Hospital "discharging" type 1 diabetics!

[Zanshin]

Yesterday I attended my annual diabetic review at my hospital hospital name removed. I was greeted by a new consultant, and following a very limp handshake he skimmed over the usual questionnaire, skipped the parts about checking sensation in my feet etc, then announced that, having been diagnosed Type 1 in 1995, with an HBA1C of 7, there was nothing more the hospital could do for me, so I am being discharged into the care of my local surgery.

I explained I did not want this to happen, as follows:

- my annual review is the only opportunity I have to discuss diabetes with someone qualified in diabetes
- I live in a small rural village with a very poorly managed local surgery, not close to my place of work
- whilst my HBA1C has been constant, it hides many highs and lows, and I have just had the worst and most difficult year of diabetes management since diagnosis 16 years ago.

My protestations were ignored, and I have been discharged from their care. I`m guessing that it is now down to me to contact my local surgery, and try to negotiate with them to test my blood for me as regularly as I would like (ie quarterly of half yearly), in the meantime, thank you technology for the internet, as it will become my diabetes support team from today!

Anyone else been dropped by their hospital, or is it just hospital name?

 

[jopar]

I wouldn't panic sounds as though you are better not attending his clinic..

What you need to do is see what other hospitals within your traveling distance/PCT that offer a diabetic clinic..

Then you pop down to your GP and have a friendly chat about your control issues and your present team not helping you but discharging you! So can he/she do a referral to XXX consultant at said Clinic of your choice..

And to be on the nice side, just say that once you have gained the control of your diabetes then you be more than happy for your surgery to oversee your diabetes, but at present with how it's all going you feel that you do need a specialist hospital team/consultant that can help and if necessary perhaps consider the need of insulin pumping etc... So your GP doesn't feel that you think that his diabetic is naff..

But it's customery now for T1's or T2's who are well controlled to have their diabetes overseen by their GP surgery so this free's the clinic for those that really do the the specialist support, this is why my husband is under our doctor, I have to be under the hospital consultant due to my insulin pump, so I see the consultant once a year, and my nurses if and when I need them I just phone... Baice bloods etc are done by my doctor,

 

[Zanshin]

Thanks, that sounds like good advice. I also kind of agree to the principle of health professionals focussing on priorities, but it wasn`t really "sold" to me like that...

 

[ebony321]

You may be surprised that your GP may have a diabetes nurse. Mine does and i live in a small village!

There is also a doctor at my GP who has a son with T1 diabetes so she is always willing to listen to what im saying and will never shoo me out the door!

You may find a doctor who doesn't specialise in diabetes could still be very well informed and willing to listen to you.

 

[Unbeliever]

Big changes afoot at the hosptal Zansbin, You migh be better off away from it until its settled.

"Poorly managed ,local surgery makes me think we could be neighbours . If so there is certainly DSN.
IIts always very diffficult getting used to a new healthcare team- and to the routine in a nwew place . Even if you are already a patient noone seems to appreciae the problems being a new
patient can pose until you get used to the system.

I think it might be necesssary for me to move house for other health reasons but I absolutely dread
having to be a new patient all over again.

 

[mrburden]

Yesterday I attended my annual diabetic review at my hospital hospital name removed.

Anyone else been dropped by their hospital, or is it just hospital name?

Surely the whole point of moderators removing names from posts is to sustain anonymity. Why have the titles of most of the subsequent posts been allowed to remain? :?

...And while I was typing they disappeared

 

[benedict]

You caught me in the middle of the act mrburden

It was a valid point you were making -thank you for taking the trouble to point this out.

Benedict

 

[Zanshin]

It was cheap of me to name the hospital...but cheap of them to discharge me. No doubt if I have any diabetes issues from this point, my GP will be at hand to suggest taking a paracetamol or getting more sleep. Looking forward to it already

 

[Unbeliever]

I was referred to this clinic by the opthalmic dept. They were helpful on the couple of occasions i attended but told me quite honestly that he could not justify keeping me on the books when my HBA1C improved.
I know it is different for you because you have been attending the clinic since diagnosis and it must be a shock but t is all part of the same hing.
Its all done by numbers. Even the DSN no longer wants to see me now that my HBA1C is OK.
Before this I felt as if I should move in.

