Constant Progress, However Small.
It has taken me a long time to find a new primary care doctor. For a good span of time, I was at the Joslin clinic preparing for pregnancy and then actually being pregnant, and in tandem with the pregnancy care team, I had a kick-ass doctor in Connecticut (where I was living at the time ... and yes, I was driving from Norwalk, CT to Boston, MA for endo appointments. Joslin is worth it, in my opinion. But that was when gas was $4.65 a gallon, so it was an expensive adventure in pancreas pandering.)
Over the last two years, I've seen a few different primary care doctors that are local to where I am now (in Rhode Island), but I hadn't found a good fit yet. Every patient is different and has different needs (same goes for docs), but I wanted a doctor who was at least familiar with type 1 diabetes care, even though I still see Joslin specifically for my diabetes care. I wanted to have a doctor who was comfortable discussing diabetes stuff, and who would be okay with shuttling information back and forth with my endo at Joslin. And I really, really hoped that their staff would be kind, because as a patient, the doctor's staff can make or break your desire to be seen by that practice.
Lastly, this person had to be a woman. (Nothing wrong with doctors who are men, but I can't comfortably talk shop with a guy. I don't know why. I've always felt most comfortable with female practitioners.) So with that "wish list" in place, it has taken me a few tries to find a good doc/patient fit.
But I think I found her. And she's awesome, because she threatened to 'break up with me' during the course of the first appointment.
As I mentioned last week, during my first appointment with her, she wanted to run the full gamut of labwork to 'establish the baseline." But we reviewed my last few lab work ups (I brought the older results with me - I'm a creepily-fastidious paperwork person), and she, like me, wasn't happy to see the higher A1C values over the last six months.
"This isn't where you want to be. I can tell," she said, watching my face as we discussed my health history. "And I don't want your numbers here, either."
"Definitely not," I agreed, trying to look like an adult capable of making my own medical decisions, while sporting the awkward paper johnny. "I'm really unnerved by those A1Cs, and I'm working to bring it down. It just seems to be a really slow process for me. I don't know why. I've always had trouble with my A1C, even as a kid when my mom was fully in charge of things."
"Did they call you that old-school name? The 'brittle' kind of diabetes?" she asked.
"Yes! That word is written all over my old Joslin charts. Always made made me think about fancy tea cups. Or really weak fingernails."
"Exactly." She smiled, and closed my chart. "But the fact remains that your A1C is higher than it should be, considering all the complications that come as a result of maintaining that kind of number. You know the list - I'm not going to run through it for you. But we've discussed the things you're doing to make changes, and I think that's the right path. I know the lows scare you."
"It's less the fear for me, personally, and more about dealing with them when I'm home alone with my daughter. I'd rather be 150 than 80, because I seem to drop so quickly."
"I understand that. I have a little one myself." She grinned at me. "They're fast, aren't they?"
She opened my chart again and reviewed one of the labwork slips. "So do you want to be my patient? Because I'm happy to take you on."
"Yes." (It felt strangely like a platonic date. I should have brought her flowers?)
"Great. The only condition I have is this: your diabetes is not in the control that you or I want it in. I know you see Joslin for your endo appointments, and that's fine, but I want to make sure that you're continuing to pursue tighter control. I like what you're doing to move forward, and I want you to stick with that. I don't expect you to have perfect results the next time we meet, but we need to have constant progress - however small - towards that goal that you have set and i agree with. Does that work for you? Because anything less than that doesn't work for me."
"More than you realize - yes."
She smiled. "Welcome to the practice, then! I'm happy to have you with us."
"Can I put my clothes back on?"
She laughed. "Of course! I'm sorry - such a strange conversation to have in a paper johnny, I know."
Constant progress, even if the steps are very small? I love that. And understanding how freaking awkward it is to meet someone for the first time and then have serious health discussions while sporting a paper dressing gown?