It’s All Good

I’m still not used to having an endocrinology appointment every 6 months.

For my first two decades with diabetes, I saw an endocrinologist (or diabetes nurse practitioner [NP]) every 3 months. In hindsight, this sounds like a slightly aggressive amount of visits, but it’s what worked for me for a long time. Those appointments often served as motivation for me to do better, as well as learn about new diabetes care options available to me. And I’m fairly certain that they were a good opportunity for my parents and healthcare team to put their heads together, at least when I was younger, and come up with ways to make life with diabetes easier for me.

But as I’ve grown older and become more independent in my diabetes journey, I’ve relied a little less on these four-times-per-year check-ins. I don’t know exactly when, but in the last few years, my diabetes appointments became more of a nuisance than a boon…and I think my provider at the time recognized that. She suggested reducing my appointment frequency to twice a year, and since making that change I’ve greatly benefited from it.

And it’s why, when I attended my first appointment of the year recently, it felt like a nice little status check of where I’m at with my diabetes. In fact, that’s exactly how my NP kicked off the appointment: She asked me, “how are you doing? Is there anything new going on that you’d like to discuss?”

It felt great to be able to tell her: It’s all good.

Nothing new, no major complaints. We did chat a bit about my “diabetes cure” fluke from last month, in which we came up with no definitive answers but I was encouraged to monitor my blood sugars around my cycle a bit more carefully to see if I could come up with any patterns. We also went over my bloodwork and she was pleased to report to me that everything looked good, which is always reassuring to hear. The appointment ended with a check of my feet and thyroid, as they always do, and then I was free to go.

Even though we didn’t make any changes to my diabetes management, it was still worthwhile and comforting to know that my care team agrees with me that everything is all good and to keep up what I’m doing. That, in its own unique way, is enough motivation for me to do the best possible job taking care of my diabetes between now and the next appointment. It really is all good, and I’m grateful for (and proud of) that.

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A Dis-Appointment: My Experience at the Endocrinologist

Welp, I had my appointment with my endocrinologist on Monday.

In sum, it was mostly an uneventful affair, considering the times.

Immediately upon arriving, I was asked to put on a clinic-provided mask and to sanitize my hands. I checked in with the receptionist and sat in a chair in the mostly-abandoned waiting area, taking in the fact that seating was reduced in order to maintain social distance.

A nurse came out to bring me into my exam room and she took my blood pressure (good) and my weight (let’s not talk about it) before leaving to get my doctor. I was slightly surprised that she didn’t check my temperature with a contact-less thermometer, but I decided not to second-guess it.

My endocrinologist entered soon after…and she spent all of 15 minutes with me. She said that she reviewed the information I sent her from my Dexcom, as well as data from my pump, and said she couldn’t really detect any patterns besides some lingering lows in the late mornings/early afternoons. Again, I found myself a bit bemused by this observation, because I hadn’t picked up on it. She decided to adjust my basal for the 11 A.M. to 1 P.M. window (I went from 0.9 to 0.8 units for those two hours) and then asked me if I had any questions.

She didn’t check my feet, listen to my heart, examine my thyroid, or review my labs with me…all things that I’ve come to expect from previous endocrinologists.

My mild shocks of surprise from earlier in the appointment turned into something else: As the kids say, I was SHOOK…meaning that it was absolutely wild to me that she was already done with me.

A Dis-Appointment_ My Experience at the Endocrinologist
Am I smiling or frowning underneath this mask? Given how my endocrinologist appointment went, I bet you can guess…

I expressed my dismay with my A1c – it had gone up a little bit – and she told me that I was “still under good control”.

I said that I was befuddled by my weight gain – I’ve been working out like a fiend the last couple of months – and she suggested that perhaps it’s muscle.

I asked if she could recommend any blood sugar meters to me – I’ve had the same one for practically a decade and I worry about its accuracy – and she said that I should try a new meter from the same manufacturer that’s supposed to hit the market “soon”.

For every question or concern I brought up in that short span of time, she had an immediate, unsatisfactory answer that made me feel like my concerns were being brushed away.

But the real kicker? I’m not seeing her again for another seven months.

SEVEN MONTHS?!

That’s right, folks. I went from having quarterly endocrinologist appointments for my first 22 years of life with diabetes to once every six months, and now in SEVEN months.

This means that I will have seen my endocrinologist once for the entire year of 2020.

That’s bananas to me, and a sign that my instincts from our first meeting were correct: This may not be the right doctor for me. I have no doubt of her intelligence or capability, but sometimes you just know when a given doctor-patient relationship isn’t the healthiest one for you.

The whole appointment – the brevity, the indifference, and the outcome – was almost enough to make me forget about my anxieties surrounding medical facilities during this pandemic…

…almost.

Luckily, that’s what face masks, Clorox wipes, several squirts of hand sanitizer, and a thorough hand-washing or five are for.

My First Endo Appointment of 2020

My first endocrinologist appointment of the year is coming up next week and it’s got me feeling allllllll sorts of emotions…

Anxiety. This tops the list because, well, I haven’t been to a medical office since the coronavirus outbreak started. My doctors have either asked me to reschedule my appointments, or I’ve been able to see them virtually. I know that my endocrinologist’s practice has many protocols in place now to make the experience as sanitary and safe as possible, but it still does put me on edge.

