Stubborn know-it-all GPs?

[arale1402]

Hi all,

I have just recently joined this support group and had introduced myself in the newbie section a couple of weeks ago: http://www.diabetessupport.co.uk/boards/showthread.php?t=22356

I am one of those patients that were 'diagnosed' type 2 w/o further research and put on 2x 500mg Metformin a day. One of your members, Northener, was so kind to tell me about C-peptide and GAD testing, which could tell me and GPs if I really am Type2 or 1, 1.5 MODY, LADA ... so, I asked my nurse to look into these sort of tests and talk to the doctors about it. Today, when I donated some of the finest bloods known to humanity 😉 I was told that 2 (allegedly independent) diabetes specialists agreed that these tests would not be helpful. But of course they did not provide a logical reason for that!

A bit of background story with regards to one of those specialists: Not very helpful, didn't know what to do with me, told me I should loose some weight (I'm bordering to underweight now, so actually have 'ideal' weight), speculated I could be MODY.) So when I heard his name, you could imagine that I didnt care much for his opinion. But to hear that another so-called specialist also refuses to approve these tests was a bit of a shocker to be honest. I was quite upset. (Makes one wonder if they are golf buddies or something...).

I am contemplating to change GPs, as there is a German GP in my city. (I am German, so hope that he will be a bit more understanding. Although, please dont get me wrong, I do not mean to 'poo-poo' British doctors. I am sure there are many competent and brilliant GPs, surgeons, diabetes experts out there...it's just I have not come across a single one of them yet.).

Does anyone have any advice what I should do? I mean, do they just think they know it all? Are they stubborn? Or am I over-reacting maybe?

For a year now, I have been banging my head against the wall, and I am growing increasing tired of this. Like all of us, I dont want to end up with much higher levels than I currently have, and would rather like a decrease and as much of a reverse as possible! I am a little overwhelmed and clueless now ... and I am very sorry to bother you with this, too!

 

[vince13]

Hello, I was mis-diagnosed as Type 2 three years ago and it was not until I was in hospital to have a gall bladder op (which they never did in the end as the pain went away and they said "an op is an op so if it's not absolutely necessary we won't do it" which I was OK with) they did the c-peptide and GAD antibodies tests along with all the other tests they were running at the time and I was then diagnosed as a LADA/ongoing type 1.

It so happens that my Dr is German - registered with him purely by chance when we moved house - and he is so good. He listens and looks at me when I talk to him and has been very involved in my diabetic care so that I have great confidence in him. I'm sure any of the other Drs in the practice would have been OK if I'd been registered with them instead but my Dr is the tops as far as I am concerned !

If you have no confidence in your GP/GP's surgery then I would definately change as I feel you have to believe your GP is doing his/her best for you otherwise the trust is not there.

Good luck whatever you decide.

 

[Caroline]

Hello, I know what you mean about doctors, mine has a VERY bad reputation.

I hope you get the help you need, it is good to have well informed advice.

 

[arale1402]

Many thanks vince13 and Caroline! I will go back next week to discuss my blood results and will then discuss with the nurse, who is very nice and helpful, what other options there are and if she can advice me on changing docs.

vince13, your story sounds absolutely shocking. It needs a near-op for them to finally test you? unbelievable... :O I'm glad your were lucky with you GP in the end!

 

[daisymoo84]

Hi arale,

I'm sorry you're having so much trouble. If I was you I'd change GPs and see what they say. I almost changed doctors just before I was diagnosed as I'd moved acorss town and it's no longer that near to me- I'm so glad I didn't as my DN is a complete gem. She suggested I have the GAD test as soon as I got diagnosed with diabetes and prescribed me the testing strips without me even asking. After reading some members posts on here I was prepared to have to fight for them!

I'm still waiting for my results but I hope that you are able to get the test soon. Let us know how it goes.

