Choosing a doctor

First the good news.

I ran out of metformin tablets at my place in a small country town
where I spend two or thee days a week, so I went to the doctor for a
prescription. (I had never been there before, so I took the empty box
with me to show that I had been taking the stuff.)

The doctor is a very old-fashioned country GP who doesn't have a
computer (or even a fax). The regular doc was away and the locum was
of a vintage which suggested that he might have been a contemporary of
Pasteur. Now we all know how family practice doctors don't know
anything about diabetes and testing, so this looked like a situation
where I might even have to explain what Type 2 diabetes is.

Not so. I was very impressed with his question about testing. He
didn't ask "Do you test yourself?", he asked "What was your BG this
morning?". I don't remember saying anything that might have
distinguished me from the haven't-a-clue majority who don't test.
Perhaps he assumed that anyone who took the trouble to go to a strange
doctor for some pills might also be the sort of person who would keep
track of how the pills were working.

Now the bad news.

I heard an interview on the radio with the head of the diabetes
department of a very prestigious hospital. On at least two occasions
she patronised the interviewer, who just happens to be a
fully-qualified medical practitioner as well as being the
most-respected medical journalist in the country. In one of the
putdowns she dismissed his comment about a relationship between
insulin resistance and T2 diabetes and seemed to be saying that both
T1 and T2 are the result of insulin deficiency, with the difference
being the mechanism of destruction of beta cells.

Her other alarming statement was that a reasonable target for HbA1C is
7. She then went on to say that this was quite difficult to achieve
without using insulin.

I'm rather glad that the endocrinologist that I found (who also heads
the diabetes department at a major hospital) seemed to think that my
tests showed no pancreas damage or shortage of insulin but my cells
were rather resistant to using it. He was also quite pleased that I
got my A1C down to 5.6 in three months (diet, exercise, 500mg
metformin BID).

Caveat diabetor.

--
Peter Bowditch aa #2243
The Millenium Project http://www.ratbags.com/rsoles
Australian Council Against Health Fraud http://www.acahf.org.au
Australian Skeptics http://www.skeptics.com.au
To email me use my first name only at ratbags.com

"Peter Bowditch" <myfirstname@ratbags.com> wrote in message
news:094m64dh4qgk3opqa9sadhmcdlbbumhpnf@4ax.com...
> First the good news.
>
> I ran out of metformin tablets at my place in a small country town
> where I spend two or thee days a week, so I went to the doctor for a
> prescription. (I had never been there before, so I took the empty box
> with me to show that I had been taking the stuff.)
>
> The doctor is a very old-fashioned country GP who doesn't have a
> computer (or even a fax). The regular doc was away and the locum was
> of a vintage which suggested that he might have been a contemporary of
> Pasteur. Now we all know how family practice doctors don't know
> anything about diabetes and testing, so this looked like a situation
> where I might even have to explain what Type 2 diabetes is.
>
> Not so. I was very impressed with his question about testing. He
> didn't ask "Do you test yourself?", he asked "What was your BG this
> morning?". I don't remember saying anything that might have
> distinguished me from the haven't-a-clue majority who don't test.
> Perhaps he assumed that anyone who took the trouble to go to a strange
> doctor for some pills might also be the sort of person who would keep
> track of how the pills were working.
>
> Now the bad news.
>
> I heard an interview on the radio with the head of the diabetes
> department of a very prestigious hospital. On at least two occasions
> she patronised the interviewer, who just happens to be a
> fully-qualified medical practitioner as well as being the
> most-respected medical journalist in the country. In one of the
> putdowns she dismissed his comment about a relationship between
> insulin resistance and T2 diabetes and seemed to be saying that both
> T1 and T2 are the result of insulin deficiency, with the difference
> being the mechanism of destruction of beta cells.
>
> Her other alarming statement was that a reasonable target for HbA1C is
> 7. She then went on to say that this was quite difficult to achieve
> without using insulin.
>
> I'm rather glad that the endocrinologist that I found (who also heads
> the diabetes department at a major hospital) seemed to think that my
> tests showed no pancreas damage or shortage of insulin but my cells
> were rather resistant to using it. He was also quite pleased that I
> got my A1C down to 5.6 in three months (diet, exercise, 500mg
> metformin BID).
>
> Caveat diabetor.

Did you know that you can simply take your prescription in to any pharmacy
and they can refill it for you? If there are no refills left, they will
have to call the Dr. I used to do what you did until I found out I could do
otherwise.

