I finally, finally got my blood test results from my doctor’s visit. My cholesterol is very good (thanks to the low-dosage of Lovastatin I’m on, which helps fight genetics). My thyroid levels (Graves Disease!) are okay, with one number being a little low—that means when the new endo looks at it, I might or might not get bumped up a dosage level. (Not a big deal. The Levothyroxine (generic Synthroid) dosage is always a balancing act; my dosages last for a year or two, then get switched.)
And then there’s my HbA1c. Sigh.
It’s a good number. A really, really good number. It’s lower than it was last summer. I should be happy. I should be jumping for joy. And a part of me is. It’s just that I’m not really sure it’s an accurate representation of what’s been going on with my body. It’s an average of what my sugars have been doing over the last three months. An AVERAGE. So if I wake up at 60 every morning, and go to bed at 160, the average would be 110. 110 would give me a good HbA1c. Doesn’t mean that waking up at 60 and going to bed at 160 is good.
My lows are too low, my highs are too high. Hence, why I’m going to my endo armed with tons of information. For three separate weeks (every other week until my appointment in April), I’m doing the testing every hour. I’m keeping detailed accounts of what I eat (I find taking a picture with the phone on my camera to be an excellent record-keeper). And I’m marking down every bit of exercise and when I do it. The doctor will be able to see every high and every low, and what may or may not have caused it, and when the numbers just happen because they happen.
I know I’m a “Type A” person. I like things very controlled, very organized. I want everything to be as close to perfect as it can be, and that includes my diabetes. I’m learning to let go a little bit and just let life happen as it does (thanks to weekly therapy sessions, in part), but I’m built the way I am and I can’t completely hang free. I know there are diabetics out there who would be perfectly happy with my numbers. But I’m not that person. I want, I need, I have to make sure I’m doing absolutely everything in my power to keep my numbers in the range I’m most comfortable with.
My doctor was happy with my HbA1c. I’m hoping my endo will pay attention to me when I tell her I need more. I want the HbA1c number I have now, but I want to make sure the daily numbers behind it are deserving of it.
Plus, just every now and then, I’d like to eat more than cheese for dinner.
As always, more to come…
Thursday, February 26, 2009
Wednesday, February 25, 2009
Unvirtuous
I wanted my next post to be about my blood test results from my Friday the 13th doctor’s visit.
I was hoping by now he would have called to share all the numbers with me, numbers about my cholesterol, my thyroid, my diabetes.
But no call as of this morning. So I’m hoping that by writing, it will trick him into calling. Like when you’re in a restaurant waiting for your food to come, if you get up to go to the bathroom, it will be there waiting for you when you come back.
So I’m writing now, in hopes that by the time anyone reads this, the call will have come.
I have no patience.
As always, more to come…
I was hoping by now he would have called to share all the numbers with me, numbers about my cholesterol, my thyroid, my diabetes.
But no call as of this morning. So I’m hoping that by writing, it will trick him into calling. Like when you’re in a restaurant waiting for your food to come, if you get up to go to the bathroom, it will be there waiting for you when you come back.
So I’m writing now, in hopes that by the time anyone reads this, the call will have come.
I have no patience.
As always, more to come…
Wednesday, February 18, 2009
Hole-y Arms
My life is being run by little bells.
After writing down all my numbers to bring to the doctor last week, I realized that I’m not always testing when I should. Wanting to improve my testing habits, and wanting to bring some sort of number chart that actually means something to my new endo in early April, I decided to take stricter action.
So I set up “appointments” on my computer calendar at work, and every hour on the half hour, little bells ring and a box pops up on my screen that says “TEST! Now.” I leave my test kit next to my keyboard and I faithfully poke my arm with a needle.
Before and after work, I’m also trying to test on the half hours. The morning isn’t so different from what I usually do—I test when I wake up around 6:30, then again around 7:30 after I work out and before I eat breakfast, to determine how many carbs I need to last until lunch. By 8:30 I’m already at work and the bells are going off. At night, I get home around 6:45 and I normally test right away to see what’s for dinner. I’ve been bad about testing beyond that, so I’ve been making a conscious effort to test at 7:30, 8:30 and about 10pm (before I got to bed). That’s a total of 16 tests per day. (Wait. Did I do that math right? English major admitting mathematical deficiencies.)
