Two weeks ago, I was in the emergency room for some severe stomach pain, down on the lower right hand side of my abdomen. After consulting with Dr. Google (bastard), I realized that it could be appendicitis. Knowing I was heading to Toronto the next afternoon, I didn't want to take any chances with this pain. So I headed off to the ER to check things out.
Looooong story made Twitter-esque short, I didn't have appendicitis. I just had some rogue stomach pain. However, while I was at the hospital, I asked to have my A1C run. I figured I was there, they were already drawing blood, so what's one more vial?
"Can you guys grab an A1C while you're at it?" I asked.
"Is your diabetes under control?" asked the doctor.
"Um ... define control? I wear a pump, I wear a CGM, and I'm very aware of my disease. But I've been having a hard time juggling things lately, on just about every level, so I'm pretty sure my A1C is crap."
The doctor shot me a very rude, very judgmental look. I shot one back at him.
"I'm asking you to run an A1C because I'm trying to regain control. I don't have this nailed down and perfected, but I'm trying. Is that the wrong thing, in your opinion?"
That sort of ended the discussion. (Actually, it didn't end the discussion - details here.) They drew the blood.
The journey at the ER ended (inconclusive, but nothing to worry about), and I made my trip to Canada. While I was away, I kept thinking about that A1C, knowing it was going to be a rough one. I don't know what the hell is wrong with me lately, but I've gone right off the rails with my diabetes control. I'm actually ashamed of myself. It's not a matter of not having the right tools - I have access to an insulin pump and a continuous glucose monitor, and a glucose meter and fast-acting insulin - but it's a matter of not being tuned in. I'm on a completely different frequency than my diabetes, these days. I don't know if I can even call it "burn out" because it's bordering on pure ignorance. I know what I should be doing. I know how I should be responding to these different numbers on my meter.
It's just that I'm too damn busy to pay diabetes the attention it deserves. And that it needs.The result? An A1C of 8.6%.
"Whoa. Seriously? That's what it was a few months after having Birdy." My eyes completely filled up with tears. "But I did have one drawn a few months ago, and it was in the 7's, so I haven't been off the rails for too long. Just long enough."
And I cried like an idiot for about five minutes, because I was so mad at myself for being surprised that my A1C is that high. What did I expect it to be? I haven't been testing as often as I should. I have been traveling non-stop since the beginning of October, deliberating running my blood sugars higher than normal to mitigate the travel lows, all added to the general chaos. I wasn't upset about the number itself, but more at myself for letting it get that high, so fast, and for my having the audacity to be surprised.
I know I've said it a million times before, but I need to try harder. Do better. Be more honest with myself when it comes to assessing my own control, and owning the problems before they start to reflect in my A1C. I just hate having the same conversation with myself, over and over. It's the cyclical chaos of diabetes, always reaching for "better" and never feeling like you've achieved it. I try to feel empowered by being honest about these kinds of set backs.
But you know? Honesty sucks. I hate having to share these kinds of results. But I can't pretend that everything is awesome, diabetes-wise, over here, so I'm telling you guys to up my own accountability. And also, writing that kind of A1C result down makes it "real" for me. My job now is to make it closer to "better," even if I feel like I'm never quite there.
Moving towards that hard-to-define goal of "good health" is still progress.
[Edit: I edited this post. The end.]