Ok, I’ll apologize in advance for the vent … I know some of you that read my blog regularly are probably getting tired of my constant Endo vents. So I’ll preface this particular post by saying that I have in fact tried to find a new one recently .. the few referrals I’ve called – they won’t take pre-existing diabetic patients, more specifically pregnant ones. And a couple of others I’ve called have too long of a wait to get in, so at this point I might as well see myself through what’s left of my pregnancy (6-8 weeks max) and then start up again on the search. So in the meantime.. it’s me and my current Endo.
This week’s appointment, I went in prepared. And by prepared, I mean I took in pages and pages of reports (thanks to Kevin’s spreadsheet!) I handed him two full weeks’ worth of data (my last appt was 2 weeks ago) as well as yesterday and today’s (a partial day of data, obviously.) I handed it to the nurse (who is AWESOME) and he comes in, shakes my hand.. then goes through the usual script.
“So what’s new with you?”
“Not too much since I saw you 2 weeks ago.”
As he starts flipping through my reports, he says, “Well, I guess I can’t complain that you didn’t bring in any records.” (Uh I was kind of hoping for something along the lines of “Gee, these are awesome! I know I told you last time that I needed better data in order to make informed decisions about your basal rates – great job on being so prepared!” But nope.)
He asked me how I thought I’d been doing. I told him that the first week on Novolog (week before last) was rough. He said, “Rough how?” I said, “Well, I was high pretty much the entire week until my body adjusted to the new insulin.” He said, “Hmmm. I wonder what would have caused that. Strange.”
He continues on with the usual script of questions.
“Have you been experiencing any lows?”
“Yes. A few.”
“You have the reports in front of you…” (Yes, the defiant child inside of me was fighting to rear her ugly head…. )
“What time of the day do you usually have them?”
“It seems to be in the evening, around dinnertime.”
Flips through the charts again.
“Hmmm. Maybe that’s just from the activity of preparing dinner.”
“How low are you going?” (again, he has the charts in front of him.)
“I usually catch it when I get in the low 60s.”
“Oh well then that’s not that low.”
“Well it’s low enough for me to feel it and need to treat it.”
“How do you feel?”
“Right now? Or when I’m low?” (Yes, I can be an admitted smartaleck at times.)
“When you’re low. What symptoms do you experience?”
Huh? “Typical hypoglycemic symptoms. I have been diabetic for over 20 years. I just know when I’m low.”
“But do you get sweaty and feel like you’re going to black out?”
“No, not in the 60s, but I get light headed and need to treat it. Especially since I haven’t gotten lows in a while, I’m more sensitive to them these days.”
“Ok then that’s not too bad.”
Again .. huh? So would he have been more interested if I HAD passed out?
I also have been waking up in the high 70s/low 80s recently. The last 2 days I’ve been waking up around 130-150. He asked me what I thought about that. I said “I’m not sure, but it seems that I’m needing to make adjustments every 2-3 weeks, and I’ve been about perfect for 2 weeks now, so it’s likely I may need to make some more tweaks?” (But doc, shouldn’t YOU be telling ME this, and not vice versa??)
He said, “Yes, but why do you think you’ve been in the 80s for a couple of weeks when you first wake up, and then all of a sudden, you’ve jumped up to the 130s/140s?”
“Maybe because I have two placentas growing inside me, and they each give off a hormone that makes me resistant to insulin?” (Oops, there’s that smartaleck child trying to come back out .. ) He said, “No, I know that, I am a doctor.”
So he suggests we up my overnight basal a bit, to bring down my morning numbers. But I’m going to wait a day or two, since it’s only been 2 days that they’ve been “up” and I just changed my site last night … I’ll give that a chance to work and if not, I’ll increase it.
The nurse comes in to draw blood (thyroid). I asked if we can include an A1C because my OB wants to see one. She says that we did the A1C a few weeks ago (they do the A1CNow in the office, not in a blood draw.) I told her yes, but my OB wants the blood draw result because there is a big variance between the two. She said they’ve tested and compared and they are always very close. I told her about the feedback I’d received when I blogged about that a few months ago, and she said she’d talked to the dr about it. So I’ll be going back to my OB next week, and I’ll let her do a blood draw to include the A1C. Another poke, but at least we’ll get the most accurate number.
Sorry for all the venting in regards to the Endo situation. I have people (friends/family) all the time telling me how good of a job I’m doing through this pregnancy .. and you know what? Overall, I have to agree. I am doing very well, considering everything I have working against me. My Perinatologist (specialist that does my high level sonograms every 3-4 weeks) always tells me I’m doing great – keep up the good work, etc. It’s nice to get that “atta girl” and affirmation that I AM doing a good job of taking care of not only myself, but also these two little boys I’m growing inside me. Sure, there are many times I kick myself because I feel like I could be doing better at this or that… but overall, I’m doing very well. And I’m doing it on my own. Yes, I have an endo to write me Rx’s, but I’M the one managing this disease myself 24/7/365. I’ve only gained 8 lbs (not by choice, though), I’ve been off of my BP meds since I was 18 weeks (and I’ve been on them for almost 20 yrs), my BG’s are very good, the boys are growing exactly as they should be, my kidneys and thyroid look great. So for that I am proud of myself. And I don’t give myself enough kudos, but since I can’t get them from my Endo .. I’ll give them to myself