Any advice on handling doctor?

[Brunneria]

Hi all,

I've got a bit of a dilemma, can't decide what to do, and thought I would throw it open, in case any of you can suggest the way to go.
(Thanks in advance, for ANY ideas! )

Potted history:
47 yrs old, lifetime hypoglycaemic, 10 yrs medication with cabergoline for excess levels of a hormone called prolactin.
The cabergoline increases likelihood of developing diabetes, and I've been creeping closer each year.
2 yrs ago, my fasting glucose tolerance test was spot on the line between pre and diabetic
I bought myself a blood tester and mapped things out.
By eating fairly lo carb and adding in green smoothies, plus reasonable protein and fats, I usually have sugar levels around
On waking 5.5 to 6
Pre breakfast 6-7
2 hrs after eating 6 to 8
Highest ever reading 12.8, four hrs after eating (after pizza, crisps and birthday cake. Hanging head in shame!)

I could do better, but love my food... So I don't...

Anyway,

I'm finally going to the doctor about an unrelated matter, and know that I am going to get a lecture about dodging my last glucose tolerance test. Sigh.

The problem is, the **** thing will be meaningless!
The results go wangy unless your body is used to eating carbs.
But I don't want to eat a 'normal diet' for days beforehand, because it will make me feel cr*p, and my sugars will be all over the place - and just doesn't represent the way I live every day.

What would you do?
Bite the bullet, eat carbs, take the test, and end up with results that aren't appropriate for your lifestyle?
Or
Produce a list of my 'on waking' blood sugar levels for the last 3 weeks, and be 'non compliant' re the test? (My doctor doesn't like this type of behaviour. He enjoys correcting my pronunciation of 'cabergoline' and considers the internet a dangerous source of mis-information. And the nurse has told me that eating lo carb is 'not advisible')

Your thoughts?

 

[Joe Sweatthang]

Carry on with low carb and get tested as such. The Hba1c gives BG reading average over last 3 months so eating carbs for a week before your test will not have a radical impact on that, but you may spike your fasting level which may lead to confusing numbers. I do not look up to any of my doctors (as I get fobbed off to many different locum's) and in particular, my diabetes nurse, who is merely a NHS parrot.

I did it my way...... Frank Sinatra.

 

[borderter]

Your numbers look good to me so just go ahead with whatever you need to do at the docs

 

[Scandichic]

Hi all,

I've got a bit of a dilemma, can't decide what to do, and thought I would throw it open, in case any of you can suggest the way to go.
(Thanks in advance, for ANY ideas! )

Potted history:
47 yrs old, lifetime hypoglycaemic, 10 yrs medication with cabergoline for excess levels of a hormone called prolactin.
The cabergoline increases likelihood of developing diabetes, and I've been creeping closer each year.
2 yrs ago, my fasting glucose tolerance test was spot on the line between pre and diabetic
I bought myself a blood tester and mapped things out.
By eating fairly lo carb and adding in green smoothies, plus reasonable protein and fats, I usually have sugar levels around
On waking 5.5 to 6
Pre breakfast 6-7
2 hrs after eating 6 to 8
Highest ever reading 12.8, four hrs after eating (after pizza, crisps and birthday cake. Hanging head in shame!)

I could do better, but love my food... So I don't...

Anyway,

I'm finally going to the doctor about an unrelated matter, and know that I am going to get a lecture about dodging my last glucose tolerance test. Sigh.

The problem is, the **** thing will be meaningless!
The results go wangy unless your body is used to eating carbs.
But I don't want to eat a 'normal diet' for days beforehand, because it will make me feel cr*p, and my sugars will be all over the place - and just doesn't represent the way I live every day.

What would you do?
Bite the bullet, eat carbs, take the test, and end up with results that aren't appropriate for your lifestyle?
Or
Produce a list of my 'on waking' blood sugar levels for the last 3 weeks, and be 'non compliant' re the test? (My doctor doesn't like this type of behaviour. He enjoys correcting my pronunciation of 'cabergoline' and considers the internet a dangerous source of mis-information. And the nurse has told me that eating lo carb is 'not advisible')

Your thoughts?

At the end of the day, you'll have to make your own mind up but he sounds like an ****. You are a grown up so what you put in your mouth is your choice and you shouldn't be browbeaten into doing something that you don't want to do. I would start to correct his grammar for kicks. Most people use the wrong relative pronoun when speaking so you could be really childish and start with that. Bet he'll soon stop correcting you. I had a colleague who did a similar thing to me. It worked like a charm - lol. I'm normally, live and let live but some people don't get the hint!

