November 18, 2009

Getting the Most From Your Healthcare Professional with Lisa Huse – 11/17/09

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Welcome to Getting the most from your healthcare professional  with Lisa Huse

JIMBOB48 says to  (09:49):
I AM DOING GOOD KIND OF MAD AT MY INRURANCE BUT I WILL GET OVER THAT

gina says to  (09:49):
Maybe Lisa can help you tonite

JIMBOB48 says to  (09:49):
WE WILL SEE

JIMBOB48 says to  (09:50):
THEY DECIDED THAT ONE OF PERSCRIPTIONS WAS NOT NECESSARY AND WONT COVER IT BECAUSE IT IS NOT A PRFFERED DRUG

Ellen9293 says to  (09:52):
What’s the appeal process?

JIMBOB48 says to  (09:52):
THERE ISNT ONE BECAUSE IT IS NOT A RECOGNISED TREATMENT

landileigh says (09:53):
i’m having a similar problem

landileigh says (09:54):
i went to get my lipitor yesterday and it isn’t in my plan, yet my doctor prescribed it. there is no generic, so i’d have to pay full price.

JIMBOB48 says to  (09:54):
IT WAS FOR SYMALIN WHICH I REALLY LIKED

landileigh says (09:54):
i don’t have $105 to pay for a month for cholesterol pills

landileigh says (09:54):
along with the insulin and all the other things i have to take

JIMBOB48 says to  (09:55):
THERE ARE OTHER STATINS THAT HE COULD HAVE PRESCRIBED THAT DO HAVE GENERICS THOUGH

CharlesNelson says to  (09:55):
i know, but of course, i have to go through a hassle to have a new script

JIMBOB48 says to  (09:55):
SYMALIN IS OVER 300 DOLLARS AMONTH

gina says to  (09:56):
that is crazy
CharlesNelson says to  (09:56):
wow! that’s nuts!

Ellen9293 says to  (09:56):
Your insurance company doesn’t recognize symlin for persons with type 1 diabetes JB?

CharlesNelson says to  (09:56):
Kaiser does

JIMBOB48 says to  (09:57):
IT IS REALLY EXPENSIVE BUT I COULD PAY THE 20% THAT I USED TO BUT NOT THE WHOLE THING

HollyN says to  (09:57):
i’m on Kaiser too

HollyN says to  (09:57):
and they don’t cover strips other than One Touch

JIMBOB48 says to  (09:57):
NOPE

Ellen9293 says to  (09:57):
When did your plan switch?  Even if the doctor writes it’s medically necessary?

JIMBOB48 says to  (09:58):
YES BECAUSE YOU CAN TAKE INSULIN AND THATS WHAT THEY RECOGNIZE

JIMBOB48 says to  (09:59):
THE PLAN CHANGED IN OCTOBER

landileigh says (10:00):
I was lucky when i was doing MDI that Lantus was covered

JIMBOB48 says to  (10:01):
I HAVE GONE THROUGH THIS BEFORE

Ellen9293 says to  (10:01):
I would call the Symlin Reimbursement Hotline https://www.symlin.com//160-reimbursement.aspx

JIMBOB48 says to  (10:02):
NEVER KNEW THERE WAS ONE

Ellen9293 says to  (10:02):
yeppers

JIMBOB48 says to  (10:02):
I WILL CHECK IT OUT

 

Lisa Huse says to  (10:02):
Hello everyone

 

CharlesNelson says to  (10:02):
hello

Ellen9293 says to  (10:03):
Hi Lisa

 

Lisa Huse says to  (10:03):
Thank you for having me

 

JIMBOB48 says to  (10:03):
HOWDY

gina says to  (10:03):
Lisa, since we are a small group right now I think we can keep it as an free flow till we get more people

 

Lisa Huse says to  (10:03):
Sounds good

 

gina says to  (10:03):
How about you tell us a little bit about you

 

Lisa Huse says to  (10:03):
Saw the string above and agree, when in doubt, call the manufacturer.  You never know what programs they may have

 

Lisa Huse says to  (10:04):
I’m one of the Marketing Directors at Roche.  Been there for 11 years.

 

JIMBOB48 says to  (10:04):
I WILL DO THAT

 

Lisa Huse says to  (10:04):
When I started, I didn’t know anyone with diabetes, now I have two in my immediate family.

 

gina says to  (10:04):
are they type 1 or 2?

Lisa Huse says to  (10:05):
My mother is insulin dependent from a lung transplant, grandma is Type 2

 

Lisa Huse says to  (10:05):
You would think in Indianapolis they would have no issues finding an endo, but the wait for my mom was over 6 months.

gina says to  (10:05):
oh wow!

Ellen9293 says to  (10:06):
That’s UNacceptable – sorry to hear it.

JIMBOB48 says to  (10:06):
i DONT SEE AN ACTUAL ENDO

landileigh says (10:06):
I’m insulin dependent after a cholecstectomy and pancreatitis

landileigh says (10:06):
i also have Stage 4 chronic kidney disease

Lisa Huse says to  (10:06):
Heard and interesting fact today that brings to life the precious time with healthcare teams – 8760 hours in a year and the average person with diabetes spends 6 hours or less with their team each year.

 

gina says to  (10:07):
i believe it

Ellen9293 says to  (10:07):
6 hours with their team would be a luxury these days

MikeyB says to  (10:07):
in my doctors office i wait almost 2 hours and see my doc for less than 10 minutes

Lisa Huse says to  (10:07):
How much time would you say you spend?

