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Re: [IP] First Day of Training



On  3 Mar 99 at 17:13, Natalie A. Sera wrote:


> I had to train the trainer ..... I oughta be charging THEM!!!!  :)
> 

Be sure you get the right coding on the bill you send them....

> According to her, the goal for post prandial, 2 hour BGs is to stay
> under 150. We both agreed that a goal is not necessarily achievable at
> all times, but I was rather surprised because it's the first time I've
> heard a Nevada CDE say anything like that! I've been told I'm obsessive
> because I want my postprandial BGs below 200!
> 

That's kind of odd, because the protocols and standards used around here talk 
about a 2 hour bg below 140.  That's what many patients are being told is the 
top end goal, but there are also many of us on tighter control that shoot for 2 
hour targets of 120.  


> They were also very confused because they couldn't figure out whether
> I'm Type 1 or Type 2 -- I repeated to them that I just have an unusual
> type of DM -- neither classic 1 NOR 2 -- but it seems to be hard for
> them to think outside the box.
> 

There seem to be an increasing number of people who are not typical type 1 or 
type 2.  I've talked to a couple of doctors and CDE's who think that it is 
because the designations were too simple to begin with.  One doctor has a 
couple of children among his patients who are Type 2 - he said that a few years 
ago it would have been almost impossible to get that diagnosis to stick because 
the definition of type 2 said "elderly"...  Then you get the strangeness of 
people who are still producing some insulin themselves - even though type 1 
they are not fully insulin dependent yet.  The problem is that the box was 
built wrong and needs to be totally replaced!

> So the trainer came to the conclusion I'm Type 2, and the dietitian that
> I'm Type 1, and guess what, they're BOTH wrong! :)
> 

That's why they are the "professionals" and you are the "patient"...  
 
> So anyway, tomorrow I'm supposed to start with saline -- and on March 17
> I officially go on insulin. 
> 

Hope it goes well and keep us posted.

> They did tell me I'm the first non-Type 1 they've ever had -- one of
> them seemed doubtful about my going on the pump at all, but I think that
> all insulin users should have it as an option. 
>

Make sure that they don't mess up your records with crossed diagnosis and 
recommendations!  They could really mess things up and cause you trouble for 
years...

 
Randall P. Winchester
WD4HVA
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