Annual Review

[Docb]

Annual review today - almost exactly a year after my last one. New DN, but like the last few was very knowledgable and had obviously checked my record before the review. We had a right good chat about stuff (including the unethical way in which weight loss drugs are promoted and the current advertising of Libra & Dexcom causing her the problem of telling people that they do not qualify for them on prescription) and together we came to the conclusion that my diabetes was in a good place and all was well.

We talked about the neuropathy and having worked as surgical nurse in a neurological department she was amused by my assessment that neurologists are strange people. Even she could not pronounce, let alone translate some of the latinesque stuff in the latest missive from mine.

I told her that we see many stories on the forum of off-hand handling of diabetes diagnoses by GP surgeries. She was horrified that people were being given a diagnosis by text. If only all surgeries were as well managed as ours......

 

[mde]

Great news that all is well!

I work in Primary Care and regularly see diabetic patients for the first half of their annual review. It's lovely to hear good things about DSNs and primary care. It sounds like your DSN is not only knowledgeable but also compassionate, which makes such a difference in the management of long-term conditions.

A thoughtful, personalised approach is what I certainly strive for, and it's really disappointing to hear stories on here of certain GPs handlings of diagnoses. It undermines the gravity of a life-changing diagnosis and the opportunity for proper support and education from the outset.

Thank you for sharing such a positive story, it’s a wonderful reminder of the impact well-managed primary care services can have. Best wishes for continued good health, and I hope your experience inspires others to advocate for better care when needed!

 

[Sharron1]

Annual review today - almost exactly a year after my last one. New DN, but like the last few was very knowledgable and had obviously checked my record before the review. We had a right good chat about stuff (including the unethical way in which weight loss drugs are promoted and the current advertising of Libra & Dexcom causing her the problem of telling people that they do not qualify for them on prescription) and together we came to the conclusion that my diabetes was in a good place and all was well.

We talked about the neuropathy and having worked as surgical nurse in a neurological department she was amused by my assessment that neurologists are strange people. Even she could not pronounce, let alone translate some of the latinesque stuff in the latest missive from mine.

I told her that we see many stories on the forum of off-hand handling of diabetes diagnoses by GP surgeries. She was horrified that people were being given a diagnosis by text. If only all surgeries were as well managed as ours......

Shock her even more, my diagnosis was given to me in a telephone message from the receptionist who had my blood test results. Her knowledge of Diabetes was because her father was diabetic.

 

[MikeyBikey]

Shock her even more, my diagnosis was given to me in a telephone message from the receptionist who had my blood test results. Her knowledge of Diabetes was because her father was diabetic.

I found out that an MDT team had decided a quadruple bypass was the best way forward when I hot a phone call asking if I wanted to go private for my bypass surgery. Up until then I had been thinking I was having stents. The cardiologist who would have done the stents had previously advised me not to go privately unless I had very deep pockets as his brother had done and because if complications the final bill was over £100k rather than the quoted £25k! I was standing when I took the call but had to sit down!

 

[MikeyBikey]

Annual review today - almost exactly a year after my last one. New DN, but like the last few was very knowledgable and had obviously checked my record before the review. We had a right good chat about stuff (including the unethical way in which weight loss drugs are promoted and the current advertising of Libra & Dexcom causing her the problem of telling people that they do not qualify for them on prescription) and together we came to the conclusion that my diabetes was in a good place and all was well.

We talked about the neuropathy and having worked as surgical nurse in a neurological department she was amused by my assessment that neurologists are strange people. Even she could not pronounce, let alone translate some of the latinesque stuff in the latest missive from mine.

I told her that we see many stories on the forum of off-hand handling of diabetes diagnoses by GP surgeries. She was horrified that people were being given a diagnosis by text. If only all surgeries were as well managed as ours......

Rather better than my In Absentia review!

 

[harbottle]

Shock her even more, my diagnosis was given to me in a telephone message from the receptionist who had my blood test results. Her knowledge of Diabetes was because her father was diabetic.

