Not happy with surgery - again

[DavidGrahamJones]

I British but currently I live in Germany, I'm type 2 with insulin and tablets. I had my regular quarterly diabetic check just 2 days ago (here in Germany I do see my regular GP but in reality I rely on my Diabetic specialist Dr for my care and treatment. So this is what happened to me... had my Diabetic appointment Dr Wed morning, appointment at 8am, first of all I saw the nurse for the finger prick test, she also does a second test into something else, its a bit like a test strip but it goes into a special gadget that then is inserted into a machine (I don't see this, I get sent back to the waiting room). Anyway about 45 minutes later (at this point the Dr is already running 'late' and he apologises) I get called into the Dr's office (he has 2 offices so a patient is being seen in one and the next patient is waiting in the second). The test results are on his desk so I have a look, 1st test is the regular fingerprint test (I don't remember what it was, but it isn't important as I do my own tests 4 times a day) the interesting part for me was my HbA1c test which was 5.0 - anyway in comes the Dr and the first thing he says is 5.0 that's great, it's about as perfect as you can get. So I'm a happy bunny, talk about my general results (I download the data from my meter and show him the last 3 months in various reports, graphs, and pie charts) and I'm happily sent on my way with prescriptions for the next 3 months supplies. I'm hoping to retire soon and what I'm not looking forward to is the experience that you've described, I remember many times in the UK waiting a week for results and then the Dr barely mentioning it, my experience here in Germany has opened my eyes so when I do get back to the UK I will have to very carefully select a GP based upon what he/she can do to help me; I'm not a number, I'm not an inconvenience, I'm a person, a valuable member of society, and I want to live healthily for many years to come. Dr's deserve respect for their work, the training they went through for many years etc. but as patients we too deserve to be recognised and treated as humanely as possible.

Am I right in thinking that in Germany you have statutory health insurance called "sickness funds" and private health insurance called "(private) sickness funds. I think comparing apples and oranges is a bit unfair on the NHS.

I'm familiar with the machine that you refer to, the one that spews out your HbA1c and have spoken about it with my GP, it's too expensive compared to the old fashioned way of taking bloods and sending them off. In the grand scale of things when you're getting your HbA1c one, two, four times a year, waiting a period of time between giving blood and getting the result is irrelevant, you will still only get your HbA1c one, two or four times a year. If we test regularly the HbA1c is only confirming what we already knew,surely.

I go to a surgery which only has three part time lady doctors and the respect I get is no different to what you describe in Germany. When you return to the UK make sure you join a surgery with a Patient Participation Program, they'll all have them soon. Furthermore take part in what PPGs are trying to do. It really isn't any good complaining about the service, you have to take part and let them know what they're doing wrong.

I wish you luck when you return to our free NHS. LOL Does Germany have cheaper rates for retired people? How do they manage?

 

[Mr_Pot]

I can fully understand why doctors and nurses want to review results before receptionists give them to patients. I think we are probably better informed on this site, at least about diabetes, than the general public. Imagine the worry if someone knows their HbA1c was too high at 7 last time and the receptionist tells them their latest result is 51. As others have said, legally you are entitled to the results, but that doesn't mean they have to tell you without explanation and guidance.

 

[MikeTurin]

Seems to me that hoding the results to the patoen os quite odd because these are personal sanitotary data belonging to a person and anyway O normalli make my tests in a different structure o I have to phisycally take the sheets with the lab results and give them to the GP or the DN. So I can always read the results

 

[Bluetit1802]

I hope your docs are explaining the basics of what the ranges of the various tests are to all their patients. It's part of their job

In England the ranges are included on the lab reports that most of us either get a copy of if we ask or can see on-line. The labs do it. If any of the results are abnormal in some way the lab highlights them to attract the attention of the GP. It isn't a secret the GPs keep to themselves. This way the GP can call us in if deemed necessary. We can see if we are teetering on the edge of abnormal and do something about it. It is only when people don't ask for print outs or see results on-line that we don't know.