"Peter Bowditch" <myfirstname@ratbags.com> wrote in message
news:094m64dh4qgk3opqa9sadhmcdlbbumhpnf@4ax.com...
> First the good news.
>
> I ran out of metformin tablets at my place in a small country town
> where I spend two or thee days a week, so I went to the doctor for a
> prescription. (I had never been there before, so I took the empty box
> with me to show that I had been taking the stuff.)
>
> The doctor is a very old-fashioned country GP who doesn't have a
> computer (or even a fax). The regular doc was away and the locum was
> of a vintage which suggested that he might have been a contemporary of
> Pasteur. Now we all know how family practice doctors don't know
> anything about diabetes and testing, so this looked like a situation
> where I might even have to explain what Type 2 diabetes is.
>
> Not so. I was very impressed with his question about testing. He
> didn't ask "Do you test yourself?", he asked "What was your BG this
> morning?". I don't remember saying anything that might have
> distinguished me from the haven't-a-clue majority who don't test.
> Perhaps he assumed that anyone who took the trouble to go to a strange
> doctor for some pills might also be the sort of person who would keep
> track of how the pills were working.
>
> Now the bad news.
>
> I heard an interview on the radio with the head of the diabetes
> department of a very prestigious hospital. On at least two occasions
> she patronised the interviewer, who just happens to be a
> fully-qualified medical practitioner as well as being the
> most-respected medical journalist in the country. In one of the
> putdowns she dismissed his comment about a relationship between
> insulin resistance and T2 diabetes and seemed to be saying that both
> T1 and T2 are the result of insulin deficiency, with the difference
> being the mechanism of destruction of beta cells.
>
> Her other alarming statement was that a reasonable target for HbA1C is
> 7. She then went on to say that this was quite difficult to achieve
> without using insulin.
>
> I'm rather glad that the endocrinologist that I found (who also heads
> the diabetes department at a major hospital) seemed to think that my
> tests showed no pancreas damage or shortage of insulin but my cells
> were rather resistant to using it. He was also quite pleased that I
> got my A1C down to 5.6 in three months (diet, exercise, 500mg
> metformin BID).
>
> Caveat diabetor.
>
> --
> Peter Bowditch aa #2243
> The Millenium Project http://www.ratbags.com/rsoles
> Australian Council Against Health Fraud http://www.acahf.org.au
> Australian Skeptics http://www.skeptics.com.au
> To email me use my first name only at ratbags.com

In my diabetes "adventures" two doctors come to mind, both GPs. One was a
doctor in a small country resort town I visited for a suspected problem with
a toe. He was a wealth of knowledge on diabetes. It was a pity that he was
alredy in his 70s and would probably not practice much longer. The second
doctor, my current family doctor of choice, is my very much admired Dr
McLean, also a GP. I have often felt that this GP is more up-to-date with
diabetes than all fou of the endocrinologists I have ever seen. Why? Perhaps
it is a "think beyond the wallet" mentality... medicine is to help people,
and all that stuff; perhaps the doctor/s has diabetes himself, or has a
close family member who does.

In your 'bad news' bit I am also amazed how professionals who should know
better have such serious misconceptions of their field of expertise - not
just diabetes. Unfortunately that "7 is good enough" mentality syill
prevails. Maybe that is because the majority of diabetics fail to achieve
even that, and it's no use setting them unachievable goals. I feel that
diabetic medicine in general is geared up to help the poorly managed
diabetic achieve a "reasonable" level of control, rather than help the
thinking diabetic achieve excellent or tight control. This is where groups
such as ASD and MHD come in.

Henry Mydlarz.

Peter Bowditch <myfirstname@ratbags.com> wrote:
> First the good news.
>
> I ran out of metformin tablets at my place in a small country town
> where I spend two or thee days a week, so I went to the doctor for a
> prescription. (I had never been there before, so I took the empty box
> with me to show that I had been taking the stuff.)
>
> The doctor is a very old-fashioned country GP who doesn't have a
> computer (or even a fax). The regular doc was away and the locum was
> of a vintage which suggested that he might have been a contemporary of
> Pasteur. Now we all know how family practice doctors don't know
> anything about diabetes and testing, so this looked like a situation
> where I might even have to explain what Type 2 diabetes is.
>
> Not so. I was very impressed with his question about testing. He
> didn't ask "Do you test yourself?", he asked "What was your BG this
> morning?". I don't remember saying anything that might have
> distinguished me from the haven't-a-clue majority who don't test.
> Perhaps he assumed that anyone who took the trouble to go to a strange
> doctor for some pills might also be the sort of person who would keep
> track of how the pills were working.
>
> Now the bad news.
> [Arrrgh!]

