Re: The Dreaded Consultant

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#8690

Dave
Participant

OK, Round 1 done.

After the initial sharp intakes of breath and pointless “what’s your dosage at lunchtime?” type questions we pushed on with what I wanted to get out of the meeting.
There was agreement on shock at lack of ‘complications’ and agreement I would donate about half of my blood for varying tests including Coeliac and Addison’s Disease. I have also moved onto Thyroid treatment after years of being borderline and stubbornly refused to accept the medicine.
I then started diving in with questions on CHO counting and time, insulin active times and effectiveness. At this stage she explained that the DSN and dietician work very closely and the hospital likes to be flexible so I’d see them next. I mentioned a CGM either permanently or borrowing and she indicated this would be possible but I’d need to discuss with the DSN on how to do this (more on this in a bit). Back in 2 months for review.
Moving on to another waiting room and I got in with the DSN. Lovely as usual (I was ‘under her’ (not in THAT way) about 13 years ago before dropping off the system), she had a quick look at the figures but agreed with me that a list of numbers isn’t really helpful apart from seeing that I’m having too many hypos. I did explain that I was playing the HbA1c game a little and trying to average out my occasional highs. We decided that the best course would be to return for a combined meeting with the dietician (I still have hopes for this guy as he’s coming highly recommended so please don’t dismiss his use yet) after a week of tight monitoring: recording everything that touches my lips, gets injected (and where), when I break into a sweat and even if I’m emotional or in a bad mood. We then get back together and try to work out strategies. I know the sample will only be seven days but it’s the type of intense analysis that can only help.
I pushed again on the possibility of CGM and it has initially come back with a shake of the head. Yes, they are provided by the hospital (not the DSN) but only for the pumpers, not the MDIers. The only current option would be a 72hr analysis but I feel this would be relatively meaningless – for any trial it has to match real life and I can’t see how three days can take in a full working week and weekend and give me time to start behaving as normal after the initial excitement. I’m not giving up on this one but feel I need to build my relationship with the DSN first to encourage her to fight my corner against the pen-pushers at the hossie.
When pushing further on carb effects she was pretty honest and said that the dietician knew far more than her, although she did strongly recommend Carbs & Cals: A Visual Guide to Carbohydrate & Calorie Counting for People with Diabetes as a decent purchase. Anyone else read this?
I casually dropped in the question of not having a spare meter and she opened the cupboard and said “Have a route around and take what you want. Most of my clients do.” Tidy! Came out with another Nano for spare and a Novopen 3 Demi for adjusting my basal as single unit changes are proving an issue at the moment.

So, in summary, it’s been a good start and I’m reasonably confident I can get what I need from the people I’ve been dropped on to. I will push for a CGM trial at a later date but at this stage I’m happy a decent start has been made in my continued rehab and I am genuinely (sad I know) excited about finally getting closer to sorting me out.

And in answer to my original question yesterday:
Paper or book with times along the top and dates down the side. A bit of fiddling has produced this from the results I record using a DiabetesDiary app on the JesusPhone so that’s all good.

@tim – I know; I’m always wrong, I’ll stop with the complimenting :-P