FUDiabetes

Feeling misunderstood by my doctor


#1

I just left my eye doctor appointment sobbing from the conversation with the head opthomalogist of the practice. He was trying to push corrective LASIK laser eye surgery and honestly I just wasn’t interested and was under the impression that t1d werent eligible for the surgery, which I told him. He continued on that now t1d are eligible because of all the new fancy technologies. He asked if I had a pump and what my a1c was. I said yes and that my latest was an 8.5 three months ago but I’m hoping at my visit in a few days that it’ll be down around a 7 (which I’m really proud of!) he was appalled - “what? You should have an a1c at a 5 if you’re on a pump” - stated very higher than thou in his white coat. I’m so upset at myself that I gave in and felt the need to defend myself when I am really happy with my progress. I told him “I’ve been working really hard on this and have relearned carb counting and have been establishing all my pump settings”. “O ya? well what’s been your highest number in the past month?” (Again how inappropriate and accusatory, but yet I felt the need to prove myself a good, hardworking patient). “The highest I’ve been since New Year’s Eve is around 190.” He starts looking at my records, “I really don’t think you should fill your prescription for new glasses. The way your diabetes is out of control, your prescription will just need to be changed again in a few months.” (1. I f$@&/:g know, it’s not like I don’t think about this every five minutes throughout each and every day. 2. Isn’t that your job?) I literally break down in tears in front of him and his assistant, which he was surprised at. He goes on to say we all have problems but we just need to face them heads on (trying to be motivational I guess), to which I respond “this problem is one that will never go away and that clearly has a lasting impact on my life. I understand that and this is something that I have dedicated and will continue to dedicate a lot of time and effort into addressing.”

So embarrassing to have broken down like that. And I’m just really upset at how a TRAINED MEDICAL PROFESSIONAL thinks it’s appropriate and productive to go accusing and looking down on patients. Also like f$&k off and let me live my life. I’m working on my diabetes management so obsessively and to have an outsider that doesn’t even specialize in it come and tell me how I should care for myself without any sort of understanding of what I’m doing and trying to achieve. Just so upsetting.


#2

That sucks.
:frowning:

Some people feel the need to pretend expertise where there is none.

I have the most confidence in professionals (of any profession) who are quite clear about their areas of expertise and do not pretend expertise in other areas. Nobody knows everything.

Maybe the dude is a good Ophthalmologist. That doesn’t make him qualified in areas of Endocrinology treatment. Sure the eyes factor in (huge factor - no doubt) but that is a long long way from putting on the actual hat of an Endo MD.


#3

I have cried in front of more doctors than I could count on all of my family members’ fingers and toes. Not all of the tears were embarrassing. Some of them just came from demoralization or fear. But the tears that came from shame… those are unnecessary, and the only shame that should be felt should be that on the doctor’s part. What a ridiculous and lousy stance—- and not a harmless one either. Doctors can really leave a lasting impression, and they know that. So this guy wasn’t trying to be motivational… he was just a jerk. So break up with him and find another.

You’re moving mountains, @LarissaW. Keep going with what you’re doing. Even with enormous progress comes small dips, so what a ridiculous stance for him to take. You are learning control, you are learning management, and you are learning the disease. Take him and all his nonsense and put it away and get back to work.

That’s what I think, at least.


#4

I am so T***d off at your imbecile of an ophtalmologist. He is incapable as a customer-facing professional. And—he does not know anything about what he is saying: an A1c of 5 because you are on a pump… The pissant has no idea what it takes, and how he, himself, would do if he was a T1D.

You don’t need to feel misunderstood: instead, be angry at the windbag! He has no place in front of a patient.

Btw, it is amazing to me that the highest you were since New Year is 190: great job, Larissa!


#5

@LarissaW, I’m so sorry. That’s awful. I’m glad you posted about it here so we can all agree with you that it is completely out of line and inaccurate.

I’ve been told I should not ever mess with LASIK bc of changing prescriptions and T1D. So I’m with you on that one.

You’ve not been above 190? That’s AMAZING! I hope for that one day. But that day’s not today, most likely!! LOL My goalposts might just be different than other FUDders, but oh well. Running my own race and all that.

I had to fire my ophthalmologist b/c she was AWFUL. She was SO RUDE, and out to lunch when it came to anything dealing with humans. I see a really awesome optometrist who takes retina pictures for me every year. I trust her way more than the ophthalmologist. The ophthalmologist got annoyed at me for being worked into her schedule one day for an eye infection. An eye infection! And when I went back for persistent blurry vision, questioning the prescription she settled on for me, she sighed and said, “Ohhhh. You’re just like all of my law students I treat. They are all SO detail oriented it could drive you crazy.”

