November 5, 2014
An Understanding Doctor
Continued from the prior blog. The day Andy had been to the new doctor, his wife did send me an email. It was not a short email either. She said her husband had a blood draw upon arrival and another A1c test. When the doctor saw them, he said I think you know what the diagnosis is. He said you have type 2 diabetes and I don't need any more tests. Your plasma glucose is 189 mg/dl and your A1c is 11.9. With the test from yesterday of 11.8, this would indicate that they are rather accurate.
The doctor then asked both to keep a food log and asked if they had a food scale. Since they did not, he urged them to purchase one from the pharmacist and had a coupon for them. The doctor asked what the wife's occupation was and was surprised when she said that she was a nutritionist. I was surprised as well, but she said she had not practiced for the last five years. Karen (not her real name) said that the doctor said then you will understand when I suggest a low carb, medium to high fat and medium protein food plan for your husband. Karen said I asked if he did not mean low fat and high carb and was told that he knew he didn't stutter and if she could not accept low carb, medium to high fat, then he would send both of them to the university for further education.
Karen said that she understood, but was surprised that a doctor would recommend this. She then said that he recommended avoidance of certain saturated fats, and of course, all trans fats, but most of the rest were on the table. She asked the doctor if he would do some more tests to determine renal problems and other tests for kidney and other weaknesses. She said the doctor now was asking questions and said he would do the tests and he could understand why. He said that he was not prescribing metformin, but would be starting him on insulin for at least 6 months to a year. He said he would be checking his A1c and wanted him to send his meter readings monthly, plus the food logs. For that, he gave them the secure email address.
The wife said she was quite impressed with his knowledge of insulin and the doctor wanted him or her to call if he was having problems adjusting the insulin. She said at anytime was his emphasis. She continued that this was totally different from the doctor they had been seeing. In addition, they were handed a copy of the tests and told to keep a record of them. Included with the reports was a sheet of websites about type 2 diabetes.
In two weeks he will have another battery of tests and the doctor said they would pull another plasma glucose test. Karen said even with the added travel distance, she was changing doctors as well. The doctor they had been seeing was about to retire and the new doctor would not say anything against their doctor, but did admit that there were doctors that had not moved past 1998 changes for diabetes.
The last of the email was from Andy and he said that he was going to have to get used different lifestyles. He said he would need his wife for the nutrition and meal plans. He felt that exercise was one and walking more instead of riding a horse or an all-terrain vehicle. He is happy they have chickens and their own animals for butchering. Karen added that now she will need to learn to make their own sausage and she will not trim as much fat and they will save the fat they do trim for use later. Andy said that the ducks and geese would be good eating too. Then he said maybe not the pet ones. Andy added that one duck is always around when he saddles the horse and raises a fuss if he is not lifted up so he can ride as well. Their wings are clipped to prevent them from flying away.
Andy concluded that he was glad that I had him use the home A1c test the pharmacist had and he would be using the second test in 30 days. He then asked my thoughts on purchasing more of them. For that, I suggested that he read this by David Mendosa and if he felt the cost was reasonable, then he could decide for himself. I also suggested that he read and understand this by David.