Been To See The Dsn, Oh Dear!

[Rustytypin]

I went to my surgery for my annual meeting with my DSN this week. I had thought that my doctors practice wasn't too bad. They are usually fairly pro-active in prevention matters. However, they have decided not to put results online, and I had to request a copy three times before I eventually got one. Black mark No. 1.
Anyway to the meeting.
Liver, kidney, cholesterol are OK, cholesterol ratios are optimal (trigs are 0.6), so no problems there.
My next question was, can you explain why my HbA1c was 44 (classed as normal on the print out), indicating an average BGL of about 7 but my daily testing averages 5.8 and an HbA1c of about 34.
Answer: You must be missing the highs! Me: I test up to 6 times a day, at all times including occasionally in the middle of the night (BG in the high 5's). DSN: you should only test weekly and rely on the annual check, besides you will only get sore fingers testing that often!
So no point in continuing that conversation then. She gave me a booklet, published by the Leicester Diabetes Centre entitled At high risk of Type 2 Diabetes. What a load of Bull Sh*t. Example, Don't eat a high fat diet, it will raise your cholesterol ! My cholesterol has gone down on LCHF. The booklet is full of such gems!
Black marks 2 to 10!
End of rant, thanks for reading.
Rusty
P.S. Actually rereading the booklet it does contain some good advice, just not on nutrition.

 

[DavidGrahamJones]

DSN: you should only test weekly and rely on the annual check,

That is criminal. I think you should ask her to explain how monitoring the way she suggests will let you know how the life style changes you have made are working . . . . or not. Monitoring once a week is pretty useless as it tells you nothing, except for your BG at one point in time (about a minute) during a period of 10,080 minutes. Waiting a whole year is ludicrous, unless they think it's a good idea to go that long without knowing what your BG is doing. I wonder how much damage can be done with a years high BG.

 

[JohnEGreen]

At least if your fingers are sore you can still feel them.

 

[Daibell]

I went to my surgery for my annual meeting with my DSN this week. I had thought that my doctors practice wasn't too bad. They are usually fairly pro-active in prevention matters. However, they have decided not to put results online, and I had to request a copy three times before I eventually got one. Black mark No. 1.
Anyway to the meeting.
Liver, kidney, cholesterol are OK, cholesterol ratios are optimal (trigs are 0.6), so no problems there.
My next question was, can you explain why my HbA1c was 44 (classed as normal on the print out), indicating an average BGL of about 7 but my daily testing averages 5.8 and an HbA1c of about 34.
Answer: You must be missing the highs! Me: I test up to 6 times a day, at all times including occasionally in the middle of the night (BG in the high 5's). DSN: you should only test weekly and rely on the annual check, besides you will only get sore fingers testing that often!
So no point in continuing that conversation then. She gave me a booklet, published by the Leicester Diabetes Centre entitled At high risk of Type 2 Diabetes. What a load of Bull Sh*t. Example, Don't eat a high fat diet, it will raise your cholesterol ! My cholesterol has gone down on LCHF. The booklet is full of such gems!
Black marks 2 to 10!
End of rant, thanks for reading.
Rusty
P.S. Actually rereading the booklet it does contain some good advice, just not on nutrition.

First, you have a right to see your results online. Since April last year ALL surgeries were told to provide access to patient records online. We have a two level access i.e. summary records and fuller records with test results; the latter you need to ask for. I think you need to ask the Practice Manager why this hasn't happened and when will it happen. You could also ask the PPG (Patient Participation Group) at your surgery to raise the issue. I'm a member of our surgery PPG. BTW never expect sensible dietary advice from the NHS as it comes from PHE who haven't a clue.

 

[Rustytypin]

TBH I wasn't expecting much from the visit, I think the DSN drew the short straw at the practice and has been given minimal NHS type training with no real background knowledge .... I didn't think there was any point in arguing with her, it would have only raised my blood pressure. Yes @Daibell I am going to take up the results situation with the Practice Manager, it is not a good situation. The booklet mentioned both DUK and the NHS so was not expecting much!