🙂

 

[Robster65]

I am contemplating to change GPs, as there is a German GP in my city. (I am German, so hope that he will be a bit more understanding. Although, please dont get me wrong, I do not mean to 'poo-poo' British doctors. I am sure there are many competent and brilliant GPs, surgeons, diabetes experts out there...it's just I have not come across a single one of them yet.).

If you do find one, hang on to them. They are quite rare these days ! 🙄

Does anyone have any advice what I should do? I mean, do they just think they know it all? Are they stubborn? Or am I over-reacting maybe?

No, you're not over-reacting. I suspect they are taught to be stubborn and arrogant at medical school but most forget how to do it. The really good ones have perfected the art and are able to fob any patient off with great expertise.

I would go straight to the other doctor and register there, since he can only be an improvement. It's a shame that your present GP is such an idiot and won't accept that he could be mistaken. It's very bad practice. We can all be wrong, doctors included. They should be smart enough to admit it.

Best of luck and keep us updated.🙂

Rob

 

[Vicsetter]

I'm not sure your not all being a bit harsh on these GPs. I wouldn't let this kind of discussion go on with a third party acting as go-between, messages do get confused. Make an appointment to see your GP and discuss it with them. I only see the nurse when bloods are to be taken, normal consults take place with a GP.

{Quote}I will go back next week to discuss my blood results and will then discuss with the nurse, who is very nice and helpful, what other options there are and if she can advice me on changing docs.{/Quote} Go and take to your GP not the nurse!

 

[KateR]

I have a problem with my GP in that she refuses to even contemplate that I have neuropathy. Last time I suggested it she almost shouted at me that diabetes is nothing to do with neuropathy (so why is there a complete section about it on DUKs website?) and I definitely do not have it as my feet have feeling in them. Excuse me, but there is more that one form of neuropathy and I never said I had the sensory kind.😡

 

[Northerner]

I have a problem with my GP in that she refuses to even contemplate that I have neuropathy. Last time I suggested it she almost shouted at me that diabetes is nothing to do with neuropathy (so why is there a complete section about it on DUKs website?) and I definitely do not have it as my feet have feeling in them. Excuse me, but there is more that one form of neuropathy and I never said I had the sensory kind.😡

I would say that sort of ignorance needs reporting - every newly-diagnosed person learns about all the -opathies. How can they argue when the evidence is all around them? It's not as though it is a rarely encountered complication! 🙄

 

[margie]

I have a problem with my GP in that she refuses to even contemplate that I have neuropathy. Last time I suggested it she almost shouted at me that diabetes is nothing to do with neuropathy (so why is there a complete section about it on DUKs website?) and I definitely do not have it as my feet have feeling in them. Excuse me, but there is more that one form of neuropathy and I never said I had the sensory kind.😡

Can you print out the section from the Diabetes UK web-site and take it with you next time you see the GP. Use it as back up and ask for a referral - or see if there is another GP at the practice who will listen to you.

 

[PattiEvans]

May I gently interject something please? I have read your original introductory thread in which Northerner mentioned that dietary measures may help and it seems that was skimmed over. So therefore can I ask can you please give us an idea of your daily diet e.g for breakfast I have porridge 30g, lunch is a sandwich... etc because this could be very very important before you go down the road of asking for further tests and changing GPs. Often a tweak in the diet can lower BGs astoundingly and I am sure we can help on that basis.

 

[robert@fm]

I have a problem with my GP in that she refuses to even contemplate that I have neuropathy. Last time I suggested it she almost shouted at me that diabetes is nothing to do with neuropathy (so why is there a complete section about it on DUKs website?) and I definitely do not have it as my feet have feeling in them. Excuse me, but there is more that one form of neuropathy and I never said I had the sensory kind.😡

As has already been said, your GP is talking nonsense. I've had sensory neuropathy almost since I was diagnosed 11 years ago, and in the early stages it manifested itself as non-stop agonizing pins and needles in the feet; it's only in the last two years or so that I've actually begun to lose feeling.

