How My Endocrinologist Inspired Me
Arianna Tuomey, University of California-San Diego '17
One year ago, it was the week before finals in my sophomore year of college at UC San Diego, and I became ridiculously sick. I didn’t have the energy to get out of bed and go to my classes, I slept all day, and found out that I had lost 20 pounds in a month without trying. My roommates convinced me to go to Student Health Services, and the doctor there seemed very concerned about my health. He called an ambulance and I was taken to the Emergency Room at the UCSD hospital. After hours of tests, and people shoving needles into my arms trying to find my veins to draw my blood, I was told that I had type 1 diabetes. Four days later, with an ICU stay, a newly discovered chronic condition, and 1 session of diabetes education under my belt, I was released from the hospital and went back to take my finals. After the whirlwind of leaving the hospital and taking finals was over, I was able to actually sit down and reflect on what happened in the past week and a half. It felt like overnight, every thing about my life had changed. I had to look at the carb count for everything I ate, make sure I checked my blood sugar before and after every meal, take at least 4 insulin shots a day, and manage the inevitable high and low blood sugars that come with this territory. All of this began to get overwhelming because I felt that I had no one in my life I could talk to who would really understand what I was going through and what I had to do. It was at that point that I went to my first appointment with my endocrinologist Dr. Tricia Santos-Cavaiola.
I had no idea what to expect when I entered the Adult Specialties office of the UCSD Hospital for that first appointment. Would it be like an appointment with my pediatrician? Would the doctor be upset with me for not managing my diabetes well enough? What will it be like going to the doctor by myself for the first time? After my name was called in the waiting room, a nurse led me into the back where they measured my height and weight, and took my vitals. I was then put in a private patient room and my nervousness kicked into overdrive with millions of questions and concerns buzzing around in my mind. These concerns were all put to rest once Dr. Santos entered the room with a warm smile and asked how I’d been doing since my diagnosis. I found myself able to confide in her easily, and she answered every question I had with a simple and nonjudgmental answer. She never chastised me for skipping a finger prick or eating carbs. She went on to explain how my insulin treatment would work, explaining with hand drawn diagrams what Lantus and Novolog do, when I needed to take insulin shots, and how many units I needed to administer each time. She even suggested that I try a Dexcom CGM and when I agreed, she called in the order right there at my first appointment. Everything was presented to me extremely clearly and, though I didn’t realize it at the time, this made a huge difference in how I adjusted to having diabetes. There was nothing to obsessively worry about because Dr. Santos had already covered every question I could possibly have and she never once criticized how I was handling my treatment.
In the months following that first appointment, I was able to send Dr. Santos a message on the direct messaging system set up by UCSD Healthcare whenever I had a question or prescription request. She was always available and easy to reach. When I travelled abroad to Peru for a medical outreach volunteer trip last June, Dr. Santos was more than willing to write a flight letter allowing me to carry my supplies on the international flights. Open, easy communication such as this is essential to have with your endocrinologist because it can greatly improve your management of your diabetes.
My more recent appointments have been less crammed with information, as I have a strong grasp on my diabetes at this point. At my last appointment in February, we reviewed my labs (6.1 A1C!), and discussed lowering my Lantus by one unit because I sometimes get lows at night. With each successive appointment, I feel even more comfortable with Dr. Santos, and more willing to share whatever has been on my mind regarding my diabetes and my treatment plan. I find it to be very important to have an endocrinologist who you feel comfortable sharing ANYTHING with. If you have doubts about whether you should share something, you should look into finding someone you feel 100% comfortable with. Nothing should be off limits.
Finally, I’d like to end this piece with one last thing I’ve loved about my relationship with Dr. Santos. I’m currently an undergrad at UCSD studying Human Biology, with a premed emphasis, and my plan after graduation is to attend medical school. When I sat in that room at my first appointment and a young female doctor walked in, I could not help but be inspired. Since then, I have decided that I would like my specialty to be in endocrinology. Having a good endocrinologist is important for all people with diabetes, but it can be especially influential for children and young adults to have an endocrinologist they feel comfortable talking to, and who they can see themselves in. A strong patient-endocrinologist relationship is essential for proper management of your diabetes, and can make a significant difference in how you view and handle your diabetes.