Tag Archives: endocrinologist

The future is not yet written.

January 19, 2014 – 11:26 pm

Sooooo, how did that visit with my endocrinologist go last Thursday?

For the first time in a long time, I was seriously worried about a visit with my endo. Simply put, I have not been a good citizen. As far as I could tell, my BGs were running higher than usual in the past three months. On top of that, my eating habits weren’t so fantastic either. I was sure that the results of my tests were going to be awful, and I was going to have to make some serious changes to get back to where I’ve been for the last five years.

I was very concerned about letting down my endocrinologist, who’s been instrumental in helping me focus on the right things, helping me keep my numbers in a good place on a consistent basis.

So… So… How did it go?

Surprisingly well.

My A1c stayed exactly where it was last time. I did manage to gain two pounds over the holidays, but I thought the scale was going to show I had gained much more. I’ve got some work to do, but overall, it could have been much worse.

I’ve spent a lot of time thinking about it over the weekend, and I think there may have been one thing that helped me.

I did a lot of glucose checks every day. Probably more than ever before. Even when I knew the number might not be good, I tested anyway, so I could make corrections if necessary. And there were days when I made a lot of corrections. That may have made the difference. Diligence works.

Going forward, I have two things to remember. I need to work out more often, without a doubt. And I need to eat better. Which, thankfully, I’m already doing.

Hey… Listen, it’s true that this diabetes thing is really a marathon, and not a sprint. That said, I’m glad that last week’s visit turned out well, and I’m happier still that I have a chance to be even better going forward. The future is not yet written. And I’m encouraged by that.
 
 
 

By StephenS | Posted in Endo | Also tagged , | Comments (5)

Keep on truckin’.

January 15, 2014 – 9:11 am

Piggybacking on last Friday’s post, I was happily able to tweet this on Saturday evening:

Tweet

Pretty encouraging, right? But that tweet hides a lot. To be honest, completing that workout was extremely difficult. Man, I’m out of shape.

This was my first real workout in a long time. There are a number of reasons for that. To begin with, my schedule at work changed in the fall. After 15-plus years, I’m now required to be there half an hour extra every day. I decided to add that extra half hour at the beginning of my workday. And since my workouts during the week were always in the morning before work, I wasn’t able to do that anymore. Also, to be honest, after my final long bike ride last year, I didn’t have the same motivation to get to the gym that I had earlier in the year. Add in participation in a clinical trial and a couple of other things that came up, and it meant I wasn’t getting to the gym on the weekends either. In fact, I hadn’t been to the gym since early November.

So I’ve started my training, but it’ll be slow going for a while. On the bright side, I’ve seen a noticeable difference in my glucose after just working out Saturday and Sunday. Really good differences, which I definitely need, because those numbers have been creeping up a bit for the last month or so. For the first time in a long time, I’m worried about disappointing my endocrinologist when I go in for my appointment Thursday. That’s how I look at it too. She works hard and has done a great job with my care for a while now, so if I’m less than stellar with my A1c, I’ll feel a bit like I let her down. Oh well… one concern at a time.

The one thing I’ll try to remember through all of this is to keep on trying. Never give up. Yesterday is yesterday. Just a reference point. I can’t do everything, but I can try to do everything I can to make things better in the future. I hope you look at your diabetes the same way.
 
 
 

By StephenS | Posted in Exercise | Also tagged , | Comments (1)

#DBlogWeek – Day One. To share or not to share?

May 13, 2013 – 8:50 am

diabetes-blog-week

Yay!!! Diabetes Blog Week has officially begun. Myself and many others will be posting for the next 7 (seven!) days. Haven’t heard of Diabetes Blog Week? Get the lowdown by clicking on the banner above. Now, on to the first day’s subject:

Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?

Well, um… my endocrinologist already reads my blog. Not every day, but enough that if I post something about a terrible low, for instance, I’ll probably get an e-mail within the next week or so.

What do I wish she, and my primary doctor could see about my daily life with diabetes? Probably that my life isn’t perfect, but I’m living. And I’m living a pretty good life. Sure, there are tough days, but I keep on going. It’s not the tough days that define me. It’s getting back up after I’ve been knocked down by this disease that means everything. And if I’m having a hard time getting my BG up into the hundreds or down into the hundreds, it doesn’t always mean I’m screwing up. Sometimes it means I’d be even worse off if I wasn’t trying so hard.

But honestly, when it comes to me and my endo, there’s not much I don’t share. What? What’s that? You’re honest and open with your endo? In what world does this happen?

It happens in a world where your doctor speaks your language. Where your doctor wants to hear what’s going on with you… so if updates are needed in your care, you can discuss them. It happens in an atmosphere where the object of an appointment is both to measure how you’re doing and to discuss what to do in the future to make you better. Such a universe does exist, and I encourage you to find it if you haven’t already.