Fear. I’m afraid of what my A1c will be. Yup, I’m actually scared to know this reading that should, in reality, help me manage my diabetes better. I know, I know – the A1c is just one way to measure how well I’m taking care of my diabetes, the one number isn’t a total reflection of my “success”. But I can’t help but be worried that I’ll be disappointed by my results, even though I know I’ve tried my best in the last few months to achieve one that makes me happy.

Beige and Gray Minimalist Quote Instagram Post
Who would’ve thought that a simple follow-up with my endocrinologist would evoke so many emotions?

Skepticism. The last time I saw my endocrinologist was just a couple days after Christmas…and it was my first meeting with her. It was her suggestion that I return in six months as opposed to the usual three, which I thought was a little weird, but I just went with it. However, I’m now wondering if this was the right call, because how on earth is she even going to remember more than six months later? I’m concerned that we’ll spend most of our time catching up on things that I didn’t want to discuss during this important follow-up, but I’m cautiously optimistic that it will go better than I’m currently expecting it to go.

Curiosity. I’m HELLA curious as to what my doctor will say about my diabetes management in the last six months. Will she tell me that I’m doing a good job? Will she scold me? Will she take the time to review my latest lab results? Will she help to address my needs so that the next time I see her, I’ll have less trepidation over our visit? I’m very eager to find out the answers to those questions.

Listlessness. Perhaps the most unusual feeling I’ve had about this appointment is…lack of interest in it. I’m nervous about physically getting out of the house to go to it, and I’m wondering about the outcome of it, but the mere thought of going right now just isn’t sparking much of anything within me. I haven’t really thought about the questions I might ask her during the appointment; instead, the only thing I’m truly focused on is the logistics of getting there and actually sitting in the appointment. Otherwise, I’m just feeling a little tired when I think about it, like I’ve already gone and it’s drained me of my energy. This could be due to some burnout that I suspect I’m contending with at the moment, but for now, all I know is that unless I leave the appointment feeling positive in some fashion, then this whole “six month follow-up” thing just might not cut it for me and my own diabetes care and management routine.

First Impressions: How I Feel About my New Endocrinologist

Last week, I wrote about how I had an appointment with my first new endocrinologist in about 10 years. I compared my thoughts and feelings about the whole thing to a first date: Many of the same anxieties are felt in both situations.

By now, I’m sure you’re wondering…how did the date go?

Well…I don’t know that there will be another one.

Freedom is the atmosphere in which humanity thrives. Breathe it in.
This blog post serves as a bit of an endocrinologist evaluation.

Before I dive into my appointment postscript, let me just clarify that my thoughts and feelings are just that. They’re my opinions on how my experience was with this particular doctor. That doesn’t mean that she isn’t a great endocrinologist; in fact, I’m certain she is. But I just don’t think that we are doctor-patient soulmates.

For starters, the appointment got off to a weird start because none of my typical vital signs were measured upon arrival. I’m used to having my weight, blood pressure, blood sugar, temperature, and heart rate checked at the beginning of every appointment. But this time around, the only thing that was looked at was my…blood pressure? It was kind of random, and I never got an explanation as to why nothing else was looked at by the nurse, but whatever.

The actual appointment with the doctor herself mostly went as I expected it to. We spent about 20 minutes together (about 5 minutes longer than I usually get with the endo) and I told her a little bit about my diabetes history. She offered me some advice on what to do about the high blood sugars my new inhaler was causing (more on that in another post) and checked my feet as well as my thyroid, just like my previous endo did at every appointment. But she did not check my eyes, and she also…did not review my A1c with me.

This was pretty huge, though not totally unexpected. I knew this clinic didn’t have finger stick A1c machines like the previous clinic did, and that I would have to come to the lab at another point in time to get a current A1c reading. But it was surprising to me that she just glossed over it, like it wasn’t super important at that moment. She didn’t even review my Dexcom/OmniPod/Verio IQ meter graphs with me, despite having downloaded information from all three devices. However, these weren’t the most shocking parts of the appointment.

What caught me off-guard the most is when she said that I could come back in six months instead of my usual three.

In my 22 years with diabetes, I’ve gone to see my endocrinologist every three months, no matter what. Some of these appointments were more like maintenance checks to make sure I was on track with everything, but other appointments came at crucial times for me in terms of improving my diabetes management. I asked the new doc why six months instead of three, and she said something along the lines of…

“Well, it seems like you have everything under pretty good control. And you seem in-tune enough with your body to know to contact us with any questions.”

That latter statement is true, but the former…I don’t know about that. How could she have this impression after talking with me for a mere 20 minutes? It was mildly alarming. I probably could’ve pushed for another appointment in three months, but I got the distinct feeling that I would’ve been rejected had I done so. As a result, I walked out of the clinic that day with another appointment set for July and a feeling of unease settling in the pit of my stomach.

I don’t know that I can wait that long to see an endocrinologist, and I don’t even know if I’ll want to see the same person again. I have no idea how she’d be able to remember me, for goodness’ sake, especially given the brevity of our first and only meeting (so far).

Among all these unknowns, there’s one absolute truth: I miss my old endo.

An Abundance of Appointments

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.