If he treats all his patients like he does you I feel sorry for all of them.
He sounds like an idiot. Sorry but geeze….Sounds like your paying him for
nothing. What a jerk. Sorry it just makes me mad that a doctor can have the
attitude he has. Sounds like he doesnt know what hes doing regarding DM.
This is an endo right? Where did he graduate from school of loosers!!!
Sorry Jan Im just mad. How can he be so inept? You mean there is only one
other endo where you live? Are you in a small town or something? Chrissy

Dunno - but endo complains he gets too much info about me from neph.

> Who will make the ultimate medication/treatment decision in case of a
> difference of opinion?

Right now neph makes the final decision about meds - my choice. Endo kind of
leaves all my care up to me. If he Rx’s an anti-biotic I check w/neph and it’s
usually nixed due to kidneys and something else Rx’d. Endo doesn’t ask about
my reg. medication routine, hasn’t asked to see a BG log in ever so long. I
insist they print off my Accu-Chek Complete and the nurse does only 2 weeks
worth! He asked me why I jump around all over the place (laying blame on ME).
I said cuz I haven’t been taught my carb/insulin ratio. He changed subjects.

There is only one other and I don’t care for him. There are 10 internists and
some are issuing pumps. A local CDE told me yesterday she’s getting so bogged
down with pump patients she may have to call any more off. There’s another CDE
with another hospital (who works w/my endo) whom I met once with someone else
and she advised the newbie to cut her basal in half if she tested under 30 for
a half hour. I say we don’t always have the puttogethers to figure that out
when that low. She said the newbie wouldn’t have any *background* insulin if
she cut it off. I said she’d get only 0.2u in the half hour since she runs
0.6u hr. and cutting it in half would be 0.3 and that would mean 0.1 straight
up and 0.1 20 min. later. The CDE argued that the MiniMed pump delivers every
3 minutes. NOT!!!! Don’t think I’d get along with her if I had a CDE.

> It sounds like a good working relationship with your
> nephrologist is a true requirement here.

It seems to be that way now.

> Also, quiz the nursing staff about their pump knowledge/experience.

That could get tricky since even lay people think they *know everything about
DM* cuz their great aunt Myrtle had it and both legs were cut off then she
died. She ate a candy bar once and that’s what did her in. Now, try
questioning a nurse/staff about their knowledge and woohoo! Trouble in DM city
fer shur.

> Sometimes this is more important than the doctor’s knowledge.

I agree. One a.m. (several years ago but same staff) I was over 600 and awful
(not ever told to check ketones - learned that from the ‘net 2 yrs. ago) and
called. I didn’t get a return call until 5:00 p.m. I asked what took so long.
He said if I didn’t know what to do he didn’t know what to do. (Argghhhh!)

I agree - mine only cares about the A1c and the BG at the moment of visit. I
was congratulated for an 8.2 once. That was down from 11-12 but I still should
have been worked with for a more normal control. After 18 yrs. (next mo) I
finally got into the low 6’s and I attribute that to the 17 or so things I
have learned about pumping from the ‘net in the last 2 years! 15 years ago
endo had about 2 dozen pumpers. Now he has about 24. That’s *progress.* (~_^)

In that case I would suggest you check with both the front office and
nursing staff re: the doc’s attitude in consulting with other docs.
Will your nephrologist forward all test results to the new doc? Is
that acceptable (some endos get fussy about where tests are done)?
Who will make the ultimate medication/treatment decision in case of a
difference of opinion? Also check with your nephrologist and see if
he/she recommends any of the endos on the list over any of the
others. It sounds like a good working relationship with your
nephrologist is a true requirement here.

Also, quiz the nursing staff about their pump knowledge/experience.
Sometimes this is more important than the doctor’s knowledge. If the
doc knows his/her stuff and is truly current and professional he/she

will have nursing staff that are informed and understand the ‘lingo’
and special circumstances that come up with pumping. Also if the dr
is unavailable what are the back-ups? His/her nursing staff?
Another doctor in the practice? Are they sufficiently knowledgable?
If the nursing staff is uncomfortable or hesitant discussing pumps,
then I would be hesitant to choose that doctor. Either he/she
doesn’t do much with pumps, or the support staff is not sufficiently
trained for that office. (I’ve learned this the hard way!)

fp