Wednesday, February 15, 2006

After the problems I have been having with my blood sugar recently, I made the executive decision to move my appointment up. Last week, I had major problems with high blood sugar (for no apparent reason) and I'm still experiencing the same blood sugar issues that I have been, after exercise. I didn't want to hold off or wait any longer, so I called and asked if I could be seen sooner.

Well, the appointment was today. My main goal was to discuss some of the problems I've been having with my Diabetes. I was hoping that by voicing my concerns, Dr. P would take my concerns a little more seriously. That is, serious enough to realize that some kind of change or adjustment is needed to my current Diabetes Regimen. I mean, isn't the goal to achieve better blood sugar readings and, ultimately, control? And who is the best judge of where things stand, than the person dealing with the disease first hand. However, that sometimes doesn't mean too much, unfortunately.

Anyway, things kind of got off to a rocky start to begin with, which is never a good sign. My plan was to get up this morning...and get my workout done and out of the way. Well, of course, things CAN'T be that simple for me- they never are. I didn't have to wake up as early as I would have to if I was going to work. I guess that was one nice thing. So I got myself dressed and ready to go to the gym. By the time I got in my car and was on my way, it was 8:20 goal was to be on my way @ 8:00.

I got to the road, before the main intersection, and realized it was completely backed up. :( This was not good. Anyway, since I am still not that familiar with my neighborhood yet, I wasn't' sure of another way to go to get to the main road. But I decided to take my chances, so I made a U turn and followed one of the other cars that had also decided to turn around.

I actually found my way out. You don't know what a big accomplishment that is, but, believe me it is. I admit, this girl has absolutely NO sense of direction. It was pretty much a miracle that I ended up on the main road and knew where I was. Of course, it was further back from where I needed to go (and also extremely backed up), but, like I said, at least I knew where I was. Finally, after I got past that road and another busy intersection, I got to my destination.

By this time, it was 8:45 am. This left me only about an hour to do my exercise, and quickly change and get ready for my appointment. The trip up to my Endo is about 15 to 20 min, depending on traffic. I was planning on running for, at least, an hour today on the treadmill, showering, and doing my hair. However, due to my chronic tardiness and the traffic situation, I knew that wasn't going to fly. I had to modify my workout substantially and skip the shower. I know that sounds gross, but there was no way I was going to make my appointment if I tried to do all that. So I quickly washed up a bit, changed, and ran my flat iron through my hair. I left the gym at about 9:55. I ended up being 5 or so minutes late. Not to make excuses for myself, but are doctor's offices ever "on time"? No, so I don' think it messed things up too much in the long run.

I soon was called back by the medical assistant, so I followed her back to one of the side offices. To my dismay, I was told to stop at the scale. I was kind of hoping to skip over this part of the exam. I didn't think that I had been overeating lately, but I always apprehensive about stepping on the scale. Well, guess what?! I gained :( :( :( . How can that be???! I am still exercising pretty religiously and I've been trying to be more conscious of my food choices and yet I put on weight? Ugh :( . How frustrating.

I know it's only up a pound or two, but I was up at my last appointment too, so I am kind of in disbelief of this whole thing. Hmmm, can I blame it on water weight? LOL. After that, I felt like a plump sausage in my pink sweater and grey slacks. You ever notice how tight clothes get after finding out that you've gained a little weight. I am trying to make peace with it, but I haven't been able to get comfortable since that point

Anyway, after that, the medical assistant took my pulse and blood pressure and then took my blood sugar (which she almost forgot). Incidentally, both my blood pressure and my pulse were low. So...I guess it makes perfect sense that my blood sugar would follow suit. I tested in at a lovely 49. I kind of had the feeling I would be , but I wasn't experiencing any drastic symptoms, such as shakiness. The only real symptom was a bit of light headed-ness.

I wasn't real happy about this reading. I knew what it would mean. They would not let me drive until we brought it back up. So out she goes to fetch juice and peanut butter crackers (just what I need for my diet :( ).