 

landileigh says (10:08):
I’m very lucky, I have a team as I’m in chronic care.

gina says to  (10:08):
I think waiting for doctors is unacceptable and they need to spend as much time as we need at appointments for the time we wait for them

CharlesNelson says to  (10:08):
if i get 15 minutes with my doctor twice a year, i’m lucky

gina says to  (10:08):
they should allot time for every person

gina says to  (10:08):
min. 30 minutes

JIMBOB48 says to  (10:09):
I DONT LET MY DR LEAVE THE ROOM UNTILL ALL MY QUESTIONS ARE ANSWERED

Lisa Huse says to  (10:09):
Wow, so you have to squeeze everything you can out of that 30 min.

 

gina says to  (10:09):
lisa, how do you think we can get our healthcare team to help us better

gina says to  (10:09):
what suggestions do you have

Lisa Huse says to  (10:10):
Come in with YOUR agenda

 

gina says to  (10:10):
like what should we have on our agenda do you think

kristen25 says to  (10:10):
what if you dont feel like you have a good relationship with your dr but you have been with them for years… still okay to switch or get a second opinion?

Lisa Huse says to  (10:11):
What is stressing you out about your diabetes?  What mystery do you need to unravel about your diabetes?

 

gina says to  (10:11):
kristen that is how i feel right now

Lisa Huse says to  (10:12):
Great question.  I’ll quote an endo I read about a few weeks ago – if your aren’t getting what you need from your team, change.  They have to be a good match for you.

 

gina says to  (10:12):
What if you think you are getting great care but not the BEST would you still switch

kristen25 says to  (10:12):
what about all of the files? are those hard to get to switch?

Ellen9293 says to  (10:12):
I agree with that Lisa, however, there are not enough endos so some people may need to change the dynamic between them and the doctor if they don’t have another option

HollyN says to  (10:12):
I find it hard to make a decision. What kind of meter should I use? What kind of pump should I have? The technology is changing from day to day, and I want to be on top of it.

Lisa Huse says to  (10:13):
When you realize the match is not working and is not acceptable, it is time for a change.  I experienced this with my mom.

 

kristen25 says to  (10:14):
is there a difference between all of the meters? They all look alike to me

Ellen9293 says to  (10:14):
FDA will hopefully be insisting on better accuracy for meters in the future.

sugar butt says to  (10:15):
which is the least painful meter?

gina says to  (10:15):
or i have to turn on moderator mode

sugar butt says to  (10:15):
i’m not diabetic but my dr told me to get a meter

Lisa Huse says to  (10:15):
I certainly recommend the products we make at ACCU-CHEK.  I can walk across the street to see the test strips being made, but you all know I’m biased, right?

 

gina says to  (10:16):
LOL

gina says to  (10:16):
of course

sugar butt says to  (10:16):
i’m too afraid to ‘zing’ myself

Ellen9293 says to  (10:16):
Did your doctor give you a meter SugarButt or a coupon to get one for free and a prescription for strips?

gina says to  (10:16):
the first meter i used was aan accucheck

northfarm says to  (10:16):
Hi –  Sorry I am late

Ellen9293 says to  (10:16):
We had an accucheck (brick) in 1989

gina says to  (10:16):
no problem northfarm

sugar butt says to  (10:16):
one that my insur co would cover

sstrumello says to  (10:16):
Diabetes OC Chippendales Dancers http://bit.ly/3qRSFR

Lisa Huse says to  (10:16):
They were definitely bricks back in the 80s.  Technolgoy has come a long way!

 

sugar butt says to  (10:17):
i live in Canada so i get a lot of medical benefits

gina says to  (10:17):
LISA, are most accucheck meters covered by insurance

sugar butt says to  (10:17):
still insurance will have to cover some

Lisa Huse says to  (10:17):
All ACCU-CHEK meters have the same coverage.  We are covered on over 90% of plans in the US.

 

sugar butt says to  (10:18):
any that will draw less blood than others?

Lisa Huse says to  (10:18):
On the pain topic, lancet device is key there.  Meters don’t really impact pain as much now that blood drop sizes are so small.

 

sstrumello says to  (10:19):
Any ideas on making meters smaller?

Lisa Huse says to  (10:19):
Some require less than others, but not huge differences these days.

 

sugar butt says to  (10:19):
a nurse says she used a commercial type on me that’s why it hurts, is that true?

gina says to  (10:19):
all lancets hurt

Lisa Huse says to  (10:19):
There are single use lancets that they use in healthcare facilities.  Those are much different and do hurt more.

 

Ellen9293 says to  (10:20):
I used a NovaMax lancet device on WDD and still have a bruise – must have hit a bad spot

Lisa Huse says to  (10:20):
The meter size question is an interesting one.  In meter development, the biggest driver of size is often the battery.  Makes it difficult to make them smaller.

 

northfarm says to  (10:21):
I have both an Aviva & One Touch Ultra Link and I am interested if I can co-exist using both. Right now I am mostly using the Aviva.

sstrumello says to  (10:21):
It seems that compared to cell phones, meters are still really large

Lisa Huse says to  (10:22):
Going back to the healtcare professional topic, any comments on what frustrates you most outside of the limited time with HCPs?

 

gina says to  (10:22):
for me personally i feel rushed all of the time

Ellen9293 says to  (10:22):
I remember the Medisense Pen – approximately the size of a standard Bic pen – loved how small and convenient it was

gina says to  (10:22):
hey guys lets stay on topic

sstrumello says to Ellen9293 (10:23):
I had a Medisense Pen, it was sooo great size-wise

Ellen9293 says to  (10:23):
Lisa, I don’t like that doctors judge patients and think everything revolves around the A1c – they forget their patients are human beings

gina says to  (10:23):
agreed.

HollyN says to  (10:23):
I think the AccuChek multiclix is the best lancet device out there. is there any thought on making it smaller?

Lisa Huse says to  (10:24):
Great point – we have a training program that teaches educators all about recognizing those differences.

