Friday, May 9, 2008

Change of Pace

As I have mentioned previously, I had been seeing a new endocrinologist recently. At first I was excited by this prospect, but my faith in the relationship had been tested along the way to the point where I wasn't sure he was the doctor for me. It took me some time, but I knew from the first meeting that this would be a relationship that, at the very least, would take some work.

At our last meeting I was less than encouraged. Though he put me on Byetta as requested, and supported the decision, there was still this nagging feeling that there wasn't the right mix involved. Here were my warning signs (some of you may relate to these things):
1. He advocated very early on (early in the first appointment) that I should consider weight loss surgery. (WLS)
2. He wanted to see me every 2-3 weeks.
3. After the initial 2-3 weeks when I did not lose weight, I was made to feel as if this were some grave dissapointment.
4. He wasn't as concerned about my lifestyle choices as he was about the pure numbers--weight, insulin levels, glucose levels, etc. Nor did he ever put any effort into discussing the lifestyle choices which would affect those numbers such as food choices, exercise levels, other conditions, etc.
5. He did not seem to take into account my other chronic illnesses in any of our discussions.

Nevertheless, I gave it a good try--even though his office was at least 45 minutes away from work or home for me. I have often had to cancel appointments for this reason. But I thought there weren't many options.

Somehow, I came across another name, a woman no less (which I prefer for several reasons) who was in between home and work. I met with her this morning and she decided to give the Byetta another try (even though it was helping, I had decided to give it a rest until I made a decision about the direction, if any, I wanted to pursue with my IR/PCOS). She also kept me on the 2000 mg of Glumetza. Here are the things that made me feel more comfortable with her and her decisions:
1. She did not mention drastic (and frankly dangerous) measures such as WLS.
2. Although she noted that weight reduction is critical for PCOS, especially if I ever want to conceive, she did not push that as the be-all/end-all.
3. She listened to me and did a thorough background history.
4. She advocated lifestyle changes.
5. She advocated me tracking my blood glucose levels fairly regularly to ensure that I wasn't treading on the line between IR and Type 2 Diabetes.
6. She understood the connection between my weight loss and eventual regain due to other chronic conditions.
7. She made the next appointment 3 months out--time for me to actually make a reasonable difference in my life.

I am optimistic about these changes. More importantly, I am, once again, comfortable with the care I am receiving. The thing is that when you have a chronic illness, you have a greater awareness of the quality of the care you receive. In the same vein, you are in greater need of a greater level of care. If a doctor does not take into consideration all of the conditions that your body has (whether they be illnesses or just facts of your life), then you are going to be boxed into certain failure in the quest to live a better life.

Not only that, but I realized the weight that was lifted off of my shoulders by having a positive experience. Granted, my weight was up from my normal weight and I'm not feeling myself all over, but for the first time in a long time I felt empowered to do something about it, instead of hounded. As opposed to feeling that I can never please my medical professional, I feel like my medical professional is trying to help me please myself.

It's a start, but it's a great feeling.