When this happened once before, they made me sit and eat until it was up. For some reason, that day, my blood sugar just did not want to budge. I basically ate the practice out of house and home. They gave me glucose tablets, juice, crackers, and pastries... before I was back near normal range. Later on I rebounded high. It's sort of a no win situation. So this time, I was praying that it would not be a repeat of that. Thankfully, it wasn't. I drank the juice and ate about 3 crackers and it seemed to do the job.

As for the visit itself, it went okay. I really like my Endo a lot. He's very down to earth and easy to talk to, which is so important when it comes to treating a disease like this one. Instead of sitting up on the examining table, he had me come sit beside him and we discussed what has been going on, on a more "level" manner. Have to say, I really do prefer that approach.

I again voiced my frustration and disappointment that I am still experiencing the same problems with my blood sugar levels. I think he understands, but, again, he stressed how important it is to make sure my basals were correct, before anything more drastic is done, i.e. Symlin. I know that makes sense and I told him that I understand that, but after a while a person's patience runs thin. He was trying to be sympathetic to how I feel, but I don't think there's any way for him to fully understand what it's like. He was pretty adamant about testing the basals (for all times of day) and then seeing where things go from there. Obviously, I wasn't going to be able to change his mind. He was sticking to his guns.

So as things stand now, I have to, again, perform the basal test-ugh- for the evening and check in with him in about 2 weeks, aka a phone conference. Then he wants to do another follow-up in a month or so to see where things are from there. Although, I am not happy that there wasn't any adjustment or change, it is nice to know that he willing to work with me on this. That is encouraging to me.

I guess we'll see how things go from here. I think once I get the basal testing finished, I'll be feeling a little better and, who knows, maybe I'll see some improvement. At this point, I'll take any improvement I can get. A slight bit is better than nothing at all.


Blogger mytime79 said...

I have to say that your post made me laugh a little (thanks I needed that). Having a doc/endo that you feel real good about is one of the most important things. Sorry that you have to do another basal test (I, of course, still haven't done mine). Did you pick a day that you were going to do the test?

1:38 PM  
Blogger Johnboy said...

It's funny what you say about being made to eat at the endo office. My nurse wanted me to have something even though i was 75 in the office one time.

Hey, I totally understand about getting the basals right, but it's funny how some people see Symlin as drastic. I don't view it that way at all and my endo suggested that if I wanted better post-prandial control or expanded meal options, I could try it even though my A1c was quite excellent.

I don't think it's a desparation move at all. Just one opinion though. :-)

5:47 PM  
Blogger Andrea said...

MT79-I'm glad that I could make you chuckle. I'm in total agreement- I'm lucky to find an Endo who's so easy to talk to. It makes a difference.

Yeah, I actually went home that night of my appointment and decided to do the basal test that night (wed). I just wanted to go ahead and get it out of the way.

I'm actually going to try and get a hold of a CGMS system. So it's possible I won't need to do any further basal testing for right now. Maybe that's something to look into yourself... I know how annoying these tests can be.

btw, I just read your latest blog- I hope things start looking up for you...take care of yourself, k?


I have made a real pain of myself regarding the Symlin issue. I don't see it as a drastic move either. However, I guess my doctor feels that he doesn't want to throw another variable into the mix. He wants to make sure all my rates are set correctly before I try Symlin. I guess that makes sense, but I'm running out of patience :( .

Hopefully, like I was telling MT, with help of the cgms system, I'll get to the bottom of this all and Symlin will be in my near future.

Thank-you both for your comments :)

11:13 AM  
Blogger bethany said...

how do you do a basal test? i'm very cursious as i'm going to try and convince my dr. to let me go on symlin on March 1st - ug - diabetes sucks sometimes. (sorry you had such a crappy day!)

11:27 AM  
Blogger Johnboy said...

Well, it sounds like getting everything in line first is probably a good idea. Increasing exercise definately lowered my basal requirements, but not my bolus sensitivity.