 

chelsea says to  (10:24):
how offten should  you  change  the  needle think in the  poker  thing  and why

gina says to  (10:24):
what kind of things are teaching them

sugar butt says to  (10:24):
i get enough attention from my dr’s, just need a phycical support group

Lisa Huse says to  (10:25):
We are teaching them different styles, different learning preferences.

 

gina says to  (10:25):
lisa, do you think that when diagnosed that an endo should recommend a pychologist

sugar butt says to  (10:25):
that’s good, lisa

Ellen9293 says to  (10:25):
Do you teach them Motivational Interviewing skills? There’s a terrific book Motivational Interviewing in Health Care – every doctor should read it

Lisa Huse says to  (10:25):
As individuals, we all want to recieve information in different ways.  Some of us are visual learners, others differ.

 

landileigh says (10:26):
do you think that all of these websites (such as Google Health/Microsoft Health Vault) will help your doctor? I have an account, but haven’t really used it

Lisa Huse says to  (10:26):
It is slightly different from motivational interviewing, but it is all about the HCP adopting THEIR style to YOU.

 

sugar butt says to  (10:26):
all D patients should be referred to group therapy, right?

sstrumello says to Lisa Huse (10:26):
Lisa, is there any plans to better integrate Accu-Check meters with Roche/Disetronic Insulin Pumps?

Lisa Huse says to  (10:27):
Until professionals are reimbursed for the websites, I’m not sure how much it will be used, but think everything is moving in that direction.

 

gina says to  (10:27):
personally having my information up on a website like that makes me feel uneasy

Lisa Huse says to  (10:27):
Another great point that we have training around – the emotional side of diabetes.

 

gina says to  (10:28):
lisa, i think that you should teach your healthcare professionals how important that is..

Ellen9293 says to  (10:28):
How receptive are the providers to discussing that aspect of diabetes? Often they are afraid it’ll take up too much time to discuss emotions

gina says to  (10:28):
the better you feel the better your blood sugars are

Lisa Huse says to  (10:28):
We most certainly are working on new pump/meter technology.  Can’t share anything until FDA cleared, but in the works.

 

gina says to  (10:28):
i am a perfect example of that

JIMBOB48 says to  (10:29):
I HAVE OFTEN WONDERED WHY I EVEN HAVE TO GO TO MY DR WHEN ALL THE INFORMATION HE NEEDS IS AVAILABLE TO HIM ON LINE

HollyN says to  (10:29):
I would like doctors to be more knowledgeable about the newest diabetes products. I had to show my doctor a brochure about the pump i wanted (he only ever ordered Minimed). He didn’t know about the Ping or Spirit pumps

Lisa Huse says to  (10:29):
EAch provider is likely different in their receptivity to talking emotions.  However, if it is something you feel you need, you could search for a professional that meets that needs.

 

gina says to  (10:29):
lisa, are your healthcare professionals responding well to the emotional side of diabetes

Ellen9293 says to  (10:29):
Lisa does Roche have online tools for patients to learn how to improve their relationship with their provider?

Lisa Huse says to  (10:30):
They are hungry for information on the emotional side of diabetes.

 

Lisa Huse says to  (10:30):
They talk often to us about the fact that they know the science of diabetes, but don’t know the art of diabetes.

 

gina says to  (10:30):
i think once you are diagnosed you get endo, CDE, pyschologist, nutritionist all in one bundle it would make life much easier

Lisa Huse says to  (10:31):
No, we don’t have a great deal on how to improve the patient/provider relationship right now.  Would you want that available?

 

gina says to  (10:31):
yes!

sugar butt says to  (10:31):
agreed, gina

northfarm says to  (10:31):
My Dr. is on a pump and has been for quite a few years. He is very understanding of diabetes and behavior.

HollyN says to  (10:31):
i think people need a team and the endo should be the head of it

gina says to  (10:31):
Lisa, i think all doctors should wear a pump for a month to see what its like to have diabetes

HollyN says to  (10:31):
my CDE/Chronic care manager is on a Ping pump just like me

JIMBOB48 says to  (10:31):
YES

Ellen9293 says to  (10:31):
I think it’s key because on many plans people only have the option to see one or two endocrinologists and don’t always have the ability to change doctors – so changing the dynamic in order to receive the

care one needs is vital.

gina says to  (10:31):
and do everything they tell us to do

Lisa Huse says to  (10:31):
Do you feel like you are the head of the team or your endo?
PowerPumper !

 

northfarm says to  (10:32):
I am the head of my team

gina says to  (10:32):
Sometimes i feel like i am in control other times them

JIMBOB48 says to  (10:32):
I AM THE HEAD

gina says to  (10:32):
right now i feel i am in control

PowerPumper says to  (10:32):
I’m BOSS!

Ellen9293 says to  (10:33):
I think it should be a mutually respectful team effort

Lisa Huse says to  (10:33):
I was ready a post by Dr. Fran Cogen.  One of her recommendations for the patient/provider relationship is to speak up.

 

Lisa Huse says to  (10:33):
If you don’t feel you are getting what you need, be assertive and say so, she says.

 

gina says to  (10:33):
I think most people are afraid to speak up

northfarm says to  (10:33):
we share and don’t have a true leader. But I am the final say and thet agree

Lisa Huse says to  (10:33):
Agree, why is that?

 

gina says to  (10:34):
because when you think of a doctor you think they know what is best

gina says to  (10:34):
for your health

gina says to  (10:34):
but that isnt always the case

Lisa Huse says to  (10:34):
Especially in diabetes

 

Ellen9293 says to  (10:34):
It’s also important to ask a dcotor to explain things in lay terminology if they are using medical terms the patient does not understand.  Asking is a strength.

sugar butt says to  (10:34):
i don’t do everything my dietician tells me to do because i have a mind of my own and i can’t remember everything she says

gina says to  (10:34):
sugar you can ask her to write it down for you

gina says to  (10:34):
mine does

landileigh says (10:35):
sometimes it is good to have someone come in with you to your appts. to take notes

sugar butt says to  (10:35):
i should be more specific, yes

gina says to  (10:35):
sugar didnt you say before you didnt have diabetes

Lisa Huse says to  (10:35):
Does anyone bring a list in to your appointment about what you want to cover?  What questions you have?

