New Endo Appt Update

I had my appt this morning with the new Endo .. I was pretty nervous going in, but was determined to go in with an open mind and a positive attitude. I’ll go over the facts from the appt and then y’all can let me know if I’m being too nitpicky? It’s been so long since I’ve had to find a new dr, that maybe some of these things are the norm nowadays?

When I was in the waiting room, they called me back but just called me by my last name and then when I went back with the nurse she never said “Hi” or “How are you?” No small talk.. Just told me to step on the scale, and then measured my height. Put me in a room and asked some basic questions. Then said the dr would be in soon.

(Side note: My old dr is in his own practice, and one thing that did keep me going to him for as long as I did was the one on one aspect of it – his office staff was very small, only 4 people, so everyone knew me as soon as I walked in and you do get treated differently in that type of practice. I knew that this would be a larger practice and I’d be giving that up but hoping that the good outweighs the “bad.)

A few minutes later, he poked his head in the door and said he’d be back in 5 min, but he had a big smile and was super chipper so I thought “so far so good!”

When he came in, there were no introductions, he just sat down and got straight to business. Still had a smile… but never looked me in the eye. First thing was he commented that he knows my former Endo (great *sigh*) and said that they have different styles of practicing medicine (good!) He asked why I was switching and I said it’s nothing personal against my old dr, but he’s very traditional and not very hands on, and I want to have more of a team effort, with someone in my corner to help/guide/support me. He said that this practice is much bigger, very involved in research, and has 6 CDE’s on staff that I would be able to meet with regularly. (Great!)

Then he starts talking about how people with diabetes don’t die from diabetes. They die from complications of diabetes, mostly heart disease related. (I already know this … and I suffer from pretty bad anxiety related to this. I feel like a ticking time bomb sometimes, just convinced I’m going to have a heart attack – but I digress.. )

He was flipping through my medical records and making conversation about how he likes to see an LDL of <100 … mine last year was 155 (yeah, I know … bad) but I told him that if he can find this most recent one from June, it had come way down. He found it and it was 97. (high five, right?) Then he said that he REALLY thinks it should be closer to 70. (Didn't you just say <100 was good?) Ok so we'll get it closer to 70. I've dropped it 58 pts .. what's another 30.

Then he sees my last A1C, which was 6.7. He said that's "fantastic" and he likes to see 6.5-7.0. And proceeds to tell me that there are recent studies that show that if you have an A1C < 6.5 there are higher risks of heart disease. (huh??) So yay me for having an A1c in a "perfect" range (according to this particular dr) but should I NOT try to improve it by going < 6.5 now??

He did check my feet, which my last dr only did maybe twice the entire 12+ years I saw him. (looked fine)

He checked my thyroid and noticed the nodule I have that was biopsied 3 yrs ago (benign) and said we'd keep an eye on it. Said it might be Hoshimoto.

He listened to my heart for MAYBE two seconds. If that. Did not listen to the back (lungs?) just in the front.

At one point he was typing on the computer and glanced over at me and said, "Yea, you're a tad overweight. If you lose some weight, your insulin resistance will be better." (huh??) I told him "Well, I weigh less now than I did when I got pregnant with my twins that were just born last year. It's coming off slowly but surely."

So after all that, he said he wants to raise my cholesterol Rx. Said BP was good so no change there. Wants me to see the CDE in the next few weeks (appt scheduled for end of August) and she and I will be able to work on tweaking my pump settings, etc. (I've been doing those myself for YEARS and am looking forward to having some guidance there.)

Then he got up and left the room … no "goodbye", no "nice to meet you", "see you in 3 months", nada. I had no idea if we were even finished? I sat there for a second thinking "is he coming back?" and when he didn't, I peaked out in the hall … nobody. So I assumed then that we were finished. I grabbed my purse and headed to check out. When I was checking out, the lady said "Ok it looks like he wants you to come back to have a ….. bone density test?" I said, "No, he wants me to see the CDE." She said "Ohhhh ok, that must be what DE means." (huh??)

He also did not ask to see my BG log. Did not even ask anything about my BG's. Did not ask if I needed any Rx's.

There are several doctors in this practice… and I've heard great things about 3 or 4 of them – nothing about this particular one. But when I called to make the appt a few weeks ago, I was not able to get in to see any of the ones I'd heard about for various reasons (booked too far out, and one doesn't take new T1 patients.) So I'm debating whether or not I'm being too picky on some of these things that "bothered" me? He seemed nice enough. But I was naively hoping for less "worst case scenario" talk and more sincere conversation about my diabetes management. I definitely want to meet with this CDE – have heard nothing but great things about her from different people. So maybe if I really like her, and she's the one helping me with my pump settings, etc, then I can look past some of today's weirdness and hope that the next appt is better? Or should I try to see another dr in the practice next time? Not sure if that is frowned upon or not.

Would appreciate any feedback/opinions ……….. Thanks!

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About Shannon

I am a wife, a mommy, and a Type 1 diabetic (since '92.) I have had two successful pregnancies - one of which was with twins. I wear an insulin pump- - off and on for 17 years; currently on the Medtronic pump and CGM. I am not a medical professional, nor am I giving medical advice. I am just sharing my day to day stories of someone who lives with this disease every day. My ultimate goal is to raise awareness.
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17 Responses to New Endo Appt Update

  1. Kim says:

    I was with you until you said that he didn’t even look at your BGs. I would be concerned, too.