 

[pollensa]

I went to my surgery for my annual meeting with my DSN this week. I had thought that my doctors practice wasn't too bad. They are usually fairly pro-active in prevention matters. However, they have decided not to put results online, and I had to request a copy three times before I eventually got one. Black mark No. 1.
Anyway to the meeting.
Liver, kidney, cholesterol are OK, cholesterol ratios are optimal (trigs are 0.6), so no problems there.
My next question was, can you explain why my HbA1c was 44 (classed as normal on the print out), indicating an average BGL of about 7 but my daily testing averages 5.8 and an HbA1c of about 34.
Answer: You must be missing the highs! Me: I test up to 6 times a day, at all times including occasionally in the middle of the night (BG in the high 5's). DSN: you should only test weekly and rely on the annual check, besides you will only get sore fingers testing that often!
So no point in continuing that conversation then. She gave me a booklet, published by the Leicester Diabetes Centre entitled At high risk of Type 2 Diabetes. What a load of Bull Sh*t. Example, Don't eat a high fat diet, it will raise your cholesterol ! My cholesterol has gone down on LCHF. The booklet is full of such gems!
Black marks 2 to 10!
End of rant, thanks for reading.
Rusty
P.S. Actually rereading the booklet it does contain some good advice, just not on nutrition.

Hearing information as within unfortunately, adds more and more to the general concern what are we to believe, who is right wrong, having to accept unprofessional replies to valid questions, including the flaws in system seemingly getting to be wider and wider, re disinterested professionals not taking time to ask the patient to elaborate more on the information provided and asking, especially re questin of A1C result. That was an important point to raise.

"My next question was, can you explain why my HbA1c was 44 (classed as normal on the print out), indicating an average BGL of about 7 but my daily testing averages 5.8 and an HbA1c of about 34.
Answer: You must be missing the highs! Me: I test up to 6 times a day, at all times including occasionally in the middle of the night (BG in the high 5's). DSN: you should only test weekly and rely on the annual check, besides you will only get sore fingers testing that often! "

You asked a truly warranted and important question important to yourself and situation to be clarified, and it seems a flippant unprofessional reply given in my personal opinion, was totally out of order.

A1C can be discordant, leading to one feeling the need to ask questions to get clarification, I had one of 8.1 that showed sugars equivalant of 128mg/dl this was not normal, normally if a A1C is 8.1% it should be sugars at 183mg/dl so obviously there was error here, I as you had normal sugars v. the info on A1C showing difference to the majority of finger prick tests, I too told ignore the sugars equated on A1C dont even look at them. yes, one gets sore fingers, this is correct info, to give forth a professional reply to your important question, you were missing highs as the answer ultimately, was not professional by any standards. Whether she is correct in saying test only weekly can be argued agreed, depending on ones personal situation, your results as you informed her clearly, certainly, a more care of interest reply, and or even better, have shown interest sufficiently to ask you continue to inform your daily testing at least to learn from a patients situation, if one is a good nurse professional medical doctor, this is demonstrated that they ask patients questions, show interest in patient and patients advices to "them", to gain knowledge on top of what knowledge they have, if they dont do that, time to move on to another professional perhaps.

 

[DCUKMod]

I went to my surgery for my annual meeting with my DSN this week. I had thought that my doctors practice wasn't too bad. They are usually fairly pro-active in prevention matters. However, they have decided not to put results online, and I had to request a copy three times before I eventually got one. Black mark No. 1.
Anyway to the meeting.
Liver, kidney, cholesterol are OK, cholesterol ratios are optimal (trigs are 0.6), so no problems there.
My next question was, can you explain why my HbA1c was 44 (classed as normal on the print out), indicating an average BGL of about 7 but my daily testing averages 5.8 and an HbA1c of about 34.
Answer: You must be missing the highs! Me: I test up to 6 times a day, at all times including occasionally in the middle of the night (BG in the high 5's). DSN: you should only test weekly and rely on the annual check, besides you will only get sore fingers testing that often!
So no point in continuing that conversation then. She gave me a booklet, published by the Leicester Diabetes Centre entitled At high risk of Type 2 Diabetes. What a load of Bull Sh*t. Example, Don't eat a high fat diet, it will raise your cholesterol ! My cholesterol has gone down on LCHF. The booklet is full of such gems!
Black marks 2 to 10!
End of rant, thanks for reading.
Rusty
P.S. Actually rereading the booklet it does contain some good advice, just not on nutrition.

