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[IP] Re: I'd like to be outraged for a minute

Some of us don't live in large urban areas.  Though we have a fairly large 
hospital in my town...and it is well-known for excellent cardiac care...there 
is not an endo on staff.  There is not an endo in this entire county.  This 
causes problems.  We have one particular doctor who is "certified by the 
American Diabetes Association," but I didn't have very good luck with him or 
his certified physician's assistant.  Every hospital is different.  Each one 
has a staff with different strengths and weaknesses.

The general practitioner who diagnosed me over 20 years ago did his 
internship in a diabetes research hospital.  He told me up front that once I 
was released from the hospital, I would probably know more about diabetes 
than most any doctor, especially in our state.  He told me that after I 
worked with my body and learned what I could and could not handle, it would 
be up to me to stand up for what was right.  He told me that after I learned 
the ropes, I would basically be my own dietitian, my own nurse and, at times, 
my own endo.  He said this because he wanted me to know that I would not have 
a traveling medical entourage who gave me good advice on everything I put 
into my mouth.  He wanted me to know that I had to be independent and do what 
was right for my body without being told.  He told me that if I had questions 
and needed help, I needed to find someone who could give me advice and teach 
me the right choices, but it was up to me to stand up to anyone who told me 
the wrong thing to do.  He even gave me some suggestions as to how to quiz 
the doctor to find out how much he knew about diabetes.  I'm amused at times, 
because whenever I see a new doctor, I often get the same questions asked 
about my diabetes.  They use the questions to see if I really know what I'm 
talking about. 

I have a friend who recently has been having a lot of problems with her MM 
pump.  She had very high BG readings for one night and started feeling sick.  
She didn't think she was going to be able to get the BG levels down on her 
own, so she went to the emergency room for help.  The attending physician 
told her to stop the insulin until they could get in touch with her endo in a 
city two hours from here.  Of course, it was a Sunday and the endo was no 
where to be found.  My friend sat in the emergency room for over three hours 
while they looked for her endo.  They didn't put in an IV, they didn't do 
anything.  She just sat there.  Even though they told her to stop all 
insulin, she kept checking her BG levels and, of course, they were going even 
higher.  She kept telling them and they just got irritated with her for 
checking her own BG levels.  Finally, she had enough and started giving 
herself insulin again.  Two hours later, her BG finally dropped to below 200. 
 (She used a formula that I learned from a former endo.) The hospital doctor 
was almost all proud of himself because he made her stop taking insulin and 
her BG went back to normal, I guess magically.  She broke the news to him 
before he discharged her.

Before the pumps came out, I was hospitalized for a non-diabetic-related 
illness and my insulin was confiscated.  After the first day, I refused to 
let the nurses give me my shots because they didn't know the areas I could 
inject without pain.  I won that battle and soon had gained their trust 
enough to check my own BG levels and give myself the correct amount of 
insulin.  I just had to keep a chart.  What the doctor was telling the nurses 
to do didn't work for me.  I was the only one who knew what worked for me.  
The nurses recognized that and talked to the doctor, who allowed me the 
freedom to take care of my condition the way I knew best.  I'm sure the 
doctor would have eventually found the right combination after a few more 
days of trial and error.  I didn't want to be his guinea pig for a few days 
when I already knew what to do.

I know that medical research is constantly changing and that I am not always 
up-to-date on the latest diabetic news.  I try to stay informed and I talk a 
lot to other diabetics.  That is why something like this mailing list is 
important.  We can share experiences and learn from each other.  
Unfortunately, doctors don't have the time to keep up with the latest medical 
developments in every area.  If I didn't have access to a good endo in my 
area, and I ended up in the hospital, I would definitely stand up for what I 
know is right.  I'm sure that most doctors and hospital staff are competent 
and able to take care of a large variety of ailments.  However, diabetes is 
not always an area in which they find it important to educate themselves.  
Most general practitioners in my area have never heard of carb counting.  
Some of them have never seen a pump, much less worked with someone who wears 
one.  One doctor asked me to tell him all about it.  He had read about the 
pumps, but had never seen one.  He was amazed.

Over the years, I've been saddened by stories of people who are diagnosed 
with diabetes and given a few sheets of information that is supposed to teach 
them all they need to know to take care of their diabetes.  My Mom knows a 
lady whose son was diagnosed with diabetes five years earlier and was given a 
sheet to explain the diabetic diet and one to explain injections.  When my 
Mom found out, she told this lady that I was diabetic.  She thought she would 
be able to offer her some encouragement.  The woman asked her how in the 
world she got me to eat the same meals for that many years.  Mom didn't know 
what she was talking about at first.  What this poor woman had done was to 
feed her son ONLY the meals that were laid out on the diabetic diet chart for 
over five years.  She didn't know how in the world someone was supposed to 
eat those same three meals for the rest of their life.  You'd think this was 
one isolated case, but I recently met another family who thought the same 
thing.  These are not stupid people.  They are just afraid to ask any 
questions.  I know there are a lot of people who are thrown out into the 
world without knowing how to really take care of their condition.  I'm very 
thankful that I received the great education I did and that I had a general 
practitioner who taught me to be independent and to think for myself.  I know 
it is important to stand up for what is right.  If I disagree with a doctor, 
I ask for his/her reasoning behind their decision.  If I still think my way 
is better, I am able to discuss it intelligently with them and to point out 
the reasons why.  Some doctors can't be reasoned with because they do have, 
as someone put it, the god complex.  Most doctors are willing to listen to 
you if you know what you're talking about.

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