Wednesday, April 23, 2008

What Rules??

Overall, I think my CDE appointment went well. I went in there determined to just accept the things I needed, get my questions answered and to try my hardest not to be sensitive. For the most part, I think it worked, but it took just about all I had at times.

First, when I walked in she didn't really know what our "plan" for the appointment was. Last time she told me that she was going to teach me to use dual bolus and wave bolus and I guess some other new pump things, but I didn't really know why she wanted to see me either, to be honest. I figured it was her job to make notes on our follow up visit since she scheduled it for me.

Well, first, I gave her my record sheet (which was given to me at my dietician's appointment) all filled out with what I ate and little notes to remind myself why I had highs, etc. I must admit, I was very proud. Two full weeks of not only checking my blood sugars at least 4 times a day, but it was written down, too!! Talk about being proud of myself. Well, she wasn't very impressed. Apparently she "can't do anything with this!" To be honest, I was taken aback, but she said that it was not on the correct form and she couldn't see patterns, etc. to make any changes. This sheet had a full week on each side and I kept the times around the same place on the sheet, so I could see patterns just fine...but it wasn't on her sheet and therefore it was apparently useless. She didn't even attempt to look at it to see if she could see anything. That's fine if she has a certain sheet to use, but don't get mad at me because I didn't know I HAD to use that one sheet...I used one that someone in the SAME office gave me! But, I just sat there, feeling my heart starting to pick up speed. I was just kind of dumbfounded at her harsh reaction. It isn't even WHAT she is saying, it is HOW she says it to me. Just tell me that I need to use her sheet starting today, don't act like everything I have done for the past few weeks was just worthless.

One problem now is that I don't even attempt to explain because she doesn't listen to what I say, I just end up getting the lecture twice. After she went off on how she can't see any patterns and as she was digging out HER sheet from her drawer, she just kept saying "Am I making any sense to you?? Do you understand what I am saying??" It took all I had not to reply with "Um, yes, I am 26 years old and have had diabetes for 17 of those years, I know that patterns are important; although, I honestly can't see why you can't see them from the sheet I brought, but I will certainly not make that mistake again. Would you like me to now go sit in the naughty girl time-out chair?" So much for feeling proud of myself...

Then, at another time she was asking me about how often I change my sites. I told her every 4 sometimes 5 days. I haven't met any diabetic who actually sticks to the 3 day rule. If you do then way to go! It is apparently very very important, although I have had no problems sticking to my own 5 day rule. After telling her that I do it every 4 or 5 days she just curtly said that I need to change it every 3 days and I need to write it down in my log...then sarcastically something like "For at least a little while you are going to have to start following the rules if we are to make any changes here".

She stepped out of the office for a minute while I gathered my nerve to actually say something in response. So, when she returned I meekly responded that "you say I am not following the rules, but I have not done just about anything for almost 10 years. I came here because I need to relearn the rules. Please tell me what they are so I can follow them." Which is TRUE. I wasn't forced to come in and I am certainly not attempting to be non-complaint (ugh I hate that word). I want to relearn what I need to do! Like the rule that your blood sugar should be over 100 before bed. I had no clue until recently (although it makes TONS of sense!). Those little things that I should know like the back of my hand...I don't and that is why I am here. If I wanted to neglect my health, I promise you that I know how. I know the tricks and I know the gimmicks to pull, and I CERTAINLY would not be going to see a CDE, let alone paying to see one! I want to make sure that I have all of the tools that I need to succeed at this and I am determined to do so. So the rest of the appointment I was just determined to ask the questions I had, get the info I needed for myself, and then just move on.

I could understand the way she treats me if we had a history. We don't! I have seen her three times (one when she interupted my dietician appointment). She has no reason to be so harsh with me. She knows nothing about my struggles in the past except that I am trying to get back on track. Her attitude just is not justified and I just don't understand it. I have not been sarcastic with her, never responded to her and just took what she had and then (sorry to all of you :/) vented about it here.

I have decided that at my next appointment with my doctor I am going to ask that he refer me to someone else. Our personalities obviously just clash and I can see that it isn't going to get better. She just has a condescending attitude toward me and since there was no reason for it from the beginning, I can see it isn't going to change. That's fine. It is important for us to know and realize that we are not going to be compatible with everyone that we meet, and we just have to remember that we can choose to see someone else. She may be wonderful for everyone else, but for me, it just isn't working. That is just how life goes and it isn't personal. Heck, for some reason she might just be dying for me to make that switch, too. Maybe I just remind her of her son's evil girlfriend that she never liked or the neighbor who used to egg her car or something bizarre like that!

I also just want to say that I know how hard CDEs work for us and they are such an important part of our treatment team. The key is finding one that you feel you can trust and get help from. It is ok to search around and find one that fits. Don't let one person get you down and I am determined to not let that happen to me. Keeping in touch with SOMEONE is important, though.

P.S.- I am still VERY proud of my two week record sheet. It might not have been done the way she wanted it, but it is proof of how far I have come! I should frame it and maybe I will :)


Jeff said...

Hi Suzanne. It sounds like the time has come for a new CDE. When the patient sees no point in wasting his or her breath because the CDE isn't listening, the whole thing crashes and burns, and becomes counterproductive.

Good for you for doing the work of logging all your stats. That's a big start. It's never easy, but it'll be that much less difficult once you find a good CDE who will work with you in a cooperative way.

Mandy said...

Hey Suzanne,

I applaud you for your efforts, and your decision to get better control. I'm pretty shocked that any CDE would behave that way, but I'm glad you plan on getting a better one. You should be completely proud of your tracking and logging. I only seem to do it right before my DR's visit, and it usually involves my meter's memory!

I have two CDEs and without them, I really would be lost! They are such an important place to draw information from and they SHOULD be on the supportive side.

BTW - Congratulations on your marriage! I wish you all the best for your future together.

bethydoll said...

You should definitely try and find someone else! That is beyond unacceptable for a person you're supposed to be building a relationship with!

I've had a rough go of it with my new Endo, her being rude and not actually listening to me. I think we're getting a bit better now, (after 2 visits and a couple phone conversations).

Good for you, though! That is so incredibly awesome for you to have done so well in keeping records for two weeks! Keep it up!!!!