As a matter of interest, are you in the Leicester Diabetes Centre's "catchment area"?

 

[Rustytypin]

I live about 50 miles from Leicester so I'm not sure if I come in their area. Every organisation seem to have their own rules as to how far their reach is.

 

[Daphne917]

First, you have a right to see your results online. Since April last year ALL surgeries were told to provide access to patient records online. We have a two level access i.e. summary records and fuller records with test results; the latter you need to ask for. I think you need to ask the Practice Manager why this hasn't happened and when will it happen. You could also ask the PPG (Patient Participation Group) at your surgery to raise the issue. I'm a member of our surgery PPG. BTW never expect sensible dietary advice from the NHS as it comes from PHE who haven't a clue.

Unfortunately not all surgery’s, inc mine, allow you access to results on line - when I asked I was told it was up to each practice what they allowed you to see/do. I can only book appointmts and order repeat meds with mine. I have however managed to get access to my results via signing up to DiabetesMyWay which was introduced into Somerset (first time outside of Scotland) a couple of months ago so at least I can look them up there.

 

[Mr_Pot]

Unfortunately not all surgery’s, inc mine, allow you access to results on line - when I asked I was told it was up to each practice what they allowed you to see/do. I can only book appointmts and order repeat meds with mine. I have however managed to get access to my results via signing up to DiabetesMyWay which was introduced into Somerset (first time outside of Scotland) a couple of months ago so at least I can look them up there.

So your surgery won't share your results with you but they will share them with a third party, My Diabetes My Way. That doesn't make any sense.

 

[Daphne917]

So your surgery won't share your results with you but they will share them with a third party, My Diabetes My Way. That doesn't make any sense.

Strange but true - they have no problems giving me a printout but won’t let me have online access. However I haven’t asked for a while so I may try again when I’m next in there!

 

[Mr_Pot]

Strange but true - they have no problems giving me a printout but won’t let me have online access. However I haven’t asked for a while so I may try again when I’m next in there!

Maybe they don't want to pay the website for that part of the service.

 

[TriciaWs]

First, you have a right to see your results online. Since April last year ALL surgeries were told to provide access to patient records online. We have a two level access i.e. summary records and fuller records with test results; the latter you need to ask for. I think you need to ask the Practice Manager why this hasn't happened and when will it happen. You could also ask the PPG (Patient Participation Group) at your surgery to raise the issue. I'm a member of our surgery PPG. BTW never expect sensible dietary advice from the NHS as it comes from PHE who haven't a clue.

I've been trying to get my surgery to give me online access for 4 months, no luck - finally got a print-out but only covered the past 6 months.

 

[DCUKMod]

I live about 50 miles from Leicester so I'm not sure if I come in their area. Every organisation seem to have their own rules as to how far their reach is.

Yes, 50 miles is a bit of a step out.

I was in the Leicester Diabetes Centre yesterday for a meeting, and they holding one of their regular T2 courses. There's a lot goes on there, as it is known as a centre of excellence, with a part of the National Institute for Health Research occupying another part of the building.

 

[pdmjoker]

My next question was, can you explain why my HbA1c was 44 (classed as normal on the print out), indicating an average BGL of about 7 but my daily testing averages 5.8 and an HbA1c of about 34.

I don't know if someone else has answered this but: the HbA1c measurement assumes your red blood cells remain in your blood for three months. If they survive for a longer or shorter time then HbA1c will not be accurate.

