A1C

The Numbers Are In

I’m home from my doctor appointment now, after a restless night of anxiously awaiting my blood work. Though I tried not to, the worry of how much my A1C had increased kept me from the restful sleep I had hoped for. 

All in all, the visit went quite well: my blood pressure, SAT, heart rate, temperature, etcetera, were all good, weight was up a few pounds, the only thing that I wasn’t surprised by that the nurse takes care of before seeing my PCP. I figured with my lack of sleep and A1C-anxiety my BP would be elevated for sure but it wasn’t. I went ahead and got my flu shot this morning, too; I’m glad to have that taken care of sooner rather than later. Finally the new nurse, a rather cheerful and concerned lady that I think I’ll like, took my blood sample for the A1C test; now to wait for the results ….

After a few minutes my PCP came in with what seemed to be a rather serious look on her face. She began with the normal “how’s life treating you” and “how are you feeling” type of questions, before turning to the real issue, or at least the one I wanted to know about: the number!

“So, on your last visit your A1C was 5.1”, she began, sounding pretty serious, “and today it is-” (I began to rehearse my excuses in my head at this point for why it had jumped so much.) “5.0!”, she finished with a huge smile. She has a great sense of humor, which I love, and enjoys teasing in this dramatic fashion I think. 

To say I was stunned would be an understatement! I went ahead and confessed my worries and stumbles to which she said I’d wasted a lot of energy on nothing. She then recapped the progress I’ve made over the last 13 months and told me how proud and happy she was of and for me, concluding with “God helps those who helps themselves and you’ve put a lot of effort into getting here. So stop beating yourself up over a few “bad” choices that could’ve been really bad ones!”

She was right. By consciously choosing better things to binge on I had improved my A1C, even if I had picked up a few of those formerly-lost pounds. And I see that in my “regular” diet I can loosen my stranglehold some and still maintain healthy, normal BG levels. I can’t tell you how relieved I was at this news!

As an added bonus, she is also giving me a prescription for a new-to-me topical gel to help my arthritic joints, which I have many of. She thinks I’ll greatly benefit from this “only one of its kind” gel, the name of which escapes me. It’ll be a week or so before I get it but I’ll try to update what it is and how it works for me when I’ve had a chance to try it out. And with winter closing in on us this new “help” comes at a great time.

The Bible teaches us that we aren’t to worry over things but to turn them over to The Lord. No matter how strong our faith, or at least this applies to me, I reckon it’s our nature to worry no matter how hard we try not to. This is another lesson that I need to do what I know I need to do and let God take care of the rest.

Blood Work Blues

At just over 13-months now since I was diagnosed with Type-2 Diabetes, tomorrow I’ll be going in for my now-regular A1C test, and other blood work; the A1C results I’ll get tomorrow but will have to wait a few days for the others to come back. I must admit that I’m somewhat anxious to get my numbers; I know that my A1C will be higher this time than last, I just don’t know how much higher it’s going to be. 

I thought that summer would be easier to control my blood glucose (BG) than the winter had been. After all, the warmer weather would, I reasoned, provide more opportunities for me to exercise since I generally feel better in the warmer weather than the cold. But as it turns out summer is hard, really hard, in other ways. Between the extra busyness of the season, trips/vacations, and the seemingly endless barrage of stress I’ve endured, my diet, and surely my BG, have suffered quite a bit. 

The busy schedule I’ve kept and traveling conspired to make it much more work to attempt to eat what I should, when I should. It really surprises me, looking back, at how much more difficult that was than making good choices during the holidays. Despite being more active during the summer, the unstable atmosphere of the season were much more challenging than holiday dinners and get-togethers last winter. 

Being stressed has always brought out the worst in my dietary habits: all good habits go right out the window to be frank. Sometimes, with some things, you have a degree of control over the stressors; I haven’t had much-to-any control over these in the last several months. I have, at least, recognized this and have tried to make choices that weren’t as bad for me. Learning, for instance, that fat helps to slow the conversion of carbohydrates to glucose has been a help; why are all the really good comfort foods so carb-rich anyway? I’ve also been trying to find extra ways to get more protein into my anxious-eating times. How well did I do at this? I reckon we’ll see tomorrow. 

Hopefully I’ve also learned from trial and error, including the above mentioned items, ways to loosen my dietary-stranglehold-grip at least some so I can lean toward a little less rigorous “plan” that I can live with day-in, day-out, no matter the situation I’m in or going through. After all, this disease isn’t going anywhere and, despite my trip-ups, I don’t have any plans to let it cause any more damage to my body or further decrease my quality of life than it already has: I will be the master not the slave to diabetes. 

Changing Gears a Little 

I know I’ve been sharing a lot of my writing lately, which I hope you are enjoying. It also seems I’ve been like a “broken record” playing “Whoa is me!” in almost every other post I’ve made: with my fall, stomach “bug”, self-inflicted back irritation, and yet another cold/virus setting in on me.  But it occurred to me that I had forgotten to post an update from my last doctor visit/on my health, which I said I would do. So, let’s change gears a bit for a post or two and get away from haiku and poems and injury and illness and such and on to the update, shall we? Okay, then, here we go!

