Saturday, February 12, 2011

Are You Courteously Assertive?

"My Assertive Teenage Type 1"
Many years ago, lets say, 15+ or so, I was referred to meet my first endocrinologist, as my family physician felt it was time to pass the care of my diabetes over to the specialist.

Prior to this appointment I had it in my head, after doing much research over the net of course(yes it existed back then) that I wanted to go on the "Run and Shoot Method" or in modern terms, a MDI regime. 

I made my merry way to meet the new Endocrinologist.  I was greeted by his Resident(A physician training to specialize) who's job it was to take a history and do a brief physical exam.  That took all of 10 minutes.

Then entered the new Endo.  He looked at me and said. "So you want to switch up your insulin?" I replied "Yes I do because, " He abruptly cut me off mid sentence and said, "That's not a good idea, you need to stay on your current insulin."  There was a long awkward period of silence, you know, like the elevator type, very uncomfortable.

He went on to ask or more like dictate, the goals I need to shoot for, asked a few other questions regarding; eyes, feet, the usual diabetes stuff.  I honestly shut down all incoming communication at that point in the interview. Then, he stood up, handed me a lab requisition and said, "keep taking what you take and see me in three months"

I was shocked, hurt, mad, and felt defeated.  My plan to go on a "current" more updated insulin regime was shot down.  I didn't handle the rejection very well.
Here I was, a motivated patient requesting better therapy, and suddenly I was shut out.  Totally powerless or so I thought at that moment.

I assume you want to know what I did next.  He had to go!  Just pictured in my head the board Room scenario's for those who have watched Mr Trump point and say, "Your Fired!"on the Reality show the Apprentice.  Ah if only......well back to the story.

I "fired him" well, mentally I did.  I waited a few weeks, phoned my Family Doc and told him I wanted to be referred to somebody who had a personality, and the ability to listen.  I also, in a courteously assertive way, asked him to prescribe the Ultralente, Novorapid regime I wanted to try. He reluctantly wrote the scrip, I think because he knew I wasn't going to leave with out some change in my therapy.

Six months later,  I finally met my new Endocrinologist; which I might add was the most important visit of my diabetic life. Not kidding. This lady was progressive and up to date, she listened, empathized and was totally okay with the regime I was on, and said, "You know, I am starting another Type 1 fellow on an Insulin Pump next week, are you interested in pump therapy?"

During my Internet search I had read some stuff on pump therapy, but hadn't considered this myself.  But that was before she made this amazing proposition.
I said to her, "That is the most current therapy available, yes I'm interested"

"My Old Medtronic Pump"
One month later I was connected and pumping insulin. I thought to myself, wow, I don't have to take a shot every few hours, three days shot free! It was a very exciting time in my diabetes life. Of course the trial and errors, basal rates, and ratios needed sorting, but my life changed.  I was in control of the Mr D, not the other way around.

In retrospect, things could have turned out different. I could have gone back to the first Endo 3 months later, he may have tweaked or changed my regime, and may have mentioned the pump at a much later date.

I chose to be courteously assertive with my family physician, I didn't demand or order him, I was simply assertive enough to not take no for an answer, I wanted to better my diabetes treatment, and that is what I accomplished.

I believe that we all have that ability to be assertive, don't give up, we have information at our finger tips, and it is up to you to ask for what you want, and get it!

Being Courteously Assertive certainly paid off for me.

A little FYI below:

World English Dictionary

courteous  (ˈkɜːtɪəs) [Click for IPA pronunciation guide]
— adj
polite and considerate in manner

assertive  (əˈsɜːtɪv) [Click for IPA pronunciation guide]
— adj
1.confident and direct in claiming one's rights or putting forward one's views
2.given to making assertions or bold demands; dogmatic or aggressive


Reyna said...

Trev...I can just imagine you shutting down in the communication dept. after this physician disregarded your interest in a new regimen. I think you handled it beautifully and with grace. I hope this post gives others the courage to handle any struggles they are currently dealing with in this very area of their lives!

Have a GREAT Weekend! And...was the "Common Sense" Book a "poke" at me? are right...I am lacking in that dept. I think that adds a little "drama" to my day-in-the-life!

Celine said...

Good for you Trev! Assertive isn't easy but it's a damn sight better than the alternative.

Lora said...

I have gotten my way many times by being "Courteously Assertive" :)

Thanks for your comment on my blog.

Jonah said...

I've switched doctors for reasons like that.

What I haven't figured out is how to let the doctors who were awful know how bad they were.