Juicyj]

In some respects @Robin_H you have to tell your consultant what you expect of them, they are there to ensure you are managing your condition and are meeting their targets, so by telling them that you want positive support of what you are doing is simply stating your patient rights. We often feel consultants are the 'holy grail' of diabetes management. They do not live with this condition 24 hours as we do, if they question what you are doing then simply ask them what they would do if they were you. You have come a long way, be proud of what you have already achieved.

 

[Ewan1]

My consultant is rubbish with diabetes, he is not up with modern ways, just asks me if i'm taking the same insulin doses, when the courses advise changing doses to what you eat and level of exercise, would love to tell him to buzz off, BUT he is good with other medical probs and refers me to other experts etc, also if i leave him, its back to GP who is even worse, BUT I am limited to only 2 choices in consultants and most probs i can sort. found the DAFNE ? course brill, but had two nurses run it who struggled with the mix of out spoken people on it, but they were good and i learnt a lot. good luck