Feeling Bamboozled!!!

I know that I cant place 100% blame on my PCP for what I am about to tell you because ultimately I have done all of this to myself; however, I go to my appointments with my PCP for a reason.  I don't just go because I am sick.  I make valid appointments and then continue on with my follow-ups as well. 

Now, I have only been in this new town for 2 years and I have been seeing this doctor every since.  I have talked to her about my concerns of Diabetes and Hypertension and Heart Disease.  My biggest fear is Diabetes.  I have my labs drawn when she wants them and this last bout was no different.  She has had a concern of Diabetes as well due to a family history, my weight and my  ethnicity.  I had my lab work drawn.  She got the results. This was over 3 weeks ago more like a month. When I went for my follow- up she tells me that I am "not" diabetic, she says that my BP is good but, I have High Cholesterol.  Now, Just because you have High Cholesterol doesn't mean that you have diabetes however due to "Syndrome X" if you have Diabetes you are more than likely and probably are a victim of High Cholesterol amongst other things. So it would stand to reason that the main concern should be preventing Diabetes.....right?  Right!  So I strode out of her office content with my weight loss efforts and the fact that I am not diabetic.

Here I am getting a phone call from my surgeons receptionist about my visit with the dietitian and that came down to leaving her a message to fax a not stating that she believes I am a good candidate for WLS or making an appointment for the next day which is today.  So I chose to make an appointment to see her again.  She asks me about my labs because she did not have the folder from the PCP since it was a last minute appointment but I relayed to her what the doctor said to me.

She proceeds to tell me that she wanted to let me know that the result of my A1c from  my previous lab work that I spoke with my PCP about was a 6.0!!! 

Now, In my past profession I was a Diabetes Community Outreach Worker meaning that I went to the homes of pt's diagnosed with Type 2 Diabetes to educate them on Diabetes, Nutrition, Insulin & Medication, Physical Activities,  the whole gambit.  So I am aware of what a 6.0 A1c is.  This means to some doctors that I am what is called "Pre- Diabetic".  I know doctors when I was doing this that would diagnose Type 2 Diabetes with an A1c of 6.0+.  

Can someone please tell me why she would not tell me that my A1c is elevated or that I am "Pre-Diabetic"?   I had made it clear my concerns of developing this disease.  Why would she neglect to tell me this.  I know that for some this may not make much since so I will explain to you why it concerns and frankly ****** me off.

In the month that I've seen her her and she did not mention this lil problem I also saw my surgeon and was told that I reached the weight loss goal for surgery.  What usually happens when you do what you need to do or accomplished your goals?  You relax right.  Well, that's exactly what I did.  I ate **** that I had no business eating.  Now, I know you are thinking "you are responsible for what you chose to eat".  This is true but I was eating under the assumption that my lab work was good I had no reason to worry about Diabetes.  How do you make better judgment without the correct information?  As the dietitian was telling me of my lab result do you know what I was doing? I was eating to packages of instant oatmeal! nothing major but I had two packs plus I added brown sugar.  Hey I had it this morning too.  And ooh, lets not forget that at lunch I had a turkey sandwich with chips  and 2 large slices of wheat bread.  Do you think that I would have been doing this had she let me know of my A1c?  Let me tell you...."Without a doubt NO"! 

I am going to attend my last appointment with her because I believe there are some things that we need to discuss as well as me informing her that this is a mistake that I cannot tolerate and thus will be changing my PCP.  If you don't agree with my choice, that is ok.  She will not have another opportunity to misinform me.  Funny thing is she seemed more concerned that I didn't have more children than with me developing DM. 

I am thoroughly disappointed. And from this moment on will no longer neglect myself or allow anyone else to do it either.

Unfortunately this world is saturatd with people who do thier job (excuse my french) half assed and don't even care who or what that lack of diligence affects. Some also think that if something is boarderline.. it just isn't present. This is what I believe to be an irresponsible approach, as diabetes is such a dangerous and life threatening disease. I am glad you have chosen to get a nw PCP. Jut do your research and get someone you trust. BUT before you change.. be sure to get that letter you need for insurance approval, so you don't find yourself back at square one.

We are our own best advocates, and we must do so with diligence. we have one life, but many doctors to choose from. we must feel like we can count on and trust that doctor to look out for us as we would ourselves. Some docs just don't seem to care or to take us seriously. I never have a second appt with a doc like that.

One more note: (please... know there is no offense intended here) BUT you really need to keep treating your body with respect and feeding it healthful foods, even though you have not yet had your surgery. You are laying the foundation for later success. A treat now and then is ok... but do try to treat your bady as fairly as you want to be teated by your doctors. It needs this from you and will reward you in so many ways for doing so.

Hugs and love to you. Let us know what happens!