Great news for you, Peter. Some of those old country docs are pretty sharp.
Glad you found one!

--
Nick. Support severely wounded and disabled Veterans and their families!
I've known US vets who served as far back as the Spanish American War.
They are all my heroes! Thank a Veteran and Support Our Troops.
You are not forgotten. Thanks ! ! ~Semper Fi~

So you're all moved now, looking forward to my weekly visit to your site
again soon :-) It's a bugga the move to the country hasn't cured your
Diabetes tho.


(- -)
=m=(_)=m=
RodS T2
Australia


Peter Bowditch wrote:
> First the good news.
>
> I ran out of metformin tablets at my place in a small country town
> where I spend two or thee days a week, so I went to the doctor for a
> prescription. (I had never been there before, so I took the empty box
> with me to show that I had been taking the stuff.)
>
> The doctor is a very old-fashioned country GP who doesn't have a
> computer (or even a fax). The regular doc was away and the locum was
> of a vintage which suggested that he might have been a contemporary of
> Pasteur. Now we all know how family practice doctors don't know
> anything about diabetes and testing, so this looked like a situation
> where I might even have to explain what Type 2 diabetes is.
>
> Not so. I was very impressed with his question about testing. He
> didn't ask "Do you test yourself?", he asked "What was your BG this
> morning?". I don't remember saying anything that might have
> distinguished me from the haven't-a-clue majority who don't test.
> Perhaps he assumed that anyone who took the trouble to go to a strange
> doctor for some pills might also be the sort of person who would keep
> track of how the pills were working.
>
> Now the bad news.
>
> I heard an interview on the radio with the head of the diabetes
> department of a very prestigious hospital. On at least two occasions
> she patronised the interviewer, who just happens to be a
> fully-qualified medical practitioner as well as being the
> most-respected medical journalist in the country. In one of the
> putdowns she dismissed his comment about a relationship between
> insulin resistance and T2 diabetes and seemed to be saying that both
> T1 and T2 are the result of insulin deficiency, with the difference
> being the mechanism of destruction of beta cells.
>
> Her other alarming statement was that a reasonable target for HbA1C is
> 7. She then went on to say that this was quite difficult to achieve
> without using insulin.
>
> I'm rather glad that the endocrinologist that I found (who also heads
> the diabetes department at a major hospital) seemed to think that my
> tests showed no pancreas damage or shortage of insulin but my cells
> were rather resistant to using it. He was also quite pleased that I
> got my A1C down to 5.6 in three months (diet, exercise, 500mg
> metformin BID).
>
> Caveat diabetor.
>

On Tue, 1 Jul 2008 23:27:22 -0700, "Julie Bove"
<juliebove@verizon.net> wrote:

>
>"Peter Bowditch" <myfirstname@ratbags.com> wrote in message
>news:094m64dh4qgk3opqa9sadhmcdlbbumhpnf@4ax.com.. .
>> First the good news.
>>
>> I ran out of metformin tablets at my place in a small country town
>> where I spend two or thee days a week, so I went to the doctor for a
>> prescription. (I had never been there before, so I took the empty box
>> with me to show that I had been taking the stuff.)
>>
>> The doctor is a very old-fashioned country GP who doesn't have a
>> computer (or even a fax). The regular doc was away and the locum was
>> of a vintage which suggested that he might have been a contemporary of
>> Pasteur. Now we all know how family practice doctors don't know
>> anything about diabetes and testing, so this looked like a situation
>> where I might even have to explain what Type 2 diabetes is.
>>
>> Not so. I was very impressed with his question about testing. He
>> didn't ask "Do you test yourself?", he asked "What was your BG this
>> morning?". I don't remember saying anything that might have
>> distinguished me from the haven't-a-clue majority who don't test.
>> Perhaps he assumed that anyone who took the trouble to go to a strange
>> doctor for some pills might also be the sort of person who would keep
>> track of how the pills were working.
>>
>> Now the bad news.
>>
>> I heard an interview on the radio with the head of the diabetes
>> department of a very prestigious hospital. On at least two occasions
>> she patronised the interviewer, who just happens to be a
>> fully-qualified medical practitioner as well as being the
>> most-respected medical journalist in the country. In one of the
>> putdowns she dismissed his comment about a relationship between
>> insulin resistance and T2 diabetes and seemed to be saying that both
>> T1 and T2 are the result of insulin deficiency, with the difference
>> being the mechanism of destruction of beta cells.
>>
>> Her other alarming statement was that a reasonable target for HbA1C is
>> 7. She then went on to say that this was quite difficult to achieve
>> without using insulin.
>>
>> I'm rather glad that the endocrinologist that I found (who also heads
>> the diabetes department at a major hospital) seemed to think that my
>> tests showed no pancreas damage or shortage of insulin but my cells
>> were rather resistant to using it. He was also quite pleased that I
>> got my A1C down to 5.6 in three months (diet, exercise, 500mg
>> metformin BID).
>>
>> Caveat diabetor.
>
>Did you know that you can simply take your prescription in to any pharmacy
>and they can refill it for you? If there are no refills left, they will
>have to call the Dr. I used to do what you did until I found out I could do
>otherwise.
>
Peter is from my part of the world, Julie. Prescriptions are
issued as "once only" or with a specified number of repeats.
When those repeats are used up, a new prescription must be
written by a doctor if more are needed.

