I thought things were on the right track after my hook up with the highly recommended Endocrinologist’s office, then I got a message from my PCF this AM (5/18):
Dear Dean,
I’ve been doing some more investigating into Endocrinology options – with PPIC insurance you also have the option of seeing one of the Meriter Medical Group Endocrinologists, Dr. Deborah Wubben or Dr. Simone Glinberg. They would be able to see you in the office for a consultation before deciding weather or not to proceed with a hospital admission for a 72-hour fast.If this option sounds better than UW Endocrinology then I will proceed with the referral process.
I had checked in with both UW-Endo and my PCF last week and was told they were talking to each other to get something scheduled. Not excited about the glacial pace of progress with getting an Endo consult. I responded to my PCF thusly:
Thank you for the follow up. I am slightly confused about this situation. From what I understand in my limited discussions with them, UW Endocrinology wants the 72-hour fast with blood work done before they’ll do a consult. I mentioned trying to do blood work during or immediately after exercise to better replicate the situation. They were not sure if this could be accommodated. Now it sounds like you’re recommending I go another route with Meriter Medical Group.
I understand that additional blood work needs to be draw when I’m exhibiting symptoms. My concern is that similar to the previous (inconclusive) tests using a 12-hour fast, the 72-hour fast may not accurately represent the conditions under which I experience hypoglycemia. If that test incurs a hospital stay for the entire 72 hours, I question whether or not it is worth the investment in time and medical resources.
On 5/6 about 5:30 PM, I had a friend assist me in checking my glucose every 5 minutes while I was running on a treadmill. Pre-run I registered at 85. Within about 37 minutes at an easy pace it had plummeted to 22, falling from 41 to 22 in the last 5 minutes alone. This episode was after a day of never going more the 90 minutes without food and having a substantial snack 60 minutes before the run. Clearly something is wrong and I know the symptoms can be replicated.
I have an Ironman event scheduled for 6/27 and hope to do a good deal of training yet before then. At this point I’d advocate whatever path is going to get me useful answers in the shortest amount of time.
thanks!
~dean
He then responded:
Hi Dean,
I’ll go ahead and try to make arrangements for Endocrinology consultation with Dr. Wubben or Dr. Glinberg with the Meriter Medical Group. I think that would be the best route. It also looks like you have an MRI scheduled on 5/26 that would still be worthwhile keeping.
PCP’s Office called me this morning (5/19) and let me know I have a consult appointment with Dr. Wubben on 6/2. So from what I understand, my preferred Endo Clinic told my PCP that they wanted better test results (72-hour fast) before they’d do a consult. Because they hadn’t seen me yet, my PCP needed to order the test, not them. I can see their point: they were trying to be expedient (because they understand the urgency of my IM time line) and wanted to start from a more accurate place – both which I appreciate. For reasons unclear to me, my PCP either likes this other clinic better and/or doesn’t want to order the tests prior to a consult. Further, it seems there may be some HMO politics at play here as well. The two Endo clinics would send me to different hospitals. Unfortunately, the bottom line is that I get two more weeks to wait with no answers…