Yup. Had to fire her. Not awesome to have someone mad at you for being worked into the schedule when you can’t open one eye, it burns, and there’s a weird glob coming out of the center of it.

So sorry, @LarissaW. You’re awesome. You’re doing awesome. Glad you’re here!!!


#6

What an absolute jerk. He has no idea what he’s talking about, made clear by the fact that he thinks all people on a pump should have an A1c of 5. You’d never hear that from a endo, mainly because they have an inkling of how difficult it would be for most T1s to maintain something in the 5s without a lot of lows.

I wouldn’t feel bad about breaking down – hopefully, somewhere way back in his brain, your opthamologist learned a lesson about guilting and threatening his patients. If you have the option I would look for a new one


#7

Right? I’m pretty sure diabetes would be cured then and the multibillion-dollar industry surrounding it wouldn’t exist…


#8

I left the office feeling attacked but crazy for feeling that way so it’s SO nice having validation that I’m not out of line feeling this way.

Amen!! It’s also so individual and i love that FUD gets that… now how can we get the MDs to see it that way.

And regarding your old opthalmaologist: I really just can’t understand why these people went into these professions if working with people is something their incapable of and yet that’s the cornerstone of their daily work???

SoSOSOOO glad to be here! :hugs:


#9

I really hope so too… I almost want to call back to his office and explain why that whole encounter was so fundamentally wrong


#10

Honestly, this doctors outrageous bedside manner not withstanding, trying to talk a Type 1 patient into a Lasik procedure tells you where his priorities lie. Making more money even if it isn’t in the best interest of his patients.

Find thee a new one. I could understand if you had gone to him hoping to get Lasik and he felt ok doing it, but physicians that foist expensive procedures on their patients have no place in my medical care. Especially procedures that carry significant risks.

My personal rule, is don’t have elective procedures until your daily life is worse than the worst common side effect of the procedure. I have seen too many times where the worst side effect hits the last patient in the world you want to see it in.


#11

Was that the cosmetic procedure so you don’t need to wear glasses anymore, or laser surgery for retinopathy?


#12

Lasik - so cosmetic procedure so you don’t need to wear glasses anymore. Sorry wasn’t aware of the other surgery


#13

I’m sorry that happened. There are some terrible doctors out there.

When I was just out of college and having problems with my diabetes, I had a terrible experience with a doctor. I didn’t know what to do and asked him to refer me to an endo. He got mad and threw a book of bcbs doctor’s at me and said “choose a damn doctor.”

Needless to say I fired that a%%hole.


#14

Here is a decent discussion of the realities of the data that your ophthalmologist was basing his decision making on. hint: there isn’t much data to say this a great way to go. It isn’t completely contra-indicated but a diabetic should think long and hard about whether this cosmetic procedure is worth it to them.


#15

bingo. Only leading his private practice to go against 3 of the 4 core values of medical ethics (beneficence, non-maleficence, and patient autonomy)


#16

That’s so terrible :open_mouth: The white coat complex is honestly astonishing

:clap::clap::clap::clap:


#17

There is also the matter of eyes changing as one ages, and whether one wants to put oneself through repeat “enhancement” surgeries, or just buy a pair of glasses and get it over with.


#18

@Chris, Thanks for this!
“However, recent studies on laser in situ keratomileusis in diabetic patients indicate that this procedure may be safe in diabetic patients with very well controlled systemic disease and no ocular manifestations…a very selected group of patients with diabetes.”

  1. “may be safe” --> I’m not going to be the guinea pig of trying this out
    “an analysis of the literature reveals a surprising shortage of clinical studies that demonstrate a potentially damaging effect of these diseases on corneal healing, and most publications are based on single anecdotal reports or small series.” - just not going to be me
  2. I don’t fall into the selective group of patients so don’t try to push me into that group for your monetary benefit alone
  3. I don’t think you should introduce the idea 1st and then check back on my diabetes control and then my presentation of ocular manifestations… not the way to manage patient expectations (if I had wanted the surgery)
  4. “The link between diabetes and surgical site infections is very well established and documented in the literature” - he mentioned no higher risk for me as a patient if I had wanted to opt in with more controlled numbers

#19

He was WAY out of line and I hope he has learned a valuable lesson: treat patients with compassion and respect! You are doing great!


#20

First, ignore your ophthalmologist! find a new one or something! He Failed! But, I did have LASIK in about 2005 when my A1C’s were always in the 8’s. I have always said it was the best money I ever spent! Great job keeping it under 190!