Just to make it clear right here and right now, I do not intend to continue testing 16 times a day for the rest of my diabetic life. I’m thinking this week, one week in March, and one week at the beginning of April right before the endo should give me a plethora of information.
I will say I’m surprised by some of the numbers. I wasn’t often testing in the afternoon after lunch, and I found out I tend to run a little high there, but come down fairly quickly—in time for when I do test toward the end of the workday. I wasn’t catching those highs at all.
I’m also surprised by how much my numbers can shift in an hour. I can drop from 130 to 85 within 60 minutes. It almost makes me think I should test every half-hour, or every 15 minutes to get a better reading. But I’m not that crazy, or that rich (16 test strips a day, plus at least one bum one already means $$$).
I’m currently at 45 units of Lantus at night, with no other insulin. The only way I have to control my sugars between doses is by carb counting. I’m low, I eat, I wait until the number drops; rinse and repeat. If I’m too high, I don’t eat, or I exercise until I can. If I’m hovering, I have to decide how many carb units I can eat without shooting me too high and not dipping me too low. (Again, complicated equations for an English major.)
I’ve been grateful to only have to shoot one insulin once a day, but based on my numbers, I think this chapter of my diabetes life might be coming to a close. I’m running too low at times and too high at others. Too much Lantus for some points in the day, not enough for other moments. I need a better balance, and I’m hoping the detailed numbers will help my new endo see this.
Oh, and have you seen the movie Holes? Where boys are digging hole after hole in the dessert to look for a treasure? And you look at the screen and see thousands of craters across the landscape? That’s what my arms look like. Another reason 16-times a day will not be a permanent testing number.
As always, more to come (still waiting for that HbA1C result)…
After writing down all my numbers to bring to the doctor last week, I realized that I’m not always testing when I should. Wanting to improve my testing habits, and wanting to bring some sort of number chart that actually means something to my new endo in early April, I decided to take stricter action.
So I set up “appointments” on my computer calendar at work, and every hour on the half hour, little bells ring and a box pops up on my screen that says “TEST! Now.” I leave my test kit next to my keyboard and I faithfully poke my arm with a needle.
Before and after work, I’m also trying to test on the half hours. The morning isn’t so different from what I usually do—I test when I wake up around 6:30, then again around 7:30 after I work out and before I eat breakfast, to determine how many carbs I need to last until lunch. By 8:30 I’m already at work and the bells are going off. At night, I get home around 6:45 and I normally test right away to see what’s for dinner. I’ve been bad about testing beyond that, so I’ve been making a conscious effort to test at 7:30, 8:30 and about 10pm (before I got to bed). That’s a total of 16 tests per day. (Wait. Did I do that math right? English major admitting mathematical deficiencies.)
Just to make it clear right here and right now, I do not intend to continue testing 16 times a day for the rest of my diabetic life. I’m thinking this week, one week in March, and one week at the beginning of April right before the endo should give me a plethora of information.
I will say I’m surprised by some of the numbers. I wasn’t often testing in the afternoon after lunch, and I found out I tend to run a little high there, but come down fairly quickly—in time for when I do test toward the end of the workday. I wasn’t catching those highs at all.
I’m also surprised by how much my numbers can shift in an hour. I can drop from 130 to 85 within 60 minutes. It almost makes me think I should test every half-hour, or every 15 minutes to get a better reading. But I’m not that crazy, or that rich (16 test strips a day, plus at least one bum one already means $$$).
I’m currently at 45 units of Lantus at night, with no other insulin. The only way I have to control my sugars between doses is by carb counting. I’m low, I eat, I wait until the number drops; rinse and repeat. If I’m too high, I don’t eat, or I exercise until I can. If I’m hovering, I have to decide how many carb units I can eat without shooting me too high and not dipping me too low. (Again, complicated equations for an English major.)
I’ve been grateful to only have to shoot one insulin once a day, but based on my numbers, I think this chapter of my diabetes life might be coming to a close. I’m running too low at times and too high at others. Too much Lantus for some points in the day, not enough for other moments. I need a better balance, and I’m hoping the detailed numbers will help my new endo see this.
