New Endo?

Pregnancy
1

Hi all,

I started clomid this cycle (all of our fertility tests came back normal, but the doctor gave me the option anyhow since it's been almost a year and I took it).  I won't know if it worked until about November 8th or so, but if it does, I'm a bit concerned about my endocrinologist.

I live in an area that doesn't have a lot of resources for high risk pregnancies, I have a high risk ob/gyn whose office is a little over an hour from where I live and my endo is 45 minutes away, there is an endo in town that I would actually rather have because I know he is one of the best and most experienced(I've heard this from any diabetic I've met in this town), but it takes almost 6 months to get into his practice, unless you use his partner, but you need a referral from your doctor.  I don't have a GP, but my endo I really would like to leave because he doesn't seem very capable of taking care of me even while not pregnant, anytime he changes my treatment plan, basal rate, carb ratio, etc, he does so drastically, which usually causes the opposite problems, if I'm having highs, his change causes lows, if I'm having lows, his change causes highs and he just switched me to Apidra for one bottle and my sugar started sky rocketing after eating, then plateaus after about 3 hours without correction, or goes too low with correction.

My question is, should I risk being switched to the better endo and if I get pregant, ask to see the CDE in town if I can't get in to his or his partner's office right away(the CDE did say she would help me, she runs the insulin pump support group out here) and rely on her and my high risk ob/gyn, or just deal with this endocrinologist who I'm absolutely certain has never dealt with a type 1 diabetic pregnancy?  If I actually want one with experience, I'd either have to drive across the bay to Baltimore  or Annapolis which is 2-3 hours away, or quite possibly this new doctor.

2

That is a tough one.  Overall, things in pregnancy are so crazy for diabetes I would go with the doc who has experience with pregnancy and see the CDE.  Will your high risk doc run your diabetes?  My high risk does my diabetes and then I go back to my endo after my pregnancy.  Perhaps your high risk will do the same and then when you are done your appointment for you new endo will be scheduled already?  Good luck!

3

Go with your gut - which seems to be saying to go with a different doc. Try to find a "diabetologist" rather than a pure endocrinologist - these physicians see mostly diabetes and large proportion of type 1 diabetes. You could try contacting the physician who has a 6 month waiting list yourself. Find his email, briefly state your case, tell him why you feel that you need his help (diabetes for 16 years, no one nearby to help, concerned about your and your fetus's wellbeing when you do conceive etc). Try to avoid mentioning the other doc as in certain areas, there is a code not to take other physician's patients. Also tell him that you don't want to wait 6 months and can suggest that you don't want to offend your physician by asking for a referral.

Most docs can make time in their schedule. If this doesn't work, going a bit further would be the 2nd best option.