I’d written earlier about going for pre-op for surgery (which has now been cancelled and moved up to January for some reason – so more time for me to dwell on … do I go for it / or not?). At the time the pre-op team didn’t realize I was a Type 1 diabetic for some reason, and red flags went up when I questioned them what to do with my insulin pump regime. Especially for my after care with 3 day hospital stay for recovery. The pre-op doctor had said that they had 2 endocrinologists that understood how to work with patients with pumps. That excited me to no end, as I’ve never had an endo/GP with that knowledge. I’m self taught in most aspects of how I control my diabetes health, by keeping up with latest technology, discussing it with my medical team, and they allow me to self guinea pig myself with what I want to try. I am my own boss behind what I do with my health care for diabetes – but sometimes it can get exhausting – but I refuse to give into burnout from diabetes.
Fast forward, I arrived at the clinic in the Lakeshore Hospital. The diabetic clinic was a small place, with patients waiting (during the time I was there - one guy was glugging water like he was a fish out of water – sprinting to the loo to pee like a horse – sadly the door does not have good sound barrier …. uhhhmmm – diabetic out of control with their ???). I asked the receptionist, out of curiosity sake, if patients were able to share their pump/blood glucose information via Internet to their office (I use Diasend with my Animas pump). I think she was almost embarrassed and a few of the staff members behind her as well, when she said “No”. Oh, Oh, …. I’m thinking to myself … am I wasting my time coming to this clinic? I looked around at various info on walls and in the hand out sections … everything … geared for Type 2 diabetics. Hot flash started due to panic mode at that point. I am ready to run out of the hospital!!
Hour and half later, sweating like a pig due to being dressed for cold weather (and that day we were experiencing unusual high temps of 18C in Montreal – ovey) – I see the endo. She gets down to asking me my history. My saying how long I’d had Type 1 diabetes seemed to floor her and at that point I wish I’d said … I’ve only had diabetes for 15 years, which she had thought I’d said when I’d told her I was coming close to year 50 of diagnosis (I joked about applying for the Joslin award – I was nervous at this point – white coat syndrome as usual).
Then we got to my insulin regime. I told her I was currently on MDI (multiple dose injections) – but planning to go onto pump again on December 1st since I thought I had figured out the right dosage for my basal portion of my insulin regime with Levemir. She seemed puzzled by my not taking the same amount for each meal (I explained it depended on the blood sugar (BG) reading at the time, my I:C ratio, ISF ). I asked her if she understood what TDD meant? A term used in the pumping world for Total Daily Dose … she did – but she didn’t seem that interested.
At this point, I knew I was not seeing an endo with full knowledge of pump experience (as she spoke to me – I slowly undid George Michael’s battery cap, and slunk him iaway for future use). She admitted that not many people use insulin pumps, and that even the largest diabetic centre in Montreal isn’t as well. For my upcoming surgery, she does NOT want me on my insulin pump but to stay on the regime I'm on at present. She wants me on my current regime but RN's will be under my orders … if I am with it … otherwise they will follow the protocol the endo has written out - which scares me .... on the order form she has put down that I take 4 units of NovoRapid for each meal – which I told her could send me into hypo land if a) I had a low blood sugar; or b) I didn’t eat all the food on the tray). Gulp.
This is obviously not the United States of America – where I’ve heard from other insulin pump users going into surgery, sometimes wearing a pump. There are no CDE’s able to help you manage your health … not at least in Quebec where doctors are Gods. No pharmacist or CDE can help assist you in your health regime – so you suffer while you await to see a specialist.
Wait though, there is some good out of this visit. She wants to see me in February, and she is actually going to be testing me for celiac disease, which is common among Type 1 diabetics. I had asked previous doctors for this test, and they’d look at me like I was off my block.
The other thing that was interesting about this so called “pre-op” visit. My feet were examined by her doing a few tests which she says should be done every year for diabetics by a doctor. I have NEVER EVER had my feet examined by a doctor. She was amazed at the sensitivity of my feet, ability to still feel (I joked about not wearing socks with sandals, only as a child with my parents did I have to do that – memories of being made fun of by American kids at a beach in Maine one year will never be erased from my sponge brain). IIf I’d known she was going to do this, I would have washed them. Luckily, she said my feet were in amazing shape …. again the emphasis was due to how long I’d been diabetic. It’s like … what … am I supposed to have dinosaur looking feet or ????
Yes, I’m scared. I want to cancel the surgery even more so now. Time to write a letter to my surgeon. I must stop procrastinating!