My diabetescare - 1

No, I didn't forget to put text in the text cloud.
There are no words to cover what happened after my former GP left.

I remember I asked to be part of the application committee to choose the new GP. He smiled.

We got two part time female doctors. Both from another profession in healthcare...using the fast way to become a GP. Meaning that there were omissions in their education.
Well, one can always look things up...especially as a GP, as that means sitting in front of a computer with google all day.

With my former GP I was in the middle of changing my diabetesmedication.
It didn't work properly anymore...as expected after so many years. And as I had severe kidneyproblems and a B12 deficiency (30% of the Metformin users develop such a deficiency) it was only wise to find something else.

In the past I tried about 10 medications that caused too many problems, before I found Avandamet. It was my perfect medication. Until it was discontinued because of a high death risk, involving heartfailure.
I had to go back to Metformin, which was put aside as not suitable by the doctor of internal medicine.
It was like I had to go back to second class/inferior medication. And I had the runs again, one of the most experienced side effects.

Since then I developed heart issues, leading to the diagnosis of DCM (enlarged heart).
My first cardiologist thought the same as I did: would Avandamet have protected me??

So it was back to Metformin until it was decided to try something else.
The first medication was not OK.

The GP wanted to try 1 other pill and after that it would be insulin.

Trajenta/Linagliptine seemed to be working well.
I used it for weeks and thought all problems were solved. Hardly any side effects,  good glucosecontrol.
Then suddenly I started feeling unwell, got muscle aches and other issues.
I thought it was the flu, but it got worse and worse. 
I stopped...
After a few days the symptoms had disappeared.
So I started again... the symptons came back...even more severe.
So I stopped.

I mailed the new GP's.
Covid was in the first wave. No vaccinations, no treatment. And I was told that I wouldn't be admitted to the IC because of all my healthissues. So I tried to live as Covid-distant as possible.

The email-exchange was "strange". They wanted me to stop medication to see if I was diabetic.
I know some people think diabetes 2 can be completely lost... but as I had gained 10 kilo (because I had a serious knee injury that took 2 months of rest and we were restricted in movement because of Covid) I didn't expect the diabetes to be gone.
Apart from that: the diagnosis had been a long process of tests, I had been in the care of the hospital diabetes specialist, and I had tried to stop medication a few times too often, so I objected.

They told me to come to the practice.
I didn't like it at all, but went anyway.
In my bag quite some scientific literature to document my statements.

The disinfectant dispenser was hot because it stood in the sun. No smell of alcohol.
I was the only one in the waitingroom. The GP of the other practice walked past and was clearly amazed that someone was sitting there.
I found a woman who seemed to have run from the farm after waking up too late.
No comb taken with her.

She tried to force me to stop diabetes medication for a week.
I told her the medication would still be in my blood as it takes far more time to completely disappear from the body. "Just for a week, to see if you have diabetes".
She tried to overpower me with her attitude, to intimidate me.
Problem is that in situations like that I unconsciously kind of mirror what the other person does/expresses. So she couldn't get on top of me. Which signalled to me that she was not solving a problem or was working with me, but used her status to make me do what she wanted, without any medical arguments.

I asked her to look at the swollen and painful pancreas.
One of the known side effects of Trajenta is spontaneous pancreas infection.
She refused. "You are not here for that"
(the pain took 6 weeks not to bother me any more).
Instead she offered me a lungvolume test.
"Well, I am certainly not here for that."

She didn't answer why she didn't follow the treatment plans of my former GP.
But she did point out that the target value of the HbA1c was far too low.
It was 52 mmol/l (should be under 53 here)

If she had said that older people can aim at a higher target, I would have told her that I was 65 at the time, not yet 70! (allows for 54-58 range)
She even could have told me that my length of diabetes would give me a higher target. (54-64).

No, she told me that the upper border of normal glucose was the target value. 
"That is?"
6.9
Hmmm...HbA1c is not the same as a normal blood glucose.
And 6.9 is the breaking point of a fasting bloodglucose to point towards a diagnosis for diabetes.

I was indeed talking to someone who didn't know anything about diabetes!!!

There was no need to take the papers out of my bag. She wouldn't understand them.

In the beginning of our conversation she claimed 4 times to have read my complete file.
I was not impressed. First because none does, and second: it takes a lot of time as a lot has happened with me in the medical world. Reading my files would have warned her about my choices in healthcare and my very critical attitude. She would never have even thought to make me do something without having the right medical arguments.
But above all she would have known I have been seen by the diabetes specialist in hospital and she could refer me back without even blinking an eye.
His advice was Avandamet... so in fact he adviced against Metformin...as I tried it before that. (As said before)

I managed to divert the "flow of conversation" to the involved specialist.
"Oh...the specialist was involved? I can ask for a physician consultation"
I had rather gone myself, but on the other hand: he might set her straight on some strange ideas.

It was a she. No diabetesspecialist. Maybe a friend.
A list of medical and non medical facts about me were send, some were omitted.
Send by mail, not through a protected environment.
The GP got a mail back.
Probably never read it or didn't know she had to check medication for contraindications.
I got that mail.
Was furious as I was precribed something contraindicated.
Mailed the GP about it and informed her where to find rules for sending medical mails.
And made clear I didn't trust her at all.

She wanted to talk.... due to Covid and other important issues I never went.

I tried to find another GP, but the doctors within the legal distance either had their practice full, or were not my choice.
I approached one and had a fun contact, but he thought I lived too far away. Which is not the case.

I got check ups from the nephrologist (kidney doctor) and the results were within range.
I kept on taking my medication very accurate.
My glucose meter broke. It was far after due date. But it worked perfect until the end.

End of december: got the flu.
Immediately after: Covid.

Something got very wrong.

I got a new glucose meter this week, because I had the feeling the glucose values were over the roof.
I calibrated it, even after the factory calibration.

Glucose value in the evening: 25.2 mmol/l (should be below 10) !!!!!

I started measuring a socalled day curve and every value was far too high.
Increased the Metformin (even though it's bad for my kidneys): only a mariginal decrease.

I don't have a new GP, so I have to inform the dodgy GP's and just wait what they want to do. (Will do it tomorrow). Of course I expect I will be referred to the specialist in hospital.

One thing is very clear: there is no need to stop taking medication to be sure I have diabetes.

There are several causes for these problems.

• Medication is not working because the pharmacy didn't keep them cool enough.
• The diabetes has worsened over time
  
• Covid has caused this... It's known that it not only causes diabetes, but also can worsen existing diabetes. It might even be the only sign of long Covid.
  

One of the many sites about diabetes and diabetes values:
  >>> here <<<

. . .

About **Syl

Syl: "Life is a chain of challenges. Sometimes the largest challenges are we ourselves. Facing life, facing others and facing yourself requires either a worryless attitude or plain courage. Most of the time it is dealing with judgement. Maybe life is about getting rid of it."