 

gina says to  (10:35):
never!

landileigh says (10:35):
I do!

sugar butt says to  (10:35):
her meal portion sizes are miniscule for things like potato salad

gina says to  (10:35):
my list is in my head lol

PowerPumper says to  (10:35):
I come in with a few written questions

northfarm says to  (10:35):
No but I know I should

JIMBOB48 says to  (10:35):
FOR YEARS I TOLD DRS THAT SOMETHING ELSE WAS WRONG AND ALL THEY TOLD ME WAS IT WAS MY DIABETES NOT BEING CONTROLED THEN I WAS FINALY DIAGNOSED WITH ADDISONS

HollyN says to  (10:36):
i do also

sugar butt says to  (10:36):
i have to keep my bs normal

PowerPumper says to  (10:36):
my potatoe salad size is zero grams 😉

CharlesNelson says to  (10:36):
i’ve never thought of writing it down

sstrumello says to Lisa Huse (10:36):
I usually have a long list of things I bring to my endo; he dreads it because there isn’t always enough time to cover everthing in 15 minutes

Ellen9293 says to  (10:36):
As a mother of a child with diabetes, I always brought in questions, and I used paper and pencil while the doctor was talking so I didn’t have to interrupt while she was explaining something – jotted down words to ask the next question

PowerPumper says to  (10:36):
prioritize your list

landileigh says (10:36):
I bet you do scott!

gina says to  (10:36):
ellen you are not normal LOL

gina says to  (10:36):
lmao

Lisa Huse says to  (10:36):
If a doctor sees you have an actual list and have taken the time to take note, do you think they might slow down and let you guide the discussion?

 

gina says to  (10:37):
i dont know

Ellen9293 says to  (10:37):
I bet Scott’s doctor looks forward to seeing him – Scott is smart – keeps the doc on his toes.

gina says to  (10:37):
mine probably would

HollyN says to  (10:37):
the beauty of the kaiser system is you can always ask a question via email of your doctor, and when they get the email through their web system it also shows your medical history so they know who you are

PowerPumper says to  (10:38):
we never follow my list. He usually picks out something he doesn’t like and focusses on that. lately it’s been my LDLs

gina says to  (10:38):
lisa, i used to be really good until my doctor told me i was giving him too much information at my appts. how would you handle that?

Lisa Huse says to  (10:38):
Like I said, I don’t have diabetes, but I do this with my pediatrician.  She does let’s me go through every question and goes through as I take notes.

 

landileigh says (10:38):
my endo is always talking about my weight

Ellen9293 says to  (10:39):
Landileigh, in an empowering way or disparaging? What do you need from your endo with respect to your weight?  What do you want the endo to know?

sugar butt says to  (10:39):
gina, what if you list your questions and concerns and let him read through it?

Lisa Huse says to  (10:39):
What about challenging your doctor with a question.  If this is too much information, what is the right amount of information?  Possibly come to an agreement?

 

gina says to  (10:40):
i will do that next time

JIMBOB48 says to  (10:40):
WHY DO DRS ALWAYS BLAME DIABETRES WHEN YOU DONT FEEL GOOD

gina says to  (10:40):
see how that works

PowerPumper says to  (10:40):
or disagreement. We agreed to disagree last visit. He wanted me back on statins and I wanted a full year of low-carbing first. Round 2 is not far off

landileigh says (10:41):
i think it is very disparaging. he makes me feel not worthy and that i get the “you need to exercise” speech every time

Lisa Huse says to  (10:41):
I’m not sure why Drs always blame diabetes.  Stumped by that one.

 

gina says to  (10:41):
lisa, do you train your doctors on how to talk to patients as well.  some doctors have 0 bedside manner

Lisa Huse says to  (10:41):
That is an example of what we’re working to teach some HCPs.  Saying “just exercise” is not motivating.

 

Ellen9293 says to  (10:41):
Landileigh, that sounds hurtful.

sugar butt says to  (10:42):
without D anyone can feel lousy sometimes

sstrumello says to Lisa Huse (10:42):
What are the biggest challenges for a company like Roche in trying to market to doctors/endocrinologists?

Lisa Huse says to  (10:42):
Just like you, it is getting time with them.

 

landileigh says (10:42):
i have started using my GP more, as he has been my doc for 20 years and is watching all of the different doctors i have

JIMBOB48 says to  (10:42):
I ALMOST DIED BECAUSE OF THAT

Lisa Huse says to  (10:43):
We are focused right now on helping nurses learn better how to talk to patietns more than doctors. Nurses tend to have more time to spend with patients.

 

gina says to  (10:43):
are you training just endos or CDE’s and nutritionists as well?

gina says to  (10:43):
some nutritionists can be worse than doctors

Lisa Huse says to  (10:43):
Most of our efforts are againts Diabetes Educators, Nurse Practitioners, dietitians.

 

sugar butt says to  (10:44):
my dietician is good, she must be exceptional

CharlesNelson says to  (10:44):
you’re very lucky sugar

Lisa Huse says to  (10:44):
Do you spend much time with the nurses/educators in the offices you visit?

 

landileigh says (10:45):
my CDE/chronic care is who i spend the most time with

sugar butt says to  (10:45):
not lately, haven’t had a visit for a while

sugar butt says to  (10:45):
too lazy

northfarm says to  (10:45):
Do you have any opportunity to train RN Nursing students during their Clinical Education

Lisa Huse says to  (10:45):
Many educators we come across have diabetes themselves.

