Diabetic nurses who dont listen...

[Marandha]

I am taking Metformin 500mg twice a day and Tolbutamide 500mg three times a day.My diabetic nurse does not see Me as a
person wanting to control My diabetes merely a set of symptoms which she will treat!.I try to explain that I want to lessen the Tolbutamide
but she refuses to listen or agree that having so many pills means I dont have to take responsibility because she is upping the dose
of pills all the time.I am 64 and very depressed.

 

[Pipp]

I am taking Metformin 500mg twice a day and Tolbutamide 500mg three times a day.My diabetic nurse does not see Me as a
person wanting to control My diabetes merely a set of symptoms which she will treat!.I try to explain that I want to lessen the Tolbutamide
but she refuses to listen or agree that having so many pills means I dont have to take responsibility because she is upping the dose
of pills all the time.I am 64 and very depressed.

I think this is an attitude many of us see in HCPs. To be fair, many patients do not want to accept responsibility for their own wellbeing. What do you do to show that you are not one of those patients? Do you exercise? What sort of diet? Etc.

 

[jack412]

Sorry you are feeling so flat, it can get to us at the best of times.
being patted on the head like a child can get tiresome.
how is your BG, do you have a home blood glucose meter.
what diet do you follow

 

[sanguine]

Hi Marandha, welcome.

What is your HbA1c history and what do you typically eat? I assume your levels are improving if you are wanting to reduce your dosages.

 

[sally and james]

@Marandha Didn't anyone tell you that you have to remove a diabetic nurse's ear plugs at the start of the consultation!

Seriously though, YOU ARE IN CHARGE, it's your body. Now, I'm a member of the awkward squad and what is for me, may not be for you, but I would simply tell her that I was not taking a particular drug any longer, or that I was reducing my dose, or what ever. However, I would know what I was doing or planning to do, instead of taking drugs and how I was proposing to monitor the effects of my actions. As others have said above, do you have a glucose meter and do you know how to reduce your blood sugar levels through diet, i.e. about reducing intake of carbohydrates?

Many people on this forum (type 2's) have reduced and some have given up diabetic medications through taking control and modifying their diet.
Good luck!

Sally

 

[Daibell]

Hi. The sulfonyl urea drugs such as Tolbutamide, Gliclazide etc are widely used for T2s but are only of use if the pancreas needs stimulating. Quite a few T2s suffer insulin resistance and the pancreas is already producing enough/too much insulin which the muscles can't use. There are also so-called T2s like myself who are actually late onset T1 and have few pancreatic cells left to stimulate so these drugs have no effect. If you aren't already on a low-carb diet then do move towards reducing the carbs. Are you overweight? If so, then you may have insulin resistance and reducing the carbs may be more important than the Tolbutamide? Do you have a meter to check blood sugar; this is essential.

 

[Ruth B]

Welcome to the forum, and that's a nice avatar you have there.

As others have said getting HCP to listen can be a problem but don't give up. Go in armed with as much information as possible, particularly concerning how well you are managing the condition. You will probably get frowned at if you admit to home monitoring (if you don't have a glucose monitor at home I would advise investing in one), but if it shows that your levels are coming down and under control the really can't argue with the facts (though many try).

Hopefully if they see that your BS is constantly low and stays low after meals they might listen. Each HCP is different, you just have to learn to manipulate yours into giving you want you want.

 

[Yorksman]

Make an appointment to see the GP and express your desire to reduce your tolbutamide to him or her. This will alert your GP to the fact that the DN hasn't explained things properly to you. Your GP may do something or may explain why it is a good thing to carry on with the existing dose. You can also ask your GP for a second opinion but you really do need to explan your concerns to him/her first. Have a look at what the NHS says: http://www.nhs.uk/chq/Pages/910.aspx?CategoryID=68

Mostly GPs have a nurse 'given' to them. They haven't always been hand picked or specially selected from a pool for their medical skills or knowledge. Often they just got what's left. A good GP practice with a long history of stable and reliable staffing is becoming increasingly rare. We only have locums in mine now, no permanent staff.

