Better Than Therapy

Going to the endocrinologist is good for me. I don’t just mean it helps me stay healthy, I also mean that it helps me stay sane.


I’d gotten reasonably zen about diabetes management, especially since I was doing really well. Then I got pregnant, and zen immediately slipped from my grasp. My control on my blood sugar suffered, not due to any lack of effort or education, and my stress went through the roof in response.

In a zen state, I’d have said, “OK, my blood sugar is going higher than it should. All I can do is what I can do. Crying and feeling guilty just wastes energy.” But I was not in a zen state. You see, not only was I hormonal and dealing with life changes, but I was also reading blogs, forums, websites, and books on pregnancy with diabetes.  Everywhere I turned I read about all the horrible things that can happen if your blood sugar is high, and a high blood sugar seemed to pretty much be anything out of that super tight range for pregnancy.  I seemed to absorb other women's obsession or anxiety over this, as if I didn't have enough of my own. Though my endo’s office had called me back right away with my new blood glucose goals (under 100 before eating, under 120 two hours after), it was the internet that made me scared of higher numbers. Not even counting the occasional and mysterious 200+ number that happened even when I did everything by the book, I felt like a horrible mother who was actively mutating my own baby whenever I decided to indulge in a treat (say, a small ice cream?) and came in somewhere closer to 150 two hours later.

*cue internal freak-out and self-guilt-trip*

But visits to my endocrinologist have put things in perspective every time, so far. Never once has she criticized me, never once has she told me that a number is dangerous, never once did she suggest I need to try harder. No. She even told me the first time I came in with numbers that upset me, “I’m not worried.” She doesn’t worry, she deals. “Numbers like these will happen, but we need to figure out how to keep them from happening too often.” Then we’d discuss a game plan.

Yesterday’s visit with her was fabulous. I handed her a sheet with numbers that were much improved, but definitely not even close to perfect. We were both on the exact same page about how to fix them, and she made some adjustments to my morning basal and evening I:C. She said that I was really doing well overall, and I walked out feeling not like I had failed with those less-than-perfect numbers, but that I had done a great job of improving them and was leaving with a plan to make them even better, maybe even get them in line once and for all… Well, once and until my insulin needs change again! Damn hormones!

Victory!

Less than six months after diagnosis, I had another appointment with my endocrinologist yesterday…  And it was full of awesome!

It addressed a lot of things that have been frustrating me since my diagnosis.  The most obvious issue is wanting to be healthy and have my blood glucose under good control, and I found out that my A1c has come down to 6.1!!!  That’s down from 13.4 when I was diagnosed!!!

*happy A1c dance*

Another huge issue for me is being in control of my own health... and I don’t necessarily mean “in control of my health despite diabetes.”  I mean something more along the lines of, “In control despite the fact that my life now contains a menagerie of medical professionals telling me what to do.”  I am so glad those medical professionals are there, and I know I could not have gotten so under control so quickly as I did if I hadn’t followed their instructions to the letter, but I couldn’t help but feel that they were in control of my health... and sometimes, I was waiting and waiting for confirmation on a change that I already knew I needed.  So I thought, once and for all, that I was going to ask my endo for official sanction to make adjustments to my treatment myself.  I went armed with a bookmarked copy of Pumping Insulin and lots of explanation as to why I could safely and effectively make my own decisions.  When she asked if I was still working with my CDE, this gave me the opportunity to explain that I was still working with her, but I wanted some more freedom to make my own changes.

“Oh yes, absolutely!”

Oh.  OK.  That was easy!

She gave me some guidelines for making decisions, told me I can fax her numbers anytime I need help, and said she was completely comfortable with me making these decisions.

*happy victory dance*

And another biggie…  Something I was sure I wouldn’t hear her say considering the numbers I was showing her included two highs over 200 and one bad low of 43 this past week…  She told me that it’s safe enough for me to go ahead and start trying for a baby whenever my husband and I decide to!!!  (She understood that last week was a weird one for me, and said, "With type 1, it's never going to be perfect.")

*happy baby dance*

I feel like I’ve reached important goals and blown hurdles right out of my path.  Life is good, and I believe I have the ability to shape my future the way I see fit instead of around my disease.

Numbers and a trip to the endocrinologist

My blood sugar numbers have gotten pretty good, and I really hope my Diabetes Educator lowers my target numbers.  They're currently 130 (before meal) and 180 (after meal), but the general range I'll be shooting for eventually will be between 70 and 140... or 70 and 120 when I get pregnant.  Most of my numbers are generally between 100 and 150 right now, which isn't too far off from that long-term goal range!

I went to the endocrinologist yesterday, which I'll talk more about later.  But she told me three things that make me very happy:

1. I should go ahead and start the paperwork necessary to get an insulin pump.  I may not be able to get it until I've met some time requirements set by my insurance (6 months), but starting now means less waiting when I get to that point.
2. She doesn't see any reason why I shouldn't be healthy enough to start trying to get pregnancy again by the end of the year, maybe even by fall.  (Also, planning a pregnancy makes getting a pump approved much more likely!)
3. She thinks we should see how much my improving blood sugar lowers my cholesterol before starting cholesterol medication.  She seems to think there's a chance I won't have to take any at all until I'm older.  *This is quite different from my GP's statement that she's never even known a diabetic who had their cholesterol sufficiently under control without medication.  If my cholesterol improves enough that my endo doesn't think I need meds, I may take the middle road:  Wait until I'm done having babies, then take the meds if my GP still thinks it's warranted.)

So far, I'm leaning toward an Animas Ping insulin pump.  (Medtronic's Paradigm is a close 2nd choice.)  I'm already looking forward to the greater precision of a pump!