To begin with, in my last post, written while in the waiting room at my primary care provider’s office, I wrote a haiku about her/their new policy; I know, I said no more poem-stuff in this post but this is pertinent. Well, I was a bit hasty in my skepticism (read the post linked in the first sentence of this paragraph if you want to know more): my wait time was less than five minutes from my appointment time. It seemed longer because I arrived early due to the new no-late-arrivals policy, but it really wasn’t. Now that I have made amends (with myself if no one else) on that jumped to conclusion- on to the results!

As I expected I had gained a few pounds back; I don’t recall the number but it was within a pound or two of what I figured: that was okay news. The good part was about to be revealed; my nurse wouldn’t tell me anything, purposefully playfully toying with me , except that she was printing something out for the PCP to show me. Well, this was not what I was expecting; I figured that, along with my weight, my other numbers had gone up. The wait to find out what this good news could be was almost unbearable – for the entire five minutes I had to wait!

When my PCP came in the exam room she was all smiles, holding a set of printouts in one hand and her tablet in the other. Brimming over with pride for me, she handed me the printout of my lab work and began to explain it; many of the numbers I knew and understood but some I wasn’t too familiar with. All of my numbers had improved again, even my A1C had dropped a bit more, bringing it down to 5.1! And while a few results are still not quite where they need to be, all showed significant improvement and should, she said, continue to normalize as my body keeps adjusting to its new regiment. 

Part of the reason I had been concerned with my labs not being as good as they had been, let alone dropping and improving further, is that I’ve released some of the tension of the “stranglehold” I’d put on my diet. When I first learned of my disease I knew I had to make dramatic changes to gt it under control. But these changes were so dramatic I was having a hard time staying within my self-set parameters all the time. I finally realized this is not a diet I’m on but a total lifestyle change and in order to stay with that change I would need to adjust my parameters to ones that I could live with day in, day out, for the rest of my life. And apparently the modifications were not too liberal as I had feared. 

If it’s The Lord’s will, I have a lot longer on this “road of life” I’m on. And I know full well that there will be plenty more potholes and detours to avoid or take. But with His grace and leading I’m confident we, He and I, can navigate through it, though the bumps and lumps will inevitably still be there along the way.  

What’s There to Worry About?

Well, despite my worry, my appointment went great today! And I am doing a lot more than my medical team is used to seeing; they were really impressed with my research, logged information (diet, BG, exercise, etcetera) and especially the changes I’ve made and progress I’ve made.

My initial A1C two months ago was 14.3 (I’m a little foggy on that but it’s close); today it was – after only 60 days – 6.5!! I was really hoping to be 7 or less and I made it. I’ve “officially” by their scales lost 13 pounds, too; mine says 15 lol. And that’s intentional weight loss, unlike the 40-ish pounds I lost previously because of uncontrolled diabetes. They were very impressed how I researched the meds, looked at my own charts and data and realized Glyburide was a problem for me, not a help. And they seemed pretty amazed when I expla Alan_S and Jenny’s “test, test, test” concept to keep my BG in check all the time, or as much as I’ve been able so far; I test mostly 1 and 2 hours after meals to see how foods and things are working with my body and medicines, not, now, being as concerned with what the pre-meal number is.

My FBG has been a little high I thought since I eliminated the Glyburide; it’s usually 90-101. But she thought that was excellent. In fact, she thought my body has begun to heal and right itself remarkably well. Not to minimize my effort, having great resources to learn from and a loving, supportive family has been huge in this, but ultimately the success comes from the Designer of this body; without God’s help I’d be a worse mess than I am – in many ways!

So I reckon my anxiety was all for naught- and I’m sure glad if that! I go back for total blood panel, A1C, and a new-to-me test 24-hour protein right before Christmas. That ought to help motivate me to stay strong during the holidays!

Anxious Anticipation Today

I go in for my first real post-diagnosis doctor visit today and I’m a little nervous, though I’m not sure why. For whatever reason, I’m not having blood work today, which surprised me, so there’s no anxiety there. Well, I’ll probably have my A1C checked since that’s an in-office test, so maybe I am having some blood work done. I’m interested to see what my weight is on their scales, fully dressed, like I was last time, compared to what my scales say in my pajamas.

I’m not anxious about breaking the news that I stopped taking the Glyburide, not at all. I have all my data ready to show her; I’m taking my notebook and iPad rather than printing everything out. I can email her copies of anything she wants/needs in the office while I’m there.

While I know that my overall BG is much better, for some reason I’m a little anxious about what she is going to think. My gut tells me that she’s going to be happy, maybe even impressed with the changes and improvements I’ve made, but for some reason I have a nagging kind of dread about being wrong about that.

