Yesterday I went to see my Endocrinologist for my regular six month checkup. Now this last cycle has been tough for me, trending fasting highs especially has been a contentious issue.

It all started a couple of months back when my Endocrinologist switched my Metformin prescription, Maybe as Karen of the Bitter-Sweet Diabetes Blog aptly put it, I have just been lying to myself and trying to deflect my lax in management but  I swear, I can  trace my precipitous fall to that particular Metformin prescription.

My regular Endocrinologist was not overly concerned when I phoned him about it last month and we formulated a plan of attack to get me back on the horse, Including targeting my fasting sugars, by using wine. I thought we were in good shape until I walked into the endocrinologist and all hell broke loose.(Maybe it was a bad batch or just a different manufacturer but it simply wasn’t working for me.)

I was ushered into the waiting area as usual, and as I was walking in there was this older guy maybe in his late 50′s, I will call Sam (Sam didn’t want me to use his real name). We make eye contact as I walked by and I could see Sam was somewhat distressed but more on Sam later.

I get into the cubicle and the nurse comes in to do the usual checks. Weight 190 (pat in the back, I am 5 pounds lighter than last visit), BP 190/85, so for a moment I was feeling good about myself until she looked at some notes on my chart and goes “Geez I see you had some major problems last time you were here, did someone contact you about these test results?”, Instantly I am sweating bullets coz I think something was seriously wrong and no one bothered to tell me about it.

Curiously I tell her that I had talked to Dr. K but he did not seem concerned about anything, well I will let you talk to the new Endocrinologist when you see her.

Her?? Wait a minute, where is Dr.K ?  Dr. k is no longer at this practice, he moved back to Chicago to Join his Father’s practice she said nonchalantly as she walked away.

Damn he never even said goodbye quipped the heartbroken me. Damn, we had built such a rapport Dr. K and I and suddenly I was reeling from the impact of a jilted one.

The New Endocrinologist walks in and she is Indian, now the only reason I am mentioning her nationality was because  there was definitely a language barrier and a not so subtle bristled bed side manner when we got down to the  gritty.

Endocrinologist:  Hey Ronn how are we doing today? Good did you check your sugars this morning?

Me: Sure I do I check them a couple of times a day

Endocrinologist: What were they?

Me: Sheepishly my fasting was 235

Endocrinologist: Yikes that is very high, do you not have any control of your glucose at all, when was your diagnosis?

Me: 1997 and yes I do have control but lately I have been having a problem which started with this Metformin script I got a few months back and I have been fighting to get back ever since.

Endocrinologist:  Ronn  your sugars are not in control at all

Me: Now wait a minute Doc, I don’t Intend to disagree but this is merely a hiccup not the sky is falling.

Endocrinologist: I don’t know what you are doing but it seems we need to go back to the basics, I am making you an appointment with the dietitian if you need help with your diet.

Me: Doc I have been a diabetic for 13 years now I am pretty sure I know something about what is expected of me.

Endocrinologist: Well from what I am seeing, you are very much non compliant.

Do you know your sugars were 300 last time you were here.

Me: Yes I know I had Dr. K run the test last month to show how infective the Metformin was at the time. He tested me an hour after I took the Metformin that morning and I was still at  that number, so we formulated a plan that seems to be working during the day but I am still having a problem with my fasting sugars, didn’t Dr. K put that in the notes.

Endocrinologist: No Dr. K’s notes are not up to date but his and your idea of control is not adequate, do you know your a1c jumped a % point this time around.

Me: Well doc if you check my history, you will see that this is the only cycle that I have been trending upwards and I am at loss too, my diet has not changed much and I still exercise pretty frequently and its only been about a month since we started working on this plan.

Endocrinologist: Control means all the aspects have to work together if one doesn’t work then nothing will, its been long enough so whatever you and your previous Endocrinologist were doing to adjust obviously is not working.

Me: So what do you suggest we do doctor New expert Endocrinologist

Endocrinologist: I am going to double your Metformin for now and we need to do a follow up in 4 weeks to see how effective that is then we will go from there.

I am just doing my job on your health Ronn so I am not going to sugar coat it and I still want you to see that dietitian.

Me: Sure Doc but my problem is just in the mornings most days it will be back to normal by the end of the day.

Endocrinologist: Ok so how about we start with 500mg Metformin in the morning and  1000mg @ night.

Me: Ok we can do that and I will see you again in 4 weeks.

Endocrinologist: Sure Ronn, I will also need you to take a blood and urine test so hang in the lobby while we set that up.

Me: Thanks Doc

I head to the lobby muttering stupid Endocrinologist, thinks I am an Idiot under my breath.

There is Sam sitting with a Bag of goodies and still has that  puzzled look on his face, I couldn’t help but overhear that you are a diabetic,  he says to me. I have just been diagnosed, do you mind if I ask a you few questions…..

More on Sam’s story tomorrow