Oh, and have you seen the movie Holes? Where boys are digging hole after hole in the dessert to look for a treasure? And you look at the screen and see thousands of craters across the landscape? That’s what my arms look like. Another reason 16-times a day will not be a permanent testing number.
As always, more to come (still waiting for that HbA1C result)…
Friday, February 13, 2009
White Coats
I had my new-doctor visit this morning. I like him. He was nice, he paid attention, he appreciated my medical resume. He asked questions. He refilled my prescriptions. He said we should see each other every three or four months until we establish a good record with each other, then we can space it out. I liked that idea—a doctor who actually wants to get to know my body and what it’s doing so he can make informed decisions when it really matters.
I didn’t go in with any complaints or specific issues; I mostly went in to establish the relationship, get a good endo referral—and to get a whole lotta bloodwork, since I haven’t had any since May (my bad). It’s funny, but it’s not actually the doctor’s visit that reveals anything; it’s the phone call a week later with the test results (TSH, HbA1c, cholesterol, etc.) that has an impact.
And here’s a fun fact about Lora. I have “white-coat syndrome.” As everyone knows, when you go see a doctor, they always take your blood pressure pretty much right when you walk into the inner sanctum. My blood pressure is always high. However, if they take it again when the appointment is ending, it’s normal. A couple nurses have told me it’s called white-coat syndrome—just the idea of being in the doctor’s office raises my blood pressure. I’ve had experience with this before, so the doctor re-checked my blood pressure at the end, and sure enough, I went from “Whoa,” to normal in the span of 35 minutes. Go figure.
And on the endo front, I made my appointment—which isn’t until April 10. I’d rather it was next week, but I guess I can wait. Maybe this is the universe’s way of saying I need to keep some better records to present. That tidy list of numbers I created really doesn’t say anything, and I doubt my HbA1c is going to give a clear picture either. I think I need to do an exercise/food intake/more frequent blood sugar thing for a few weeks. Maybe I’ll even borrow my mom’s PC and hook my meter up to it, since my meter doesn’t like my MAC.
For now, though, I’m just going to psych myself up for removing the Band-Aid from my very sensitive inner elbow skin where they drew the blood. It always hurts like a bitch.
As always, more to come…
I didn’t go in with any complaints or specific issues; I mostly went in to establish the relationship, get a good endo referral—and to get a whole lotta bloodwork, since I haven’t had any since May (my bad). It’s funny, but it’s not actually the doctor’s visit that reveals anything; it’s the phone call a week later with the test results (TSH, HbA1c, cholesterol, etc.) that has an impact.
And here’s a fun fact about Lora. I have “white-coat syndrome.” As everyone knows, when you go see a doctor, they always take your blood pressure pretty much right when you walk into the inner sanctum. My blood pressure is always high. However, if they take it again when the appointment is ending, it’s normal. A couple nurses have told me it’s called white-coat syndrome—just the idea of being in the doctor’s office raises my blood pressure. I’ve had experience with this before, so the doctor re-checked my blood pressure at the end, and sure enough, I went from “Whoa,” to normal in the span of 35 minutes. Go figure.
And on the endo front, I made my appointment—which isn’t until April 10. I’d rather it was next week, but I guess I can wait. Maybe this is the universe’s way of saying I need to keep some better records to present. That tidy list of numbers I created really doesn’t say anything, and I doubt my HbA1c is going to give a clear picture either. I think I need to do an exercise/food intake/more frequent blood sugar thing for a few weeks. Maybe I’ll even borrow my mom’s PC and hook my meter up to it, since my meter doesn’t like my MAC.
For now, though, I’m just going to psych myself up for removing the Band-Aid from my very sensitive inner elbow skin where they drew the blood. It always hurts like a bitch.
As always, more to come…
Thursday, February 12, 2009
Avoid Void
So, in preparation for my new-doctor appointment tomorrow, last night I keyed in all my numbers that I had written in my notebook so they made a tidy list on a sheet of paper.
I want to be able to show the doctor that my numbers are high at night, that I have a hard time keeping a cap on them after dinner, and that I’m having to eat less and less (I’m down to one carb unit) in order to keep things even somewhat in check. I’m already pushing the maximum units of Lantus (45-47 each night) I can handle without continuously dive-bombing during the day, so I’m thinking it might be time to work in another insulin at night, before I eat dinner.