Patrece,

I know you are right.  Although I am pissed, I know that the responsibility of my health is on me.  I've known for years the realities of diabetes and that I have horrendous eating habits that would ultimately see that I developed the disease.  I am taking responsibility for that.  Mainly I am upset because I really do like my PCP and was sure that she had my best interest in hand and now feel like she is any other doctor that believes that African Americans don't care about their health and or are to stupid to care.  The is such an issue with this type of attitude and.  I would like to believe that she just forgot but she had the lab results in her hands as she told me that but didn't say "oh, your HbA1c is way to high".  She got down on the cholesterol and I think one far out weighs the other even though they are both dangerous.  Just disappointed.  

What you say is true that I need to treat my body with respect.  Thank you for reminding me.  I needed that.

P.S. How is that grand baby of yours doing? 

Gigi... Maybe a good first step with your pcp is to sit down and have a very open and candid discussion about how her oversight made you feel. If she does truly care, she will be grateful for your honesty and for taking the time to let her know your feelings and concerns. It may be worth gicing this a try if you do like her.

I have no doubt that it ****** you off and disappoints you big time. Maybe she was having a very stressful day and it was an oversight... but this isn't acceptable. maybe if you take the time to discuss your concerns, she will be better at making sure she stays on top of things. Once she knows you are holding her accountable, she may be more focused when caring for you.

He is doing better but has been having rough evenings and nights. candice is gong to follow up with denver Childens Hospital on it. His troubles are in his digestive system, and I think mainly intestinal. He was diagnosed with and treated for anal stenosis, but as of lately, he has been having rough rough nights.

thank you for remembering the lil man. I love him sooo.

What I look for in a PCP is someone who listens to me and respects my opinion and right to ask questions.  I have also learned that it is a give and take relationship.  My health is my responsibility.  I am the only who has control of it.  While the PCP knows about health issues and such, they don't know my body and how it reacts. The PCP has lots of patients to try to diagnose and to treat.  So what I look for from my PCP is someone who will listen, speak openly with me, treat me with respect, answer my questions, treat me as a person and not expect me to know everything just because I am a nurse.  I realize that I have to take charge.  If I was faced with the same situation, I would have not just taken the PCP's word.  I would have asked for the results and then have them explain it to me.  I would have demanded what the number was and even asked what it was the last time that I had lab work done.

I don't think I would change PCP's just because of this.  I definitely think that you should be talking to her about this though.  But you have to accept partial blame.  This may make you and ur PCP bond more.  Unless you have had other issues or u didn't feel comfortable with her, then I would most likely stay with her.  But let her know that you are dead serious about being included in your health care decisions.  If you have your labs drawn there then tell her that you want it set that you have copies of your lab work sent to your house so that you can look at them and develop questions to ask at your follow up appt. 

I too recently had my HgbA1c be elevated at 6, with my last tests results.  I have PCOS and am insulin resistant.  We been keeping a watch on it every 3-4 months.  I know mine was up so high because I ate like crap, lots of sweets, and did not take my metformin (GYN prescribed metformin daily).  My PCP didn't make any changes, but we are monitoring things closely.  My suggestions for you is to get a monitor and check your blood glucose levels atleast once a day.  Keep a record and share with your PCP.  You can also see is she will diagnose you as being pre-diabetic and write the script for the monitor.  If not, then you may just have to eat the expense as a way to monitor things. 

What I have done differently since those labs:
-not eating sweets everyday.  I had it down to once a wee****il TOM decided to show up.  Sweet tooth has been a little worse. 
-limiting my carbs: No bread and pasta in one meal.  Eating smaller servings of pasta. Limiting bread to 2 slices a day most of the days.  Haven't even been eating it every day.
-NO sodas: crystal lite, water, and G2 (sm. amt of sugar)
-Protein: been trying to increase my protein intake to 100-160 a day.  Adding supplements in.  Part of this is because I want to get use to having them as part of my diet so it wont be so hard once I have my surgery.
-Checking my BS every other day: I really need to get better at this.  But atleast I am trying.

Take charge!  It's your body!  It's your health!  If your PCP cannot accept that, then I suggest finding another PCP.  But give her a chance.

Celebrate your body, feed the temple the best things for you.  Start making the healthy changes you will be living with after surgery.  Make the sandwiches open faced, using half the bread if possible.  I like that you are planning and active involvement in your choices.  One change at a time and build on your successes.

Wishing I had a pcp right now, my last pcp moved last month.  I had an appointment with another internist.  Not sure if we are going to "click", I will see his PA next appointment, hoping for a better connection.  I have access to my lab results within hours of the lab with a connection called 'My Health' through my clinic.  It is a program that I signed up for, the clinic has access to certain parts of our medical record available to us online, with a special password and account.  I can access my medication list, health problems, lab results, email questions to the nurse and ask for an appointment this way.  The hospital where I had my surgery is part of the same system, so I have access to my wls labs too.  Reasuring knowing the actual numbers and seeing the trends in my lab values.

Let's take this one day at a time together.  Start each day like it is the rest of your life, it really is.  Hugs