I recently wrote a 'drabble' (100 word short story) based on my experience of diagnosis. A late phone call, 'you're diabetic, stop eating chips. Take this Metformin. Bye.'

 

[JITR]

Dribble drabble: 'Your glucose is far too high. Diabetes is a life long condition. Learn to live with it. Start taking as much Metformin as you can at once. Your Ferritin is far too high too. We suspect hemchromatosis. The iron may have damaged your liver. We are arranging a scan. Stop eating red meat and greens.'

Diagnosis spot on. Prognosis and treatment not.

 

[everydayupsanddowns]

Glad you had a good review @Docb

Always good to hear some positive experiences of interactions with GP surgeries - we get enough howlers shared here after all!

 

[SB2015]

Good to hear of such a good review @Docb

 

[Docb]

Always good to hear some positive experiences of interactions with GP surgeries - we get enough howlers shared here after all!

I am sure my experience is much nearer the norm than those who have had howlers. I would encourage anybody who has had a poor experience to contact the practice manager with their concerns and to start a dialogue to try and improve things.

 

[rebrascora]

So pleased you had a good review @Docb

I have a very good DN (not DSN) at the GP practice. She is always lovely and supportive and encouraging and very upbeat and positive. Her knowledge of Type 1 and Libre is steadily improving but she knows that I know what I am doing with my diabetes management so she doesn't interfere and just asks if there is anything she can prescribe or refer me to, to help support me. She enjoys looking at my Libre data on my reader because it helps her learn and I am always keen to share info with her to help her learn (things like compression lows etc) as I have learned from this forum and she is very open to that.

The advantage of the appointment is that I get my bloods done a week before and toes tickled/pulses checked etc and she was able to prescribe me blood ketone test strips last year, when I had been trying to get them prescribed by the clinic/consultant since the start of Covid.... and failed, despite them insisting I have a dual BG/Ketone meter but then don't prescribe ketone strips, although I did have urine test strips. I almost never use them but when the pandemic hit it was a sensible precaution to have blood ketone testing to keep ourselves safer. I was impressed that she could just look them up to find the correct ones and prescribe them herself and was happy to do so whilst I was there.
My review is due next month and I quite look forward to my appointment because it is so upbeat and it means I don't have to have bloods done for my consultant appointments now because he can access those results.

 

[harbottle]

To be fair, since diagnosis, the nurses have been amazing, and I've spoken to other GPs who are far nicer.
Not that they have much to do, as the tests all come back fine so the review is usually a pleasant chat.
(And my surgery is keen to not over-medicate.)

 

[Amigo]

My annual review is carried out at the surgery by a nursing assistant not a trained nurse. The bloods are taken at the same time so there’s no recent Hba1c to discuss. I’ve told them it seems to be a ridiculous system because any issues the bloods reveal have to be then addressed by the GP. Surely this isn’t standard practice?

 

[victorhamesse]

My annual review is carried out at the surgery by a nursing assistant not a trained nurse. The bloods are taken at the same time so there’s no recent Hba1c to discuss. I’ve told them it seems to be a ridiculous system because any issues the bloods reveal have to be then addressed by the GP. Surely this isn’t standard practice?

Not in my experience. My annual reviews are booked by an app and then two dates are set. One for a blood test and another a week later to include the blood results (that I will have already seen via the app).

 

[Docb]

If you walked into a new ALDI, the chances are that the layout would be the same as your local Aldi and that you would find the Moser Roth 85% chocolate you were looking for on the left hand side at the far end of aisle 2. OK, sometimes the beetroot is at the bottom end of Aisle 1 rather than at the end of the veggies on the right hand side of aisle 1, but you will see my point, ALDI know that if they make life easier for customers by being predictable, you can get more customers through, they are happier and it costs them less to do what they do.

I often wonder how better the NHS would be if some of the ALDI mentality crept into the way they do things.