 

gina says to  (10:46):
i spend the most time with CDE

gina says to  (10:46):
my cde daughter has diabetes

Lisa Huse says to  (10:46):
Not in nursing school.  That curriculum is pretty much locked down so we have to get them after graduation.

 

gina says to  (10:46):
do you train them in diabetes and pregnancy

gina says to  (10:47):
i worded that wrong. Diabetic pregnancy

Lisa Huse says to  (10:47):
No, not specifically, but we have supported some specialists to speak on this topic.

 

gina says to  (10:47):
i think that there is a lack of information in this topic at endo offices

gina says to  (10:48):
especially since this is the next phase of my life

Lisa Huse says to  (10:48):
The endos I have come across who specialize in Diabetic pregnancy are some of the most passionate I’ve ever met.

 

PowerPumper says to  (10:48):
education being locked down is a big problem with all HC professionals IMHO. Things change too fast. None of my care providers ever heard of basal testing, and all but my endo are vehimently opposed to low-carbing. Very frustrating when a dietitian tells y

PowerPumper says to  (10:48):
you to eat sugar

gina says to  (10:48):
i think that endo offices need better resources to give women

gina says to  (10:49):
we have so many things to deal with

sugar butt says to  (10:49):
eat sugar, seriously?

gina says to  (10:49):
menstrual cycles, pregnancy, menopause, diabulimia

PowerPumper says to  (10:49):
pasta & flour = sugar in my world

Ellen9293 says to  (10:49):
Are they saying it’s ok to eat sugar (because it is) or that you should eat sugar and they are not hearing what you are saying?

sugar butt says to  (10:49):
yes powerpumper

sugar butt says to  (10:50):
how about milk chocolate for a low?

PowerPumper says to  (10:50):
i eat 50-80g of carbs a day and I’ve never felt better. But everyone in white coats says I’m wrong.

gina says to  (10:50):
power pumper you ever hear of YMMV

PowerPumper says to  (10:51):
i coined teh term 😉

gina says to  (10:51):
there you go

Ellen9293 says to  (10:51):
Are they concerned you aren’t getting sufficient nutrients? How are they coming to the conclusion you are “wrong”?

Lisa Huse says to  (10:51):
Kelly Kunik of diabetesaliciouness.blogspot.com wrote a Dear Healthcare Professional letter.  It’s great if you have not seen it.

 

gina says to  (10:51):
i will find it to link it here

northfarm says to  (10:52):
Smarties are CHEAP and pure carbs for a low quick fix

Lisa Huse says to  (10:52):
She says, “whey you tell me what I should do without explaining the reasons why, don’t be shocked or angry when I have questions….”

 

Lisa Huse says to  (10:52):
We are often afraid to ask health professionals WHY.  A very important question.

 

gina says to  (10:53):
you are so right

diabeticizme says to landileigh (10:53):
when need to be VIP (very informed patients) if we don’t ask and stand up for ourselves no one else will

gina says to  (10:53):
i never ask why?

PowerPumper says to  (10:53):
I need to know why.

gina says to  (10:54):
why do healthcare pros get angry

gina says to  (10:54):
its so annoying

Lisa Huse says to  (10:54):
Another thing we try to cover in training – explain why.

 

gina says to  (10:54):
i hate when they act like i am bothering them

Lisa Huse says to  (10:55):
Goes back to that trust and match. It is hard, but if you don’t jive, may be a time to voice the frustration or find someone else.

 

gina says to  (10:55):
Kelly Kunik’s blog: http://diabetesaliciousness.blogspot.com/search/label/Dear%20Diabetes

JIMBOB48 says to  (10:56):
I INTERVIEW MY DRS BEFORE I MAKE A SECOND APPOINTMENT

gina says to  (10:56):
thats interesting

Lisa Huse says to  (10:56):
How do you do it?

 

gina says to  (10:56):
what we dont realize is we can fire them they work for us, we dont work for them

landileigh says (10:57):
i tried that… and the other endo was worse, went back to the first one

sugar butt says to  (10:57):
wow, jimbob

Lisa Huse says to  (10:57):
We fired my mom’s pulmonologist.  If we hadn’t, she never would have been put on the transplant list.

 

JIMBOB48 says to  (10:57):
I WASNT  TO KNOW HOW THEY TREAT AND WHAT THEY EXPECT I ALSO TELL THEM WHAT I EXPECT AND WHAT I RESND TO

gina says to  (10:57):
ha

gina says to  (10:57):
thats awesome

Lisa Huse says to  (10:58):
What else would you want your healthcare team to do, besides give you more time?

 

gina says to  (10:58):
lisa, K2 is Kelly Kunik

k2 says to  (10:58):
Guilty

gina says to  (10:58):
Lisa, just quoted you

Lisa Huse says to  (10:59):
Kelly, I just quoted you!!

 

sstrumello says to  (10:59):
K2 is guilty!!  LOL

gina says to  (10:59):
http://diabetesaliciousness.blogspot.com/search/label/Dear%20Diabetes

JIMBOB48 says to  (10:59):
ACT LIKE THEY UNDERSTAND

k2 says to  (10:59):
Oh boy!

k2 says to  (10:59):
COOL

Lisa Huse says to  (10:59):
Your dear HCP letter was empowering and covers a lot of what we talked about tonight.

 

gina says to  (11:00):
instead of treating us like bad diabetics treat us as though we are people living with a chronic illness people that need help not talked down to

k2 says to  (11:00):
I’m glad to hear that and Im sorry I missed most of the chat

gina says to  (11:00):
there will be a t ranscript for people that missed it

k2 says to  (11:00):
great

Ellen9293 says to  (11:00):
I would want the healthcare team to order tests that I want run, if I can justify why they should be run (i.e. vitamin d levels, celiac panel, inflammation markers…) even if the team didn’t think of it on their own

Lisa Huse says to  (11:01):
If any of you come across suggestions on how to help HCPs serve you better, email me at [email protected].  I would love to hear from you.

