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.
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?