Thursday, March 27, 2014

What is Good?

Recently I went into the lab to get some routine blood work done, as I have an endo. appointment coming up next week.  Of course, not only do they forward the lab work to my end's office, but also to my family doctor's office.  It did catch me off guard when my family doctor called this morning.  It was the nurse on the other line telling me that she just received my blood work. I flashed back to when the same lady called me five years ago to tell me that my blood sugar was high and that I needed to come in.

Sadly, she said something along the same lines, "your blood work came in, your A1c is really high..." I thought I heard her wrong. I was mid-nap as we had to leave Hamilton at 7 am to make it to London for 10 a.m (since Vince booked an early doctors appointment) so I figured I must have heard her wrong.  My last A1c was 7.2, just before my climb up Mount Kilimanjaro.  So, I asked what the A1c was:


7.8, well it's not perfect, but I've seen higher, I've heard of higher and I am not sure that my endo. is going to be overly disappointed in me. After all it's been winter for a few years (or at least it feels that way) and it's crunch time for school, finals are coming up, essays are due, assignments are due, and not to mention I maintain a social life and work life that gets me through.  She then asked if I am still seeing my doctors in London.   My god.

See, I feel like as type one diabetes we are spread thin between so many health professionals, amateurs, judgey-mc-Judgersons, and to be honest our friends, families and all of the people that keep tabs on our diabetes.  It's not a bad thing to have people guiding us along the way but when a diabetic feels like they are running out of air, it truly feels like we're well, running out of air.

I wanted to say back, "Of course I see my doctors, why else would I get my blood work done.  Also, do you know it's the end of the school year? Do you know what is 'good' for people with diabetes. Do you know what it is like to deal with a disease that wakes you up in the middle of the night forces you to eat cookies, tabs, bananas, juice boxes and glasses of milk and then you're expected to write important exams the next day? Do you know what it is like to have to apologize time after time for getting short with someone because your blood sugar is high because your pump is in your shirt and you didn't want to disrupt the conversation by having to reach down your shirt to give insulin...DO YOU KNOW!"

And, while I know not everyone can know. Those that are in the professions that need to know, well they need to know.  I am not new to diabetes and telling me that my A1c is high on the phone, in the morning, is not the ideal way to wake up, especially when I don't feel like it is all that bad.  I am sure I have ranted about this before, as it has happened before. But, the important message to anyone that stumbles upon this post is that people living with diabetes are spread thin sometimes and it is important to acknowledge that we actually do care to take care of ourselves, but it is not always easy and the messages we receive as patients can be very misunderstood as we never really know, what is good?

1 comment:

  1. We may actually have the same family doctor (not even exaggerating). If you are curious (plus I understand if you don't want me to post the doctor's name) I can send you a private message somehow ?

    Anyways, the confusion that came into play with the nurse is she thought the random or fasting BG listed on the lab report meant that your a1c corresponded to that number. Its hard to explain what she was saying, but my a1c was 8 something at the time but they drew m blood when my sugar was 15 something. So she called me because she thought the lab report said my average sugar was 15 and that is what the a1c of 8 something corresponded to an average sugar of 15.

    Technically, they say your a1c should be below 7 but that is not realistic for most type 1s without a CGM.

    I have not heard of many clinics in out area pushing patients to be below 7, some clinics in the US are very big advocates of the a1c being below 6.9 maximum (I think it has something to do with the Endo getting incentives from the insurance companies if he or she has more patients meeting targets.)

    They say that to get to 6.9 you have to meet CDA targets. So spike to a maximum of 10 mmol for a maximum of 2 hours after eating and spike no higher than 7 any other time. If you deviate from that supposedly you cannot hit 6.9. Not sure if I believe that though.