Virtual Endocrinology Appointment

Apr 08, 2020

Today, I saw my Endocrinologist via a telehealth visit. As a patient, this was a new experience for me. I routinely have quick telephone check-ins with my own patients and since the advent of COVID-19, I've been offering appointments via Zoom video chat. As a solo provider, I don't have the resources for an official "telehealth" software suite so I was curious to see what it would be like to experience an appointment offered through a large corporate practice.

Yesterday, a medical assistant called me for my "pre-check-in." It was pretty much the same as being at an-in office appointment, except no one took my weight or blood pressure. I verified my allergies, current medications, and told the MA what I needed to talk to the Nurse Practitioner about. Because I wear a continuous glucose monitor (CGM) that provides excellent insight into my blood glucose over the past three months, I had opted not to go to the lab for my routine A1C test (3-month average of blood sugar). The MA verified that my NP had access to the data from my continuous monitor. Then he gave me instructions for logging in for my appointment today, including going to the website ahead of time to make sure I have the software loaded on my computer.

I'm glad he warned me to start early because, while relatively simple, it wasn't obvious what to do. I followed the step-by-step instructions, downloaded the software and got into the "waiting room" about 10 minutes before my scheduled appointment. 

At the scheduled time, a bell chimed, a new window popped up and my Endocrinologist said "Hi. So good to see you virtually this morning!" She was wearing a mask because, though I was in the safety of my home, she was still seeing patients in the clinic.  

Our appointment started with the niceties that occur during a normal face-to-face appointment and quickly shifted to discussing the state of my diabetes. My NP had reviewed my CGM data prior to the start of our appointment. She had noticed what I was most concerned about: My blood sugar has been OUT OF CONTROL since the whole pandemic thing started. 

This is data from last week:

Compared to this from my best week in early February.

We talked strategies for improving my blood sugar: more intentional exercise, reducing the carbs that I've been turning to for comfort, and practices to reduce stress including getting adequate sleep, meditating, and avoiding distressing news reports. Then, the part I didn't want to do: we increased my insulin. A lot. I know it's necessary but I'm still crabby about it.

When I started taking notes about my dose increases, she told me she was keeping track of all of it and would send me an after visit summary with my new instructions. Just like in a normal appointment, she's sending prescription updates to my pharmacy.

At the end of the appointment, she gave me my normal instructions to follow up in 3 months but also added a caveat: please feel free to reach out via the normal messaging system or schedule another appointment sooner if needed. She told me that many people aren't keeping their appointments and the normally-very-busy endocrinology clinic now has more time to respond to messages and schedule appointments closer than the routine 3-month follow-up. 

Overall, I had a great experience with my first telehealth appointment and I'll happily do it again as long as it's unwise to be out during the pandemic. Actually, I hope telehealth will continue to be an option after the pandemic; I think I might prefer calling in as opposed to driving to the office and sitting in a waiting room. I'm curious to see what awaits us in our new normal that is to come.

Have you had a telehealth experience? I'd love to hear about it! Join in the conversation about telehealth or anything else related to your Type 2 Diabetes over on the Facebook page.

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