My diagnosis actually resulted indirectly from a visit to my
doctor for a repeat prescription for lipitor back in 2002.
He didn't just write the scrip, he did blood tests.

You are correct in one aspect. If Peter had a current
prescription with a repeat available, he could take it to
any Aussie pharmacist.

Cheers, Alan, T2, Australia.
--
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com
http://www.flickr.com/photos/alan_s/
http://loraltravel.blogspot.com (On Indian Roads)

Congrats on finding good doctors in both towns, and not having the
misfortune to meet the so called "fully qualified medical practicioner"
being interviewed. Why is is that so many interviews are granted to the
least informed?

Also, many many congrats on your wonderful A1c!
--
Best regards,
Michelle C., T2
diet & exercise
BMI 21.5

"Peter Bowditch" <myfirstname@ratbags.com> wrote in message
news:094m64dh4qgk3opqa9sadhmcdlbbumhpnf@4ax.com...
> First the good news.
>
> I ran out of metformin tablets at my place in a small country town
> where I spend two or thee days a week, so I went to the doctor for a
> prescription. (I had never been there before, so I took the empty box
> with me to show that I had been taking the stuff.)
>
> The doctor is a very old-fashioned country GP who doesn't have a
> computer (or even a fax). The regular doc was away and the locum was
> of a vintage which suggested that he might have been a contemporary of
> Pasteur. Now we all know how family practice doctors don't know
> anything about diabetes and testing, so this looked like a situation
> where I might even have to explain what Type 2 diabetes is.
>
> Not so. I was very impressed with his question about testing. He
> didn't ask "Do you test yourself?", he asked "What was your BG this
> morning?". I don't remember saying anything that might have
> distinguished me from the haven't-a-clue majority who don't test.
> Perhaps he assumed that anyone who took the trouble to go to a strange
> doctor for some pills might also be the sort of person who would keep
> track of how the pills were working.
>
> Now the bad news.
>
> I heard an interview on the radio with the head of the diabetes
> department of a very prestigious hospital. On at least two occasions
> she patronised the interviewer, who just happens to be a
> fully-qualified medical practitioner as well as being the
> most-respected medical journalist in the country. In one of the
> putdowns she dismissed his comment about a relationship between
> insulin resistance and T2 diabetes and seemed to be saying that both
> T1 and T2 are the result of insulin deficiency, with the difference
> being the mechanism of destruction of beta cells.
>
> Her other alarming statement was that a reasonable target for HbA1C is
> 7. She then went on to say that this was quite difficult to achieve
> without using insulin.
>
> I'm rather glad that the endocrinologist that I found (who also heads
> the diabetes department at a major hospital) seemed to think that my
> tests showed no pancreas damage or shortage of insulin but my cells
> were rather resistant to using it. He was also quite pleased that I
> got my A1C down to 5.6 in three months (diet, exercise, 500mg
> metformin BID).
>
> Caveat diabetor.
>
> --
> Peter Bowditch aa #2243
> The Millenium Project http://www.ratbags.com/rsoles
> Australian Council Against Health Fraud http://www.acahf.org.au
> Australian Skeptics http://www.skeptics.com.au
> To email me use my first name only at ratbags.com