Unfortunately, that tidy list doesn’t show a lot of my high-at-night numbers. Not because I don’t have any, but because, as I realized last night, I haven’t been checking my numbers at night.
It’s a case of avoidance, in the worst way. I know the number is going to be high. The high number gives me stress, makes me worry, and there’s not a whole helluva lot I can do at 10pm at night to make it drop (no, I am NOT hitting the treadmill right before bed). So rather than take the test and see the high number, I just don’t test. My tests stop around 7pm, right before I eat dinner. There’s only a handful of numbers that show up around 10pm.
Also, I realized that while I test multiple times a day, I tend to test when I know I’m low, just as a confirmation. I don’t really feel highs, so I don’t think to test at other times of the day. I think I need to start testing two hours after I eat, just to see what’s going on. Do you think testing every 15 minutes for two days is overkill? Just to get a better handle on where my numbers are really at?
So, I’m not sure how much help my tidy list of numbers is going to be when explaining things to the doctor. I can point out the few high numbers from when I did test, and I can point out that I’m not testing at night, but I’m wondering how far that will take me.
It’s an internal medicine doctor I’m seeing tomorrow, but I’m planning on making an appointment with an endo next. Maybe I will try that 15 minutes thing, or at least stop avoiding seeing that high number and actually testing after dinner.
As always, more to come…
I want to be able to show the doctor that my numbers are high at night, that I have a hard time keeping a cap on them after dinner, and that I’m having to eat less and less (I’m down to one carb unit) in order to keep things even somewhat in check. I’m already pushing the maximum units of Lantus (45-47 each night) I can handle without continuously dive-bombing during the day, so I’m thinking it might be time to work in another insulin at night, before I eat dinner.
Unfortunately, that tidy list doesn’t show a lot of my high-at-night numbers. Not because I don’t have any, but because, as I realized last night, I haven’t been checking my numbers at night.
It’s a case of avoidance, in the worst way. I know the number is going to be high. The high number gives me stress, makes me worry, and there’s not a whole helluva lot I can do at 10pm at night to make it drop (no, I am NOT hitting the treadmill right before bed). So rather than take the test and see the high number, I just don’t test. My tests stop around 7pm, right before I eat dinner. There’s only a handful of numbers that show up around 10pm.
Also, I realized that while I test multiple times a day, I tend to test when I know I’m low, just as a confirmation. I don’t really feel highs, so I don’t think to test at other times of the day. I think I need to start testing two hours after I eat, just to see what’s going on. Do you think testing every 15 minutes for two days is overkill? Just to get a better handle on where my numbers are really at?
So, I’m not sure how much help my tidy list of numbers is going to be when explaining things to the doctor. I can point out the few high numbers from when I did test, and I can point out that I’m not testing at night, but I’m wondering how far that will take me.
It’s an internal medicine doctor I’m seeing tomorrow, but I’m planning on making an appointment with an endo next. Maybe I will try that 15 minutes thing, or at least stop avoiding seeing that high number and actually testing after dinner.
As always, more to come…
Tuesday, February 10, 2009
My Medical Resume
I have an appointment with a new doctor on Friday morning. I’ve had four doctors since my dx, and I’ve had to give a detailed history to each one.
I’ve finally gotten smart.
Knowing I’m going to have to give my story all over again, I decided to write everything down. When the doctor asks, I’m just going to give him the sheet of paper. I’ve written down my childhood conditions that might be pertinent today, my teen/early 20 issues and everything about my current conditions, the two biggies being diabetes and Grave’s disease.
I wrote down who my other doctors currently are (gyno, dentist, eye doctor, therapist), what prescriptions I’m on (seven) and what dosages.
I wrote down what my HbA1Cs have been over the past years and what my numbers have been in general.
I’ve written down any procedures I’ve had and any hospitalizations.
I might even call my mom and get some background history on what the grandparents all had (they’ve all passed from various issues which I generally know about, but not the specifics), and on what mom and pop are currently dealing with (I inherited the Grave’s from dad, but what else is looming on the horizon?). I should have all this info anyway, and it’s about time I act like I’m a responsible 40-year-old and write it all down.
