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Walt: Glucose Question MALPRACTICE?

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Walt: Glucose Question

Posted by
Barbara, Larry, and cats [20.1955] on March 31, 2006 at 14:46:49:

Walt,

We just went and got CBC's and a ton of blood work and my question is --Do you have any idea why nobody ever mentions Larry's sugar being a little high. He was 199 when the normal range was 75-110. They called and mentioned the cholesterol and what to do on that, but said all the rest was normal. They mailed us a copy so that's when we noticed. This isn't the first time I've noticed that, in his file in the past, he has always been a little bit above the range. My guess is that it's not high enough for it to matter, yet high? Right?

We couldn't find a holistic doc close so now are with a group in Murray Kentucky and are thrilled. Two of them were at University of Louisv when I was in the hospital there once and I know just about everyone there was wonderful. The Doc we got seems wonderful.
Put Larry on Lisinopril only so far. He seems to take one thing at a time. Said he can come off of it later if he does good. For: BP 200/114 in office before blood test fear and 168/86 resting, & smoking a factor.
As for me, they gave me a new Urologist and he ordered a cat scan and cystoscope scheduled for hematuria (sp?) next Tuesday. I'm scared about the catscan but not the other. On the BP I have 3 months to diet and get mine down, no meds.

Final thought - After all this, I did locate two integrative places in Tennessee. We may end up at Clarksville, Tn, later on or perhaps just for some issues ie. biofeedback only as a guess. The one at Nashville is both conventional and holistic and I think it's a new place, so if you get any requests, I can get the name to you. It sounds great.

All I really wanted to ask though is that sugar question. How are you doing? I guess the archives will tell me that.
Barbara, Larry, and cats





Re: Walt: Glucose Question

Posted by ANN [1003.516] on March 31, 2006 at 18:36:28:

In Reply to: Walt: Glucose Question posted by Barbara, Larry, and cats [20.1955] on March 31, 2006 at 14:46:49:

did he fast before the blood tests?

Follow Ups:


Re: Walt: Glucose Question

Posted by Walt Stoll [93.1889] on April 01, 2006 at 08:09:31:

In Reply to: Walt: Glucose Question posted by Barbara, Larry, and cats [20.1955] on March 31, 2006 at 14:46:49:

Barb,

You would be amazed to learn how sloppy some physicians can be about reading blood test results.

First of all taking blood exactly 2 hours after a measured carbohydrate meal is a LOT more meaningful when screening for diabetes. How was his blood test done?

In this case, the level is high enough to be diagnositic for diabetes--no matter how it was taken. Apparently they are waiting until the bum on the corner can tell he has diabetes!

Walt



Re: Walt: Glucose Question

Posted by
Barbara, Larry, and cats [20.1955] on April 01, 2006 at 10:01:09:

In Reply to: Re: Walt: Glucose Question posted by Walt Stoll [93.1889] on April 01, 2006 at 08:09:31:

Walt,
For this reading last week, they had us fast after midnight and we hadn't eaten until noon the next day. We did it religiously this time, too.

But he was not really checking for sugar - we just requested a CBC because the one that was taken up in Louisville in October was not fasting - we had just eaten - and that office told us later they forgot to tell us to fast. So this was a re-check we requested on our first visit - a new CBC.

You are alerting me to two things - 1) Maybe Larry should call Monday or even today and ask, if Drs. or usual people are there on Saturday. 2) Since there was a lot more bloodwork and physical exam maybe another test showed it was okay. But I know we did not do the long all-day glucose thing I had in 98 at some guy's office once. It was just your routine stuff for a first visit -- and I also had the feeling he didn't want to hit Larry with 40 changes at one time but take the worst first. Just guessing. Thanks!

Someone told me I am always disobeying Doctors like an alcoholic continues to drink. In one sense, I do cheat on diets but not any more. But in another sense, I think of you as our Doctor and we try to obey-it's just that it is harder this way. Oh, and yes I know this board is educational only.


Barbara, Larry, and cats




Re: Walt: Glucose Question

Posted by
Barbara, Larry, and cats [20.1955] on April 01, 2006 at 10:06:01:

In Reply to: Walt: Glucose Question posted by Barbara, Larry, and cats [20.1955] on March 31, 2006 at 14:46:49:

Ann,

Thanks for your ans. Yes, we fasted from midnight religiously - nothing - test was at 11:00 a.m.

What do you think?