"Nick Cramer" <n_cramerSPAM@pacbell.net> wrote in message
news:20080702034104.613$7b@newsreader.com...
> Peter Bowditch <myfirstname@ratbags.com> wrote:
>> First the good news.
>>
>> I ran out of metformin tablets at my place in a small country town
>> where I spend two or thee days a week, so I went to the doctor for a
>> prescription. (I had never been there before, so I took the empty box
>> with me to show that I had been taking the stuff.)
>>
>> The doctor is a very old-fashioned country GP who doesn't have a
>> computer (or even a fax). The regular doc was away and the locum was
>> of a vintage which suggested that he might have been a contemporary of
>> Pasteur. Now we all know how family practice doctors don't know
>> anything about diabetes and testing, so this looked like a situation
>> where I might even have to explain what Type 2 diabetes is.
>>
>> Not so. I was very impressed with his question about testing. He
>> didn't ask "Do you test yourself?", he asked "What was your BG this
>> morning?". I don't remember saying anything that might have
>> distinguished me from the haven't-a-clue majority who don't test.
>> Perhaps he assumed that anyone who took the trouble to go to a strange
>> doctor for some pills might also be the sort of person who would keep
>> track of how the pills were working.
>>
>> Now the bad news.
>> [Arrrgh!]
>
> Great news for you, Peter. Some of those old country docs are pretty
> sharp.
> Glad you found one!

In my experience as a medical technologist, most of the old country docs
were the best doctors. Why? When they learned medicine, they did not have
9 million medical tests to make the diagnosis for them. They had to
*listen* to their patients, pay attention, and make a diagnosis from what
the patient said and what they could observe. To do these things, they had
to *care*. I worked for an old country doc, and he could almost always nail
a diagnosis without any help from testing. If he ordered a test it was to
*confirm* a suspected diagnosis, not to *make* the diagnosis for him.

I noticed that the newbie docs tended to be less able to communicate with
patients, because they didn't rely on the information provided by the
patient to make the diagnosis. They used a scattergun approach--noted the
basic symptoms, not taking the time to tease out the details, then ordered
every test under the sun in order to make the diagnosis. I know it seems
that basing medical decisions on the science of the testing would seem to
provide better diagnoses and care, but it doesn't. You have doctors as
healers of patients versus doctors as researchers on lab rats. (At least
that's how some of the newbie doctors make me feel.)
--
Best regards,
Michelle C., T2
diet & exercise
BMI 21.5

"Alan S" <loralgtweightandcarbs@gmail.com> wrote in message
news:hltm64le32m0qq9sakmd2bu224vnjgdail@4ax.com...
> On Tue, 1 Jul 2008 23:27:22 -0700, "Julie Bove"
> <juliebove@verizon.net> wrote:
>
>>
>>"Peter Bowditch" <myfirstname@ratbags.com> wrote in message
>>news:094m64dh4qgk3opqa9sadhmcdlbbumhpnf@4ax.com. ..
>>> First the good news.
>>>
>>> I ran out of metformin tablets at my place in a small country town
>>> where I spend two or thee days a week, so I went to the doctor for a
>>> prescription. (I had never been there before, so I took the empty box
>>> with me to show that I had been taking the stuff.)
>>>
>>> The doctor is a very old-fashioned country GP who doesn't have a
>>> computer (or even a fax). The regular doc was away and the locum was
>>> of a vintage which suggested that he might have been a contemporary of
>>> Pasteur. Now we all know how family practice doctors don't know
>>> anything about diabetes and testing, so this looked like a situation
>>> where I might even have to explain what Type 2 diabetes is.
>>>
>>> Not so. I was very impressed with his question about testing. He
>>> didn't ask "Do you test yourself?", he asked "What was your BG this
>>> morning?". I don't remember saying anything that might have
>>> distinguished me from the haven't-a-clue majority who don't test.
>>> Perhaps he assumed that anyone who took the trouble to go to a strange
>>> doctor for some pills might also be the sort of person who would keep
>>> track of how the pills were working.
>>>
>>> Now the bad news.
>>>
>>> I heard an interview on the radio with the head of the diabetes
>>> department of a very prestigious hospital. On at least two occasions
>>> she patronised the interviewer, who just happens to be a
>>> fully-qualified medical practitioner as well as being the
>>> most-respected medical journalist in the country. In one of the
>>> putdowns she dismissed his comment about a relationship between
>>> insulin resistance and T2 diabetes and seemed to be saying that both
>>> T1 and T2 are the result of insulin deficiency, with the difference
>>> being the mechanism of destruction of beta cells.
>>>
>>> Her other alarming statement was that a reasonable target for HbA1C is
>>> 7. She then went on to say that this was quite difficult to achieve
>>> without using insulin.
>>>
>>> I'm rather glad that the endocrinologist that I found (who also heads
>>> the diabetes department at a major hospital) seemed to think that my
>>> tests showed no pancreas damage or shortage of insulin but my cells
>>> were rather resistant to using it. He was also quite pleased that I
>>> got my A1C down to 5.6 in three months (diet, exercise, 500mg
>>> metformin BID).
>>>
>>> Caveat diabetor.
>>
>>Did you know that you can simply take your prescription in to any pharmacy
>>and they can refill it for you? If there are no refills left, they will
>>have to call the Dr. I used to do what you did until I found out I could
>>do
>>otherwise.
>>
> Peter is from my part of the world, Julie. Prescriptions are
> issued as "once only" or with a specified number of repeats.
> When those repeats are used up, a new prescription must be
> written by a doctor if more are needed.
>
> My diagnosis actually resulted indirectly from a visit to my
> doctor for a repeat prescription for lipitor back in 2002.
> He didn't just write the scrip, he did blood tests.
>
> You are correct in one aspect. If Peter had a current
> prescription with a repeat available, he could take it to
> any Aussie pharmacist.

