Unsteadily Stable

“Molly,

Your labs are stable. A1c is just slightly higher.”

This was the ultra-concise memo that my endocrinologist sent me post-appointment.

Nothing about this note was shocking, but somehow I’d deluded myself into thinking that my doctor’s analysis of my diabetes management in the last six months would be…I don’t know, a little more personal? Maybe contain congratulatory sentiments or words of encouragement?

Words of encouragement may have been more helpful in getting me to tip the scale and feel steadier about my diabetes management…

After all, I’d told her during our appointment that while I didn’t have any specific diabetes concerns to discuss, I did have a strong desire to improve my management. I know that I’m doing better than I was, say, at the age of 18 or 19, but as I grow older I become more acutely aware of the things that I could improve upon with my diabetes care. I acknowledge and accept that it’s up to me to be accountable for taking steps towards progress, yet I do rely on the input from my healthcare team in order to come up with realistic ways for me to make said progress. So naturally, I felt a slight tinge of disappointment when we discussed and agreed on a single, minor tweak to my basal and bolus settings before parting ways, with plans to see one another again in six months.

I couldn’t help but feel…that’s it? That’s all that I got out of this appointment? I suppose I’m feeling a bit jaded about it because it was my first time seeing my endocrinologist in about a year, since she had an extended leave of absence. In the time since I last saw her, I’d had a couple of appointments with the nurse practitioner who she allegedly works closely with, and I guess I had assumed that the NP would update my doctor on how I’m more determined than ever to take steps to achieve more time in range.

Now, I realize more than ever that I can only rely on myself to convey my thoughts and feelings about my diabetes to my healthcare team. Now, I realize that while my labs indicate my diabetes “stability”, my attitude towards my diabetes is the opposite.

I’m calling it…unsteadily stable. I’m doing fine with my diabetes, but I know that I am capable of doing better and feel like the path there will be a bumpy one.

Another way of putting it? I’m like one of those children’s roly-poly toys – I’m a little wobbly in terms of the goals I have for my diabetes management, but I certainly won’t let it cause me to fall down.

3 thoughts on “Unsteadily Stable

  1. Molly, I hate to say this but endocrinologists are not good for much other than to prescribe insulin and pump and CGM supplies. They are too busy to really care about your personal well being and if your CGM numbers and A1c are good, they have virtually nothing to offer you.

    My 30 year average A1c is around 6.0. Because of that, I used to spend much more time arguing with my former endocrinologist about politics than discussing strategies for improving my control or time in range. He didn’t have much to offer me because my A1c “report card” always looked good. And most physicians don’t appreciate how much daily effort it takes to achieve such good control.

    The only person who really cares about you and your diabetes…is you (and your loved ones). Your doctor simply reviews data and nothing else. A robot with artificial intelligence could do the same thing.

    Back to my original point. The only reason I continue to see a doctor for my Type 1 diabetes is because I need him or her for my scripts. If you want to see someone for the reasons you cited, you are only going to find that in a good CDE.

    You will get more helpful information on improving your life and control from diabetics on social media than you will from most endocrinologists. You probably also know more about technology that is in the pipeline than your endocrinologist does.

    It’s sad. Try and find a good CDE for your needs and think of your doctor as little more than a source of new scripts.

    Liked by 2 people

  2. Molly, I have a mantra. You can barrow it if you want, or not of course. But here is mine.

    I will do better with diabetes when I am sick and tired of being sick and tired.

    It drew me out of a long-term funk of over 30 years. Maybe it will help you someday as well.

    rick

    Liked by 2 people

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