I do have some of my medical records, and I’m in the process of tracking down the rest of them, but I’m thinking that even if I hand the new doctor a four-inch thick stack of papers at our first meeting, he’s not going to sit down and read everything while I wait (it will take him way longer than that to decipher the various handwritings). He might, however, read a couple pieces of paper and be fairly caught up to speed.
So now, in addition to having a professional resume, I now have a medical resume. How important am I?
As always, more to come…
I’ve finally gotten smart.
Knowing I’m going to have to give my story all over again, I decided to write everything down. When the doctor asks, I’m just going to give him the sheet of paper. I’ve written down my childhood conditions that might be pertinent today, my teen/early 20 issues and everything about my current conditions, the two biggies being diabetes and Grave’s disease.
I wrote down who my other doctors currently are (gyno, dentist, eye doctor, therapist), what prescriptions I’m on (seven) and what dosages.
I wrote down what my HbA1Cs have been over the past years and what my numbers have been in general.
I’ve written down any procedures I’ve had and any hospitalizations.
I might even call my mom and get some background history on what the grandparents all had (they’ve all passed from various issues which I generally know about, but not the specifics), and on what mom and pop are currently dealing with (I inherited the Grave’s from dad, but what else is looming on the horizon?). I should have all this info anyway, and it’s about time I act like I’m a responsible 40-year-old and write it all down.
I do have some of my medical records, and I’m in the process of tracking down the rest of them, but I’m thinking that even if I hand the new doctor a four-inch thick stack of papers at our first meeting, he’s not going to sit down and read everything while I wait (it will take him way longer than that to decipher the various handwritings). He might, however, read a couple pieces of paper and be fairly caught up to speed.
So now, in addition to having a professional resume, I now have a medical resume. How important am I?
As always, more to come…
Thursday, February 5, 2009
1, 2, 3, 4…
I’m playing a different sort of numbers game today…
17 the number of days it took Saturn of Glenview to fix my car (Saturn sucks!)
70 the route number of the city bus I took to get to work for 17 days
7 the approximate age of the girl on the bus who had a runny nose and kept wiping at it with her hand, then rubbing her hand EVERY WHERE
99.8 my fever this morning from the cold/flu I’ve managed to fight off all winter, until, well, see the three above
3 the number of “really great” doctors my gyno recommended for me to try (Saturn sucks, my gyno is fabulous)
5 is how many pounds I’ve lost so far this year—yay me!
6 requests are waiting for me on Facebook. I’m just not sure I want to get into the whole fairyland, blue cove thing…
2,312 the number of vacation days I’m ready to take right now. Somebody send me a plane ticket and a million dollars and I’m gone, baby, gone
2 is the number of requests I’ve made to St. Mary’s of Nazareth Hospital for my medical records from my DKA stay with them. I’m hoping this second time does the trick
1 day is all I have to left to endure before it’s Saturday and I can sleep in, watch Tivo, share my overstuffed chair with my dogs and eat popcorn (which, surprisingly, doesn’t have that big of an effect on my sugar—go figure)
As always, more to come…but NO MORE BUS!!!
17 the number of days it took Saturn of Glenview to fix my car (Saturn sucks!)
70 the route number of the city bus I took to get to work for 17 days
7 the approximate age of the girl on the bus who had a runny nose and kept wiping at it with her hand, then rubbing her hand EVERY WHERE
99.8 my fever this morning from the cold/flu I’ve managed to fight off all winter, until, well, see the three above
3 the number of “really great” doctors my gyno recommended for me to try (Saturn sucks, my gyno is fabulous)
5 is how many pounds I’ve lost so far this year—yay me!
6 requests are waiting for me on Facebook. I’m just not sure I want to get into the whole fairyland, blue cove thing…
2,312 the number of vacation days I’m ready to take right now. Somebody send me a plane ticket and a million dollars and I’m gone, baby, gone
2 is the number of requests I’ve made to St. Mary’s of Nazareth Hospital for my medical records from my DKA stay with them. I’m hoping this second time does the trick
1 day is all I have to left to endure before it’s Saturday and I can sleep in, watch Tivo, share my overstuffed chair with my dogs and eat popcorn (which, surprisingly, doesn’t have that big of an effect on my sugar—go figure)
As always, more to come…but NO MORE BUS!!!
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