Oh... Here they just call the Dr. and get it refilled.

On Wed, 02 Jul 2008 15:59:21 +1000, Peter Bowditch
<myfirstname@ratbags.com> wrote:

>First the good news.
>
>I ran out of metformin tablets at my place in a small country town
>where I spend two or thee days a week, so I went to the doctor for a
>prescription. (I had never been there before, so I took the empty box
>with me to show that I had been taking the stuff.)
>
>The doctor is a very old-fashioned country GP who doesn't have a
>computer (or even a fax). The regular doc was away and the locum was
>of a vintage which suggested that he might have been a contemporary of
>Pasteur. Now we all know how family practice doctors don't know
>anything about diabetes and testing, so this looked like a situation
>where I might even have to explain what Type 2 diabetes is.
>
>Not so. I was very impressed with his question about testing. He
>didn't ask "Do you test yourself?", he asked "What was your BG this
>morning?". I don't remember saying anything that might have
>distinguished me from the haven't-a-clue majority who don't test.
>Perhaps he assumed that anyone who took the trouble to go to a strange
>doctor for some pills might also be the sort of person who would keep
>track of how the pills were working.

Yes they do exist, the problem is finding them.

>Now the bad news.
>
>I heard an interview on the radio with the head of the diabetes
>department of a very prestigious hospital. On at least two occasions
>she patronised the interviewer, who just happens to be a
>fully-qualified medical practitioner as well as being the
>most-respected medical journalist in the country. In one of the
>putdowns she dismissed his comment about a relationship between
>insulin resistance and T2 diabetes and seemed to be saying that both
>T1 and T2 are the result of insulin deficiency, with the difference
>being the mechanism of destruction of beta cells.
>
>Her other alarming statement was that a reasonable target for HbA1C is
>7. She then went on to say that this was quite difficult to achieve
>without using insulin.
>
>I'm rather glad that the endocrinologist that I found (who also heads
>the diabetes department at a major hospital) seemed to think that my
>tests showed no pancreas damage or shortage of insulin but my cells
>were rather resistant to using it. He was also quite pleased that I
>got my A1C down to 5.6 in three months (diet, exercise, 500mg
>metformin BID).
>
>Caveat diabetor.

Sounds like she needs slapping around a bit.

Maybe she was related to the NURSE I saw post on the ADA board that
there was no relationship between Type 2 and High BP. She also must
have slept through the brief mention of diabetes during her medical
education

<sigh>

The only part of her statement that may have been correct is that
there are a bunch of different diseases called Type 2 with differing
genetic and other factors and to reach an actual diagnostic FBG you
will normally need *both* insulin resistance *and* a defect in insulin
production.

RodS" <fred@fred.com> wrote in message
news:KdGak.16476$IK1.14777@news-server.bigpond.net.au...
> So you're all moved now, looking forward to my weekly visit to your site
> again soon :-) It's a bugga the move to the country hasn't cured your
> Diabetes tho.
>
>
> (- -)
> =m=(_)=m=
> RodS T2
> Australia
>
I reckon a move to the country can be the closest thing you get to a cure!
There's nothing like digging a few dozen (or hundred) post holes to work off
some bg!

The next door neighbour near our land in the bush is a young diabetic -
probably Type 1. Takes insulin, probably knows bugger all about his diabetes
except the basics. Works his guts out all day. I reckon he'll live
forever....

