Wednesday’s DSMA Chat was very timely this week. We all spoke of our feelings about, and tips and tricks surrounding, doctor visits. I had my quarterly visit with my endocrinologist yesterday. I always cringe when I read about someone’s bad medical care experiences: either a doctor who has no time for them, or someone who makes them feel like crap for yesterday’s issues, instead of helping them look toward solving the future. My endo is great. I had to go through three doctors to get to this point, but I’ve finally got a keeper. I mean someone who talks to you, who asks the right questions, who lets you ask questions, and then gets you to adjust what you’re doing rather than telling you to scrap your entire plan of attack for something that’s comfortable for them, or for something that big pharma is paying them for.
So on to the appointment, or as much as I can divulge of my appointment over the internet (tongue firmly in cheek).
First, the big number. I expected my A1c to go up this time. My last one was 6.3. It’s been going down steadily for over two years, so I figured the streak had to end sometime. And I haven’t exactly been on a starvation diet over the last three months. So imagine my shock when I found out that my latest A1c is: 5.9
WTF?
There has to be more to this story. I mean, I’m trying my best to take care of myself, but this is too good to be true. “Have you been having a lot of lows?” asks the doctor. Why, not more than usual, I say (what is usual anyway?). So we look at the Medtronic readout. The chart for the last two weeks tells me everything I need to know about where I need to focus, and why my A1c is good, but not a definitive snapshot of my glucose levels over the past three months:
I know it’s hard to read, so I embellished it with a couple of lines of my own, only to help point out where my trouble is. Right in the middle of the day! My okay to slightly high morning and evening readings over the last two weeks (with a couple of exceptions) were counter-balanced by almost universal lows around lunchtime. It made my average BG over the last two weeks: 106.
The page also suggests three things that I already knew about. One, I eat too many carbs at breakfast. Two, I eat too many carbs at lunch. Three, I eat too many carbs at dinner. Which suggests, without a look in the mirror, that I’m managing my glucose better than my waistline right now. Even though I’ve actually lost a few pounds. Good thing the lettuce will be ready in the garden soon. I have a feeling there will be a lot of salads in my future.
So what do we/I need to do going forward? As you can guess, I’ve already ratcheted down my morning basal a bit. And we talked about how to manage my 150 mile ride in a week and a half. I’ll have the pump on the whole time for this, which makes it different from any other event I’ve entered. I’ll use a temp basal of 50% of my normal rate during the ride, then 60% to 70% of normal for about four hours after. And the carb thing is my problem. Only one way to fix it, and we all know what that means.
Here’s hoping your next visit with a medical professional goes well. Feel free to tell me about it, good or bad, by leaving a comment below.
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