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Locum Trouble

LionChild

Well-Known Member
Messages
302
Location
Birmingham UK
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
whisky
Hi Everyone!

I wanted to discuss my blood test results with a GP, and ended up not seeing one of the usual GPs at my practice but a locum. At the outset this doctor, very worryingly argued with me about my diagnosis of type 1 diabetes! I told her I had only been diagnosed with TYPE 1 diabetes in 2019, and she said that in fact I would have had type 1 from the time of being a child, (what did she mean by that I thought?)...What she seemed to be saying is I did not get it as an adult but it must have been present when I was a child ----- because only children got type 1. (puzzled?!)..... I said but that is not the case - adults can also get type 1 diabetes. I was rather confused, and in further discussion she asked me What Caused It? I said I did not know. She appeared astonished that no one had worked out what had caused it, and appearing not to believe me, asked me who my diabetic nurse was? I am afraid the discussion verged uncomfortably on argument by this time....! I said I had not been for regular appointments since Covid and so only knew my consultant's name. She then looked my details up on the computer, and said, yes, I was right, I was diagnosed in 2019 with Type 1. I could not make head nor tail of her comments, and her apparent ignorance. I am inclined to say something about this to one of the partners, but feel that is a bit tricky. Frankly, For a GP to be so ill-informed..has left me feeling shocked, and in a crisis of confidence...and really, for my own safety, I feel I must avoid her in the future..!

There were other details this locum doctor got wrong but that is for another post...................

Furthermore, I keep getting pains in my legs (AND cramp), when in bed first thing in the morning, and to date, I have had no definitive diagnosis but neuropathy has been mentioned. When I stand on my feet, after a few seconds/minute, it goes away usually... Now I know anyone can get neuropathy whether they are diabetic or not, but the nurse at my surgery did the usual diabetic tests a few days ago, and announced that I did NOT have neuropathy; the GP I usually see but who is presently on holiday seemed unsure, but hinted that it might be neuropathy; the locum mentioned above, yesterday, said it WAS DEFINITELY neuropathy; another doctor who I have been in touch with (quite informally) said, it probably was NOT neuropathy because, if it were, the pain would be constant, not just in bed first thing in the morning....

My concern about this neuropathy diagnosis is that I have known diabetics who have been seriously ill and have had amputations as a result--- in my understanding, of neuropathy - but the locum doctor says it is the result of infection that amputations are done, and not directly related to neuropathy but the result of not realising that you have damaged your foot......Now that makes some sense, yes... However, the question remains.......& in fact, I can feel my feet very well, thank you.... In fact they are highly sensitive little feet! And they have a very strong pulse apparently...

Another point is my blood test did not include a CRP test. Wouldn't that have been an obvious inflammation marker that might be an important test given that my legs are painful? I might be utterly wrong to think this, but if the leg issue was arthritis, (esp. if rheumatoid), simply, surely that would have been a good idea. I am just questioning this (I am afraid I do tend to do that quite a lot).

Any comments on any of this welcome!
 
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Lack of knowledge with GPS regarding diagnosis in adults is pretty appalling and I avoid them like the plague. I have my care through the hospital only.
Regarding cramp I have it regularly, and it can come with subsequent leg pain if a bad attack. It was one of the things that flagged up that there was something wrong with me just before diagnosis 10+ years ago. Since then it often occurs during the night, just as I’m waking and even in the pool. I definitely do not have neuropathy having had a foot problem last year that I had extensive tests for. I notice it more if my levels have gone a little above 10 and for this reason I work hard to avoid higher levels.
 
Yes i'd be reporting the locum for their clear lack of knowledge and attitude, the practice needs to be aware of what treatment their locum is providing patients. This attitude can make you question your own mental capacity when heard from a 'professional', appalling behaviour. I would of ended the appointment at this point through a complete lack of trust and rebooked with your regular GP, however with this being said they are General Practitioners so not specialists, are you seeing anyone at your hospital with your Diabetes care ?

A simple foot care check with a nurse can check foot health and hairy toes are a good sign of good foot health as suggests a good blood supply.
 
I would definitely mention what happened to the practice. They are responsible for hiring and employing the locum and should welcome the feedback, negative or positive. In all probability they used someone supplied by a locum agency, rather than selecting someone personally. It might help them improve decisions next time a locum is needed.

Having (had) neuropathy myself, my experience is that the pain is not constant, but comes and goes: can be anything from burning pain to stabbing pain and a sort of "pins and needles" effect plus numbness, although I had very little of that. And it can be greatly reduced by keeping BGs at a normal level.

Again, my understanding is that neuropathy damages nerves, which leads to both pain and, via numbness, injuries not being detected, which can lead to wound infections and additional complications.
 
Definitely report them - that's shocking.

Can you get a blood test organised with one of the nurses? They can check out your circulation at the same time.
 
Hi Everyone!

I wanted to discuss my blood test results with a GP, and ended up not seeing one of the usual GPs at my practice but a locum. At the outset this doctor, very worryingly argued with me about my diagnosis of type 1 diabetes! I told her I had only been diagnosed with TYPE 1 diabetes in 2019, and she said that in fact I would have had type 1 from the time of being a child, (what did she mean by that I thought?)...What she seemed to be saying is I did not get it as an adult but it must have been present when I was a child ----- because only children got type 1. (puzzled?!)..... I said but that is not the case - adults can also get type 1 diabetes. I was rather confused, and in further discussion she asked me What Caused It? I said I did not know. She appeared astonished that no one had worked out what had caused it, and appearing not to believe me, asked me who my diabetic nurse was? I am afraid the discussion verged uncomfortably on argument by this time....! I said I had not been for regular appointments since Covid and so only knew my consultant's name. She then looked my details up on the computer, and said, yes, I was right, I was diagnosed in 2019 with Type 1. I could not make head nor tail of her comments, and her apparent ignorance. I am inclined to say something about this to one of the partners, but feel that is a bit tricky. Frankly, For a GP to be so ill-informed..has left me feeling shocked, and in a crisis of confidence...and really, for my own safety, I feel I must avoid her in the future..!