 

[everydayupsanddowns]

May I gently interject something please? I have read your original introductory thread in which Northerner mentioned that dietary measures may help and it seems that was skimmed over. So therefore can I ask can you please give us an idea of your daily diet e.g for breakfast I have porridge 30g, lunch is a sandwich... etc because this could be very very important before you go down the road of asking for further tests and changing GPs. Often a tweak in the diet can lower BGs astoundingly and I am sure we can help on that basis.

I was wondering the same Patti... Many people get put on treatment regimes that do not work, but in some cases it is not the Diabetes diagnosis that is wrong, but the suggested treatment/dietary approach. Diabetes can be infuriatingly individual at times and one-size-fits-all advice can cause no end of problems.

An indication of food intake, blood glucose levels etc (if you monitor your own BG) would be very useful for folks to comment on it you are willing to share it arale1402.

 

[arale1402]

Oh dear, work as been swamping me up, and I totally forgot about this thread.

Many thanks to you all for your posts. I havent got any news regarding new GP yet, as I had to postpone my appointment to today. I will give you heads-up as soon as that's done.

@Vicsetter, I dont mean to be harsh to them, but I have talked to both GPs and nurse and it's getting really tiring. I dont know if I mentioned it, but especially the diabetes specialist (who happens to be in once a fortnight or so), did not even look at me properly, but said I should lose some weight. I am bordering underweight btw. And he was not the one that put me on medication, but said change your diet a bit and exercise and see what happens. hmmm...well not much happened there. So, sorry but I dont think I am being harsh without a good reason.


Diet/Daily intake seemed to be something some of you wanted to know about.

My daily intake usually consists of musli, with branflakes (small-medium portion) with soya milk for breakfast. Lunch usually consists wholemeal sandwiches, carrot sticks, an apple. When I'm at home I may cook a small meal e.g. rice-vegetable porridge (Thai-style), usually something light veggie. (I also like sandwiches spread with pesto and tomato slices - yumm). Dinners are cooked and mostly consist - again - of vegetables, small portion of rice or potatoes (I know carbs, but I try to keep it small portion size) and chicken or beef. I like to cook Thai, Japanese, Korean style food (I love tofu), sometimes British or Italian style. But I really try to keep it light, and well-balanced. In winters we have a bit more meat and carbs which is normal I think. We have a homemade soup once a week. We have vegetarian or even vegan dinners 2x a week, usually containing lentils or beans. I try to have a sufficient fibre in-take as I read somewhere this helps to keep BG down.

I admit it's not easy to totally do without any sweets or cakes, so once a week there may be a treat. My readings are not totally out of control, but I'd rather try to reduce BG levels than wait for them to increase. And the fact that metformin (current dose 500mg mornings and evenings) has not done a great deal to improve them yet, is the reason why I want to be tested.

Is it not helpful to know what type I am regardless of diet, and take the right type and amount of medication, plus getting proper advice on diet? Currently, I am still on a learning curve myself in terms of what I should and should not eat. It would be nice if I could get professional advice telling me if I am doing it right.

@KateR, I was not even adviced on neuropathy...is that when you have tingling sensations in your toes and gradually lose sensitivity there? I dont like the idea of that at all and will have to read up on that topic. Thanks for raising awareness in that regard.

Anyhow, I better stop the whinge-fest 😉

We're going to see family in Germany over christmas, and my Mum can certainly give me more info material diest-wise.

In the meantime, I wish you all a VERY HAPPY CHRISTMAS!!! Dont let diabetes spoil your Christmas! Speak to you all in 2012 I guess!

All the best,


arale1402 xx

 

[Copepod]

Arale

Hope you enjoy Christmas with your family - guess you'll have to incorporate St Nicklaus into 24th / 25th Dec? I'm very lucky that for the third year running, last weekend, I was asked to organise a party for triplet boys with a Swiss German mother at a country park where I work, which meant my annual fix of southern German / Swiss food, and this Saturday we're going to the home of my partner's German officemate for mulled wine etc.