 

[Prem51]

One thing I have never figured out about this 50 shades chart is why the A1C numbers are not equivalent of mmol numbers ?

I don't understand that too.

 

[cott97]

So reasons why a receptionist may not give you the results (any results)...
- they are usually sent electronically from the hospital and filed automatically - sometimes this goes wrong and they can see the results but they haven't been released to the GP system yet. In this instance they are not in a position to judge whether the results are accurate so will often say looks like they're back but I need to have a GP check them - by the time you next call a GP will have seen them or the system will have sorted itself.
- this also means that for those set up for access to their medical records if you have a test done on a Friday, the results will be visible to you on Saturday but your GP won't see them until Monday...
- GP has reviewed results and put against them patient to speak to me or to see me or nurse - the receptionist no matter what they think won't go against this though they might behind the scenes ask a polite question on your behalf.
Putting it into perspective the GPs come in each morning to over 60 blood test results to go through each. Now some are simple but others can take 10 or 20 mins to deal with as they may require further tests being ordered, other tests to be reviewed against the new results and in some instances an immediate call to a patient. Most receptionists will do anything they can to give you what you want ( I know, no one will believe me), and they hate making you wait or call back as much as you do mainly because next time you will have waited longer to get through and be more upset. They do have to deal with their own doctors when they are ill and queue like everyone else so believe me they understand. If you feel that you haven't been dealt with properly then write to the practice manager explaining what you think went wrong. They may not be able to help but they will bear it in mind and try to improve things when they get a chance. I was just talking to someone in France about their GP care which was excellent but they pay 25 euros a visit as part of their health care system. Ours is still free at the point of access so people use it regardless of whether or not they could have swallowed a paracetamol for that headache or gone to the chemist for their sore throat and those who have to use it because of long term conditions like diabetes get delayed. It's not perfect and I honestly don't think there is the will from any political party or the money to put it right so we will continue to live with the consequences and in 10 years we will look back at what we had today with rose tinted nostalgia and say how good it was. Definitely sign up for on line access and use both the app based options you get as well as the desktop versions as in my experience they give you different answers. On systmone the app wont allow detailed record access but by going into my record on the desk top version I get to see my full coded record which includes blood results but only from when I was first given access not retrospectively. The app also makes you order medication individually but the desktop version I can do as one large order. Hope that helps explain things from a different perspective even though it won't make your experience any better. Joining the PPG is also a good idea and you would be welcomed with open arms.

 

[Mr_Pot]

Hi @Contralto and @Prem51
The Blood Glucose level is the amount of glucose in the blood in mmol/L.
The HbA1c (DCCT) is the percentage of hemoglobin that has been glycated (had glucose attached).
The numbers are coincidentally similar but one is directly measuring glucose, the other is measuring an effect of glucose over time.

 

[cott97]

I have used US primary care whilst visiting and it did make me glad of the NHS. Strangely we are always told your system is better and have the large companies come over to tell us where we are going wrong. Next time I will throw in some of your comments if I may. I do think we don't appreciate what we have and by not doing so are in danger of losing what we have.

 

[Rachox]

Having just been diagnosed Type 2 nine weeks ago I just had my first HbA1c this week. I had the blood taken on Thursday late morning and saw the result on line just over 24hrs later. I may have an advantage that I live in a city with a very large teaching hospital, where all the blood tests are sent. However I recommend registering with your practise for on line access to results to cut out the middle (wo)men, the receptionists!

 

[serenity648]

Having just been diagnosed Type 2 nine weeks ago I just had my first HbA1c this week. I had the blood taken on Thursday late morning and saw the result on line just over 24hrs later. I may have an advantage that I live in a city with a very large teaching hospital, where all the blood tests are sent. However I recommend registering with your practise for on line access to results to cut out the middle (wo)men, the receptionists!

my surgery doesnt offer that service. I can register to book appointments, and re-order meds. Thats all they offer.