There were other details this locum doctor got wrong but that is for another post...................

Furthermore, I keep getting pains in my legs (AND cramp), when in bed first thing in the morning, and to date, I have had no definitive diagnosis but neuropathy has been mentioned. When I stand on my feet, after a few seconds/minute, it goes away usually... Now I know anyone can get neuropathy whether they are diabetic or not, but the nurse at my surgery did the usual diabetic tests a few days ago, and announced that I did NOT have neuropathy; the GP I usually see but who is presently on holiday seemed unsure, but hinted that it might be neuropathy; the locum mentioned above, yesterday, said it WAS DEFINITELY neuropathy; another doctor who I have been in touch with (quite informally) said, it probably was NOT neuropathy because, if it were, the pain would be constant, not just in bed first thing in the morning....

My concern about this neuropathy diagnosis is that I have known diabetics who have been seriously ill and have had amputations as a result--- in my understanding, of neuropathy - but the locum doctor says it is the result of infection that amputations are done, and not directly related to neuropathy but the result of not realising that you have damaged your foot......Now that makes some sense, yes... However, the question remains.......& in fact, I can feel my feet very well, thank you.... In fact they are highly sensitive little feet! And they have a very strong pulse apparently...

Another point is my blood test did not include a CRP test. Wouldn't that have been an obvious inflammation marker that might be an important test given that my legs are painful? I might be utterly wrong to think this, but if the leg issue was arthritis, (esp. if rheumatoid), simply, surely that would have been a good idea. I am just questioning this (I am afraid I do tend to do that quite a lot).

Any comments on any of this welcome!
Were they definitely a qualified GP or any chance they were a PA (Physician Associate)?
PAs are being used more and more as I believe there are financial incentives to employ them.
They seem to be being used as doctor substitutes and while they are supposed to be ‘supervised’ this usually means that they choose when to ask for advice and there are many worrying tales of some not doing so.
They do not need a medical degree and just get 2 years medical training. They don’t always make it clear that they are not doctors.
Whether or not the person was a qualified GP, some feedback should definitely be given to the practice.
 
Yes i'd be reporting the locum for their clear lack of knowledge and attitude, the practice needs to be aware of what treatment their locum is providing patients. This attitude can make you question your own mental capacity when heard from a 'professional', appalling behaviour. I would of ended the appointment at this point through a complete lack of trust and rebooked with your regular GP, however with this being said they are General Practitioners so not specialists, are you seeing anyone at your hospital with your Diabetes care ?

A simple foot care check with a nurse can check foot health and hairy toes are a good sign of good foot health as suggests a good blood supply.
Oh NO! I don't have hairy toes!!!
 
Were they definitely a qualified GP or any chance they were a PA (Physician Associate)?
PAs are being used more and more as I believe there are financial incentives to employ them.
They seem to be being used as doctor substitutes and while they are supposed to be ‘supervised’ this usually means that they choose when to ask for advice and there are many worrying tales of some not doing so.
They do not need a medical degree and just get 2 years medical training. They don’t always make it clear that they are not doctors.
Whether or not the person was a qualified GP, some feedback should definitely be given to the practice.
Geez that's shocking. I have mental health issues and who's to say that a PA could be questioning my mental state without having the sense to look into my history. I has happened before with the DN which I pointed out during a telephone conversation, she went quiet and obviously read the long list of medical notes on her screen and became very sympathetic. She has been since I must add.
 
Neuropathy does give a reason for amputation but if you say get ulcers or cut any part of your limb that say you didn't feel happen due to Neuropathy that's when complications set in ie infections gangrene which left untreated would lead to amputation.

I have Neuropathy which can also be known as atherosclerosis, dependant on who you're talking to, and it isn't constant pain it comes and goes which is then called intermittent claudication, which when in pain there are gentle exercises that help to relieve the pain.
In the worse case scenario regarding Neuropathy they generally put stents in clogged arteries like they do when a heart attack is caused by blocked arteries.

You need to get in touch with the diabetes department to get a nurse reinstated as it's your right to have one. I rely only on my diabetes team for advise and any diabetic concerns. In my opinion GPs only have a basic knowledge of diabetes care unless they studied it in medical school as a speciality. For example my ha1c say is 79 my DSN says its good compared to the last, my GP says it's appalling then write to my team who tell him that I'm doing well. So anything diabetes related or is brought up by GP I tell them my team have it in hand.
 
Oh NO! I don't have hairy toes!!!
I do have, so far, relatively mild peripheral neuropathy currently with slowed nerve conduction, OK circulation and skin sensation. I remember being concerned when the small amount of hair growing on my toes disappeared never to return...
 
Is hair loss just general aging? Not questioning the idea that it is connected to some form of diabetic nerve damage, but most people over a certain age start losing bodily hair. Obviously if you are relatively young then aging has little to do with it.
 
Is hair loss just general aging? Not questioning the idea that it is connected to some form of diabetic nerve damage, but most people over a certain age start losing bodily hair. Obviously if you are relatively young then aging has little to do with it.

Not sure about age being a factor. It depends if you had good hair growth on your toes previously, my podiatrist told me that hair on toes indicates good circulation, if you lose it suddenly then it could indicate circulatory issues, but there's other factors at play too such as hormones and potentially nerve damage but in direct relation to my type 1 this is what i've been told to be aware of. I used to be slightly embarrassed about my hairy toes, but am quite cool about it now !
 
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