 

gina says to  (11:01):
Lisa, we are at 10pm if you want to stay you can if not the chat is all wrapped up

landileigh says (11:01):
i know it took a lot to get my doc to do an A1c

 

Lisa Huse says to  (11:01):
This is fun.  I will stay on as long as people want (or as long as a 2 year old stays in bed).

 

gina says to  (11:02):
LOL

k2 says to  (11:02):
I agree with Ellen0- I had to fight to get my cortosol levels checked

gina says to  (11:02):
Lisa, maybe you can answer some of the accucheck questions from before that were off topic

gina says to  (11:02):
i think Scott asked some

Lisa Huse says to  (11:02):
Scrolling up to see what I missed.

 

JIMBOB48 says to  (11:03):
mY ADVICE IS TO ENCOURAGE DRS TO AVOID GETTING STUCK IN A RUT WHEN IT COMES TO HEALTH CARE

gina says to  (11:03):
we all tend to be stuck in ruts a lot

gina says to  (11:04):
its an up and downhill battle constantly

Lisa Huse says to  (11:04):
Gina, can’t see all the way back to the beginning.  Any suggestions?

 

gina says to  (11:05):
do you see a notepad

Lisa Huse says to  (11:05):
Got it

 

JIMBOB48 says to  (11:05):
BUT REALLY SOME OF US ONLY SEE OR ENDOS ON A REGULAR BASIS AND THEY NEED TO KEEP OUT OF THE D RUT AND TREAT THE PATIENT

gina says to  (11:05):
scott the accucheck questions were from you

gina says to  (11:05):
maybe you can repeat

gina says to  (11:06):
Kelly, I looked for the exact dear HCP letter

sstrumello says to  (11:07):
Well, I think they were answered about integration issues with Accu-Check and Roche/Disetronic insulin pumps; pending FDA review

k2 says to  (11:07):
I can send u the link

gina says to  (11:07):
link it in here

gina says to  (11:07):
just copy and paste

k2 says to  (11:07):
OK- just a minute

gina says to  (11:07):
oh ok, i thought you asked mo re

Lisa Huse says to  (11:08):
speed reading

 

gina says to  (11:08):
YOu guys can ask Lisa anything you want

gina says to  (11:08):
it doesnt have to be on topic

sstrumello says to  (11:09):
The other question I had was on meter size; we were told that batteries are a big reason for their size, but I said compared to cell phones, it seems like meter batteries are enormous!

gina says to  (11:09):
questions about Roche or other stuff

Lisa Huse says to  (11:09):
Differences is that cell phones can go dead.  Meters cannot.

 

gina says to  (11:09):
I just got the Bayer Contour

gina says to  (11:09):
the usb

gina says to  (11:09):
it is the most amazing thing ever

gina says to  (11:09):
that is a little bigger than a flash drive

sstrumello says to  (11:10):
Is the memory in Roche meters dependent on a continuous supply of power?

gina says to  (11:10):
you can plug it into the computer to charge it

sugar butt says to  (11:10):
lisa, i corresponded w someone who had islet cell transplant and he says after a while he was back on insulin, but reduced amount.  do you recommend that?

k2 says to  (11:10):
Found it! http://diabetesaliciousness.blogspot.com/2009/09/dear-diabetes-healthcare-professionals.html

Lisa Huse says to  (11:10):
No, on Roche meters the memory is not held by batter.The memory is held by a back-up battery that you never have to change.

 

sstrumello says to  (11:11):
Thanks!

sugar butt says to  (11:11):
can you imagine sleeping in and eating chocolate cake for a while?

gina says to  (11:11):
sugar, I dont think lisa is qualified to answer something like that

Lisa Huse says to  (11:11):
I’m not a healthcare professional so i can’t recommend anything about islet transplant, but I have read the research.

 

sugar butt says to  (11:12):
i do, of course, but insulin dependent D’s can’t, i understand’

k2 says to  (11:12):
I eat chocolate cake- but I bolus and test like a crazy person

gina says to  (11:12):
me too!

gina says to  (11:12):
lisa, you never have to change accuchek meter batteries?

Lisa Huse says to  (11:13):
No,a bit confusing.  That comment was about what holds the memory in Roche meters.

 

gina says to  (11:13):
oh sorry

Lisa Huse says to  (11:13):
In other words, to run tests, uses the standard batteries in the meter.  The memory of the meter is maintained by a back-up battery.

 

gina says to  (11:15):
Lisa, do you think there will be another blogger summit in the future

Lisa Huse says to  (11:16):
We have some thoughts to share in early December.  Magic 8 balls says, very likely.

 

gina says to  (11:16):
thats funny!

andy7352 says to  (11:16):
what’s at a blogger summit?

k2 says to  (11:17):
I was always a fan of Magic 8 Ball & that phrase specifically ~

gina says to  (11:17):
LOL k2

sugar butt says to  (11:17):
when we meet in December we should discuss Christmas treats

k2 says to  (11:17):
I still say it! As does Lisa- so I’m in great company! OF course my nephew looks at me like I have 3 heads

Lisa Huse says to  (11:17):
In July we brought together 29 of the blogger/ecommunity leaders to teach us industry folk how to behave.

 

gina says to  (11:18):
Roche was the first pharma to do something like this

gina says to  (11:18):
it was a great experience for all of the bloggers that attending

k2 says to  (11:18):
Yes they were

gina says to  (11:18):
attended

Lisa Huse says to  (11:18):
The best part has been connecting personally with many of them.  Did you all know that Gina is nocturnal?