Now, what do I hope my medical team doesn’t see? I hope my doctors don’t see how concerned I am about my weight. I’m doing what I can to keep from gaining, but my metabolism just isn’t helping me these days. Still, I’m doing what I can. But I could use the help of a dietician. I’m still eating a lot of junk. Anyway, that’s probably the top of the list.

Other than that, my medical team pretty much knows everything. And that’s good. My doctors can help the most when they know the most. It goes without saying (but I’ll say it anyway), two-way discussion without making a patient feel guilty is worth its weight in gold. Hope your medical team is 14 karat spectacular!
 
 
 

By StephenS | Posted in Diabetes Blog Week | Also tagged , , , | Comments (9)

Endo recap.

March 28, 2013 – 9:29 am

Can’t believe that I’ve let almost two whole weeks go by without mentioning something about this. Too busy with other things, I suppose.

Here are some random moments from the appointment with my fabulous endocrinologist a couple of weeks ago:

– Hemoglobin A1c was pretty good. I’m again in the range where she’s worried that I’m encountering too many lows. It still feels weird after so many years of “Your numbers need to come down” to hear “This is a little lower number than I would like to see”.

– After reading about my adventurous week in January, she asked if I’m still eating gluten free. Umm, no… I’m not. But I do dig the pizza that I made, and the bread, and I felt pretty good that week, so if I can afford it, I’ll probably be doing at least some gluten free meal making in the future. Also, I’m eating a lot of salads right now, and I’ve been looking for gluten free salad dressings (Wish Bone makes some good ones).

– We talked about infusion sites. I had a stubborn high BG episode a few days prior to the visit, and we talked about whether it might have been site-related. I’m convinced that it was insulin that went bad after five days hanging on my hip. But I finally remembered to ask her opinion about whether sticking to the FDA-mandated 3 day limit to infusion sets would cause me to have too much scar tissue over time, as opposed to what I do now: keep the thing in until the insulin is gone (usually 4-6 days). Her opinion? If I’m careful about rotating my sites, I shouldn’t have to worry too much about changing out every three days. And there’s no evidence that keeping a set in longer is doing me any good anyway. I may have to rethink my position on this one.

So in conclusion: I have to tweak my basals ever so slightly, and stop aggressively blousing at every opportunity. I like eating gluten free, but haven’t moved all the way there yet. And I should consider going back to site changes every three days. Oh, and my other lab work came out okay too. No liver, cholesterol, or thyroid issues. I’m good for another three months!

Of course, I still have plenty to work on in the meantime.
 
 
 

By StephenS | Posted in Endo | Also tagged , , | Comments (4)

Has it been 3 months already?

September 3, 2012 – 8:48 am

Happy Labor Day in America! Here in the USA, we set aside the first Monday in September to celebrate those working souls who have, and continue, to help make this country what it is. At least the good things that it is. Those working souls are most of us, so here’s to us.

Has it been three months already? In fact, it has been three months since I last visited my endocrinologist. Last Friday was the time to get some tests done, talk about the last three months with regard to my diabetes, and make any necessary adjustments.

My A1c? It was a little better than last time. Out of deference to some of the people I’ve been reading in the DOC (Diabetes Online Community), I’m not revealing what that number is anymore. Those people are right… it’s just a number, and I don’t want anyone feeling really good or really bad about where they are based on my numbers. Everyone is different. Your Diabetes May Vary.

We talked about a lot of things in this visit. We decided that I need to adjust my nighttime basal rate down a bit, and also adjust my morning basal down a bit.

But I also admitted to something that I think I’ve been doing for a while, but I haven’t let on to yet:

I feel like I’m starting to bolus based on where I want my BG to be, rather than based on where my BG is and what I’m eating. I think that I’ve been starting to say to myself, for example, “Okay, I’m a little high now; I’m going to bolus a little extra to get to where I want to be, and 100 mg/DL is too high”. Do you do that, or is it just me?

My endo told me that my insulin usage has been about 60% basal, 40% bolus. Interesting to know, but is that good? It turns out that the percentages should probably be a little closer to 50-50. However, she added, “That thing where you’re over-bolusing to get to a certain low target? Stop that.” Okay, Doctor.

We also talked about my 100 mile bike ride back in June, where I had gotten dehydrated at the end. I’m hoping to do a ride co-sponsored by JDRF in a couple of weeks, and I was seeking advice on how to keep history from repeating itself.

The answer is to get a little more salt in my system prior to the ride, to get a little more protein in my system during the ride, that electrolytes are good early in the ride (but not late), and to listen to my body, and if it’s bothering me, to give it up and live to ride another day.

That’s about all. It was a good visit. I like being able to talk with a doctor who speaks the same language. Who I can ask questions of, and who I feel comfortable answering questions from. Not much more to it than that. I hope your next visit goes as well.
 
 
 

By StephenS | Posted in Endo | Also tagged , , | Comments (0)