We should always do what medical professionals tell us to do…right?
I mean, why wouldn’t we? They’ve gone through many years of extensive training. They’ve got the education and degree(s) to prove their medical expertise. So why would a patient question a doctor or a nurse when they’re telling them to do something that will improve the patient’s health?
Well, a patient might question a medical professional’s advice when it seems contrary to everything else that the patient’s been told by other, trusted members of their healthcare team.
This is exactly what happened to me when I went to see my primary care doctor a few months ago.
Actually, more specifically, I saw a nurse practitioner who works at my primary care doctor’s practice. I made an appointment with the office because I’d been experiencing some wheeziness that made me think I might have asthma that couldn’t reliably be treated with a rescue inhaler (which is all that I had) on its own. I figured it’d be smart to talk it over with my doctor, or at least someone at his practice, to see if I should start treating my symptoms with another kind of medication or therapy.

My appointment barely lasted 20 minutes. I met with a nurse practitioner who I’d never seen before. I explained how I’d been wheezing the last several days, and how it got worse when I went to lie down in bed at night. Before I could get another word out, she asked me if a rescue inhaler was all I had to use in these situations. I said yes. She proceeded to tell me that rescue inhalers aren’t designed for daily use because, as the name implies, they’re for emergency situations. Then she started telling me about a steroid that she thought I should begin to use twice daily.
I cringed at the word “steroid” because I know that they don’t interact well with my blood sugars. Steroids can make blood sugars go high rapidly, and it can take hours for blood sugar to come back down to normal levels. I told her this, and she shrugged off my concerns by telling me that the inhaled steroid would be going directly to my lungs, not my entire body like a typical steroid. I remember nodding uneasily and asking her how to use the steroid – I wasn’t going to leave the room until I had a satisfactory amount of information on this new, unfamiliar drug.
She told me I’d take it once in the morning and once at night, before brushing my teeth. Apparently, I would need to be careful and remember to rinse my mouth out with water immediately after administering the medication in order to prevent…thrush. (If you’re unfamiliar with that word, it has something to do with oral, yeast, and infection…A.K.A. something that sounds like a nightmare.) That’s when I really became alarmed. I told her that people with T1D are already more susceptible to that kind of infection, and wouldn’t it be a bad idea to even risk it by taking this steroid two times a day? And again, she essentially disregarded my protests and told me I’d be fine as long as I remembered to rinse. Then, she sent the prescription to the local pharmacy and left me in the exam room in a confused daze.
I went to pick up the prescription, but I never used it. I decided to trust my judgment and avoid a steroid that seemed like it would cause more harm than good. I also figured that since the weather had abruptly gotten cold, then perhaps my asthma symptoms would subside before long; in the meantime, I could use my rescue inhaler as necessary. And you know what?
I was right. My breathing was normal again in a matter of days, and I only had to take a few puffs from the inhaler when it was all said and done. My decision to take my health in my own hands was further validated when I went to go see my allergist soon after this ordeal. I told her all about it as we ran through the list of medications that I regularly take. She was incredulous that I was prescribed the steroid in the first place, seeing as my asthma is practically non-existent. To quote her, “You’re (meaning me) already sweet enough, you don’t need this steroid or a risk of thrush!”
That remark alone sealed it for me: I did what I thought was best because I knew I was capable of making a decision about my body; nobody knows myself better than me…even a medical professional.
I went through this issue with my now former endocrinologist. She kept blaming my poor control on what I was eating. My diet is not perfect but I saw another issue poking its head out of the sand. My metabolism. I told her when I sit and watch TV my sugars rise and as soon as I get up to do anything they seem to plummet. I expected her to do some sort of test to check it out. She didn’t even bat an eye and for the rest of my time with her, blamed it on me eating too many carbs and not enough fats and proteins. Poor woman didn’t listen to my explanation of why I consume 280 to 340 carbs a day, down from 420 when I started the 670G pump. Because this was not the first time she had brought this up, I had already checked it out. The 150 grams a day is based off a 1200 to 1500 calorie diet. Most days I’m eating 2800 to 3400. Using simple math that means I should be eating at least 300 grams a day to hit the same percentage. To this day I believe my wild swings are linked to apparently massive swings in metabolism. Shortly after starting the Dexcom we had a storm that took down several trees. My aunt had a huge branch come down. I waited until almost noon to get started. Until then, my sugars had been hovering above 300. 1 and 1/2 hours later and I was asking my aunt for cookies to get my sugar level out of the basement. It was down in the 70s. I may be just a patient but I live in my world each and every day. Don’t ignore my ideas simply because I didn’t go to medical school. I see the patterns better having to live with them. Like you I have learned so much over the 42 years of living with this disease.
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