DH needs a insulin pump, need advice on how to convince docs of that too - Page 2

rickst29 · 12-28-2006, 03:12 AM

I'm with Ruth (SamQKitty) on this one, NOT with Blondie2061h and Coravh (although they're MORE expert than I am)....

If the current MD can't give SPECIFIC reasons why pumping would be worse for him than the current MDI regime, you should go shopping for a competent MD. I think that MM and Deltec have the biggest market share among adults, Ruth even suggested the companies which will have the MOST prescribing MDs.

That was a smart post, I think. Do it! Also note, Minimed makes a Continuous Glucose Monitor, although it typically costs $999 *PLUS* $100-200 month to use it 24x7. Maybe that's a show-stopper right there. A lot of people don't have good luck with the two current devices (Dexcom and Minimed), but if he tries it and turns out to be one of the LUCKY people for whom they work well, (AND you can afford it), he'll be able to get his A1c well under 8 without even trying hard.

With a little attention and support from one of these gadgets, even people with very unpredictable and difficult-to-manage cases can easily score an A1c in the mid 6s. I know, because I'm one of the 'Lucky' ones, and have been using a Dexcom for months.

ZERO Glucagons since I got the gadget.

Coravh · 12-28-2006, 10:09 AM

Quote:

Originally Posted by rickst29

I'm with Ruth (SamQKitty) on this one, NOT with Blondie2061h and Coravh (although they're MORE expert than I am)....

If the current MD can't give SPECIFIC reasons why pumping would be worse for him than the current MDI regime, you should go shopping for a competent MD. I think that MM and Deltec have the biggest market share among adults, Ruth even suggested the companies which will have the MOST prescribing MDs.

That was a smart post, I think. Do it! Also note, Minimed makes a Continuous Glucose Monitor, although it typically costs $999 *PLUS* $100-200 month to use it 24x7. Maybe that's a show-stopper right there. A lot of people don't have good luck with the two current devices (Dexcom and Minimed), but if he tries it and turns out to be one of the LUCKY people for whom they work well, (AND you can afford it), he'll be able to get his A1c well under 8 without even trying hard.

With a little attention and support from one of these gadgets, even people with very unpredictable and difficult-to-manage cases can easily score an A1c in the mid 6s. I know, because I'm one of the 'Lucky' ones, and have been using a Dexcom for months.

ZERO Glucagons since I got the gadget.

I also agree with Ruth but feel that you need to address issues with the doc before you swap him/her for a new one. The problem is that if you are not dealing directly with your doctor, not speaking your mind and demanding straight answers, you are almost guaranteed to run into the same problem all the time. That is why I suggested the questions and the attitude.

Now, if the doc has no good answers, then yes, definitely trade him in for a newer and better model. The reason I posted the way I did is the simple fact that many people are afraid to confront their docs. When they do, they often get much better results.

Who knows? Maybe the doc feels that the gentleman is not testing enough (I don't know how often he does). Maybe the doc has never expressed that and the gentleman doesn't know that's what the doc wants.

Cora

blondy2061h · 12-28-2006, 12:17 PM

I mentioned that I did have to find a new endo to get my pump. I found it off a list that Minimed has on their website.

If you otherwise like the endo, it may be worth trying to educate them on how a pump would help you, but I didn't already like my endo. I hated her, actually, and this was the straw that broke the camel's back. I am glad I found a new endo. Some endos are just too old school, and stuck in their ways,

roadfamily6now · 12-29-2006, 06:36 AM

this is so helpful! thank you all.

We dont have any endos in state but we are searching for an internal medicine doc as I type. They are hard to come by here for some reason.

Right now, it is just hard cause we have been to so many docs and they are all so retarded when it comes to diabetes. They just blab on and on but never really help you.

I think that is the more frustrating part of it all. You are your own doc, you self medicate, etc........if you dont do it, no one will.

rickst29 · 12-29-2006, 07:37 PM

Actually, it shouldn't be that "frustrating": When you have a GREAT Doctor, and are a GREAT patient, the MD is more of a "consultant". My last Endo visit, he asked *me* about my Dexcom tricks (how to keep it stuck to my skin, what I do for showers, how do I know when it's starting to die). We've both been wearing Dexcom for many months.

And I asked *him* about Apidra timing diferences other pts. were seeing, and about his thoughts regarding a "natural" supplement which I wanted to consider.

Nice consultation. And he has often provided me with the information and tools which I need to live better. But only *I* can DO the treatment, he merely advises and reviews.

BTW, my wife tells her Severly Persistently Mentally Ill patients the same thing: she can give them the tools, but they have to 'fix' THEMSELVES, she can't MAKE them better. (This isn't true for acute ER, infections, surgeries, etc. but for chronic stuff like D. it really is.)