Endo Day Twofer

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2012: d was d and kids’ heads were about as wide as their shoulders were broad.

We all liked the boys’ new endo. Impressions: down to earth, smart, patient, good listener, not a showboat, attitude-free. That’s a relief. Also she is from Yale, and seemed to maybe know something about Tab’s experimental drug (or placebo).

Other things:

  1. It was my first time signing in two d-kids at once. Check it out: I’m two-thirds of a Meri or TinaWe went into an exam room together, and did most of the talking portion together, focusing on one boy at a time, and then Tab and I sat in an empty exam room while Bubs got a physical, and then Tab and Bubs traded places while I stared at a bouquet of extremely long (18″?) cotton swabs and wondered what orifice on a human could accommodate such a long swab, and on a casual enough basis that the swabs were not even individually wrapped.
  2. Prior to the appointment, we had postulated that the new endo would say Tab did not need to return to her office until things got worse. She did not say this. But she did use phrases like, “When you get it for real…” and “If it progresses…” (So do you think it might not progress?) “Well, I wouldn’t say that, but we don’t know what the effect of the experimental drug he had will be, so who knows? Maybe if he hadn’t had that drug, he’d have diabetes by now.” Tab likes to be considered to not have diabetes. He liked her phrases.
  3. In the end, only Bubs got lab slips for the annual d-bloodwork. Is there a lab slip for my other son? I asked the receptionist, who hands out the lab slips. She checked with the endo and relayed the response, “Tab doesn’t need labs, only Bubs.”(Shouldn’t Tab at least get labs for celiac/Hashimoto’s, like any other autoimmune-ish person? <—need to ask.)
  4. In the end, both boys are scheduled to return in three months. Why Tab, since he’s not even d-enough to require labs, and we can/do monitor his BG at home? (<—need to ask.)
  5. When we went to TrialNet in August, Tab’s A1c was 6.2. This week at the endo, it was 6.0. Our new endo said diabetes is 6.5+; 6.0-6.4 is a gray area; under 6 is not diabetes. I mean, I think I heard her say that, but can’t believe she might really think that is true, so I must be mistaken. Or TrialNet is mistaken**.
  6. Bubs’s A1c this week was 6.2, which was teensily higher than it has been in recent years, but we are still doing our best. The new endo seems to have the philosophy of emotionless numbers. She did comment that 6.2 is under 7.5, and therefore is meeting The Goal. She also acknowledged that it takes a lot of effort to have a 6.2. But she did not throw glitter or turn on a disco ball, which is basically what our previous endo would do, which, frankly, I loved.

**What is Type 1 diabetes?

TRIALNET: presence of autoantibodies + person has blood glucose of >200 mg/dL on two consecutive oral glucose tolerance tests.

WORKADAY PEDIATRIC ENDOCRINOLOGY: this remains unclear to me

EVERYWHERE ELSE: presence of autoantibodies + person dies without exogenous insulin.

 

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4 responses to “Endo Day Twofer

  1. New endo sounds a bit cold and methodical to me. Not necessarily bad, but very textbook-ish (perhaps this is mandated by insurance regulations?). I had an endo like that once.

    Personally, I don’t want glitter and disco balls and emotion at my doctor appointments. My A1c “revelations” (an odd term, since LabCorp now tells me before I even get to the doctor) are very low-key and non-dramatic (nor is any element of judgment in its delivery) An X.2 and an X.5 are essentially the same to my doctor, unless they’re part of a trend that is followed by X.8, X+1.1… (sorry about the algebra; I just don’t disclose my own A1cs).

    That said, I like how my endo’s thought process works; and this is what concerns me about yours. First visit is a “feeling-out” stage, but beyond that I would ask questions about “do you think…” or “in your experience…” Stuff that isn’t answered in textbooks. That’s where the doctors really get to prove their value beyond their prescription-writing privileges.

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  2. skchrisman

    I read this, and think it must be maddening to be in the strange world of “wait and see”. Relief. Questions. Time. Hope.

    Like

  3. Beeko

    Thank you x a million for continuing to write here about these things.

    Like

  4. Finding a good endo is like finding a good mechanic…it’s great if they know all the parts, but it’s better if they understand how you drive.

    Like

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