WHat do doctors think when you tell them this?
 

Been a Type 1 diabetic for 36 years. Been on a pump for 9, numerous diabetic issues that I have dealt with, went completely blind in 2017 for 3 months and after 3 major surgeries in 6 weeks I now have good sight in the right eye and OK sight in the left eye. Was talking to my general practitioner and she was asking how the diabetes was going. Talked a bit and at present my kidney function is pretty good. Only slightly declining on what normal function should be. So at that moment I told her that if the kidneys begin to fail that I have elected to NOT do dialysis. She kinda gave me a look that I couldn't place. As I left the office I saw her looking at me with a different look as well. So. for the docs out there, when a patient tells you something like this does this what are you thinking? Does it make you want to care less? Do you have to notify insurance about something like that? I have not mentioned this to my Endo doc after seeing the reactions from my GP.

Well, it could indicate suicidal thoughts so they would be obligated to take note.

Not suicidal at all. She knows that I have multiple situations in the past that could have been take advantage of if that were the mindset. Great observation though.

She's probably wondering why you would give up, after all you have been through.

Perhaps the look was more philosophical than judgmental.

I'd totally respect that, and maybe she did too.

The looks could be derived from a LOT of different things. Your age, your history, your presentation...but just as important would be whatever is also going on with her...every healthcare provider is a person behind it all and they consciously or subconsciously can drag their own stuff or the stuff of others along in their day and life. Also, she may be under pressure from someone following your lab work as a way to measure her performance. Lastly, she may have let her need to remain objective slip a bit...which isn’t always a bad thing.

Why don't you ask her.

Bingo! Getting right to the meat of it.

BUT...refusing treatment doesn't necessarily mean you are suicidal. It just means you are refusing treatment. Some things they try to push on me tells me "we get good money for ordering this test, so we want you to do it." I often say no....

And if refusal kills me? Well, that's okay by me. I've had a generally good 75 years.
If extending that to 80 meant I'd have a much less enjoyable life, I don't see that as a gain.

If you said that to me and asked me what I thought, I would tell you I am on the same page as you.

Lots of docs will not go through some of the torture that is common medicine.

Tobra may be spot on.

My wife and I have seen "that look" when we talk about do not resuscitate and other wishes like that. Make sure you have a strong living will and end of life care document. Doctors by training will want to do everything to extend life even if the quality of life is low due to the treatments. Be sure all your family is aware of your wishes and have access to copies to those who are assigned authority if...

Are your depressed?

My grandfather elected not to do dialysis. I don't blame him.
With the advanced medical treatments. Death is denied. It's the same way for terminal cancer patients. Going to hold on for that sliver of hope with chemo, or live the last month not sick hoping that the steroids make good days.

Thanks guys for the input. To answer a question, I am not depressed. I still have a good life, enjoy life, I'm only 54, but I have seen the horrors of dialysis and do not want to go through that, knowing the final outcome AND I don't want to leave my wife with unnecessary bills after I am gone. Now I could get hit by a truck today and its all over but for now I am OK.

Our ability to keep the human body working has outstripped our ability to understand what that means to the human in the body.
Good on you for taking control. If it was me I’d at least try the dialysis. You can always stop if it’s as bad as you fear.

A friend of mine was told he had terminal cancer and about six months, get things in order. His wife and kids talked him into kemo, for them to have more time with him. I stopped by his house every week when he got bad and he ended up lasting about three more months. They weren't good months. He wasn't happy about it, but the kids.

Same boat as you. 50 yo, T1 for 37 years. Eyes starting to go bad. Other things. Hope when things start going it goes quick like a heart thing instead of slow multi organ failures. Don't want my wife to have to take care of me . She's aware of my feelings and has the medical power of attorney

People in generally good health may try to understand but until you live with serious health issues you can't really relate. I suspect the OPs doctor was having a moment of reflection.

I'd think most doctors would understand completely, although there are probably a few who would react the same way a car salesman would act after he lost a sale.