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RE: [IP] Re: What a CDE/endo does at the office visit?

You know Laura, I first went to a family practice physician when I was first
diagnosed 15 years ago.  As a matter of fact I can thank him for finding out
that I was diabetic in the first place.  But after awhile, I really felt
that his treatment for me was not very aggressive.  I have had several
doctors over the years to help me with my diabetes.  Probably the best one
was an Endocrinologist (sorry, I hate to abbreviate things) but he went with
an HMO and I lost him.  I am on Blue Cross and I refuse to get treated like
an HMO when I pay the kind of premiums I do for Blue Cross Coverage.

He got tired of this and finally went into practice with four other
Endocrinologists.  I went back to him and he immediately made several major
changes in my diabetes treatment.  I called one day though and his nurse
refused to allow me to see him for anything that was not directly related to
Diabetes.  Wow, what a deal huh.  I now go to a lady doctor, (who in my
opinion are much better doctors regardless of their specialty) and she sees
me for everything.  She does have board certification in internal medicine
and Endocrinology.  But to tell you the truth, she sometimes gets so busy
seeing people for so many different things that I get frustrated.  But just
about the time that I am ready to tell her I am leaving she redeems herself
and I think what a great doctor.

The bottom line is this, do you know what a doctor is?  Give up?  They are
just another person who had a little better grades in school or had parents
that were doctors or to tell you the truth were people that just wanted to
make great money (and they do most of the time).  But they are no different
than if you go to a mechanic, a plumber or a car salesman.  Some are good at
what they do, others suck from the start and the rest are in the process of
professional burnout.  It just depends on what stage in life they are when
you darken their door.

The best advise I would give to anyone is to:

* Educate yourself
* Take the good advice and throw out the bad advice.
* Give the doctors the boot when they fail to perform and make sure that you

Believe me, if the word gets out enough even they will come around or get
out of the practice of medicine all together.

Good Luck and Keep Trying.  Mark

-----Original Message-----
From: email @ redacted
[mailto:email @ redacted]On Behalf Of email @ redacted
Sent: Monday, December 01, 2003 12:12 PM
To: email @ redacted
Subject: [IP] Re: What a CDE/endo does at the office visit?

 In a message dated 11/27/2003 6:32:39 PM Eastern Standard Time,
email @ redacted writes:
> Anyone want to share details of what their endo/CDE does at the office
> Laura G.


 I've been a type 1 diabetic for close to 47 years; until recently I always
the family doctor for my diabetes management. Most of these have been fairly
decent doctors who know more about diabetes than most. But I had a terrible
keeping my blood sugars under control and had an especially strong dawn
phenomenon. No one had ever suggested that I see anyone else and I had never
heard of an endo or CDE prior to 1999.

 After trying everything under the sun (or so we thought) to get my blood
more consistent and in line, my current PCP finally suggested in 1999 that I
to a newly established diabetes center at a local hospital. It was there I
met a
CDE and a dietician who have since become two of the most important and
people I've ever known. First they introduced me to the pump which of course
changed my life.

 They always have me keep a very detailed diary of blood sugar readings with
food intake, insulin dosages, stress level, activity level, any sickness,
anything else that may affect my bg's. At each visit, they review my diary
by day, ask certain questions, and try to help me analyze the effect certain
things have. Then they make certain suggestions about things to eat or
basal increases/decreases, etc etc; and we make realistic goals for the next
period of time before I see them again. At each visit we also discuss how
well I
met each of the previous goals and the reasons why or why not.

 Additionally they make me aware of new products available or "in the
Also I have their email addresses and pager numbers that I can use at any
time I
need their help.

 I have a real problem trying to keep the detailed records (even though I'm
accountant-lol), but I have terrible time constraints so I probably need to
a PDA or something to help me along those lines; however I do manage to get
done for my CDE visits.

 I saw an endo for the first time in October; I was not impressed with him
all. He basically reviewed my records and told me I was doing a fine job,
up the good work yadda. yadda, come back in January. However since that
visit, I
learned that he is the chairman of the diabetes center where I see the CDE
dietician! - lol. I think it remains to be seen whether I will develop a
trusted relationship with him.

 You really need a doctor and/or CDE who will do something to help you
your diabetes care; otherwise what is that point?

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