Category: Diabetes and the Doctor

Reflections on my Recent Endo Appointment

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Last week, I wrote about some anxiety that I was feeling the day before I was due to see my endocrinologist. Now that the appointment has come and gone, I feel like I understand the reasons why I was so nervous…

  • Reason #1: Some part of me must’ve known that my A1c has gone up over the course of the last three months – it rose half a point, much to my dismay. I confessed to my doctor that I’ve been a little careless, particularly in the last month or so, when it comes to carb counting and healthy eating. Luckily, she wasn’t critical of me, but I almost wish that she’d reprimanded me in some way. It would’ve been the talking-to that I felt I deserved.
  • Reason #2: My endo permanently switched locations: She’s now based at the medical center that I used to go to when I was seeing a pediatric endocrinologist. I hadn’t been back there in about eight years, and boy, it brought back some unexpected emotions. I must admit that I had to hold back tears as I walked into the building. I don’t know why all the feelings hit me so hard, but I suspect that it might have been because of the flood of memories that flowed through my mind. It also symbolized the journey I’ve been on in just the last eight years of life with diabetes, in which I:
    • Transitioned from injections to a pump.
    • Stopped using Lantus.
    • Started using a Dexcom.
    • Improved my A1c/overall health significantly.
    • Decided to become a more active member in the diabetes community.

Those are some major changes, and the magnitude of them practically knocks me               out as I think about the last 20 years I’ve had with diabetes.

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Just making some awkward faces while I wait for my doctor. Also, I love that the exam room has a full-length mirror in it: It’s perfect for taking pictures/killing time while I wait!
  • Reason #3: I was meeting all sorts of new people, which is very nerve-wracking to an introverted extrovert like myself. I was used to the receptionists and nurses at the old location. I got to know them and vice versa. It made going to appointments a little easier. At this new/old location, though, I don’t know a soul except for my doctor. A reassuring smile or light conversation would’ve placated me on this visit, but perhaps those things will come in time.

Anyways, now that I’ve had time to think about the emotional aspects of this appointment…I’m going to switch gears and start doing the things that I need to do and that I am capable of doing in order to get my A1c back to where I want it. I know that I’ll get there. As my appointment wrapped up, I looked my endocrinologist in the eyes and promised her that the next time she saw me, I’d be down more than half a point. And I intend to fulfill that promise.

 

What Went Wrong During my Recent Visit to the Eye Doctor

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You want to know what went wrong during my annual eye doctor’s appointment last week? Just about everything, that’s what went wrong!

Okay, that’s being over-the-top dramatic. Nothing life altering happened, thank goodness. But the appointment started out on the wrong foot when I had to wait more than an hour to be seen by the doctor. Let me tell you, there is nothing pleasant about waiting in a room that hasn’t been updated since about 1982, with ancient stacks of National Geographic as the sole source of entertainment.

Anyways, after an agonizingly long hour and change, I was finally called in to see the doctor. He started the appointment asking the usual slew of questions: How are you? How are your eyes? (My answer to both was a short, but still polite, “good”.) Then he asked the annoying question: Is your diabetes under control?

I hate that – the “under control”. It makes it seem as though diabetes can be tamed 100% of the time, like it’s a savage beast that just requires domesticating in order to live a normal life. But I answered it anyways, knowing he wouldn’t care to hear why his word choice was bothersome. “I’m doing well,” I said, my eyes wandering over to the doorway. I couldn’t understand why he’d chosen to leave the door open – the hallway to the waiting room was very short, and based on what I’d heard when other patients went in to see the doctor, everyone in the waiting room would be able to hear the entire doctor-patient interaction. Definitely not cool in my book, but instead of confronting the doctor about it, I opted to speak in a much quieter tone of voice than normal. At this point, I just wanted the appointment to be over.

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QUIZ TIME! Is this A) a medieval torture device OR B) a phoropter? (It’s B, which is the legitimate name of this piece of ocular equipment. Who knew?)

He spent 15 minutes running the standard eye tests (read the chart in front of you, does this setting make it better or worse, etc.), then dilated my eyes. I was sent back to that horrid waiting room for another 20 minute while the dilation took effect. When he called me back in to give my dilated pupils a final inspection, the following exchange happened:

Doctor: You know, I saw a patient the other day who was diagnosed with diabetes at birth.

Me: Yeah, I know a couple of people who were diagnosed as babies. It’s awful.

Doctor: Even though he’s had it his entire life, he doesn’t take very good care of it. He’s got diabetic retinopathy now. *shuffles paperwork*

Me: *Fidgeting uncomfortably in the chair, waiting for him to add to that. A long 20 seconds elapses before he finally says…*

Doctor: Fortunately, that’s not the case for you.

Um, WTF, Doc?! What’s up with that weird dramatic pause? Were you TRYING to freak me out? Mission accomplished, dude. But my oh my, such a sweet relief to hear that there is no diabetes in my eyes.

As I walked out of the building a few moments later, I couldn’t help but think about how this was a textbook example of how an appointment shouldn’t go. I left feeling an odd mix of emotions: disappointment with my doctor’s behavior as well as relief with his assessment that my eyes, at least, were proof of my well-managed (NOT under control) diabetes.

A Good Diabetes Day

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I’ve blogged plenty of times about my “bad” diabetes days – you know, those posts that I talk about stubborn blood sugar that won’t come down/up, or how technology refuses to cooperate, or how I’m feeling intense diabetes burnout.

This made me wonder about the “good” days. Besides my blood sugars looking so perfect that I question whether my pancreas has magically started to produce insulin again, what sets those days apart from the “bad” (and plain, old, ordinary days)?