Henry (driving to the block in a couple of hours)

On 7/1/08 11:27 PM, in article g4f74b$rki$1@aioe.org, "Julie Bove"
<juliebove@verizon.net> wrote:

>
> "Peter Bowditch" <myfirstname@ratbags.com> wrote in message
> news:094m64dh4qgk3opqa9sadhmcdlbbumhpnf@4ax.com...
>> First the good news.
>>
>> I ran out of metformin tablets at my place in a small country town
>> where I spend two or thee days a week, so I went to the doctor for a
>> prescription. (I had never been there before, so I took the empty box
>> with me to show that I had been taking the stuff.)
>>
>> The doctor is a very old-fashioned country GP who doesn't have a
>> computer (or even a fax). The regular doc was away and the locum was
>> of a vintage which suggested that he might have been a contemporary of
>> Pasteur. Now we all know how family practice doctors don't know
>> anything about diabetes and testing, so this looked like a situation
>> where I might even have to explain what Type 2 diabetes is.
>>
>> Not so. I was very impressed with his question about testing. He
>> didn't ask "Do you test yourself?", he asked "What was your BG this
>> morning?". I don't remember saying anything that might have
>> distinguished me from the haven't-a-clue majority who don't test.
>> Perhaps he assumed that anyone who took the trouble to go to a strange
>> doctor for some pills might also be the sort of person who would keep
>> track of how the pills were working.
>>
>> Now the bad news.
>>
>> I heard an interview on the radio with the head of the diabetes
>> department of a very prestigious hospital. On at least two occasions
>> she patronised the interviewer, who just happens to be a
>> fully-qualified medical practitioner as well as being the
>> most-respected medical journalist in the country. In one of the
>> putdowns she dismissed his comment about a relationship between
>> insulin resistance and T2 diabetes and seemed to be saying that both
>> T1 and T2 are the result of insulin deficiency, with the difference
>> being the mechanism of destruction of beta cells.
>>
>> Her other alarming statement was that a reasonable target for HbA1C is
>> 7. She then went on to say that this was quite difficult to achieve
>> without using insulin.
>>
>> I'm rather glad that the endocrinologist that I found (who also heads
>> the diabetes department at a major hospital) seemed to think that my
>> tests showed no pancreas damage or shortage of insulin but my cells
>> were rather resistant to using it. He was also quite pleased that I
>> got my A1C down to 5.6 in three months (diet, exercise, 500mg
>> metformin BID).
>>
>> Caveat diabetor.
>
> Did you know that you can simply take your prescription in to any pharmacy
> and they can refill it for you? If there are no refills left, they will
> have to call the Dr. I used to do what you did until I found out I could do
> otherwise.
>
>
Peter lives in Australia. The rules are not necessarily the same there.

--
Martha T2 Canada
1500mg. Metformin, 4mg. Avandia

On Jul 2, 1:59*am, Peter Bowditch <myfirstn...@ratbags.com> wrote:
> First the good news.
>
> I ran out of metformin tablets at my place in a small country town
> where I spend two or thee days a week, so I went to the doctor for a
> prescription. (I had never been there before, so I took the empty box
> with me to show that I had been taking the stuff.)
>
> The doctor is a very old-fashioned country GP who doesn't have a
> computer (or even a fax). The regular doc was away and the locum was
> of a vintage which suggested that he might have been a contemporary of
> Pasteur. Now we all know how family practice doctors don't know
> anything about diabetes and testing, so this looked like a situation
> where I might even have to explain what Type 2 diabetes is.
>
> Not so. I was very impressed with his question about testing. He
> didn't ask "Do you test yourself?", he asked "What was your BG this
> morning?". I don't remember saying anything that might have
> distinguished me from the haven't-a-clue majority who don't test.
> Perhaps he assumed that anyone who took the trouble to go to a strange
> doctor for some pills might also be the sort of person who would keep
> track of how the pills were working.
>
> Now the bad news.
>
> I heard an interview on the radio with the head of the diabetes
> department of a very prestigious hospital. On at least two occasions
> she patronised the interviewer, who just happens to be a
> fully-qualified medical practitioner as well as being the
> most-respected medical journalist in the country. In one of the
> putdowns she dismissed his comment about a relationship between
> insulin resistance and T2 diabetes and seemed to be saying that both
> T1 and T2 are the result of insulin deficiency, with the difference
> being the mechanism of destruction of beta cells.
>
> Her other alarming statement was that a reasonable target for HbA1C is
> 7. She then went on to say that this was quite difficult to achieve
> without using insulin.
>
> I'm rather glad that the endocrinologist that I found (who also heads
> the diabetes department at a major hospital) seemed to think that my
> tests showed no pancreas damage or shortage of insulin but my cells
> were rather resistant to using it. He was also quite pleased that I
> got my A1C down to 5.6 in three months (diet, exercise, 500mg
> metformin BID).
>
> Caveat diabetor.
>
> --
> Peter Bowditch aa #2243
> The Millenium Projecthttp://www.ratbags.com/rsoles
> Australian Council Against Health Fraudhttp://www.acahf.org.au
> Australian Skepticshttp://www.skeptics.com.au
> To email me use my first name only at ratbags.com

your pancreas needs to be inflated...thats all.