Good luck and have a great weekend!

5:47 PM  
Anonymous Tiffany said...

Jeez Andrea, you've been having it rough. I hope things smooth out soon!

There are a few things you've said here that really resonated with me:

"I made the executive decision to move my appointment up"
"And who is the best judge of where things stand, than the person dealing with the disease first hand"

From what you've posted in the past, I gather that you don't make any treatment changes without direction or consultation from your endo. Girl, I think you need to grab the bull by the horns and start taking a proactive and direct approach towards your disease. After all, you said it best; no one knows your disease better than you do! You're never going to learn how to micro-manage your own disease if you're constantly taking direction from someone else, especially using the pump. Have you ever gone to a Diabetes Education class? They teach you the mechanics of Diabetes, and encourage independence. Support groups are also a Great place to learn about self-management from peers who've experienced years in the game.

Maybe it's time you make an executive decision about the Symlin, too. Yes, your basals should be tested. But that doesn't mean that you shouldn't have access to every advantage available to you. Do you have a GP/PCP? If you really want to go on Symlin that badly, you could always take the initiative of procuring the Rx yourself, from someone who is willing to give it to you. Yeah, it's sneaky, but it might get you what you want. And if you're not willing to go that route, then maybe you need to be firm with your endo, give him an ultimatim. Either he works with you on the Symlin thing, or you find someone who will. You're paying his bill; just because he's got years of education and some fancy degrees doesn't mean that he's entitled to pass an iron-clad verdict on what you can or can't do with your own body.

(OK, stepping down off of my soap-box now...)

I say blame it on water retention...or even better, Muscle Mass! ;)
I'm serious though; do you ever measure yourself with tailor's tape? Maybe that 2 lbs is resulting in extra buff??

Hang in there and don't let it get you down! And, as always, if you need an ear you know where to reach me :)

5:17 AM  
Blogger Andrea said...

Bethany- I apologize, I wasn't ignoring your post.

I don't know if you are a pumper or not, but if so, you should have been given basal testing guidelines by the manufacturer/pump company in the manual. My pump is part of the Paradigm series by Minimed. Included in my manual were instructions on how to do a basal testing. Generally it means skipping a meal- that's to see if your blood sugar stays pretty level despite food being withheld. I think if you check out the MM website, you might be able to find instructions. Hope this helps :)

I know I can always count on you for good advice, info, and support. You've always had a sympathetic ear for me and my "issues" (lol) and I can't tell you how much I appreciate it. I hope I can, someday, return the favor ;).

Yes, I agree, it's my body and I know it better than anyone, even a fancy-schmancy MD. In the past, I would rely on my doc to make most of the adjustments. Saying that, I would make minor changes, but nothing real significant.

I remember one time I changed it- I reduced it slightly, and it seemed to throw everything off in a problematic manner :(. I spoke to my CDE/dietician later on about the problems I was having. She was confused and bluntly asked me why I lowered my basals. At the time, I didn't really have an explanation or reason to do so, but I felt like I was taking too much insulin. I thought that was reason enough, but I guess things don't work like that. I could sense her annoyance in her voice and I now hesitate to change things, even in a minimal way.

I have thought about those classes, but I'm thinking that a support group may be more beneficial to me at the moment- so we'll see.

Yeah, the weight gain is a bit of a bummer :(, but that's how it goes sometimes. My weight has always fluctuated- and I guess now is no exception. I was hoping that Symlin may help with this issue, but it's currently on hold at the moment, until my Basals are figured out.

Speaking of basals and adjustments, I'm wearing the CGMS, as we speak. I'm hoping it will provide some useful and beneficial information on how to adjust or make any modifications. (I'm going to post about this). If all goes well, I may not have to continue with all this basal testing,yay :), and it may speed up the process of figuring out my rates and getting on Symlin. I'm keeping my fingers crossed. :)

Thanks again for your support- you've been such a good friend :)


3:24 PM  

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