No diabetics in my family so I have no experience with that issue - no friends with it I can think of right off the top of my head - this is really the first test that we fasted religiously and I notice the cholesterol was better for both of us even tho not 100%, Larry in 200's not 300's. So...........I think some of our poor results in other years were due to cheating on the fast.

What dummies we can be.

Barbara, Larry, and cats



Re: Walt: Glucose Question

Posted by ANN [1003.516] on April 01, 2006 at 12:31:20:

In Reply to: Re: Walt: Glucose Question posted by Barbara, Larry, and cats [20.1955] on April 01, 2006 at 10:06:01:

Larry appears to have diabetes. In addition to the test Dr Stoll recommends, I'd suggest you ask for an HbA1C test. This shows average blood sugar over the last 3 months, which will give you some idea if the high blood sugars having been going on for a while. Note: the 5 minute office machine HbA1C is really inaccurate- ask for the lab test HbA1C .
If you are interested in a dietary approach to diabetes (assuming it's type 2, which is most likely in overweight older people, but, if he's thin, check the diabetes archives for type 1.5), there are a couple of books you might read. Whole foods style would be Julian Whittaker's Reversing Diabetes. For a low carb approach, see Richard Bernstein's Diabetes Solution. If you are open to macrobiotics, Michio Kushi has a book on diabetes and his wife, Aveline Kushi, I believe, wrote a diabetes cookbook.
At any rate, when you have diabetes questions, post them-I've learned a lot about diabetes over the last 8 years since the first of my kids with it was diagnosed aand Dr Stoll has diabetes (actually living with it is a lot better education than studying it in med school).
Also check out the diabetes archives- lots of good info.



Re: Walt: Glucose Question

Posted by
Barbara, Larry, and cats [15.1955] on April 01, 2006 at 14:23:57:

In Reply to: Re: Walt: Glucose Question posted by ANN [1003.516] on April 01, 2006 at 12:31:20:

Ann,and Walt actually......

Thank you for the good references. I printed out what you said and have errands & meetings today and will get on this Monday. We had kind of decided to try diet without saying anything to the Doctor until our 3 month checkup. We did call the Dr. office today and got a Nurse who **seemed to not really know and said to call back Monday and ask the regular nurse to our Dr. But then today we got a 2nd printout of all tests with Doctor's orders written in there which clearly shows the glucose on the printout (4pages) and instructions saying "Go on low fat diet and return in 3 months.".......So kind of hate to be a pest to call Monday. Especially if diet would work. I might just order the book you suggested. I wonder if Walt thinks calling Monday would be the best. Larry doesn't want to be a pest but I usually am one.
Thanks again.........I might post a new post to you later instead of in this thread!
Barbara, Larry, and cats



Re: Walt: Glucose Question

Posted by ANN [1003.516] on April 01, 2006 at 15:17:32:

In Reply to: Re: Walt: Glucose Question posted by Barbara, Larry, and cats [15.1955] on April 01, 2006 at 14:23:57:

lowfat diet not necessarily best, but emphasize healthy fats. Avoiding smoking super important with diabetes. Explore the stuff in the archives about cholesterol and hearts-the connection isn't as strong as once thought, but any heart or kidney issues Larry has have to be considered and an eye exam is a good idea if he hasn't had one lately.

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Re: Walt: Glucose Question MALPRACTICE? Archive in diabetes.

Posted by Walt Stoll [93.1889] on April 02, 2006 at 06:43:54:

In Reply to: Re: Walt: Glucose Question posted by Barbara, Larry, and cats [20.1955] on April 01, 2006 at 10:01:09:

Thanks, Barb.

In my opinion, this has to be an oversight by the doc. Bloodwork done this way (with the sugar result you have mentioned) is not only diagnostic of frank diabetes but fairly advanced diabetes.

For the doc to say everything is all right is malpractice in my opinion.

At least let him know he missed it and listen to the embarrassed apology you are given.

Let us know what you learn.

Walt



Re: Walt: Glucose Question MALPRACTICE? Archive in diabetes.

Posted by
Barbara, Larry, and cats [20.1955] on April 02, 2006 at 21:56:03:

In Reply to: Re: Walt: Glucose Question MALPRACTICE? Archive in diabetes. posted by Walt Stoll [93.1889] on April 02, 2006 at 06:43:54:

Walt,

Thanks and will do. I bet it was an oversight, then.
I am hugely impressed by this clinic and this guy. I forget when you left Lexington but he got his undergrad. at UK (1991) and maybe you even might know him, yet I think he is too young to have crossed paths and with the word malpractice in the post, I guess I better not use his name right now.