 

k2 says to  (11:18):
It was fantastic!

gina says to  (11:18):
k2 and I were two of the bloggers

gina says to  (11:18):
Lisa lol

k2 says to  (11:18):
I knew that and Im SO jealous

gina says to  (11:19):
more like notnormal

k2 says to  (11:19):
that 2

andy7352 says to  (11:19):
we’re all a bit special aren’t we?

gina says to  (11:19):
k2 please dont be jealous its a sickness

gina says to  (11:19):
lol

k2 says to  (11:19):
Hey- I ride the short bus daily- and I mean that in the best sense of the term

Lisa Huse says to  (11:19):
Gina taught me just last week that Avatar is a real word and not just a movie coming out in December

 

gina says to  (11:19):
LOL

gina says to  (11:19):
avatar is a cartoon on Nick Jr right

gina says to  (11:20):
i have actually seen it

gina says to  (11:20):
i love cartoons

gina says to  (11:20):
ok i am a nerd right now, please dont hold it against me

Lisa Huse says to  (11:20):
One of the bloggers is also a world champion powerlifter – Ginger Vieira.

 

gina says to  (11:20):
Ginger is amazing

k2 says to  (11:20):
We are all nerds. Lisa and I quote the Magic 8 Ball

k2 says to  (11:21):
Ginger absolutely is!

gina says to  (11:21):
she also does crazy yoga moves

Lisa Huse says to  (11:21):
You can see Ginger at www.healthcentral.com/diabeteens/

 

andy7352 says to  (11:21):
I’m slowly trying to work my way onto Team Type 1… if you ever see me there you can say you met me on here

Lisa Huse says to  (11:22):
Do many of you go to Children with Diabetes?

 

gina says to  (11:22):
yes

gina says to  (11:22):
ellen who was on here before is from there

andy7352 says to  (11:22):
I’ve been here a few times before. Mostly chat on CWD when I’m on

Lisa Huse says to  (11:22):
The event in June/July?

 

gina says to  (11:22):
i havent been there yet

k2 says to  (11:22):
Lisa- I did a community out reach program tonight and spoke to 20 type 2’s and I was trying to convince them to test more oftne

k2 says to  (11:22):
often

gina says to  (11:23):
type 2 motivation is a huge problem

gina says to  (11:23):
i hate stereotyping

Lisa Huse says to  (11:23):
Testing with a purpose is important.

 

Lisa Huse says to  (11:23):
You all said something great in the summit- even “bad” numbers are good information

 

gina says to  (11:23):
i am on preconception mode and i have been testing 12-14 times day with a cgm!

k2 says to  (11:23):
It is- but I convinced several to start with two extra tests a day- for a total of 5 per day.

andy7352 says to  (11:23):
I’m not sure how many bike racers are also diabetics, but I’ve been training for the past yaer and have done well in some local races so I’m working my way up

k2 says to  (11:24):
I test between 10 and 15 times a day!

Lisa Huse says to  (11:24):
Especially for a Type 2, finding a question they want to unravel can be more insightful than just testing

 

gina says to  (11:24):
you know what kelly, if they test once a day its a start

gina says to  (11:24):
and gradually move up

gina says to  (11:25):
its better than not testing at all

k2 says to  (11:25):
I know- these patiients tested 3 Xs a day- breakfast, Lunch, and dinner.

gina says to  (11:25):
thats wonderful

Lisa Huse says to  (11:25):
Another consideration, try a new tool we developed with Dr. Polonsky.  It’s called ACCU-CHEK Testing in Pairs

 

Lisa Huse says to  (11:25):
Here is a link to print it.

 

Lisa Huse says to  (11:25):
https://www.accu-chek.com/us/data-management/testing-in-pairs.html

 

k2 says to  (11:25):
For 1 week they are also testing at 3pm and before bed

gina says to  (11:25):
you gave that to us on the flash drive

gina says to  (11:25):
from the summit

gina says to  (11:26):
kelly its great you are motivating them

gina says to  (11:26):
huge kudos

Lisa Huse says to  (11:26):
For sure.  What tips did you share on motivation?

 

k2 says to  (11:26):
I love talking with patients!

gina says to  (11:26):
lisa, that is another important thing to know. how to motivate patients

k2 says to  (11:27):
I told them that testing is a road map for where your body is at and if it’s going north or south

gina says to  (11:27):
fun ways to motivate are support groups

gina says to  (11:27):
people just like you learning from each other

k2 says to  (11:27):
I talked about small changes = big differences in how they feel

Lisa Huse says to  (11:28):
Whenever we hold market research, the sessions always end with groups sticking around to talk to one another.

 

gina says to  (11:28):
yes

gina says to  (11:28):
i just went to a support group last week, where i learned so many things from the older type 1s

gina says to  (11:28):
especially pregnancy issues

Lisa Huse says to  (11:28):
Another challenge in the professional dynamic.  Rather than bite sized pieces, it can be a huge download.

 

gina says to  (11:28):
that i was concerned about

k2 says to  (11:29):
The best part was when a guy with parkinsons disease and diabetes ( he was young- iin his 50’s) asked me about testing and how hard it was for him to get the blood drop on the strip. I told him to take the meter and move IT to the blood instead of the othe

k2 says to  (11:29):
of the other way around

gina says to  (11:29):
yea

gina says to  (11:29):
the best way to learn and be motivated is from other people that live with the disease

k2 says to  (11:29):
AMEN GINA

gina says to  (11:30):
we are our biggest supporters

gina says to  (11:30):
and understand completely what the other person is going throuogh

gina says to  (11:30):
through

k2 says to  (11:30):
We motivate one another when we need it

k2 says to  (11:30):
which is continually

gina says to  (11:30):
yep

gina says to  (11:31):
we do it online on a daily basis

Lisa Huse says to  (11:31):
The online world has created such a new environment for you to find that support.