By the way, many GPs and consultants find the resource restrictions under which they work, especially financial constraints on precribing medications & blood testing items, plus expensive blood tests (GAD - the result might not change treatment significantly) frustrating - going with knowledge sometimes helps to "manage" the situation. However, telling someone who is normal weight / bordering on underweight to loose weight does sound very odd!

 

[Northerner]

It can't be denied that some doctors and consultants seem very disinterested in what patients have to say - I have encountered the same on more than one occasion (also being told I needed to lose weight at BMI of 21 at the time!), happily now both my GP and consultant are very good listeners, I hope you can find ones that can communicate better with you.

Your diet sounds very good to me - have you tried calculating your average carb consumption in a day? As a guide I have between 140-180g per day and don't feel I am restricted in any way. I hope that you can make some progress today. You are still only on half the max dose of metformin I believe, so there may be some further help to come from that.

Hope you have a wonderful Christmas too! 🙂

 

[Robster65]

Good luck Arale. I hope your appointment today is fruitful.

As you say, there is a lack of understanding about type 2 in underweight people and the assumption is often poor diet/exercise regimes.

Enjoy christmas. I'm sure it'll be colder there than here. 😱

Rob

 

[imtrying]

surely it just goes to show the number that diagnose T2 and go on auto-pilot to then follow up with 'lose weight' to people who don't need to!! 😱

 

[arale1402]

Thank you all for the good wishes and your understanding. You are too kind! 🙂 Sorry that you too have had to put up with this - I'd almost call it - negligence. Rather on the irresponsible side that it.

I forgot to add numbers of BG levels as everydayupsanddowns suggested. I must admit I need a kick in the backside to not forget to test regularly, so there are gaps (grrrr to myself). But morning tests were usually in the 8 range (which I am of course not all too happy about). After breakfasts were lower when I went to work as opposed to staying home; at work around the 8 range again, at home today was 11.8 (although I may have test 30 minutes early). Before lunch is in the 5ers, after lunch I only have a 8.4 and a 9.9 reading for this month. I have not come round to testing before dinners and before beddie-beddie times yet. So here is to a new year's resolution! 😉 It appears that the routine of having to go to work helped (although colleagues tempted me with cake and what good cake it was *scraping the sugary stuff from the top* 😉). Now that my internship is over I hope I get a regular job soon to go back to a routined every day life.

Apart from that I really try my utmost to do everything right. And we're possibly getting an exercise bike for the cold winter days - yippieh, I miss cycling!

Thank you Copepod and Robster65, I am so looking forward to that. I dont drink alcohol very often and that mullet wine is a little on the sweet side for me (since cutting down sugar my taste buds have become a little more sensitive ironically hahaha). Indeed likely to be colder over there, but cold = burn calories hahaha, so I may actually be ok for a treat of two! 😛

So once again, Happy Christmas to you all, and I hope and pray that next year will be one of better GPs and improved BG results and health for all of us!

All the best - ho ho ho

arale 1402 xxx

 

[everydayupsanddowns]

I forgot to add numbers of BG levels as everydayupsanddowns suggested. I must admit I need a kick in the backside to not forget to test regularly, so there are gaps (grrrr to myself). But morning tests were usually in the 8 range (which I am of course not all too happy about). After breakfasts were lower when I went to work as opposed to staying home; at work around the 8 range again, at home today was 11.8 (although I may have test 30 minutes early). Before lunch is in the 5ers, after lunch I only have a 8.4 and a 9.9 reading for this month. I have not come round to testing before dinners and before beddie-beddie times yet. So here is to a new year's resolution! 😉 It appears that the routine of having to go to work helped (although colleagues tempted me with cake and what good cake it was *scraping the sugary stuff from the top* 😉). Now that my internship is over I hope I get a regular job soon to go back to a routined every day life.

Not sure what others think, but given the slightly moderated carb intake with a few treats thrown in suggested above those numbers seem not half bad. It would be interesting to see what would happen if you really cut down the carbs for a week or two once the Christmas party season is over, particularly in the mornings, just to see what happens.

Have a great Christmas!