Basically I don’t have a “team” behind me of doctors and CDE’s, etc, like some people do. And it’s my own fault. I’ve blogged about this before, but in a nutshell I’ve gone to my Endo for about 12 yrs now.. because he’s convenient. He’s very low mainteanance, I see him every 3 months, he gives me my Rx’s, and we move on. He’s a very nice person but is not JUST a diabetes dr (he’s a true Endo, so he deals with other issues as well). Honestly, I’ve probably stayed as long as I have because I like his staff so much.
As most of you reading this probably know, I am 26 weeks pregnant with twin boys. This is my 2nd pregnancy, and this one is pretty much exactly like the first one (but a lot more uncomfortable .. lol) in that my insulin needs have increased pretty drastically as I arrived in the later part of the 2nd trimester. I’ve been adjusting my basal rates on my own (I did visit a new Endo/CDE last year and she told me I’m “the CEO of this operation”) and I keep records of when I make the adjustments, and how much they changed from/to. I’ve had to adjust them three times in the last 5-6 weeks.
Earlier this week, I had a bad site which caused some unexplained high’s for a couple of days, so my logbook that I brought in didn’t reflect true numbers (in my opinion.)
I gave the dr my logbook, explained my basal changes, gave him the notes on those as well (note that I do not normally come in this prepared.)
After we went through his script of questions –
“What’s new with you?” (Uh, I’m further along in my pregnancy than I was last month when you saw me?)
“How often do you get up in the middle of the night to go to the bathroom?” (Well, I’m pregnant with two growing boys, so I actually go to the bathroom quite a bit, but unrelated to my diabetes.)
“What are your current basal rates?” (Can’t you look in my chart?)
“What is your current carb ratio?” (Again .. see above.)
Then he looked at my logbook and said, “The last few days have had some pretty bad high’s – that’s not acceptable.” So I then explained to him about the bad site. He asked when I changed sites (even though it was written in the book).. I told him “yesterday” and that I’d also increased my basal rates yesterday, and since then, they’ve been pretty much perfect.
He also said we should increase my carb ratio. I was at 1:5 (which from what I see from other folks, that’s already pretty high, but YDMV) and we changed it to 1:3. It actually seems to be doing the trick so far. Then he said “And we should up your basals, because you obviously need more insulin.” Then I reminded him of what I’d told him 5 min earlier about just having increased my basal rates the day before, so let’s give it a chance to work.
He also only checks my A1C using the A1C Now meter in his office. Unbeknownst to me until last time I recently blogged about this topic, that is not a very accurate number. And I also had no idea until my appt last month, that when he does a blood draw, he does not include an A1C to get a true number. *sigh*
But at my appointment last month, that A1C meter showed 6.2. This week’s appointment showed 7.3. Yikes. That was a 1.1 jump in just 30(ish) days. Granted, the number itself is likely not accurate, but the increase probably is accurate. I’m still in an okay range, and I know that …. but going back to being the CEO “of this operation”… if a true corporate CEO saw reports come in that showed a decrease in profits of that significant of an amount, wouldn’t he/she beat him/herself up about it?
So that’s what I did. I got in my car and I teared up. I kept thinking I need to do better, it’s not only MY life depending on it, but these two precious ones I’m growing inside me – even though I truly feel like I AM doing as best I can – there are always places to improve. One of the first things that popped in my head was carb counting. I am really bad about SWAG’ing it and not very accurately .. so that is definitely an area I can improve upon.
The thing that stood out most to me after my appt was when I tweeted “I hate leaving the Endo’s office feeling like a failure.” I immediately received a call from my husband to ask me what had happened, and he (more than once that day) encouraged me that he’s amazed by how well I do in managing my diabetes. I also got a very nice and encouraging text from my friend, Suzanne. And then I started receiving encouraging tweets from my friends in the DOC (shout out to Jess and everyone else that replied – you all ROCK!) I was not at all looking for that when I sent the tweet.. I was just venting. But I can’t even express how much it meant to me to hear from these friends that live with this disease like I do every single day, 24/7, telling me that I’m NOT a failure. I know deep down that I’m not .. but I sure felt like one when I left his office.
I vowed to do even better. And I guess it worked. My next few BG readings were as follows –
95, 142, 118, 127, 129, and 106.
For some people those numbers might be normal and no big deal. But for me, I’ve been hovering in the 150-200’s … so I was pretty darn proud to see them. And not just one good one scattered here and there. 😉
I do feel much better, and I know that I am NOT a failure. 🙂 I’m just someone trying to figure out a disease that does not play by any sort of rules, and changes every single day.