A Hostile Doctor

After my diagnosis, I was lucky in that I was near a teaching hospital which had an endocrinology department. I was getting specialist treatment for my diabetes; the service and advice were good but conventional. Well the advice was good…at first.

My blood control was very good with my insulin injections, so I only needed to see the doctor for check-ups every six months. It was during one of these windows in 2012 when I adopted the paleo diet and no longer needed insulin. I had also stopped taking thyroxine, as I was eating coconut oil to heal my thyroid instead. I got my blood work done and went to my appointment.

I don’t know how that department was organised, but I rarely saw the same doctor twice. This time round, it was another new doctor. She went through my blood work (6.2 mmol/L) and said everything looked good including my thyroid levels.

That’s when I dropped the bombshell: I told her, I’d stopped insulin injections five months prior and thyroxine three months prior.

Her reaction was disbelief, “You need to be on insulin!” She didn’t like this. Was I lying? Crazy?

There wasn’t much she could do though? Tell me to go back on insulin even though I didn’t need it? She told me to come back in six months as usual. Her demeanour: frosty.

So, six months later I came back. My blood had been creeping up a bit. When looking back, it was because I was nowhere near as strict as I am now. I was still a little bit in limbo between the traditional Western diet and paleo. I was probably 85% paleo then. The bad habits I still had from my previous life led to a higher HbA1c.

So what was interesting at my next appointment was that I did have this doctor again. She looked at my blood glucose (7.6) and recommended insulin again. She prescribed me with something she described as a “background” insulin.

Some of you reading this may find this a strange treatment. My pancreas was clearly still functioning on some level. Insulin was not the typical first step here. Metformin was.

On my walk home I decided I wasn’t going to fill the prescription. I ignored her advice.

Fortunately at that time, I was also seeing a diabetes nurse at my local doctor’s office every three months. She was a diabetic herself; I told her about my change in diet and what had happened at the hospital.

Now it was her turn to be surprised. “Insulin? Metformin’s the half-way house for someone in your condition,” she said or words to that effect.

What did she think about my diet? I don’t think she cared. My nurse was a pragmatist and had been living with diabetes herself for thirty odd years. So long as it kept my blood at good levels, and I was feeling fine, keep on it. She wrote me a prescription for metformin and the rest is history. That was six or seven years ago.

Conclusion

I came up against a doctor who was blinded by conventional wisdom and not prepared to entertain anything that went against her world view. Whatever she had memorised from her textbook at medical school was all she needed to know. I believe Carol Dweck would call this a closed mindset. I’m sure the doctor thought she was doing a pleb like me a favour.

In contrast, my nurse was open to the possibility that diabetes affects everyone differently, and that whatever I was doing was working. She was sympathetic and gave me the correct treatment for my situation.

The whole episode made me realise I needed to take more ownership for my disease. I needed to research more about diabetes, paleo, fitness, food, etc.

Looking back, I’m so glad I ignored the doctor and listened to the nurse. My hostile doctor was not helpful.

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