"Michelle C" <bookbug_35@yahoo.com> wrote:
> "Nick Cramer" <n_cramerSPAM@pacbell.net> wrote in message
> > Peter Bowditch <myfirstname@ratbags.com> wrote:
> >> [ . . . ]
> In my experience as a medical technologist, most of the old country docs
> were the best doctors. Why? When they learned medicine, they did not
> have 9 million medical tests to make the diagnosis for them. They had to
> *listen* to their patients, pay attention, and make a diagnosis from what
> the patient said and what they could observe. To do these things, they
> had to *care*. I worked for an old country doc, and he could almost
> always nail a diagnosis without any help from testing. If he ordered a
> test it was to *confirm* a suspected diagnosis, not to *make* the
> diagnosis for him.

Yep. Dr. Porcello in the 30's, Dr. Saupaw in the 40's and Dr. Mucelli in
the 50's were like that. They took their time, asked questions and listened
to my Mom and me. My current Diabetician/PCP is that way, too, although he
orders full blood tests to make sure I'm not slipping! Good thing he
doesn't read a.s.d and a.f.d. Same with my Cardiologist and Nephrologist.
I've got a good team.

> I noticed that the newbie docs tended to be less able to communicate with
> patients, because they didn't rely on the information provided by the
> patient to make the diagnosis. They used a scattergun approach--noted
> the basic symptoms, not taking the time to tease out the details, then
> ordered every test under the sun in order to make the diagnosis. I know
> it seems that basing medical decisions on the science of the testing
> would seem to provide better diagnoses and care, but it doesn't. You
> have doctors as healers of patients versus doctors as researchers on lab
> rats. (At least that's how some of the newbie doctors make me feel.)

Ain't that the damned truth!

--
Nick. Support severely wounded and disabled Veterans and their families!
I've known US vets who served as far back as the Spanish American War.
They are all my heroes! Thank a Veteran and Support Our Troops.
You are not forgotten. Thanks ! ! ~Semper Fi~

On Wed, 02 Jul 2008 15:59:21 +1000, Peter Bowditch
<myfirstname@ratbags.com> wrote:

>The doctor is a very old-fashioned country GP who doesn't have a
>computer (or even a fax). The regular doc was away and the locum was
>of a vintage which suggested that he might have been a contemporary of
>Pasteur. Now we all know how family practice doctors don't know
>anything about diabetes and testing, so this looked like a situation
>where I might even have to explain what Type 2 diabetes is.
>
>Not so. I was very impressed with his question about testing. He
>didn't ask "Do you test yourself?", he asked "What was your BG this
>morning?". I don't remember saying anything that might have
>distinguished me from the haven't-a-clue majority who don't test.

Heh - where does he usually practice? Might be worth trailling around
the place!

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.4% BMI 25

Nicky <ukc802466929@btconnect.com> wrote:

>On Wed, 02 Jul 2008 15:59:21 +1000, Peter Bowditch
><myfirstname@ratbags.com> wrote:
>
>>The doctor is a very old-fashioned country GP who doesn't have a
>>computer (or even a fax). The regular doc was away and the locum was
>>of a vintage which suggested that he might have been a contemporary of
>>Pasteur. Now we all know how family practice doctors don't know
>>anything about diabetes and testing, so this looked like a situation
>>where I might even have to explain what Type 2 diabetes is.
>>
>>Not so. I was very impressed with his question about testing. He
>>didn't ask "Do you test yourself?", he asked "What was your BG this
>>morning?". I don't remember saying anything that might have
>>distinguished me from the haven't-a-clue majority who don't test.
>
>Heh - where does he usually practice? Might be worth trailling around
>the place!

http://www.grenfell.org.au/location.htm


--
Peter Bowditch aa #2243
The Millenium Project http://www.ratbags.com/rsoles
Australian Council Against Health Fraud http://www.acahf.org.au
Australian Skeptics http://www.skeptics.com.au
To email me use my first name only at ratbags.com

On Sat, 05 Jul 2008 00:13:23 GMT, Peter Bowditch
<myfirstname@ratbags.com> wrote:

>>Heh - where does he usually practice? Might be worth trailling around
>>the place!
>
>http://www.grenfell.org.au/location.htm

Thanks. I hadn't kept up and was wondering where you went.
Nice region - I went to Primary School in Forest Hill,
outside Wagga.


Cheers, Alan, T2, Australia.
--
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com
http://www.flickr.com/photos/alan_s/
http://loraltravel.blogspot.com (On Indian Roads)