Tuesday, November 22, 2011

"Coming Down", as sung by My A1C

I've lately found I have a good rapport with my female health care providers.  Dr. M (my endocrinologist) and I get along fabulously.  At my last visit at my primary care doc's office, Kate, who is an amazing nurse practitioner, and the office nurse both remarked that they like when I come in to see them because I make them laugh.  I think being able to be yourself around your healthcare team is a huge key to success. 

Today, I went to Dr. M's office for a checkup.  She is a very nice woman, usually on the perky side, always willing to answer my questions and often smiling at my jokes, as hinted at above.  This is good, because I'm usually nervous when I go to the endo.  Not for anything she's doing wrong, mind you.  It's just me.  Thoughts of bad A1C's or surprise bad results on other lab work make me anxious.  

I've been told a million times that I am more than an A1C.  I am more than just diabetes.  Usually, this isn't an issue for me.  I live my life, I get along, and if diabetes tries to throw me a curveball, I do my best to catch it.  But when you're staring down the barrel of an endocrinologist appointment, it's easy to catalog all the things you haven't done right, all the things that could have been so much better if you just tried.  You worry.  You wonder what all the neglect is actually doing to your body on the inside.

I have said it here a zillion times:  I am a diabetes blogger.  I am not a model diabetes patient.  I don't have an amazing A1C.  Compared to some people, I may take "a lot" of insulin.  I am definitely not getting enough exercise.  I'm not a role model--I'm just a person who is here to share her experience, to find support, oh, and to mouth off when I feel like it.  Does the world need my 2 cents about living with diabetes?  I like to think so.  I enjoy being able to lend my unique perspective to the world.

I was able to start breathing the sighs of relief early in this appointment.  My blood pressure was great.  My weight was not really any different from last visit.  The nurse didn't even make a face when my BG reading was 235 mg/dl after lunch.  Dr. M came in pretty promptly, and we started talking about doing basal tests before we make any adjustments.  We talked about how I want to continue with the Symlin, even though I had taken a break from it.  We talked about her belly!  She's expecting her second child in January.  Then I talked about the biggie.

I told her I've been thinking about a Dexcom.  She said that normally, when people want to get an insulin pump and they haven't had one before, she doesn't just let them contact the company to ask about one.  She said she likes to meet with her patients and make sure they get the training they'll actually need.  Dr. M then told me for somebody considering a CGM and a sensor, she's quite happy to write a prescription for the system without any kind of preparatory visits.  She also reassured me that if I want to get a continuous glucose monitor, the Dexcom is the way to go.  She told me it wouldn't hurt if I also find some kind of exercise that I really like and start doing it.

So I have a plan for the next few months.  I won't see Dr. M again until April, when she is back from maternity leave. 

The biggest surprise today?  The in-office A1C test.  My last A1C was 9.8.  I know, nothing to cheer about, something to improve.  Today's A1C?  9.0!  Again, not perfect, but enough to make me do a little happy dance.  That's almost down a full point!  I was smiling; Dr. M was smiling and told me that was actually a great job and way better than she expected to see given some of my numbers we had been talking about.  It may be a tiny victory, but it's a victory for me nonetheless.

As Dr. M and I said our goodbyes, she told me to keep up the good work.  She then also added, "But make sure you really enjoy your Thanksgiving!"  I told her I was looking forward to the pie.  "And you should!" she said. 

I know I need to do some serious basal tests, but you know what's amazing?  When your endocrinologist acknowledges that you shouldn't guilt yourself along through a holiday.  I may just drink a toast to Dr. M with my turkey on Thursday. 

And in case you need a reference, here is the theme song to my A1C today:


  1. Congratulations!
    What a great appointment!
    What a great physician!

  2. Congrats! I know agree with you point of view on being yourself and having good rapport with your healthcare team! It makes all the difference.

    I have been wearing a medtronic insulin pump since 2006. BUT In 2009 i was diagnosed as "brittle" While in the ICU recovering from Keto. Now I'm trying to get my insurance to agree with my endo about a CGM monitor that communicates with my pump. Funny how difficult it can be to get something your need to survive. I've gone into keto at least once every year for the last 5 years! I suffer from unawareness on highs and lows.

    I triumphed on the A1C recently by going from an 8.9 to a 8.1, though I am due for a draw tomorrow morning.

    Good luck with the CGM. I enjoy your blog very much! If you ever want (or need) to swap stories or see how little I know about managing diabetes, just drop me a line! LOL

    Happy Thanksgiving!

    Brant (sunontiepost)

  3. You crack me up Hannah, I am so thrilled you have an endo you like and work well with. It is my greatest wish for Grace as an adult, to have doctors and people who care for her, understand her and not judge her.
    Great job on the A1C my friend!

  4. i was thinking more along the lines of this song (which always seems to be stuck in my head)" "baby are you down, down, down, down, down?" http://www.youtube.com/watch?v=oUbpGmR1-QM

    congrats on your downward movement.


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