Tuesday, December 20, 2005

Bless Their Little Hearts

I don't know about your endo, but my doctor has one of those A1c machines right in the office. So, by the end of the visit, you know the good...or bad...news. Frankly, the A1c result is all I really care about in the entire visit. Sure, he schedules blood work for me, makes sure I can still feel my toes and all...but none that really matters to me as much as that A1c number. Place your bets, place your bets. Will I make it below that magic number seven this time? Find out after a word from our sponsors (err, doctors).

Today is that day for me. My three-month check up. Time to find out if I've been naughty or nice. And, I'm afraid, I'm expecting more naughty than nice. Something has happened in the past several months, and I think it is time for an overhaul on my basal rates. I've been putting off the work of doing that, however, until after this A1c. My highs have been higher, and my lows lower lately.

I'm guessing a 7.3 this time around. We'll see if I'm right. But if I am, I'll hang my head in shame. I haven't been above a 7.1 in years.

So, anyhow, you know the routine (or perhaps you don't, if you're not diabetic). Offer up that blood sample and wait. And wait. And wait some more. When the doctor comes into the room, you try to read some indication from his body language where you stand. But doctors are master poker players, I think. No hint of what cards are in his hand.

And actually, what I hate worse than waiting for the number is what advice comes after the number is revealed...especially when the number is higher than before. Because, as a diabetic with twenty-three years under my belt, I pretty much manage everything myself. My doctor will try to send in the interns, looking through my BGLs they printed out from my meter to figure how what the problem is that led to the elevated A1c. Perhaps if I raise my basal here, and cut it back here. I smile and nod, whole-heartily agreeing. Then, I leave the office and ignore it all.

That's probably not very good to admit, but it's true. Because, frankly, their advice is never really too helpful. They aren't there to see what I ate that caused those morning highs, for example. The meter doesn't show that. The trick isn't to add more insulin...the trick might just be to eliminate that donut, or bolus more accurately. But bless their little hearts for wanting to sound so involved. And, since I'm paying them big money for their advice, there is no point in shattering their egos by telling them I'm about to ignore everything they are telling me.

My A1c. Today. Then, it is time to buckle down and do the hard work of re-calculating everything. It is tedious. Probably takes a good month of hard work and skipping various meals to get the basals correct. But it will be worth it in the end, because then I can go back three months from now expecting a 6.8 instead of a 7.3 (or 7.5 or 7.8).

Maybe Santa will bring me a lower A1c than I expected, but I have my doubts. So, good luck to you all on your A1cs, whenever they are due.


Erica said...

I don't get why more endos don't have them in office when you can buy a kit at CVS for $19.99! Bah humbug...

Andrea said...

GOOD LUCK, RYAN. :) Keep us posted!

My A1c is due next month. I'm actually anxious for my apt. to come. I want to know where things stand and then there's meeting this new doctor. I've been hearing some good things about him...and I think he'll be more receptive to my concerns and other needs. So I'm looking forward to it.

Anyway, I wish you the best with your appointment and please let us know how it goes :)

Sandra Miller said...

Good luck today at your appointment!

Joseph's endo has one of those A1c machines as well-- we see results in just a few minutes. I've wondered when reading about those who must wait days for their results, if there is any difference in accuracy between the two tests... hmmmm.

Anyhow, hope all goes well at your visit.

And hey, have a wonderful Christmas!