Wednesday, February 9, 2011

When doctors tell you bad things...and they are WRONG. A cautionary tale.

I wasn't ever going to tell you this. I was kind of embarrassed. And scared. But I'm going to, because I think there's something to be learned from what happened to me today.

Back in December, I went for a much-needed physical. I hadn't gotten one in about three years. I kept delaying it because it was hard to find the time to go. Mostly, I didn't want to deal with the fact that I need to drop some pounds (the only scales we have at home are the ones on Puppy the Fish). When your kids are 8 and 6, you can't really call it baby weight. It's just plain old pudge. Actually, it's fat, but pudge is a nicer word.

I went to a doctor recommended by several moms in my neighborhood. I almost cancelled the appointment because of December insanity, but I forced myself to go. You know how kids get stickers at the doctors' office? I think they need to come up with incentives for adults to get check-ups. Like maybe a nice wine and cheese bar in the reception area. Or a free iPod at every check-up. Bring it on, health care reform!

The doctor and I talked. We agreed I needed to exercise more (I knew that was coming) and also down more veggies and fruit (I am way too carb-centric). She had a nurse draw blood for tests.

Cut to the Thursday before Christmas Eve. The phone rang at around 7. It was the doctor. "I got your blood test results, and I figured I'd call now while I had the time!" she said. Bah, humbug.

She proceeded to tell me that my blood sugar was 106. "That's a little on the high side," she intoned. "It's usually a sign someone is prediabetic."

Uh-oh.

I asked a rapid-fire bunch of questions: What can you do if you're prediabetic? Change your eating habits and exercise more. But can that head off diabetes? No, she said, "in my experience it can't, maybe for only five percent of patients." What does living with diabetes mean? Regularly checking your blood sugar levels. Maybe insulin injections. We agreed I'd do a follow-up visit in six months.

I came home and immediately hit diabetes.org. I needed to understand more before I told Dave. Most terrifying sentence of all: "Recent research has shown that some long-term damage to the body, especially the heart and ciruclatory system, may already be occurring during prediabetes."

Dave was utterly freaked out. I vowed to reform my ways. Then we went on vacation, not exactly a great time to kick off a better eating regimen. In the last few weeks, though, I've been watching what I down and squeezing in as much walking as I can (the most realistic form of exercise for me right now). And regularly thinking, I'm going to get diabetes.

Today, I called the doctor's office to ask why I hadn't gotten copies of the blood test and the written letter I'd requested about her findings. And suddenly, it occurred to me that I'd better make sure the doctor knew I hadn't been fasting when I took the blood tests. Since nobody had called to tell me to fast before the appointment, I'd figured it wasn't required. Hmmm.

I got the doctor on the phone.

Me: "What we discussed about my being prediabetic has been on my mind a lot. I just wanted to verify that you knew I wasn't fasting when I took the blood test."

Doctor: "Let me check the chart."

Ten second pause.

Doctor: "No, it looks like I didn't know. Your sugar level is normal for someone who wasn't fasting."

WHAT?!!!!

Me, talking very slowly: "OK, just so I'm clear, I'm not showing any signs of diabetes?"

Doctor: "No. That sugar level is normal for someone who wasn't fasting."

She went on to apologize. Someone in her office should have called to tell me to fast. The nurse taking the blood should have asked if I'd fasted. She herself should have questioned me on it.

"I know this is your first time visiting, and I hope you don't get the wrong impression of my office," she said.

!!!!!!!!!!!!!!!!!!!!! And furthermore, !!!!!!!!!!!!!!!!!!!!!

But I was too relieved to get worked up over the mistake. I don't have prediabetes. I do still need to work on the healthier lifestyle thing. Maybe there's some cosmic reason I got this scare.

I'm telling you this because I think it's a reminder to question doctors' findings, whether it concerns you or your child. I'm all over that when it comes to Max. From his first days in the NICU, I have never taken doctors' words for granted. I have asked incessant questions. I have grilled them mercilessly. I have emailed, called, called again, researched things on my own, called yet again.

Clearly, I have to take better charge of my own health. Because I need to be around for my kids for a long, long time.


Photo/istock

26 comments:

  1. Wise advice. Well said. Thank you, Ellen.

    Barbara

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  2. I had gestational diabetes and know I am at risk for developing type 2 diabetes in the future. It scares the crap out of me.