I finally remembered to pick up whole, old fashioned oats yesterday; it’s the first time in a very long time I have made them. I remembered something about them pretty fast this morning: they boil over in the microwave in the bowls we have. So, I started the day with a big, sticky mess and lost “x” amount of the oatmeal. Lord, please don’t let this whole day go like that.

“A Guy Walks into the Doctor’s Office and ….”

Sounds like the beginning of joke, doesn’t it? It’s supposed to = because that is exactly how I felt when I got my diagnosis, like someone was pulling my leg, or at least confused or wrong. But let me back up a little and share how I got “the news” and a little back-story for context.

I met my family doctor, I’ll call her Dr L, about 15 years or so ago; she was my mother in law’s doctor and I took her to some of her appointments. I was impressed with her: she was kind, gentle, knowledgeable, and had a good sense of humor. Up until I was almost 40 I used my neurosurgeon as my primary care doctor. When my wife’s insurance company made a change that required me to get a physical and some blood work I realized I needed a primary care physician – a family doctor. Who better, I thought, than Dr. L? She was great, I’ll start off by saying, from day one. I found out that I had high cholesterol and triglycerides (but everything else was good) so taking my limited ability to exercise and family history of heart attack into account she got right on getting those things under control; in six months, with slight diet modifications and medication, all of my blood work was good. And it stayed that way for years, and her care for me was always top-notch in other ares that I needed a doctor, referral, medical advice, etc. for until about 18 or so months ago.

Dr. L and her husband were going through a nasty divorce, which started about two years ago. I don’t know all the details, and I don’t care to, but I know it ended badly with custody fights and eventually her selling her private practice and going in with a “group”; I now know her home was also foreclosed on, a sad thing for anyone to go through, with or without a divorce.

During my last three visits to her I noticed a difference: she wasn’t as bubbly as normal, was a bit cold, and somewhat distant. I figured she was having some depression issues with all she was dealing with; changes of large magnitude are hard on all of us. I hoped she would soon “snap out of it” and prayed for her.

A few weeks ago I got a call from Dr. L’s office to confirm an upcoming appointment – except they didn’t say it was Dr. L’s office calling but another name, one I didn’t know. The receptionist, who I’ve known for five or six years, told me Dr. L had left that office and was transferred to an urgent care facility that the “group” also owned. I was saddened to hear this but figured it was probably a change she needed to make to move on with her life; I confirmed I’d come in to see the new lady (my new “family doctor” is actually a Family Nurse Practitioner).

A couple of days later I found myself sitting in a familiar exam room with an unfamiliar face, thinking “How much does she know already about my medical history and what am I going to have to go over again with this new lady?” when she asked me who was taking care of my diabetes; I’m going to have to go over everything with her was what I was now thinking. I chuckled a little and replied “No, one; I don’t have diabetes.” Her right eyebrow raised inquisitively as her eyes darted down to my chart and back up at me; I knew then something was very wrong.

She went on to ask if I had been given the results of my recent blood work, the most recent were about 16 and 10 months old, respectively. I told her no, I’d heard nothing; both of my last few labs were ordered and performed after my regular visits and Dr. L always called if any concerns came up and I’d gotten no calls. As she started to explain that my sugar and A1C were both abnormal my head began to spin. First, I didn’t even know what an A1C was, and second this all had to me a false reading/mistake I began to tell her. She gently replied that we could do a quick test to see, if that was okay with me; I was all for that! I wanted to get this put to bed and now.

The minutes went by very slowly waiting to get that test back; the less than-10 minute test seemed to take hours. But Jamie, the new “doc”, and I spoke about other things, medically related to me, while we waited, though I could barely focus on them. The nurse, whom I dearly love, came in and gave Jamie the results, which she read and compared to my previous tests. After a minute or so she told me (sincerely) she was sorry no one had followed up on my labs and then began to explain to me what my results showed: my first test, 16-18 months ago, was 6+, a definite danger/concern number, my last test was 7+ (I can’t recall either decimal on these readings), a diabetic reading, and today was 14.3, literally off the chart she later showed me. Angry, dumbfounded, confused, helpless, and scared are a few of the things I felt at that moment; I was also still in denial. New fasting blood work was ordered for the next day and a follow-up appointment was set for the next week. She gave me very little info, not wanting me to be overwhelmed (too stinking late for that!) and told me that she would go over everything at my follow-up, which she did as I’ll write more about later. She tried her level best to set me at ease, saying there would likely be some changes I’d need to make but nothing too drastic. And that she was almost certain that I’d not need shots, though I would have to do blood glucose (BG) testing.

As we parted ways that day she made some very tasteful, and very helpful and comforting, jokes, revealing her sense of humor and personality a bit to me; I needed that more than I can say, and I think she knew it. And so I left the office with a million and one thoughts, concerns and questions but one that loomed larger than an other: This has to be a mistake, and the new labs will prove that. Later I’ll write more but let us close with this: The new labs confirmed a lot, but nothing that my delusion of denial had me hoping for.