 

The answer likely varies among people with diabetes, but let me describe my version of a darn good diabetes day:

  • Going to an endocrinologist appointment first thing in the morning and discovering that your A1c has dropped nearly half a point, down to 6.7. YAAAAAAS!
  • Being told by said endocrinologist that you’re doing an amazing job, and passed all other blood work tests with flying colors – I was most thrilled with my HDL cholesterol (the good kind) levels, which have gone up due to my current exercise regimen. And she said I lost a couple pounds, to boot!
  • Coming home from work to a package from Dexcom containing the brand new G6 receiver, transmitter, and sensors. I can’t remember the last time I was so excited about a delivery!
  • Topping it all off, my blood sugars throughout the day weren’t too shabby.
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Dancing excitedly with my new Dexcom G6! My puppy couldn’t understand what the hullabaloo was all about.

It’s days like that that make me feel validated – like all my hard work is worth it. It isn’t easy to manage diabetes every moment of every day, so when the diabetes stars align like this, it feels…wonderful.

Insulin Pumps and X-rays

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“You have to remove your insulin pump before we can take your X-rays,” the technician said to me. I stared at him, and responded point-blank, “What? No, I can’t take it off.” I tried to hide the panic in my voice, but it quavered as tears stung my eyes.

“Well, let me check our insulin pump protocol…” his voice trailed off as he left me in the dark room with my right arm held up in the air in an attempt to mitigate the throbbing sensation going up and down my forearm.

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That pod on my arm can’t simply be removed on command.

When I fell and broke my ulna a couple weeks ago, my insulin pump was one of the last things to cross my mind as I was shuffled from doctor to doctor and one medical facility after the other. All I could concentrate on was the injury – how severe was it? Would I be able to work? Could I keep up my exercise regimen? Was I going to need surgery? My diabetes, for once, was far from my thoughts.

But this instantly changed when I went to get an X-ray. When the technician told me that I’d have to remove my pump, I wanted to shout at him, “No! If I do that, my blood sugar will skyrocket! You can’t expect me to do that!” It was hard to keep calm, and my emotions were already running amok due to the chaos of the morning so far. So even as I tried to fight the tears, a couple escaped and ran down my cheeks. When he came back into the room, the X-ray technician’s expression changed. He looked at me empathetically.

“It’ll be okay. Come on, let’s call your endocrinologist. We’ll see what she has to say and get this all figured out.”

Twenty minutes later, after a series of phone calls and a few accidental hang-ups, we received confirmation that I could, indeed, wear my pump for the X-ray. The nurse practitioner who I spoke with at my endo’s office said that it was safe as long as I wore the protective vest. “It’s really only a problem if you’re going in for an MRI or a CAT scan, because those involve magnets,” he told me.

Once I got off the phone, I ran over to the X-ray technician and explained it to him. He smiled at me and said, “Got it. Let’s get these pictures over with – you’ve already had quite a day so far.”

I nodded and thanked him for his patience. He was right, I was overwhelmed from the events of the day – it wasn’t even noon yet – but in hindsight, I’m glad that the technician didn’t try to fight me when I said I couldn’t remove my pump. His willingness to hear me out was huge. It’s not easy to be your own advocate in a high-stress situation like that. But I’m proud of myself for speaking up and getting the answers we needed. Everything worked out in the end – well, except for that pesky broken-bone bit.

An Abundance of Appointments

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Ugh, I don’t know why I did this to myself, but about a year ago, I decided to schedule a bunch of my key doctors’ appointments back-to-back. That means every week for the next three weeks, I’ll be seeing one of my main doctors. Fun!!!

Truthfully, I don’t HATE going to see the doctor. It’s just the waiting and the feeling of being in a hospital-like environment that I detest. And I’ve gotta say, I’m not overly fond of my personal bubble being invaded for the sake of evaluating my wellness, but it is what it is.

First up on the calendar was a visit to the dentist. This is the only doctor I see who never asks about my diabetes, which is very refreshing. But that doesn’t mean diabetes is far from my mind when I go to get my teeth cleaned. My big fear is that my blood sugar will go low in the middle of the appointment, which would make things difficult seeing as I’d have to ask the dentist to stop what she’s doing and let me correct for the low. This would be super frustrating for both parties, as she’d probably have to start her work all over again and I’d have to wait for my blood sugar to go back up to normal.

Fortunately, this fear has yet to come to fruition and my blood sugar is usually fine, if not a little high, at the time of these appointments. And this trip to the dentist was likely one of the easier appointments I’ve got scheduled this month, because I was told my teeth look great. I was also told that my hair is awesome, which made me flash my pearly whites even bigger at the dentist. Yup, definitely the easiest (and CERTAINLY the most flattering?!) appointment I’ll have all month…possibly all year.

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The patient’s perspective.

Next up is my primary care doctor. It’s time for my annual physical. This appointment was basically a complete wash because it occurred within the hour of me fracturing my ulna (see a couple posts down). In between my tears, my doctor asked me standard questions and requested to me to fulfill the usual battery of annual lab tests. My blood pressure was a little high during the appointment, but if I had to make an educated guess, it’s probably because I was stressed due to the excruciating pain I was experiencing in my right arm. Just a hunch.

Thank goodness that everything else came back normally, though. Fewer things to worry about when it comes to my health will always be a welcome concept.

I don’t want to count appointment number three on this list, but I guess it’s worth mentioning my trip to the orthopedic’s office – you know, because of the broken bone. I get to have at least two more with him in the next six weeks as follow-ups. Joy!!!

Finally, the last truly pre-scheduled appointment I’ve got is with my endocrinologist. I’m nervous because I don’t know what my A1c will be like. I have an excellent and empathetic endocrinologist, so I know whether it’s good or bad, this reading won’t affect the overall tone of the appointment. It’s just pressure that I put on myself.

We’ll find out what happens before long. All I know for sure is that I’ll be relieved when I’m finally through with all these appointments.