    So, so, so glad you are okay and it was just a mix up!

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  3. So glad to hear that it was all a huge mistake! Do you ever feel like you're living in a big episode of "Three's Company?". Wake up calls come in all shapes and sizes.

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  4. Ellen, this is a great reminder. We are responsible for our health care, but we're often afraid to question. We want to get in and out, not make waves, not think about this when we've got a million other questions zipping through our minds.

    I'm glad you're OK. I hope you start taking good care of you too! You deserve it.

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  5. The doctor really should have verified that you had fasted before lowering that boom on you. That was just sloppy. It's like when they do cholesterol tests; you can eat fresh fruit and veggies six days out of the week, but if you dare go to that work holiday party and foolishly decide to chomp down on a ton of yummy shrimp on the seventh day and forget you have to have your cholesterol tested on the eighth day, they'll be telling you that you "need" one of those cholesterol drugs, when you really don't, if you aren't the type of person to eat fat-larded meat and other animal products hand over fist on a regular basis. The contents of your blood are on a continuum....stuff comes and goes--it's the AVERAGES that count. If you get a test result that seems questionable, it's smart to demand a retest.

    If you're a nervous type and/or hate doctors, you can show up with "high" blood pressure--especially if you're late for the appointment and ran from the parking lot--but if they just let you wait and calm down and take the BP midway through the appointment, instead of taking the BP first thing, they'll find you DON'T have HBP....but then they won't be able to put you on some expensive blood pressure drug, either.

    I really do have a problem with the way some doctors do business--the operative word being BUSINESS. They're in the pockets of the drug companies and get kickbacks for prescribing expensive drugs, often to people who don't really need them. They get bonuses from the drug companies for pushing name brand drugs on people, and a lot of these drugs are poorly vetted by the FDA.

    I think the scummy drug pushers on the street corners are more honest in many cases--they aren't there to pretend to "help" you, they're there to make money and they admit it. When you learn that many doctors are given vacation cruises by these Big Pharma companies for "selling" large amounts of fancy and poorly tested drugs, that's pretty disturbing. And it happens a LOT.

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  6. Good post, second opinions are indeed helpful.

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  7. great post. yes that was a piece of careless work on the part of the doctor. but nice to know you are fine.

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  8. It really is all about the second opinions and getting another test done. Glucose levels are a fairly inexpensive test. Given the rates of diabetes in this country and the potential long-term effects, I'd like to offer that it's reassuring your doctor took the threat seriously rather than just dismiss it. Type II diabetes can often have its impact reduced by diet and exercise, and being proactive about it helps in the long run.

    Is it frustrating to have an inaccurate lab result? Absolutely. But I'd keep going to that doctor. Your description tells me that she's going to be someone who wants to look at preventive care and help you be around for your kids as long as possible.

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  9. That is awesome news! I am sorry you went through such a scare needlessly. But all's well that ends well, right?

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  10. JennieB, me too, so this one hits home.

    I'm actually impressed with the doctor. Many doctors will not admit they were wrong. They would say something like, "Well, why wouldn't you fast? Everyone knows that." or they would insist you were told even if you weren't, because that's procedure.

    So to me, this doctor is a keeper.

    The message, of course, id beyond true.

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  11. I'm so glad you aren't prediabetic. It can be scary when d octors give bad news, but it is so relieving when they are wrong.

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  12. maybe this was God's way of kicking your butt and getting you to *do* what you knew you needed to do...

    that being said, 6 years ago I was working out at the gym and trying to follow weight watchers, and I GAINED weight. One could argue that I was gaining muscle, but generally that would cause you to lose inches, not gain them. I went to my doctor and told her I had gained 20-30 pounds while trying to lose weight, and she did blood tests. The tests came back that I was prediabetic. She gave me roughly 8 weeks to go on a lower carb diet to fix my labs before she resorted to medications. when I went back, not only had I dropped 17 pounds, but I was 4 weeks pregnant.

    all tests since then have been negative, despite my not sticking to the low carb diet.

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  13. A great reminder that we must be informed and ask important questions and NOT assume the doctors know everything about everything. We are our own best advocates (like we have much advocacy left after what we do for our kiddos!).