 

[Rachox]

my surgery doesnt offer that service. I can register to book appointments, and re-order meds. Thats all they offer.

Oh no! I thought they all had to provide this service now

 

[Bluetit1802]

Oh no! I thought they all had to provide this service now

Only in England, and a few surgeries aren't up and running yet.

 

[jamin1]

I don't understand that too.

 

[jamin1]

I don't understand that too.

 

[hooha]

HbA1c I sympathise with you. Recently diagnosed with type 2 in OCTOBER 2016 - I got fed up with them running me around and treating me like an imbecile. I WANTED to do the NEWCASTLE diet , ref Prof Roy Taylor, etc to reverse my diabetes. They discouraged me, and when I said I wanted to monitor my sugar levels with a finger pricking kit, just like Dr M Mosley reported in the Daily Mail online etc they said they didnt want me to ' worry '. What kind of nincompoops are they? Telling me I have a life threatening disease and not allowing me to do anything about it. ? They don't want me to worry ? This is called training the patient into ' LEARNED HELPLESSNESS' which makes their system run smoothly. And of course keeps everyone from the drug manufacturers down nice and busy, albeit costing the NHS millions....I went ahead and did the diet ALL BY MYSELF and reversed my type 2 without their help. Bought my own Accuchek Active meter - perhaps they didnt want to pay ? Then I rang up and just about made the receptionist cry demanding all my back records of labs. LO AND BEHOLD ! Up pops a test of HbA1c dated back in 2011 FIVE YEARS AGO showing a fully diabetic reading. Although I had requested my results each year SOMEHOW the HbA c result got left off ! First I knew about it was in January 2017 !! They never told me about that high reading and I WOULD NOT know today if I hadn't screamed and cursed at the the dad blasted receptionist etc etc In the end the GP was calling me several times a day offering all my results. He had no explanation of why I had not been told before, and no real explanation of why they did not encourage me to help myself. SOMETHING STINKS. Diabetes Uk [ the dot org crowd ] are still preaching Eat CARBS at every meal. etc etc All weird. Thanks be for the internet and this dot co uk site. good luck.

 

[hooha]

No change of surgery possible. The next surgery is 20 miles away, I dont drive, and public transport is a joke.

However, this morning it has occurred to me the 49 is NOT good. Its borderline diabetic. I feel lost and confused now, and a bit scared. Can anyone point to to the chart which shows what average blood sugar level 49 is please?

It seems the 18/6 fasting and only eating twice a day hasnt altered anything for me. Not sure what to try next.

HI !! See my other post . look up guardian and daily mail on line ref richard doughty, type 2 diabetes , carlos cervantes , etc newcastle diet - it's all there dont worry ! First lose excess weight. Then exercise as per Dr Michael Mosley HIT also online inthe Daily Mail again. Then try LCHF maintenance dieting. NOT HARD to avoid carbs. you are welcome to message me. I already noticed they told you 49 was ok.. usual blather 'dont worry' DO WORRY and then FIX IT as much as you can. you can find a chart on this site showing you how blood sugar numbers relate to the various methods and units. For your quick info, normal HbA1c is from 5.6% to 6.5% [ in DCCT units ] or from 38 to 48 [ in IFCC units ]. Why are they telling you 48 is fine ? Because they are mixing up type 1 [ which often are maintained at higher levels than is really good, just to avoid the risk of hypos, ] with the other diabetes the type 2 which you have. good luck,

 

[hooha]

HI SERENITY ! CORRECTION ! I put wrong info in last message. Think of 5.6% to 6.5% [or 38 to 48 in other units ] as the range just before diabetes. So some will claim this is 'normal' some will call it ' prediabetes'. HOWEVER if you are 6.5% or more, or 48 or more that is diabetes. Why they tell you not to worry....well at least on the NHS they seem to be treating things at the last minute when everything is spiralling out of control. An ounce of PREVENTION is worth a POUND OF CURE !
Dont accept a reading of 48 as ok. good luck