Wednesday, July 3, 2013

On and Off the Wagon

So, for several years I have had pretty bad control of my diabetes. There, I said it. I know it was bad, and I know it was wrong, but I was doing it anyway. I feel like most of the people in the diabetes online community have some wicked good control, or at least decent. I feel this is a coming out of sorts. I hope this can help anyone who has had bad control get back on track, or at least let them know they aren't alone.

This time last year, my A1C was about 12. Seriously. I don't know how I did it, but I survived for quite some time with A1C values above 10. Aside from being more thirsty than anyone around, I didn't feel too bad. I could exercise, think clearly, and see very well. I knew what I was supposed to be doing, but I never did it. Why? I'm not sure. It wasn't all laziness. Some of it was just apathy. I was experiencing some serious diabetes burnout. On average, I did between 0 and 1 blood test per day and bolused randomly. I changed my set when the old one fell out, which could be up to 14 days. I was bad news.

Things began to change for me when I got a new endocrinologist. My old endo (OE) was pretty bad. I was not taking care of myself, and he was content to let me continue that way. He put me on Metformin, which is usually described for type 2 diabetics. He said it would decrease the amount of insulin I needed. In reality, it did nothing to my insulin needs and gave me a terrible stomach ache for as long as I took it (over a year). After a while you just get used to feeling like garbage. I never did get a clear reasoning for the Metformin.

One day I called to make an appointment and was told that OE no longer worked there, but I could see the new doctor (NE). When I showed up to the appointment, they had no records of what medication I was on. OE had never made record of what he prescribed me! After sorting out the medication record, NE told me point blank that I had really crappy control and I needed to do better. She asked me why I wasn't taking care of myself. I (obviously) couldn't give her any good reasons. How hard is it to do a blood test? Then she changed a bunch of my basal rates and carb : insulin ratios. She then scheduled me for a follow up two weeks later with her nurse, and made an appointment with me one month later, when my prescriptions were going to expire. She asked me to do four blood tests every day for two weeks: breakfast, lunch, dinner, and bed. Okay, I could do that. I started testing and bolusing accurately, and my blood sugars plummeted. It felt strange because NE lowered all of my insulin needs before asking me to start testing. I thought maybe my carb counting was rusty, so I started being super, super vigilant about my carbs. I was still low all the time. When my blood sugar was normal it would bottom out as soon as I did anything active.

When I went to my follow-up appointment with the nurse, we changed a lot of my settings again, and added a few new basal rates. A month after that I kept going high. I had changed more pump settings. I think I'm now on some good rates.

 As a result of all of this, my A1C is now sitting at around 8.5. While it's not perfect, it's much better than my 10.5 A1C. I feel like right now I'm on the right path. I test about 7 times per day, minimum. I bolus regularly.  If I'm not sure about a carb value, I'm more likely to look it up than just guess. I mean, sometimes I do guess, but nobody's perfect.

Now that I have this off my chest, I feel much better. I feel honest. :)

1 comment:

  1. Courtney, I am so happy you are writing. And honesty is such a great way to do go about blogging. The truth is, most of us are in the same boat as you. I certainly relate to not understanding why I just don't 'do' diabetes sometimes. Apathy is the word i have used also, but it doesn't seems to encapsulate the activity of non-intentional ignoring. Thank you for offering your voice to the community. Your honesty and courage will resonate and help many. <3