 

gina says to  (11:31):
but, lisa we need it in real time as well

gina says to  (11:31):
it is very important

k2 says to  (11:31):
The on-line world has given patients an opportunity to learn and support one another

gina says to  (11:32):
i have been doing online support for the past 9 yrs and the first time i went to a real-time support group was last year and it was the best experience of my life

gina says to  (11:32):
you need both

Lisa Huse says to  (11:32):
There is something powerful about face-to-face

 

k2 says to  (11:32):
Face to face is amazing

gina says to  (11:32):
there is something you get face to face that you dont get online

gina says to  (11:32):
ooops

gina says to  (11:32):
LOL get off my brain wave!

andy7352 says to  (11:32):
I’d love to meet people in person, but I have a feeling there are many 20-somethings, are there?

gina says to  (11:33):
there are

k2 says to  (11:33):
which is why the Summit was so fantastic

gina says to  (11:33):
yea

gina says to  (11:33):
it was the first time we all met in person

gina says to  (11:33):
normally we couldnt do something like that

andy7352 says to  (11:33):
oops, meant aren’t many

Lisa Huse says to  (11:33):
Roche learned more in a day than we had learned in a year.

 

k2 says to  (11:33):
and dialoging w/Roche

gina says to  (11:34):
it was important for us as a community to be there with roche too

gina says to  (11:34):
andy there are more twenty somethings in our community that teens

andy7352 says to  (11:35):
wow I wouldn’t expect that Gina

gina says to  (11:35):
than

landileigh says (11:35):
i’ve never been to a D-support group

 

gina says to  (11:35):
i was 25 at diagnosis

andy7352 says to  (11:35):
20-somethigns are usually the lazy ones that are more into going to bars

landileigh says (11:35):
i’ve been to grief support groups though and they were immeasurable

 

gina says to  (11:35):
no they arent

k2 says to  (11:35):
Go to a D support group- youll be glad

gina says to  (11:36):
andy where do you live

Lisa Huse says to  (11:36):
How difficult is it to find local support groups?  I know thediabetesresource.com provides a great way to access, but are they otherwise difficult to find?

 

gina says to  (11:36):
if you arent internet savvy it can be very difficult

gina says to  (11:36):
thats another good thing to tell HCP

landileigh says (11:36):
i wanted to go to one when we lived in Napa, but i wasn’t a part of their medical group to join it

gina says to  (11:36):
how we can find support

k2 says to  (11:36):
Some Dr’s offices offer the info –

gina says to  (11:36):
give them sites like thediabetesresource.com

Lisa Huse says to  (11:37):
Interesting to talk to HCPs about the online world.

 

gina says to  (11:37):
that is going to be my goal for the year coming up

k2 says to  (11:37):
but the lists are not always up todate at the offices

Lisa Huse says to  (11:37):
some fear misinformation, others think it is great.

 

andy7352 says to  (11:37):
I went to a support group after Dx, but it was all parents and not people my age

gina says to  (11:37):
andy where do you live

sugar butt says to  (11:37):
in the US log onto American Diabetes Assoc, in Canada log onto Canadian Diabetes Assoc

andy7352 says to  (11:37):
I’m in Ithaca NY

gina says to  (11:38):
ok i will help you find a support group

k2 says to  (11:38):
HCCP’s are experts in their field and we are experts at living with our disease

gina says to  (11:38):
you are pretty far up there lol

sugar butt says to  (11:38):
i’m in Toronto so it’s easy

gina says to  (11:38):
andy i am in NY as well, long island

k2 says to  (11:38):
I love Toranto

Lisa Huse says to  (11:38):
Kelly, I may quote you on that again.

 

k2 says to  (11:39):
You may quote me on that

gina says to  (11:39):
kelly is good at quotes

k2 says to  (11:39):
And it’s on my blog

andy7352 says to  (11:39):
I’ve been to Toronto once, great city

Lisa Huse says to  (11:40):
Oh, our lawyers will be so happy, I have written documentation to quote you – lol

 

sugar butt says to  (11:40):
lots in toronto

gina says to  (11:40):
Lisa, is this your first time in a chat?

andy7352 says to  (11:40):
I biked around Lake Ontario earlier this year, Ithaca to Toronto in 3 days

sugar butt says to  (11:40):
i love new york too, great shopping

Lisa Huse says to  (11:40):
Yes, I’m a rookie

 

gina says to  (11:40):
newb

landileigh says (11:40):
you did GREAT!

gina says to  (11:40):
yea you did

Lisa Huse says to  (11:41):
Thank you all for being gentle with me.

 

Lisa Huse says to  (11:41):
A quote from my husband before we started

 

Lisa Huse says to  (11:42):
You have your game face on.

 

Lisa Huse says to  (11:42):
My response – I have to keep up now go away.

 

gina says to  (11:42):
LOLOL

landileigh says (11:42):
you were awesome

gina says to  (11:42):
lisa we need you back!

gina says to  (11:42):
this was really great

Lisa Huse says to  (11:43):
I hope i can return again and will most definitely join in just to learn from you all.

 

gina says to  (11:43):
im not kicking you out or anything just giving you props

Lisa Huse says to  (11:43):
Roger that

 

gina says to  (11:45):
if you have twitter, i just added a new tab for diabetes twitter users on https://www.thediabetesresource.com/content/the_nest.html
gina says to  (11:45):
Lisa, thank you so much for doing this chat tonite.

Lisa Huse says to  (11:46):
Thank you Gina and all. It ‘s been great.

 

gina says to  (11:46):
I hope you enjoyed yourself and will do it again

Lisa Huse says to  (11:46):
Absolutely!