I agree with you that it would seem very shortsighted of them not to put all the circumstances together to reach a conclusion rather than look at them individually.
Short sighted is the understatement but even worse is the apparent failure to examine ALL the prospective problems. Hell's teeth! If I can do that why can they not do so?
Do you have the patient information leaflet out of the Canagliflozin packet and is the information about the conflict with Lisinopril and the possibility of fainting printed on it? If so the Dr can hardly argue with that if you show it to him (preferably highlighted)
After reading your post on the subject, I examined everything in detail and came to a conclusion similar to you. However when I pointed this out to the Diabetic Nurse she didn't disagree [just as well for her] but stated that each one carried out its function by influence on different systems to achieve the desired results. That is one to act on the kidneys, one to act on the blood vessels and the other on
now not sure. I said I didn't accept that as a valid response since although they might act on different components of the body the net result was the same therefore any conflict or undesired effect of one would have a direct consequence on the others. I was told that the mixture of meds given was a common practice and I was not the only one.
Anyway I refused further treatment at the moment and was asked why. "Because I need to understand the circumstances more clearly since you are unable to" and left the surgery. I was later telephoned and asked if there was a problem by one of the administrators. I said there was but it was pointless discussing it. They insisted so I told them that there was a possibility of other medications instead of Metformin and I was not happy that I was being pushed towards Insulin simply as a cost consideration. It has to be noted that they have continually tried to get me on Insulin for many years and I am now begging to discover that they do not offer any other medications. I have asked around and the answers are not encouraging.
Most Drs will offer Byetta/Bydureon/Victoza before insulin. However, what is is about insulin that bothers you so much?
Don't laugh.........don't you dare..........this is not the only reason but a long time ago and for no reason at all that I can understand, I see a needle go into me and I then keel over. It happens every time and you have no idea how embarrassing it is. So every time a needle comes near, I look away. It's been like this for many years now. However, the only concerns are the current and in my opinion mistaken circumstances, that have stopped them from giving me Metformin. To get back on the med which was very successful in my treatment I am having to jump through some major hoops.
The biggest issue at the moment is that the stupid medics [Consultant] are covering their arses because of the mistakes made on my admission. Mistakes: 1] failed to x-ray a damaged coccyx - this was a direct error of the non-English Dr in the Emergency Department. They X-Ray'd every other bloody part of my torso! 2] Failed to find the split gum and damaged denture [now fixed] 3] Failed to examine the correct ECG readout [my wife saw it left in the Ambulance!!]
Not once could I sit up because of the pain from my Coccyx and they all though I just had a bad back! I was examined by the Dr on admission but because there was no obvious bruising etc they dismissed it. So the long and short of it is that I have to have an ECG monitor fitted for three days so they can determine why my heart 'skipped a beat'. Hmmmmm When the Ambulance crew saw that they knew the machine was buggered because they told us so and did another one in the Ambulance. I told the Consultant this last week but he is not prepared to change his view. I also stated that on that day I was dehydrated because I had not had anything to drink which was a consequence/side effect of the medication I am on for Diabetes. That's why they dripped two litres into me then discovered I was OK to release with normal Lactic Acid levels in my blood. Duhhh!! Anyway he will not be persuaded otherwise so I asked what would be the consequence if I failed to attend for the test. I was told the file would remain open and any determinations relevant to the incident would therefore remain in limbo.
I cannot get an appointment sooner than three weeks from now so as a consequence cannot get back on my Metformin. I have asked if I can have another test to determine my circumstances but was refused because it is tantamount to insulting the Consultant......fer c~~~~~~~ sake! All I asked for was to go back onto Metformin for a week and then do a blood test. Simples - no Lactic Acid no problem.
So the bottom line is I now have to do this heart monitor thing in three weeks then they will close my file on that issue. I then go back to my GP and ask for Metformin again and when they say no they will have no reason to give for not putting me back on it because the previous file is closed and no longer valid. They will have to test my response to it because a refusal on the basis of the Consultant will not be valid when I am no longer under his care.
I was advised on a low dose of Lantus - one stab a day. I am not happy with it simply because I do not see it as necessary at the moment, the need has not been proved adequately and until it is I am not prepared to make that choice. I will have to in the near future and I have had no doubts about that but I will not be pushed down a route just for the convenience of the Dr's practice or because other options have not been bothered with.
So there it is.......warts and all. the worst thing about all of this is it is now clear what has happened and more importantly why. If I can figure it out then why is it so damn difficult to get the medical bods to either agree or disagree instead of just dismissing it out of hand? The worst thing about all of this is simply that I now am loosing weight quite a lot [nearly 8lbs overall since the start] and I have nothing left to sit on!!! Except bone!!
I might very well not last the three weeks or so and go for the Insulin before I see the Consultant. Not sure if I can keep the BG down for that long or before I look like them poor buggers out of a WWII prison camp.