When In Doubt, Look to Kevin.
Last week, I met with a new primary care physician, and as part of the "getting to know you" groundwork, she ordered a full lab work up, including an A1C. And I felt pretty good about it, because I've tried really hard to leave the gross bout with diabetes burnout behind, moving forward with a better mental attitude about the whole thing.
"So you're feeling all sunshiny. That's great for you, but a good mood doesn't lower your A1C," says the grumpy voice in my head.
Right. Which is why shaking off the burnout included letting go of the guilt, but also ditching the bad habits and making a focused effort to make sense of my diabetes management.I've tuned back in to my Dexcom, and am making the most of the information it's throwing my way (like correcting those subtle highs of 170 mg/dL, instead of letting them linger). I'm testing my blood sugar way more often (back up to about ten times per day), and while the average on my meter isn't anything to write home about (151 mg/dL), I'm really working to bring that number down without an onslaught of low blood sugars. I don't know ... I feel better, overall, and more confident in how I'm managing my diabetes these days.
So when the nurse called me yesterday with some labwork results, I was really, really disappointed to hear that my A1C was not reflective of the work I've been putting in. It's lower than it was a few months ago - a major plus - but not close to where I want it. And that frustrates the hell out of me, because I want that number to reflect effort. The A1C value is what we're judged on, as PWDs. That number is what healthcare professionals ask us about, and base their judgment of our diabetes control - sometimes of us, personally - upon.
When the nurse told the result, I let out a low whistle and admitted, "I thought it was going to be a bit better than that."
"It's higher than we'd like you at," she said, without a trace of judgment in her voice.
And I wanted to tell her that I have been testing a lot and reacting to the Dexcom and working out and trying to eat better and with more regularity ... I wanted to give her that deluge of information, because I didn't want her to think I was okay with That Number. I was new to her practice, and I wanted her to know that these labwork results matter a whole lot to me, that I was working diligently towards better control, and I wanted to be a patient they wanted to work with.
But all I said was, "It's higher then I'd like, too. But I'm working to bring it down."
Life gets in the way of good diabetes management. When I was trying to get pregnant and then during my pregnancy, I spent the majority of my day stalking diabetes. I tested a ton, wore the Dex, logged my blood sugars, and didn't do much other than that. My A1C was gorgeous (6.3 %), and my job was to create a safe environment for my growing baby. Incentive, at that moment, was the Birdy.
Now, I'm not in a position to dedicate my entire day to diabetes management. It's that whole "Life" thing again. The Bird is on the loose, and her little legs are freaking fast. I'm working a lot, doing some traveling, and spending time with Chris. However, diabetes is still part of the mix, and I need to find ways to further fine-tune in pursuit of a more solid A1C, and to keep diabetes complications in their stupid boxes (because they are worth more in their original packaging).
So what's missing? Testing? Bolusing? Dex'ing? Nope x3. What's missing, I think, is the stupid logbook. I hate logging. But every time I dedicate myself to it for a few weeks, I see good results. And since I'm in a healthy stride, diabetes-management-wise, I need to just keep at it until the A1C starts to reflect the effort.
So I'm returning to Kevin. The Kevin spreadsheet (he should trademark that shit) is back and in full-effect, and I've been logging numbers. (It's only been two days, but I'm hoping I can stick with it.) Maybe this is the tool that's been missing from my arsenal. Maybe this is just a tangible reminder to stick with the anti-burnout program I've been working hard to make habit. Whatever it takes to bring this stupid A1C down, I'm in.
Before, it was about being healthy enough to have a baby. Now, it's about being healthy enough to be here for her for a long time.