I expect that there is a raionalisaion exercise going on.

The disturbing thing is that ,as you point out the HBa!C does not tell the full story. The challenge is finding someone at local level who understands his.
It is very frustrating when they ignore problems with "spikes" and resons - illlness , life events - which account for a high result but ignore queries about lows etc.

This retrospective tst .performed at diffferent intervals and potentially influenced by other conditions may be all hey have but i think the limitations should be rcognised.

Still waiting for more recognition of individuals and fewer "One size fits all policies amd protocols".
And some think I am a pessimist.

 

[donnellysdogs]

I was discharged years ago from hospital care to gp care. I was lucky that I had a superb gp who always used to let me email him or turn up at surgery to see him at 7.30am prior to surgery starting at 8am. Then I moved. New GP idn't want to issue more tha 2 strips a day for testing (T1 and a driver!!!)....my occupational doctor at work advised me to ask for referral to hospital who would tell GP to prescribe more....

I am so glad that I went back to hospital care (never thought I needed it with my great gp), but if I hadn't moved back, there is no way I would have now been on a pump and improved my levels so much.....my current gp admits he knows nothing about pump and leaves everything to hospital..when they said to him to prescribe me 300 strips a month....I have never had any problems at all....he can see that I am healthier, that I am happy and that I am less bother to him-so he now takes all instructions about presciptions for diabetes, cholesterol etc from my hospital and never argues.

I was quite happy when I had a superb GP that really looked after me exceptionally well, but when that care and level of service dropped when I moved then I had no other choice but to ask to go back to hospital.

 

[anniep]

I think Donnelysdogs has hit the nail on the head,it is all down to the quality of the GP. Some have an interest in diabetes and have read mroe than the small amount that they do on it in medical school and kept up to date.

Other have just got the 'crib sheet' and work of that, come what may. I never get to see the GP with mine (i'm T2) the practise nurse oversees diabteics, asmatics, no smoking, baby inoculations....... etc etc.

There is no way that one nurse can be an expert in all of these, she had never even heard of the dawn phenomenon unitl I told her. I may not know the science behind it all, but I AM the expert in my own body.

I do get one prescition for test strips every 2 months, it ws given to me very relucatantly by one of the practise nurses. I saw the other pracitse nurse (they both do everything not specialities) at my last review - my results were 'perfect and consistant' and a great improvement on 18 months ago. Then she asked how often I tested 'because we don't really reccomend testing for T2's'. I pointed out to her that my 'perfect adn consistent results were BEAUSE I tested - she could only say 'point taken'

 

[donnellysdogs]

There is one difficulty as far as I am aware with type 1's going to GP care....if you are getting good hba's but still having extremes of highs and lows within the good hba's....then a pump is excellent. Gp's are NOT as switched on to pumps and don't supply them...as far as I know pumps are only given out by hospitals....

 

[noblehead]

I was under the hospital then got switched to the care of my gp, although I didn't mind and the care and checks with regards to Hba1c, feet and cholesterol were just as good, I find the hospital team were more knowledgeable about type 1 and insulin related issues and got switched back 3 years ago.

Nigel

 

[Zanshin]

Can`t agree more about treatment depending on the quality of the GP / surgery. An extreme example, but my best friend was suffering from persistent headaches and cough a few years ago, his GP kept telling him to get more sleep, stay out of smoky bars etc etc, then finally he was diagnosed with lung cancer and a brain tumour, and died aged 32.

I`m not keen on developing horrendous diabetic complications under the management of a non diabetic specialising GP because a jumped up new consultant at {the hospital we are not allowed to name} has decided to get himself a gold star for budget control.

I`m tempted to write to the press just for fun, but it feels like the kind of thing you should only do when you`re retired :roll: