D appointment

I did today's post a little differently than I normally do.  Yesterday was latest "endo" appointment, and there were a lot of emotions swirling around in my brain.  So I wrote the beginning of my post before I left.  I didn't know where my emotions would be post appointment, and I wanted to be able to accurately capture all emotions included both before and after this appointment. 


Before:

Today I have an appointment with my D nurse.  I'm excited for this appointment.  I know, it sounds crazy.  But for the first time in a LONG time, I think I'll have an A1C under 8.  And I think the last time that happened was when I saw her and when I had the first one.

But I also have a list of questions I need to ask.  The first being about seeing an endo.  Since I had such an awesome endo as a kid, I feel as though that is the right path.  I won't stop seeing my nurse, because she's awesome.  But there's just something in me that thinks I should also see an endo.

And then the fun questions.  When I was skiing, my 3rd and 4th toes of my right foot got tingly.  I think it only happened in the chairlift, and skiing down the mountain made it go away.  But I still don't like that feeling.  BUT, it could be because my toes are in a tight, enclosed space.  And cold.  Please pray that that is what it is.
But my feet also get tingly when I sit cross legged.  And I sit cross-legged all the time.  I know that sitting like that can enhance neuropathy.  But it's such a habit.  And even sitting here writing this I'm cross-legged.  I am trying beyond anything to stop sitting like that, because it's the only time my feet get tingly.  But Diabetes, PLEASE don't be the cause.  Please let this go away if I stop crossing my legs.  When I get the little pokey thing on my foot, please let me feel it.  Please don't make me walk away crying.

And just this week I wasn't feeling like I was at the top of the game, and as I went to bed Sunday night I realized that I have the classic Celiac symptoms.  This is the one that is most pressing on my mind at the moment.  I have friends and family who have this, so I've certainly eaten this way before, but not as a lifestyle.  Yesterday I tried to eat gluten free to see if my symptoms stayed or went away.  And guess what, they went away.  I know that one day doesn't prove anything, but it's certainly leaning in that direction.  There was more around that was gluten free than I thought there would be, but then as I was getting the kids snacks ready, I just grabbed a piece of cereal (before the milk was in it) and ate it.  If this ends up being a new "thing" for me, that is going to be one of the hardest parts.

My thoughts going into this appointment: C'mon diabetes.  I'm working at this again and now you're going to shove all this at me?!

After:


I AM KICKING DIABETES' ASS!  Yes, I need to tell you about the whole thing, but first, my A1C is 7.2!  At my last appointment it was 8.1.

I go in and do all the boring things (blood pressure, weight(it went up slightly, but I blame the rain boots and jacket), BG test and blood for A1C) and they take my pump(s) to download them.  (And I hope you didn't want a waiting room picture because I never was actually in the waiting room.)  When I was done with her, I went to wait in the exam room and I didn't even time to tweet that I was there before my nurse came in.

She asked how I was, what my basals were, which led to talking about switching pumps and how the meter remote was my deciding factor, waiting for my pumps and their reports to come back and if there was anything else I wanted to talk to her about.  I told her how I had been experiencing a few Celiac symptoms lately (my guess is that it's been a few weeks) and how on Tuesday I ate gluten free and I did not experience the symptoms.  I wanted to make sure she knew that I was not self-diagnosing, but it was the best way for me to test my theory in such a short period of time, and that I would just like to get tested.  I wasn't going to need labs today, but I think that is worth knowing.  She informed me that there are also people who are not Celiac, but have a wheat intolerance, so I may just want to cut back.  This is something I have been trying to do, but now I think I just need to focus on it a little bit more.

We continued on and she asked about my feet, so I told her my tingly feet experiences, and she did the metal vibrating tool thing on my big toe and it felt like forever before I could stop feeling.  She said she does not think I have neuropathy, it's just that when I cross my legs my blood vessels are getting squished causing my feet to feel funny.

And then my pump(s) came back with a ton of print outs and we realized that I've been going high before lunch, so we increased my breakfast insulin:carb ratio.  I told her how I was going low post lunch (a time when I'm frequently getting in the car) so I changed my basals without doing a basal test, but I'm not going low anymore.  Tuesday and Wednesday morning I woke up high, but Monday night I was eating a lot and SWAGing, so I didn't count that as a high BG in the morning, but an unsuccessful SWAG.  She agreed.

And then she said, "let's check your A1C."  And she squealed.  "Are you ready?" as she turned her computer screen to me.  But I couldn't find the number!  And she told me..."7.2"  And as I stammered through composure and smiling and a whole lot of happiness I heard "Look at what YOU did!!"  (And this statement reminded me of something I think George's doc would say)  And I managed to tell her I haven't been this low since before I started college.  If you don't me well enough and want a reference point, that was 2003.  And then even better, "I hope you're going to celebrate tonight!"  I don't know if I squealed or not, but I did when I got back to my car.  And then she told me that this number/drop is even more amazing because it wasn't achieved because of lots of and/or extreme lows.

And then I had to go back out for labs.  I was standing there waiting with all these other people and they were all looking kinda blah, and I couldn't help but smile!  I got my blood taken, scheduled my next appointment, and sat down to text my mom.  And then of course share it with all of you. I'm still riding on this high, and I couldn't be more proud of myself if I tried right now.  

Painting

College Art Class

Last night I had my first watercolor class.  The painting above is a watercolor I painted my junior year of college during an intro to art type class.  The assignment was kind of a past, present and future assignment with icons depicting the major events in our life.  I did not become serious about taking care of my diabetes until I started writing this blog, and yet this was done 3 - 4 years ago and most of my icons are diabetes related.  

Diabetes Icons

The river: diagnosed with diabetes

The green trees: Camp Carefree

The red cross: ketoacidosis in 2003

6.0: diabetes A1C 

I believe that the third island is "future."  This island includes Camp Carefree, 6.0 A1C, becoming a teacher and traveling.  The only thing I have done is traveled.  This is not bad, it's just another reminder that life doesn't always go in the direction you think it will.  I never did make it back to Camp Carefree, But I went to Gales Creek Camp, which is also part of traveling.  And I may not be a teacher, but I do teach every day and I love my job and feel as though I am making an impact.  And right now I'm working really hard on the A1C.  So hopefully I can get that part of my future island.  And maybe not 6.0.  But a 6._ would be incredible.  

First Day at Joslin

This week I had my first ever appointment at Joslin.  It started a little stressful because of my lack of paying attention to the time and my dislike for the Longwood area.  I get inside and I got directed to the Beetham Eye Institute, where I thought I would be getting my eyes dilated, but that wasn't part of my plan that day.  Instead I went upstairs where I met a very nice woman who helped me check in, and I received a folder with a whole bunch of information.  I started with the Joslin Vision Network where they took pictures of my eyes.  I have never had this done before. The woman showed me different parts of my eye, but since I did a research project on macular degeneration in college, I kinda knew what I was looking at.  I found it a little eery though knowing I was looking at my own eyes.  We talked about the specific parts of the eye, me needing a dilated eye exam, and then I went back to the waiting room.   I emailed & texted friends until I  got called in by a nurse who took my pump and meter to download it, and take a quick sample to test my A1C.  Back to the waiting room.  The nurse came back and handed me my pump.  My site is currently in my leg, so I was a little hesitant to reconnect in the middle of the waiting room, but I'm at Joslin, so, what the hell!  I reconnect, go back to my phone and wait for the nurse practitioner.  I want to give them some sort of nickname, but I feel it either is too obvious or doesn't do her justice.  So I will just call her my nurse practitioner.  We start talking, but how do you put 21 years of diabetes history in just a few sentences?  So we talked about my diagnosis, but that was a lot of  "I think this is how it happened...", and how long I have been on the pump (March 16, 2002), and if I've ever been hospitalized for DKA (yes, twice).  We went over my pump and meter printouts, and my A1C.  Since I test about 15 times a day, a sensor probably wouldn't help me, except overnight.  Good thing since I'm not ready to fight with insurance yet.  My A1C is higher than my BGs portray, so we're focusing on the overnight.  Although I'm not excited about waking up in the middle of the night for a while.  But if it helps me get my A1C down, I'm all for it.  And considering my last official A1C was way higher, 8.2 is definitely something to start to be proud of.  For your information, this is not where I want to be, but the downward slide is something I'm planning on continuing.  We changed my sensitivity factor, talked about my shin splints and I got a new meter to match the test strips my insurance actually covers.  After I got my prescriptions from her, and when to see her again, I went back into the waiting room to wait for the Diabetes Educator.  At this point, my stomach was screaming.  I was so nervous that I hadn't really eaten anything all day.  But I go back to my phone and I finally open the folder and I find out that there are two surveys that I am supposed to fill out.  I start filling them out and I get kind of frustrated with them because well some days my answers might be a one and somedays they might be a five.  (That one had a lot of questions about frustrations about living with diabetes.)  And then the diabetes educator comes out and calls my name, so I gather all my things, including my log book (which no one actually looked at) (and is a binder) and walk back with her.  It was a little later than my scheduled time, and I'm a patient that technically doesn't mind, but the nanny taking care of Girl Genius has already called me, so I'm a little bit nervous about that.  (I checked the message and there was no emergency.)  So we go back and we just start talking.  We talk about how long I've had diabetes, where I got taken care of before Joslin (I will always love you Dartmouth), how I treat a low, and what to do on a sick day, and all those sorts of fun things.  She also asks me what I talked about with the nurse practitioner.  We go over my surveys a little bit and I speak about how I made comments on mine because diabetes can't be characterized by one number.  This diabetes educator was a fast paced woman who treated me like an adult!!  Yes, I'm 25 years old, but during my college years I wasn't so confident about diabetes (and with good reason), so now I'm here and this woman is looking at me like a peer.  We talk about the information I know and how to use it.  Both the educator and nurse seemed surprised that the doctors and nurses were knowledgeable from Dartmouth.  She asks me if I wanted to attend classes, and I too hastily said "NO!"  and she laughed, but with good reason.  Classes aren't aimed to people who are already knowledgeable.  And I am knowledgeable about diabetes; I always have been.  It's just a difference of knowing the information and correctly applying it to my life.  In that whirlwind visit, I got a "blue book" (which I should have looked at by now, but haven't), talked about overnight testing, and agreed to come back in one month.  The other thing we talked about is my weight.  I am not where I want to be, but I'm also not too big.  She asked if I gained weight since I've been on my pump. "Well, Diabetes Educator, I got it when I was sixteen.  So yes, but I don't think the pump is the reason why."  We both laughed at this, because my pediatric (pediatric = favorite ever!) endo had talked to me about this.  And my fluctuation in weight over the years has really never been related to the pump.  It's just life.  


I feel like the end of this post is a little whirlwind, and little all over the place, but that is how the meeting went, so I'm going to leave it.  I feel empowered now.  I feel in control.  I feel great, and  when my day started I didn't think that is how I would feel.