    • Shannon says:

      Didn’t ask for them, didn’t check it. The nurse that initially took me to the room asked what my bg was that morning, but that was the only mention of bg at all. Other than the discussion on my A1C.

  2. Keiran says:

    I know that with all the HIPAA laws, most offices will only use one name when calling back patients, instead of both. But the rest… I’ll leave the more specific questions for others to answer, as I’ve only ever seen an endo once.

    It does bug me when doctors have that kind of attitude, though. When they don’t fully go over things, don’t really leave you room to bring up concerns, etc. Hopefully the CDE will be much better. Will she be the one you’re seeing most often, anyway?

    • Shannon says:

      Makes sense on using just my last name …

      And my assumption is I’d be seeing the Endo and the CDE every 3ish months. But I think she’d be the one helping me set my pump settings, work on diet, etc., and then he’d oversee it and he’d be the one to manage the overall picture, if that makes sense?

  3. Diana Wetzel says:

    I would meet with the CDE….I bet she will want to see ur log and prob be the best person in the practice for you! Hang in there and see 🙂

  4. SarahK says:

    ((HUGS)) Honey, I had my endo like that when I was a kid. I met with him once a year and the other visits were with the CDE. Hopefully this was just an initial visit and then you’ll get to see her from here on out. 🙂

  5. Erika Turton says:

    You will know in your heart and gut if this practice is the one that will be the best for you. I bet you didn’t know I changed my OB/GYN at 6 months pregnant with the twins and because of the change, the hospital I was going to deliver at. I kept the same Perinatologist because I liked the practice and the attention I was getting.

  6. Sara says:

    Nope. Keep looking! You deserve better.

  7. StephenS says:

    Shannon, I have a problem with a doctor asking me why I left the last practice. None of their business. It’s okay if they ask what I’d like to get out of seeing them though. That’s appropriate. Everyone is different, but my biggest concern is that if they have trouble communicating with you in the beginning, what’s it going to be like when you have something difficult to deal with? Good luck with the CDE.

  8. Karen says:

    For me the biggest red flag is that he didn’t look at your blood sugar numbers. But even so, if there is any doubt in your mind that he’s not the right doctor for you, definitely try to see one of the other ones. You need to have a doctor/patient relationship you feel confident in.

  9. Scott E says:

    The story does seem a bit unusual, but nothing that would suggest you need to run away. I’d give it another appointment and see how it goes… everyone has their “off” days, even doctors. Plus, it’s a feeling-out stage for both of you, just getting to know each other.

  10. CW says:

    I’ve switched endos in the same practice. I’ve also switched corneal specialists in offices when inappropriate comments were made. I spoke with the the office manager about that one and she said “oh, I’ve heard that before, it’s how he is”. That was enough for me. The next doctor was kind and empathetic. (No ego trip.) “Off” day or not, you deserve not to hear about “dying from complications” at your first meeting.

    I hope it goes really well with the new CDE and I you can interview another endo at that practice. Even if you have to wait a few months to get an appointment.

  11. l1zb3th says:

    Prayers you have a grateful day. The reason you mentioned changing doctors was to have someone in your corner, team effort and leading-edge physicians.
    The communication between the specialist and his patient- you – seems completely one-sided. The CDE is certified* … if any problem arises, she would have to communicate to this same brashman to be able to help you. The specialist and his ‘expertise’ are what you are looking and paying for. The other ‘endocrinologists’ may all be of the same private corporation and abide by the same rules of dealing with patient for 6 minutes and handing them off to the Certified consultants.
    1) He did not read your BG log.
    2) He did not touch nor enquire/download/etc. the pump? … !!!
    3) Increasing your ACE/ARB’s and/or Statins doesn’t sound new school, but old school.** Were your liver enzymes even checked to see the medicine is not hurting you before prescribing more?
    4) Were you given e-mail, fax, phone to call in case of emergency?
    5) Seems to be in the business of keeping the buck and passing the buck at the same time. It sounds as if few ‘new type 1’s’ are going to these practitioners, if any. Also, by ‘new type 1’s’ – is that ‘newly diagnosed type 1’s’ as well as ‘new to the practice patients that are type 1’?
    The team effort you are looking for seems to have left that building. I’m sorry it is completely exasperating, but there are doctors with morals and intelligence, yes. Check your insurance website for covered physicians, and then check*** what articles they have written. Sometimes going to the hospital’s website will show their research credentials.

    *Certified Diabetes Educators. https://www.diabeteseducator.org/export/sites/aade/_resources/pdf/Definition_Diabetes_Educator.pdf
    ** Niacin for cholesterol … http://www.ncbi.nlm.nih.gov/pubmed/24991087 … being flushed for a bit seems a lot better than muscle rigidity/increased inflammation and increased BG.
    ***National Library of Medicine, ScienceDirect, Lancet, New England Journal of Medicine, etc.

    • Shannon says:

      No, no blood work was taken. He said he’d do it at my next appt.

      • It just seems cruel for him to be so negative knowing your A1C is good, your LDL is only a tad high. You have been doing a great job keeping the numbers down, especially on a pump. If they are close, your friends/family go there, and there are no problems that you are aware of, more blessings for you.
        James 1:17 … Every good giving and every perfect gift is from above, and cometh down from the Father of lights, with whom is no variableness, neither shadow of turning. …

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