Strikes me as being 100 times smarter than the other guys I've been to. He even was in there with us about an hour when the sheet said 10 minutes. Even did physical exams.

....actually maybe the gal who said call back Monday even noted it someplace to him and if we are lucky maybe they will call us. Looking forward to your expertise (diabetes) on this later on. Sorry I overposted again.
Barbara, Larry, and cats

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Re: Walt:I called today!!!!!!

Posted by
Barbara, Larry, and cats [6.1955] on April 03, 2006 at 23:43:56:

In Reply to: Walt: Glucose Question posted by Barbara, Larry, and cats [20.1955] on March 31, 2006 at 14:46:49:

Walt ~

I called the new Doctor about Larry's 199 sugar reading. The girl said he is religious about reviewing all the bloodwork and she's sure he saw it. Then she explained a bunch of stuff about how he considers the physical exam and other questions he asked Larry (which he was in there 1 hour for both of us).............and urine test was okay. But...she finally said she would go see if lab still had Larry's blood and they would run that test ANN told me about that shows 3 month's sugar average.

Later, she called back and said they ran that test and it came out normal.

Larry returns 1 month for BP re-check on how Ace Inhibitor and lifestyle changes are doing, 3 months on low fat diet recheck.

So---whew! Glad that is over, but still hope to hear how you are doing and hints you have just in case for later on.

Oh, see my catscan post. ...I hate to post so much. I don't think I'm a very good patient. I'm probably going to go in there tomorrow and cancel that catscan and get them mad. Written: Monday night 4/3/06

Barbara, Larry, and cats



Re: Walt:I called today!!!!!!

Posted by Walt Stoll [93.1889] on April 04, 2006 at 08:15:53:

In Reply to: Re: Walt:I called today!!!!!! posted by Barbara, Larry, and cats [6.1955] on April 03, 2006 at 23:43:56:

Barb,

As far as I am concerned this is not over. One reading of 199 is DIAGNOSTIC for diabetes--especially on a fasting specimen! MY guess is that the nurse did not even talk to the doctor about it but just told you that she did.

I would insist upon a 5 hour GTT with appropriate 3 day loading of 400 milligrams of carbohydrate/day for those 3 days (See the diabetes archives for protocol.)

My bet would be that they did not do the long term test either and just told you that they did.

Walt



Re: Walt: Thanks, Tuesday answer

Posted by
Barbara, Larry, and cats [6.1955] on April 04, 2006 at 08:33:05:

In Reply to: Walt: Glucose Question posted by Barbara, Larry, and cats [20.1955] on March 31, 2006 at 14:46:49:

Walt,

Thanks for both answers, I will ans. those sweet people on the catscan issue when I get back tonight.

About the diabetic thing, you could be right about not asking him. I can say this - after 1 hour with him I'm pretty sure he's awfully smart and kind but who knows what could have interrupted him the first time or who might have forgotten to give him all sheets of paper. He had 8 sheets 4 on Larry, 4 on me.

Larry sees him in 3 weeks - I will re-read what you said later today about other tests - Larry could insist on the other tests then, that is, if you do see the Doctor when you go back for recheck on whether the meds are right. I got glowing referrals on the Family Doctor - people who describe him with twinkle in their eye and very emotional. .....Good references on this urologist, too,...but I'm not so sure about whether he is going to be my friend. I don't want stupid detrol or anything unless the tests they do today make me worse.

I don't see how I can call again. I have called with a question every day since we went there. Pretty soon I will be like the lady in the Nursing Home who buzzes the Nurse all day long. Ha ha. Again, will decide later today.

Barbara Larry and cats

Follow Ups:


Re: Walt:I called today!!!!!!

Posted by Mari [2251.1462] on April 04, 2006 at 10:56:46:

In Reply to: Re: Walt:I called today!!!!!! posted by Walt Stoll [93.1889] on April 04, 2006 at 08:15:53:

I'm sure Dr. Stoll is right about them not running any more tests on your husbands lab specimen. No lab is going to keep tubes that long. Also I will bet you did not talk with a "nurse" it was probably a medical assistant who is not a licensed person and as Dr. Stoll said they probably never talked with your doctor.Very dangerous!!



I agree

Posted by ANN [1003.516] on April 05, 2006 at 14:50:36:

In Reply to: Re: Walt:I called today!!!!!! posted by Mari [2251.1462] on April 04, 2006 at 10:56:46:

it's super unlikely they still have Larry's blood to test.

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