 

[Randburg]

The Hb1Ac Test really gives a true reflection of your average glucose over the last 10 to 12 weeks.
I would insist that he conducts this test as well as any others he may wish to do, as virtually most other tests are a snapshot of your situation at the time of the test, and not a true average.
Your Hb1Ac also lets you know how well you are doing, and from the look at the info you have given you are going very well!
Good luck, let us know what happens
Regards

 

[Mud Island Dweller]

Change drs

The fact is you are leading your life in secret when it needs clear communication says you do not have a healthy relationship if you were married to him you would be divorced.
You need to live your life not the life a bully and abuser wants you to live and l make no bones l am tired of the medical profession staffed by bullies and abusers and like all such people they need to be kicked out of not just our lives but everyones lives shoved into a prison or whatever.
Your numbers speak for themselves he doesnt like it tell him get stuffed and move on as you are doing.
You have started to control one part of your life and asking if an abuser should be allowed to mentally punch you and in reallity be allowed to push you down the road that will lead to a life that ends up like Kevs in Terminal and Scared on this forum....what do you think?

 

[2131tom]

Have you tried changing your GP? At my practice the online appointments system allows me to make an appointment with any one of the half dozen doctors in the group. I believe the NHS is looking for all surgeries to adopt the online system, sooner rather than later, so if you haven't got it yet, it should be coming shortly.

The point is, having tried several of them I've now managed to 'adopt' one who seems to care. He doesn't shoo me out of his surgery when I've a cocktail of issues to discuss, explains why he's suggesting various courses of treatment, doesn't balk at prescribing (Metformin SR, for example) and has never palmed me off onto the (rather dippy) DN.

I've always thought that the relationship between doctor and patient is a lot more equal than some doctors would like to think, and you have perfect right to be heard and listened to.

You obviously know your own body very well and have thought things through. The doctor might be responsible for your treatment, but he's not the one who has to live with the results if he gets it wrong.

 

[izzzi]

Hi Brunneria,
I would still carry on with the glucose tolerance test, and ask for a copy of the results then use these copies for your own reference.
You have good control which should be admired, well done.
I know the Doctor wants the best for you in his opinion, the Doctor is also correct regarding many people finding a source of mis-information from the internet.( lucky for me my Doctor recommended to this Forum)
At the end of the day you need to be in good terms with your Doctor,so no point winding him/her up if you know what I mean.
your nurse is just being a typical untrained expert,

Enjoy your next lecture at the Docs; (somehow I think you dont mind to much as your on top of things).

 

[AndBreathe]

If the GTT is for diabetic diagnostic purposes, I'm a little quizzical. My understanding is that these days the HBa1c is the gold standard diagnostic test.

Either way, I would tell him your misgivings, and take your personal data with you, so that you have positive evidence that your way is making a difference.

Your GP is your chosen medical advisor and gateway to specialist medical services, when required. As a result, it is important that you can achieve a frank and open dialogue, where he listens to,you and you listen to,him, with mutual respect.

 

[AlexMBrennan]

You have the right to refuse medication, and since you obviously know more about diabetes than your GP I can't see a reason why you wouldn't

I would insist that he conducts this test as well as any others he may wish to do, as virtually most other tests are a snapshot of your situation at the time of the test, and not a true average.

That would be completely pointless - OP is worried about the OGTT, and the hba1c CANNOT be used to exclude diabetes diagnosed by other tests such as the OGTT. You may not need treatment for it beyond avoiding carbs ( determined by adding more and more drugs unril hba1c is acceptable) but you'd still be considered diabetic.

 

[Brunneria]

Hi All,

And thank you all for your good advice.

I've asked for an HbA1c before and been told that 'we only do that for diagnosed diabetics'.
I will ask again!

Changing the doctor is definitely on the cards, but unfortunately not in time for next Friday's appt. The anticipated lecture may well tip me into action on that front. Lol

Great advice from everyone and I'm very grateful. Thank you .

 

[Kat100]

Take a list of all your questions and requests and ask that all are noted in your notes/files....

You have the right to be treated with respect your gp is there to serve you....but may need reminding though.....:/

 

[Scandichic]

Hi All,

And thank you all for your good advice.

