Practice nurse appt- depressed & somewhat alarmed!!

[Sunny]

Well had my first appt with practice nurse today -had read lots on here so wasn't expecting marvels - but OMG!!
Firstly she checked my BP 100/60 so I'm pleased about that. Asked her about my cholesterol she said 'it's not bad' but wasn't keen on giving me the actual numbers but did write them down in the end. Mentioned HbA1c -she said 'yes we'll repeat that in about 6-12 months' I said ' will that be soon enough to say my levels were very high & I'm on steroids?' ' no it'll be fine you need some time to change your lifestyle'.
She next wanted to check my feet & started in a way that she's obviously been taught - I told her that there was an area on my left heel that alternated between hurting & being numb she didn't even look at that & didn't comment!!
Her lifestyle advice consisted of telling me I'd learn everything I needed on the xpert course but I neede to lose some weight & do some exercise.
I asked if I would be referred to a specialist, with my other medical challenges but she said 'o no we manage all Type 2's here'.
That seemed to be it she obviously was ready for me to leave then & hadn't mentioned testing at all so I told her I'd bought a meter & was testing as I was very keen to really get a hold of this condition & control it. I was really happy because 3 weeks in my levels have been in single figures for the last 5 days & this morning my fasting was 6.8 so I was thrilled with that - she wasn't in the slightest bit interested!!! When I said I'd been low carbing she said 'but with Type 2 you need a healthy diet'?!!

How can anyone maintain any motivation & make improvements when they won't support you testing & onlyoffer the HbA1c yearly? I've worked in the NHS for a long time & have seen the challenges of providing good patient care & especially now with financial restraints but this basically boils down to- the NHS can't/ won't support Type 2 diabetics to improve their health & minimise complications. It's just so awful.
I can't let this lie - it's not in my nature. I am going to write to the GP & practice manager with the evidence requesting 3 monthly HbA1c's & testing strips - I have to take responsibiility for my health

 

[dawnmc]

Yes you do have to, no-one else will. You have to stand your corner. Sometimes wonder if these people enjoy there jobs or are just going through the motions till retirement.

 

[Truffle]

My doctor (who is great most of the time) won't give me any testing equipment as he says that it does not serve any useful purpose for T2. I bought my own! He does support a low carb diet but stresses the importance of huge portions of veg or salad and extra vitamins so I don't have to fight with him over that! The nurse pokes a needle into my foot once a year to check that I can feel it but apart from the yearly blood test I am left to my own devises. I now realise that if I have a problem the best way to solve it is to look on the forum, check out recent studies and do my own homework and not rely on my surgery. My doctor seems happy that I do it my way so thats what I am doing.

Good luck with your battle!

 

[Pneu]

In my experience with the local PCT and discussions with numerous HCP's at the local diabetes centre they all agree on one thing... and that's type II is being managed incorrectly in the NHS... the sad reality is that when yearly budgets are drawn up often by non-clinical staff then they don't really think about long term effectiveness.. they only think about this financial year... until a longer term strategy is enforced on them treatments will not improve.

 

[Grazer]

In my experience with the local PCT and discussions with numerous HCP's at the local diabetes centre they all agree on one thing... and that's type II is being managed incorrectly in the NHS... the sad reality is that when yearly budgets are drawn up often by non-clinical staff then they don't really think about long term effectiveness.. they only think about this financial year... until a longer term strategy is enforced on them treatments will not improve.

Think you've got it spot on. Big corporation departments run on this year budgets rather than strategy if you let them, and the NHS does.

 

[hanadr]

Every time someone mentions a Healthy diet to me in the diabetes context, I ask them to tell me the scientific studie that show what tha Healthy Diet consists of. I've been doing this for years and no-one has obliged me so far. I've searched myself and it doesn't appear to exist.
If you keep healthy on a LV/VLC diet, that diet is HEALTHY for you. I've been doing it for years.
I'm pretty fit for my age and with my lingering traces of stroke damage.
I would say Read Gary Taubes's book "The Diet Deception" also published in the USA as "Good Calories, Bad Calories".
It's a real eye opener on the subject.
Taubes isn't a medic, but he is an experienced scientific journalist [with a science education and degree].
I'm sure it says somewhere that her researched the book for 10 years. My copy has HUNDREDS of references to research papers.
Hana

 

[BaliRob]

Dear Truffle,

Stop the nurse sticking needles into your feet - the feather test is perfectly adequate for checking foot neuropathy!!

Rob

 

[Truffle]

Thanks BaliRob - I think she was taking out her frustrations on me last time - 6 pinpricks to each foot (I wasn't allowed to look) but she was left in no doubt that I felt it!

 

[phoenix]

Thanks BaliRob - I think she was taking out her frustrations on me last time - 6 pinpricks to each foot (I wasn't allowed to look) but she was left in no doubt that I felt it!

She shouldn't be pricking you with a needle!. She should be using a tool for the purpose ie a 10 gram monofilament. A bit like a bit of fine fishing line like this
http://www.diaped.co.uk/ads/retractable-monofilaments/
It is supposed to be applied to the skin at 90degrees with just sufficient force to make it buckle.The test looks at the extremities ie the toes so that test wouldn't check the heel. If you are having numbness in your heel you could ask your doctor for a second opinion or better visit a podiatrist

There is a lot of good info about feet , what to look for and how to get help if you are worried on the DUK site.
http://www.diabetes.org.uk/Guide-to-dia ... ring/Feet/

 

[BaliRob]

I still maintain that if you cannot feel a feather caress the bottom of your feet further examination should be considered.

 

[SweetHeart]

So she sticks your feetses with needles, a half dozen times in each foot......that should be sufficient to leave you open to infection! :thumbup:

That's almost as good as our DSN telling my husband 'never cut your toenails' and having to be pushed for an explanation of that sentence! Why should he not cut his own toenails? Because he's a diabetic.......of course, that tells us everything......not!

Ju

 

[Sunny]

Thanks Phoenix - I read that stuff about foot care - very useful as I wasn't given any advice.

 

[jonesd]

I had an appointment with the diabetics nurse last week at my instigation. The visiting nurse who I met once was an absolute mine of diabetes infio but sadly he will no longer visit the practise. as the other nurse is back from maternity leave. It took three attempts to take my blood sample,three holes - two arms and i hate blood tests so not impressed.
Asked again about monitors and this time the reason was that Type 2 do not need to test when on Metformin ( I'm not taking them as yet ! )as they do not experience HYpo's ?
Going back thursday for the results of Hba1c , etc, BP and foot examination. Will report back.