Dr Peter Attia mentions this issue in Diet Doctor Podcast #2 about 10 mins from the end. He has smaller red blood cells than average and HbA1c for him isn't representative...

 

[Pinkorchid]

I wonder if it depends on the size of the practice as to how much online access for patients they give. Ours is a village practice and covers 3 small adjoining villages with two surgeries which the doctors rotate between. It has a small surgery where I live and the main one is in the next village but it is not a large health center. Does that make any difference I wonder as maybe not many patients have asked or even want online access and is why the receptionists are a bit confused and do not know much about it

 

[david1241]

hello i applied for my medical records recently .what a job they did not want to give me them.They were making a sorts of excuses .Like they haven't time the doctors are busy.If i hadn't hounded them over the phone .when they answered it .I'd still be waiting now 6 weeks later When i got them with surly service there was 82 pages most of it bullsh-t.I read in 2001 i had a routine fasting blood test my blood sugar was 11 mm/l I don't know if that reading would be ok them All fasting blood tests up 2014 no blood sugar readings were recorded.Then they told me i was diabetic.I the reason i wanted my medical records I have been enquiring about the price of an operation done privately abroad .seeing they won't do it here on the NHS Even though i have always worked full time and paid my taxes.I know this is a bit off subject.I upset the top doctor at this malpractice I was in agony with my hip and i asked him if he would prescribe me some stronger pain killers as the over the counter co-codamol i was taking were no longer working he flatly refused.he would only prescribe the ones i was taking.Two months later i had been round town I had to come home early because i was in that much pain with my hip .On the way home i was passing the general hospital .I called in at A&E I had an x-ray on my hip.The A&E doctor told i had severe arthritis in my hip .he said i would need strong pain killers ,or my mobility will suffer.I said they won't give me any .he sent a report in and requested they give me stronger painkillers .I was going into the surgery as the chief doctor was coming out he was usually friendly.But not this time ,he was raving he never spoke you could almost see the steam coming out of his ears i thought he was maybe having a bad hair day.A few weeks later.I saw a new doctor at the malpractice and asked hip if he would refer me to a hip specialist which he did no problem.On December 14th 2012 i saw a hip consultant.When he saw me his face dropped a mile,well you can't please everybody.He was a real nasty piece of work He asked me a few questions how far can you walk without a stick etc then he said why are you here why have you come why are you sat in this room today shouting and waving his arms about.He said huh what did you do see your G.P. about something else and just happen to mention your hip.Then he said your hip is bone on bone a nd you will have pain from time to time.I could see that my A&E x-rays were on his laptop.Then he said i would be able to find a surgeon to replace my hip .He said i think painkillers are the answer i will refer you back to your your GP.I dicovered why the the consultant was nasty because the top doctor at the malpractice was highly upset as he felt i had gone over his head .so he put the boot in and stopped me having my hip replaced .The said doctor has retired .The best place for him in my opinion.The health records were incomplete there were no photo copies of my X-rays.So I phoned the records office to see were they were were they said i would have to get them from the hospital The manager was the the only person who wanted to know why i was considering going abroad to pay for my hip replacing.i said they won't do it here on the NHS I don't want to give the i am an old age pensioner bit I may be able to afford it by maxing out my credit cards if i can't afford to pay them back they can take it outof my estate when i snuff it lol.The manager said she would find me a doctor who would refer me to a hip consultant on the NHS.She made me an appointment with an out of town doctor .He seemed ok He took details and sent me off to the hospital for an X-ray .He said i have made an appointment for you to see me in 3 days time.After 2 days his receptionist rang up canceling the appointment..I was waiting for a dear john letter there was nothing .In the meantime i rang up about my recent x-ray they knew nothing about them.they got the doctor to ring me I told him i'd been for an x-ray after the appointment.He said he would let me know I shall not hold my breath .I think he chickened out in the first place .Totally useless the lot of them .At least the ones i have seen so far.I believe the are some good doctors somewhere .Finding them is the problem.I must be still on the blacklist.