Yesterday I had my appointment with Not House. All is well in Casa de Chris. A1c is 6.5. All other medical-sounding values are where they should be. As far as any official statement on A1c goes, I’m right on target. Had I written this immediately after my appointment I might have a more chipper tone, but despite this success I’m still a bit perplexed.
Just a reminder, I’m not a medical professional and my words are not to be taken as any kind of sound, intelligent, or reasonable medical advise. I’m just thinking out loud in this one. This is more of a trip into the Mind of Chris….You’ve been warned.
Don’t get me wrong, 6.5 is fantastic. I’ve been working my butt off for this. Obviously a great deal of credit for this one goes to Hal Jordan. I knew that my control had improved after adding the Dexcom to my arsenal. Highs were treated sooner and more aggressively. I’ve had fewer overcorrecting-low incidents, although there are still too many for my liking. And each day I’m getting better at having a sexy, straight line for 3-6 hour intervals on my receiver’s display. This thing works, I’m living proof. Joining the revolution was one of the best things I could have done for my health. Luckily I had you all, my eager-readers, specifically the Diabetes Online Community to get my back.
But that’s the problem. The DOC was my initial exposure to this technology. I know the Internet is much faster and more accessible than my doctor, but I doubt he would have ever suggested this or any other method to improve my control if I hadn’t said anything. I know that I have to be active and engaging when it comes to my own health care, and I value each and every one of your input when I need it, but you all should not replace my endo or a CDE or any other kind of training. And right now that’s what it feels like. I wonder why I pay a guy to say “keep up the good work” when he has had so little input and impact on my health. Right, appointments are (supposed to be) every three months and if necessary I could always call, but I don’t want to feel like I’m a burden just because I’m the one not satisfied with my control.
This is a tough mental state because I know I’m doing a great job, even with my somewhat analog technology. Daily shots and a Dexcom got me to 6.5%, sweet. But what about all the bumps along the path to getting here? Who was it that suggested switching the timing of my Lantus? Who was it that suggested splitting the Lantus, and to that point, who worked with me to figure out how much to take and when? I’m not trying to dismiss the value of an endocrinologist, but I didn’t expect things roles to feel so out of place. There’s no right way to say this, but it feels like the more hands-on and go-get-em I have become, the less I seem to need a medical professional.
I know that’s not how it really is and I should appreciate that things are going well right now. With something like Diabetes, the only thing I can be certain about is the uncertainty of this disease. No matter how hard I try, no matter how hard I focus on doing what I need to do to be healthy, there’s always the risk of something coming around and screwing life up. I’m doing what I can do minimize that potential and with that I have some decisions to make.
I don’t know what to do about Not House. I have done a lot of this on my own, and as it stands, with my analog scheme of MDI, there isn’t too much tweaking that an Endo could really do. A lot of this is more or less “guess and check”. Does 10 units of Lantus work during the day? No? Try 11 (or 9 depending on the need). Even if splitting the dose was his recommendation, I would still have a lot of work to do on my own. I can’t necessarily blame him for the amount of effort that I’m putting in to this because this is MY Diabetes, not his.
The worst part is that I’m not exactly sure what it is I want out of my Endocrinologist. I’m almost 26, I don’t need a firm pat on the back when I get things right. I’ve shown that I am capable of fairly awesome control without too much external motivation. Surely that’s the kind of patient a doctor would love to have, right? At this point I know I’m rambling so I should probably wrap this up. I’ll figure out what I need to do and execute my plan when the time is right. Maybe that time will be tomorrow, maybe in a month, maybe a year. One thing I do know – it could be worse. Anywho.
6.5%. MDI. Dexcom. I am Spartacus.