Socialized Diabetes Care - First Impressions

About a month ago, Nathan and I registered at the surgery (translation: regular doctor's office) and had our initial health checks. I asked to have a referral to an endocrinologist in order for me to get prescriptions for all of my diabetes supplies. You see, when I learned that we would be moving to England, I started rationing my supplies while they were covered by my insurance in the States. I feared socialized medicine would reject my desire to continue what's working (insulin pump therapy) because it's rather expensive to keep up. I'm probably good on supplies for a year, just in case this happened.  

Anyway, the surgery sent a request for me to the hospital, where the endocrinologist is, and I received a letter in the mail last week telling me I had an appointment at 9 a.m. on Wednesday. I called to see if I could get a time before or after work, but it turns out I didn't have that option. So, I had to take the morning off of work without pay. Thankfully, my supervisor is letting me make up the time by taking shorter lunches this week.  

Nathan and I walked up the hill in the opposite direction of where we both normally go (the library and my job) for 35 minutes and found the hospital. It was big and shiny and new. However, when we reported to reception, they sent us to the East Wing, which looks like a mental institution straight out of movie from the 50s. It was a long and scary looking corridor with thick bundles of internet cables bound together with zip ties where the wall and ceiling met.

See?  I wasn't kidding.

Nathan and I poked our heads in the Diabetes Center, which really was a hallway with a few chairs and a couple of rooms off of them. There was no checking in or medical assistants or real clear procedure about what to do. And with the whole absence of white coats thing, I wasn't sure if the group of people talking at the end of the said hallway was made up of medical professionals or not. I think we looked confused enough, because someone asked if we needed help, and when I showed her my appointment letter, I was shown into an examination room right away. Nathan sat in the hallway and waited for me.

The endocrinologist and a nurse walked in with me (they were in that group after all!) and we sat down in an assortment of tangerine, avocado, and chickpea colored chairs that reminded me of the Bakersfield College tile squares in the Fine Arts building. There was no examination table or scary instruments like tiny scissors or needles or even boxes of gloves. There was an old desk from the same era, some open shelving full of supplies, and us in our food colored chairs.

I think the doctor was from the Middle East, and I had a hard time understanding his English-English, if you know what I mean, but he was really warm and kind and attentive. The nurse was English, and she was in training I think.  She was wearing a navy dress with white piping on the edges that made her look like she worked in housekeeping at a hotel.  It came with a badge that said "Practice Nurse," which I hope means "Nurse Practitioner" rather than what it actually says.  

As they sat across from me I felt like I was in an interview rather than at a medical appointment. They asked me a lot of questions about my diagnosis and my daily management with the pump. The nurse was really confused when I was talking about my blood sugar numbers because they use a different unit of measurement here. I can make the change on my meter, but I'd rather just leave it because it's what I know. If I really want to fit in, I can divide my blood sugar readings by 18. Um, I hate math and do enough as it is... No thanks.

After a while, I just pulled out a letter written by my doctor in Atlanta, which was just a dictation of my last appointment and a little about my history, and gave it to the doctor. A copy of it was supposed to have been sent by the surgery, but I guess that didn't happen. He looked it over eagerly and asked if he could make a copy himself. While he was gone the nurse took my blood pressure and checked my weight, which was honestly the most medical thing that happened the whole time.

When he came back, he told me not to worry, that all of my supplies would be paid for, and that I could continue doing what I'm doing. Now my thinking is this: maybe I should keep rationing my supplies in case we don't have insurance and I have to pay out of pocket for them when we come visit and/or move home in a few years.

He, and I quote, "preferred" for me to come some to some diabetes education and management classes periodically.  When I asked if I could opt out because I'd already been to some and felt like I had a pretty good handle on things, he said, "We really prefer for all of our patients to come."  I take that to mean that if I don't come, I'll be labeled non-compliant and they'll snatch all the free stuff away.  

All in all, I spent about thirty minutes together with the doctor and the nurse, which really impressed me.  They seemed genuinely interested in me and my case.  It wasn't until after I walked out and met Nathan again that I understood why.  

"Gimme the camera," he said, holding out his hand.

"Why?"

"I'll tell you later.  Just give it to me."

"Okay..."

While he was busy snapping the picture below, I read a poster on the wall that talked about diabetes care in County Durham (our new county), which is the biggest county - geographically, not in terms of population - in England. It boasted the introduction of insulin pump therapy in 2006 and proudly announced that as of July 2009, 26 people in the county had pumps.

The first pump came to Country Durham in 2006?!?!?!?!?!?! Only 26 people with pumps?!?!?!?!?!?!?!?!?!

Whoa...

No wonder they were so interested. It turns out I'm a rarity. Maybe I'm lucky number 27. :)

Nathan was interested in the camera, on the other hand, because this poster on the history of the diabetes care said "Urine Tasting" instead of "Urine Testing" and had a black and white picture of a man hooked up to the first insulin pump.  He looked rather like the Rocketeer.

Click on the picture to see it more clearly.  It's worth it.

I couldn't leave without taking some literature about living well with diabetes, especially if it meant I could be as cute as this lady.