I've asked for an HbA1c before and been told that 'we only do that for diagnosed diabetics'.
I will ask again!

Changing the doctor is definitely on the cards, but unfortunately not in time for next Friday's appt. The anticipated lecture may well tip me into action on that front. Lol

Great advice from everyone and I'm very grateful. Thank you .

Why don't you ask him to do a pee test and fasting bloods although he sounds like an idiot!

 

[kesun]

I've asked for an HbA1c before and been told that 'we only do that for diagnosed diabetics'.

Well, if you want to get one from this GP, you could consider stuffing yourself with carbs for several days before the OGTT as ordered and hope the results will be properly diabetic in your GP's eyes. Then get the hba1c and show your great control. But that would mean harming your own health in order to get the right test. Changing GPs would be preferable. I only suggest it because you can't be sure the GP you change to (or the next, or the one after that) will be any better.

Kate

 

[Omnipod]

dont change anything. have the tests as you are with your normal routine. That way its all honest and true and you will know if your current lifestyle is good. Low carb is your choice. It obviously suits you and by the sounds of it, your blood sugars are doing well. At the end of the day its your life and your choice. I cant see a dr wanting you to change as it seems youre on a good path with your readings below:

On waking 5.5 to 6
Pre breakfast 6-7
2 hrs after eating 6 to 8

 

[Brunneria]

Thanks again, everyone.

Had the appt this morning. Quite funny, really. On the way in, I had a word with the receptionist and arranged for a fasting blood sugar test, rather than a glucose tolerance test. She asked me if the doctor advised this, and I said yes (on the principle that he wants a test, just not that exact type of test, lol).

Then went in to the appointment. No mention of testing, diabetes, or similar.

Instead, he prescribed a support stocking for my newly throbbing varicose vein.

Came home, looked up 'Do support stockings work for varicose veins?' On Google and found out that in 2010 the NICE guidelines started to advise doctors not to prescribe support stockings for v veins. Apparently they temporarily relieve symptoms but do nothing to improve/resolve. Early intervention via a range of treatments (laser, foam injections, etc. are much more effective than stockings for years followed by a major op). I'd speculate it might save money too, in the long run...?

I am now wearing the prescribed stocking, which slips down an inch every time I stand up. Will go for a trundle with the dog later, by the end of which, I will look like Nora Batty's sister. Do you think it is the shape of my leg? It isn't tubular (my leg), it just gets wider as it goes up, so gravity and elastane are going to slide that stocking right down...

Am going to have my 2 fasting blood sugar tests then change doctors with a sense of relief!

 

[Robbity]

Did you get your leg measured for the stocking? I'm supposed to be wearing compression stockings (which I assume are the same thing?) for swollen ankles and had to be measured up at various points on my legs by the pharmacist to ensure a correct fit.

Robbity

 

[Brunneria]

Hi,

Yes, I was measured by the pharmacists assistant lady. But I don't think she did it properly.
The picture on the stocking packaging suggests that the leg should be measured in 4 places (ankle, calf, above knee and upper thigh.

She just did the first two. And it certainly fits excellently below the knee. Lol.

I am toying with the idea of buying myself a pair of support tights, as I think that any 'stay up' stocking will just slip down...

 

[Alanp35]

My support hose work well but they are below knee only. If yours are full leg why not add a suspenders to keep them up?
Just a thought.



Late onset T1, several auto immune issues.
Humalogmix25 twice a day, Methotrexate 25mg once per week, FolicAcid 5mg once per week, prednisolone 5mg daily, Allopurinol 300mg, Calcichew-D3 800iu, Levothyroxine 50mcg, Atenolol 50mg, Losarten 100mg, Aspirin 75mg, Nicorandil 20mg, Nitrolingual GTN spray, Metformin 2000mg, Allimemazine 10mg, Lanzoprazole 30mg, Atorvastatin 20mg, Co Codamol 8/500mg, Depo Medrone (Methylprednisolone) or double Prednisolone for 7 days in case of RA flare.

 

[Bebo321]

Brunnaria, you are an absolute hoot!
I honestly think your doctor should be counting his (or her) lucky stars, because you are the ideal patient. You take an active interest in your health and proactively educate yourself to better understand the issues and then act on the information. Awesome!
Feel empowered, and don't allow yourself to be patronised.
You go girl!
By the way, if you aren't convinced that support stockings are the best option for you, get back to that doctor of yours and state your case for the alternative you'd prefer.