 

[Bluetit1802]

Mostly GPs have a nurse 'given' to them. They haven't always been hand picked or specially selected from a pool for their medical skills or knowledge. Often they just got what's left. A good GP practice with a long history of stable and reliable staffing is becoming increasingly rare. We only have locums in mine now, no permanent staff.

That's a poor do, or maybe we are just lucky here to have a Health Centre with 2 separate Practices. My particular practice has 11 permanent doctors who are all partners. Each of them has his or her own speciality, 2 of them purport to be diabetes specialists although I've never seen either of those 2 since diagnosis. (I've stuck with my trusted GP of several years as she knows what I am like). There are more nurses than doctors, many of them sisters, several Health Care Assistants and various other nurses such as a large District Nurse team, and a treatment room that does everything from ear syringing to minor ops. They all seem to have been there for years, but I may be exaggerating there.

 

[Yorksman]

They all seem to have been there for years, but I may be exaggerating there.

Ours was like that but the GP who had been there the longest, 30 odd years, got some fancy new ideas which he managed to force through. Immediately the long standing GPs left and the good doctor's supporters started to realise they'd made a mistake. Some left and then the good doctor was forced to resign after a period of one years 'ill health'. The rest were proper fed up by then and got jobs elsewhere. My DN, who was in a worse state than me, was exiled to our town's equivalent of Siberia and they are left trying to recruit permanent staff. But, they have such a bad reputation now, no one wants to come.

It is set up as a with profits centre and most GPs want either a fixed salary or will settle for the better paid but more uncertain locum work. Running a practice, trying to make a profit and pay staff out of that profit is very stressful for people who are not business minded. One of the big problems that the NHS has is that, although everyone has a budget, often, other people can spend YOUR budget and you have no authority over them. So for example, A&E can order blood which comes off the haematology labs budget but they don't then use it and it gets thrown away. The haematology lab don't know anything about it until they see it itemised on a bill. Our practice was running an information campaign complaining that everytime a patient goes to A&E even without the practice knowing, they got a bill for £78.

I'm sure you've hear the saying that a camel is a horse designed by a committee. That's what we've got.

 

[douglas99]

I am taking Metformin 500mg twice a day and Tolbutamide 500mg three times a day.My diabetic nurse does not see Me as a
person wanting to control My diabetes merely a set of symptoms which she will treat!.I try to explain that I want to lessen the Tolbutamide
but she refuses to listen or agree that having so many pills means I dont have to take responsibility because she is upping the dose
of pills all the time.I am 64 and very depressed.

What is your control like?

As to the meds, she can't make you take them.
If you personally want to lessen the dose, and she doesn't agree, she's either right, and you should take them, or she's wrong, and you shouldn't.
My nurse saw my BS results, and suggested I reduce my meds, and tbh, that's the way it should be.
Show them the results, and if they think they are over prescribing, they can cut your meds.
They could never under prescribe, and rely on you to 'catch up' though, as that would be completely unethical of them.

 

[@Sophb]

I am taking Metformin 500mg twice a day and Tolbutamide 500mg three times a day.My diabetic nurse does not see Me as a
person wanting to control My diabetes merely a set of symptoms which she will treat!.I try to explain that I want to lessen the Tolbutamide
but she refuses to listen or agree that having so many pills means I dont have to take responsibility because she is upping the dose
of pills all the time.I am 64 and very depressed.

Sorry to hear that I too had a nurse like that she didn't listen to me she kept saying its ur bypolar rearing up when I sed that I was tired after a night shift and my sugars were up x we know ourselves better than anyone.

 

[Scouser58]

Hello to all, the nurse not listening is not good, does your hospital specialist have any say in your treatment and what about your diabetic specialist nurse? they may well have a more experienced/expert opinion of your current levels. If your practise diabetic nurse won't listen, then as others have said make you decision on what your own body and your bs level readings are telling you. The bit about the blood, it is the ordering department who ends up paying for it, even if it has been sent on with the patient to another ward/department, this issue was highlighted on casualty last saturday, in the bit about the deparmental spending and saving exercise. Daft to think that something that is given for free by the donar, it then costs money from the heamotology department to casualty, who has to pay up, even when they did not use some/all of it, crackers ain't it, ttfn