 

[Burylancs]

Annual review today - almost exactly a year after my last one. New DN, but like the last few was very knowledgable and had obviously checked my record before the review. We had a right good chat about stuff (including the unethical way in which weight loss drugs are promoted and the current advertising of Libra & Dexcom causing her the problem of telling people that they do not qualify for them on prescription) and together we came to the conclusion that my diabetes was in a good place and all was well.

We talked about the neuropathy and having worked as surgical nurse in a neurological department she was amused by my assessment that neurologists are strange people. Even she could not pronounce, let alone translate some of the latinesque stuff in the latest missive from mine.

I told her that we see many stories on the forum of off-hand handling of diabetes diagnoses by GP surgeries. She was horrified that people were being given a diagnosis by text. If only all surgeries were as well managed as ours......

A good MOT. But what's 'the neuropathy' you mention ? Big Toes on the blink ?

 

[Docb]

A good MOT. But what's 'the neuropathy' you mention ? Big Toes on the blink ?

The "neuropathy" I mention is entirely on the face. My face just feels weird. It is not painful, it is not really numb but the affected area is spreading and the sensory disturbance has been increasing in intensity over time. It is beginning to affect my speech and swallowing. The pros can tell me what they do not think is causing it but they cannot tell me what is. It may or may not be related to a nystagmus and the tinnitus which I developed at the time it started. There is no suggestion that it is in any way diabetes related.

My experience somewhat colours my comments on posts on the forum about neuropathy. I do not think the pros are incompetent, it is just that the tools needed to get to the bottom of anything other than gross neurological damage have yet to be developed.

 

[helli]

If you walked into a new ALDI, the chances are that the layout would be the same as your local Aldi and that you would find the Moser Roth 85% chocolate you were looking for on the left hand side at the far end of aisle 2. OK, sometimes the beetroot is at the bottom end of Aisle 1 rather than at the end of the veggies on the right hand side of aisle 1, but you will see my point, ALDI know that if they make life easier for customers by being predictable, you can get more customers through, they are happier and it costs them less to do what they do.

Interesting.
When I used to work for a supermarket. they would deliberately rearrange the store every few years to get the customers to look at different aisles and maybe buy things they wouldn't have thought to buy before. We had a very independent blind customer who hated when this happened.
We don't have an Aldi in my store but my local supermarkets still go through "refits" where things move around. They all always keep fruit and veg in the entrance because it is light and appealing but the fridges will to the back of the store or the baking will move to the end or ...

However, when I was a Product Manager, we would often give the example of Volvos - they varied but when you drove Volvo you always knew where the rear screen wipers was or where to find the dip beam. So, if a customer was thinking of changing their car, they would likely buy another Volvo because they knew their way around it. AS a Product Manager, we kept things consistent between products.

The difference with GP surgeries is that few of us will chose our surgery - we go to the nearest - and we rarely go into another one because we rarely move. So they have no need to be the same - they don't get more business from a customer coming from another surgery.
The variation maybe down to demographics - a surgery close to a university will be different to one near a large assisted living centre.

 

[Burylancs]

If you walked into a new ALDI, the chances are that the layout would be the same as your local Aldi and that you would find the Moser Roth 85% chocolate you were looking for on the left hand side at the far end of aisle 2. OK, sometimes the beetroot is at the bottom end of Aisle 1 rather than at the end of the veggies on the right hand side of aisle 1, but you will see my point, ALDI know that if they make life easier for customers by being predictable, you can get more customers through, they are happier and it costs them less to do what they do.

I often wonder how better the NHS would be if some of the ALDI mentality crept into the way they do things.

I was annoyed in Aldi a couple of weeks back - they moved the little boxes of raisins from the Nuts and dried fruit section to children's/ baby food !

 

[grovesy]

My review the Health Care Assitant takes bloods, does blood pressure, feet checks, then I either have phone or in person review at later date withDiabetic Nurse.