Cancer (The Zodiac One)

6.9

The last time I spoke of the fabled HbA1c I was at 7.5. That was six months ago. Since I’ve started my blog, the numbers continue to show progress to greater control. I’ve been thinking about that number since I got my blood work back yesterday. Under normal circumstances I should be pleased with my continued progress. Big picture…short term…at a glance…regardless of how you look at the numbers, this should be a good thing. I know this, but for some reason I’m not happy about it.

Get it? 6.9? Get your mind out of the gutter...

It’s been almost 2 months since I met with Not House to discuss my management. It feels like I have been chasing high numbers ever since I left his office. Trying to negotiate a lower dose of Lantus while actually injecting Humalog based on the food I’m eating instead of chasing a set-in-stone amount of insulin with food has been taking its toll on me. I have been fearing that this change was doing more harm than good (Bad Habits) as far as my A1c is concerned. For as much pressure as I put on that single number, the idea that potential results could paint a picture contrary to what I am striving toward is not a fun thought to have swimming around upstairs. But according to the numbers I’m doing a good job. Ok…sweet?

I’ve only been at this for 8 years, but I never thought I would be disappointed in an A1c under 7.0. I’m not sure how I got to this point, but I thought that little to no progress was going to be made since I last had blood drawn. Then I see that number – 6.9 – and instead of relief or joy, I immediately return to the thought that I don’t understand any of this. I’m the one living with this, I’m the one chasing and correcting and correcting and chasing. And despite all the numbers I’ve written down, all the test strips I’ve used in the middle of the night, all the meticulous effort, despite it all I still feel a lack of understanding. There’s a disconnect with what I’m seeing and what I’m doing. According to the numbers I’m doing the right things, but that’s not what I see. Me and my negativity I suppose.

I did leave my appointment with a new prescription. I had mentioned that Diabetes and being African-American is a sweet combination for kidney failure – I guess it’s time to start fortifying. I don’t want to call it “delaying the inevitable” but that’s what it feels like. I don’t like the idea of my genes dictating what is going to happen to me without any input from how I manage my Diabetes or any other health related shenanigans. But at this point, it’s just another pill. I can handle that.

Despite my unusual disappointment, I did bring up my concerns with Not House about the Road Runner/Wile E. Coyote thing I’ve been experiencing. “I think you should increase the Lantus a little. See how 2 more units work” sigh (I hate it when people wait for their turn to talk instead of simply listening.) Sorry Doctor, when the numbers are “in range”, I’m comfortable with how 15 units works overnight. It’s the rest of the day I’m concerned with right now.

I suggested the daytime dose of Lantus to add a little something to the afternoon hours. While he didn’t discredit that idea, he recommended being more aggressive with my Humalog. I don’t remember the exact word or words he said in describing how to approach lunch and dinner, but the bottom line is the amount of insulin I’m using isn’t enough so I need to step it up a notch.

One of my problems with this is that I’m afraid to go low. I don’t like how I act/feel when I see numbers under 50. It’s a work in progress but that fear of going low keeps me from overestimating the insulin necessary for a given meal. I think this fear has a strong enough influence that I’m actually underestimating insulin. Going low sucks, but if I have the tools/resources/glucose tabs to support me, an extra unit here or there could mean the difference in the rest of the day. Lows happen, as long as I’m prepared for them I can minimize their impact on my body (and my psyche). I can do this.

And to these lows (that happen), and highs (that I chase) I’m still considering a CGM if only to help figure out the daytime. I spoke with Not House about it but I need a few days to clear my head and organize my thoughts before I expand on this thought.

So there you go. 6.9 is progress. I know it is. Maybe tomorrow I’ll be happy with it. And despite my frequent feelings of lack of understanding or control, it looks like I might actually have an idea of what I’m doing. Who knew?

7 thoughts on “Cancer (The Zodiac One)

  1. Chris – 6.9 is good and falls under the *Excellent* control category. Don’t sell yourself short. I also hate, seriously hate the feeling when I’m low. It’s the panic, shaking and can’t talk feeling that I dread more than seeing a 250 pop up.

    I think I may have underestimated my Humalog at meals unconsciously. The way I have recently overcome this is by eating much less simple carbs and more fiber, veggies and protein.

    Keep your head up bro!

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  2. In my opinion, sometimes the hardest part of diabetes is how often it doesn’t make sense. Work hard for a certain A1C number – then see it when you know your numbers are not what you want them to be. Inject the “right amount” of insulin, but still go too high or too low. Eat something you are sure will spike you, but end up with Blood Sugar Nirvana (to steal a phrase from K2).

    What is important is that you are trying. You are learning. You are growing. You are finding ways to improve. What’s most important is that you are doing a great job – whether the numbers reflect it or not. Keep on fighting – you can do it!!

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  3. Ugh. If you change all your Lantus/Humalog references to Novolog/pump, I could have written this post. I’ve been struggling with a lot of chasing and a lot of readjusting to my relationship to fast-acting insulin – I’ve found that my great A1Cs from before probably had a lot to do with the dose of Lantus I was on, and how that cleaned up any “mistakes” I made with my Humalog and carb-counting. It’s been a long, frustrating road – it’s hard to feel like you don’t get it anymore, and that after all these years you’re more reliant on doctors for the day-to-day.

    I know we’ll both get it wrangled again – gotta have faith, right? – but I just wanted to give a “You’re not alone!” shout-out about the endless slogging and work front in the meantime.

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  4. I totally understand your dissappointment. When I dropped from 7.9 to 7.4 after atarting the pump and cgms I was happy but bummed. I wanted that under 6 number! But progress is progress. And I have this noice solid goal of having a healthy baby someday. So I guess its a little different. But yes. Being disappointed with a good number when you were expecting better is absolutely underatandable.

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  5. 1) congratulations! That is fabulous work.
    2) I hate to give you advice. Because every single PWD is different. but lows with higher doses of lantus does not bode well for Not House’s recommendation. How do your #s do if you don’t eat? that will tell you if your lantus dose is good. A basal trial. Which I have to do on the pump. If your basal is good… don’t change it! At least with fidgeting with novolog doses it only works for 6 hrs or so vs too high of a lantus dose that works for more than 24!!
    3) you certainly aren’t alone. None of us know what we are doing. NONE OF US. This whole disease state is a bunch of guessing. And it sucks.
    4) 6.9 proves you know something though. not all, but not none either. 🙂

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  6. Great post! I totally get what you are saying, and have had that same “huh?” experience with my A1C, which can be very demotivating, regardless of whether it’s better or worse that expected. Usually, I’m sure it’s going to be worse than it is. So I’ve become more reactive and less analytical in order to save sanity and balance life….for now.

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  7. Many times I have gone to the doctor wanting my A1C to come back as a certain number, only to be disappointed. I know I put tremendous pressure on myself to achieve that perfect A1C score. If it is anything but perfect I am disappointed. I’m sure when you get another one done in a couple months or however long you wait it will be lower wtih how much time and energy you are devoting to the D.

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