Friday, July 23, 2010

Speaking of that A1c...

As I mentioned earlier this week, I had an endo appointment on Monday. I went to the center armed with lists, questions, and - I hoped - the gumption to tell my doctor what's what when it comes to my diabetes management.

We got off to a rocky start -- she had to hunt me down in the office. My BG had tanked down to the 40s and I'd had to abandon my spot in the waiting room to grab some crackers. (Shame on me for only having one glucose tab in my purse.) Obviously my endo's office is the best place in the world to have a tanking blood sugar, but it was still a little awkward. My mouth was all full of cracker when she found me, I was stuttering and losing my train of thought, I dropped all of my Dexcom graphs on the floor of her office, and I felt embarrassed -- not to mention a little less "Listen to me!" full of authority and self-confidence than I'd wanted for this particular appointment.

It turned out all the flustered low ridiculousness -- and all my preparation -- was besides the point. My A1c came back at 6.2. She gave an "explanation" for where that .6 went from my June blood draw, but it sounded like a bunch of hooey about test sensitivities blahblahblah. Not that I was going to complain about a .6 drop in my number - I was pleased, and even more so when she said that meant we were basically where we wanted to be. Just one last leeeetle tweak for the next few weeks: overnights.

Apparently, I sleep a lot. ("Not that that's bad," she hastened to add when my expression turned to one of shock and horror at such a statement.) And all those hours in sleepyland with BGs that aren't awesome means an uptick in my A1c. My numbers are steady throughout the day -- "impressively steady" enough that she can't tweak them down any more -- so all my work has to be done on my overnights.

Like any PWD, I knew where the work needed to be done. I live with my numbers day in and day out, and I knew where I had to be a little more rigid. My marching orders now are to implement that rigidity -- the doc said they try really hard to be accommodating and make life for PWDs as normal as possible, but "This is not the time for that" for me. So that's my new mantra. I'll be putting little sticky notes up all over the place to remind me of that, to help underscore the fact that there's a goal I'm working toward and this maniacal level of attention paid to my disease is not going to last forever. But until that goal is hit, there's Karen's New Night Regime, which includes
  • mantras on Post-its
  • iron-clad rules about how late I'm eating and what I'm eating late
  • submission of Dexcom overnight graphs to see what my BGs are doing
  • rounds of 3 a.m. fingersticks to make sure my basals are all aces
I'm sure KNNR will grow and adapt as time goes on, but it's nice to have a proactive plan again. Just like I'd been all prepared to demand in the first place.

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