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  14. I'm surprise you were told that pre-diabetes couldn't usually reverse. I tested pre-diabetic once. Started walking regularly, watched what I ate (better but not perfect) and have been smack in the middle of average for blood sugar since. Still good to find out that you don't have to worry :o)

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  15. What a great reminder. WE are on the ball with our kids and stuff like this, but it is far too easy to let things slide with ourselves.

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  16. So glad to hear the pre-diabetes news was wrong. By the way I put off my own visit to the internist for a long time for similar reasons. Finally went and felt so relieved that all was OK. I started Weight Watchers a few weeks ago (they just revamped their program) and it is going really well. I'm down 6lbs and feeling better already. It is so easy for us to forget how important is to take care of ourselves so that we are here for a long, long time to take care of our kids. Thanks for this reminder.

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  17. Interesing that she thought your level was pre-diabetic. Based on what the ped endo has told me (my 12-year-old DD has pre-diabetes, if not diabetes) that one reading isn't enough to say that. I find it interesting that she didn't follow up with a a1c test (can be done w/ finger prick or draw). This test will give an indication of how your glucose levels have been for the past 3-months.

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  18. cannot tell you how I have learnt through bitter experience not to trust doctors opinions! I know I have a child with sms as every time i walk into an 'experts' office they get notebooks out and start taking notes from me! hey ho!

    so pleased your scare remained that! heres to a healthier 2011 for both of us xxxx

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  19. Gosh! I'm sorry you had to go through that anxiety. But I'm glad to hear the outcome. Good for you for thinking and speaking up!

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  20. Somewhat disturbing but at least the news is good. I think a lot of people expect doctors to be almost godlike, but they make mistakes too, except that their mistakes could be more costly than mistakes made by people in other professions.

    I have had the same thing happen to me, but I knew that I had to fast before my blood test, so I did.

    Try to be healthy anyhow - you have a lot of people who love you and care about you.

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  21. Good thing you checked!

    I was diagnosed with gestational diabetes with my first. They actually put me on meds for it. But, my levels were testing really low(b/c I had to test myself at least 3 times a day), so they told me to go off meds and just be on the diet and test. NEVER got a high reading.

    Changed obs with my next baby b/c we moved. I told him my concerns about gestational diabetes. He looks through my records, sees my test results and said that I NEVER HAD IT.

    Crazy, isn't it? I guess we all make mistakes...but when doctors make them, it can be dangerous!

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  22. I have always been proactive and I ha some limited healthcare experience so I always look things up, get whatever books websites etc.I can find and ask a million questions. Some drs, like my husband's, treat me like an annoying pestand others, like mine and my son's, are happy that I am educated on our health issues and can participate better in finding treatments and discussing options. My best advice (especially having been on both sides of the situation) is don't be afraid to question and ask for clarifications and options, but also don't be rude. It works out much better for both dr and patient if you can politely and actively be involved!

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  23. What a good reminder...I hope you can start taking better care of yourself too! :)

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  24. Thanks, all. I do NOT think this doctor is a keeper. There are certainly other caring doctors I can find. And yes, she admitted her mistake but still. Like Janet said, she did not follow up with any tests. Also, it wasn't just her who erred—her staff, did, too. And as we all know, dealing with competent staff is a key part of doctor visits.

    Another mom in my 'hood read this and emailed today to tell me she's also dealt with mistakes in that office, which is the nail in the coffin.

    KatieB: I thought she was surprisingly pessimistic, too, about reversing prediabetes, because from what I've read diabetes can sometimes be headed off.

    JennieB and StayingAfloat and everyone here: I hope you stay healthy.

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  25. Very well said, thank you for reminding us that even the Doctors can be wrong!

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  26. Ellen, I just have to chime in on this one. I went through the same thing, had pre-diabetes which later turned into Type 2 Diabetes. You know what? It's not the end of the world. There are LOTS worse things that could have happened to me. LOTS! I still do everything I did before, except now I eat much better than I used to, and I pay more attention to my health than I used to. If this happened to you, I know exactly what you would do. You would deal with it. You would be in shock at the beginning because diabetes sounds so scary! but then you'd get over it and move on with your life.

    Paula

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Thanks for sharing!