Pat on the Back

Usually, my relationship with my diabetes and self-care is a rocky one. I tend to focus on the times that I don’t feel well (highs, lows), the numbers that feel like failures, the frustrations of unpredictability and feelings of body betrayal & lack of control. Some of that is a result of my barely-beneath-the-surface perfectionism and just human nature. When things are going well, we hardly notice. When something goes wrong – whoa!

someecards-mind

Change “men” to “people w/o diabetes” and “woman’s” to “PWD’s”

Yesterday I had a regular appointment at my endocrinology office. It’s a fairly new office for me; yesterday was only my third appointment at this practice. I ‘ve seen the endo once and the NP twice. I’m happy with the NP – and I especially noticed yesterday how good she is at reading the download reports from the Omnipod & Dexcom. I can’t quite put my finger on it, but she manages to balance out the big picture and fine detail views so that patterns are easier to see and think about. When I do downloads at home (not as often as I “should”) I get mired in irritation over how many highs I see, ignore the lows, and generally go straight to my own biases. I still may work on a pattern or two if I see them, but I always end up feeling badly.

The first time I saw the NP, we made a lot of changes. I was very skeptical but had committed before the appointment to try at least some suggestions. I had about 8 different basal settings in the 24-hour period and 5 correction factors (sensitivity). We cut the basal settings back to 3 and correction back to 2.  I fully expected to switch back after a couple of weeks, believing that my micromanaging was necessary. I was really wrong.

fig1Yesterday (and yes, some “good” numbers & results are coming up!) my downloads showed that I was in range 78% of the time. That’s seventy-eight per-cent… whaaat?? Unheard of. And, lows (below 70) were only 8%. And, lows under 55 were only 1%. My A1c (and I almost never share this number) was 6.4. That’s .1 higher than last time but last time I was in the low range about 25% of the time. I was ready to think that maybe they got my downloads mixed up with someone else’s 🙂

But, thinking about the past 3 months, I have been feeling better. I’m exercising regularly (yay running!), eating sensibly (foods & portions), using my CGM responsibly (testing before treating, not jumping too quickly on highs or up arrows), and cutting myself some slack rather than always playing the blame game. So maybe those really are my results.

We went over the daily downloads for patterns and only found one that looks like slightly too much dinner mealtime insulin. We changed that I:C ratio by 1 which now gives me only two I:C ratios. For once, my settings are pretty close to the calculations she always does to see what is “suggested” based on my total daily dose, etc. When we looked at the other things that have been frustrating me — having the same breakfast every day but getting different postprandial results and the variability in post-exercise blood sugars — there just weren’t any patterns. Of course, that’s what drives me crazy, but she framed in a different light that was very helpful — obviously there are factors there that aren’t in our control. I’m using the CGM well to catch any excursions before they get completely out of hand and that’s working overall. Not my fault?? What a concept.

So, normally I don’t take any time to think about what I might be doing right, or take any credit for maintaining or improving my health. This time, I just want to. It’s not my diaversary, but it’s a good time to pat myself on the back and say “good job.” I texted the BHE after the appointment to say “If the endo had gold stars, I would have gotten one.” Really though, I need to give that gold star to myself.

Disclaimery Thing: I cringe to post actual numbers. I don’t want to be judged in any way for them — And judgements that come from people when they think your numbers are “too good” or that you are making other people feel badly, or that you have “no right” to complain when your numbers are better than someone else’s are the worst for me. I just want to say that everyone’s experience with diabetes is individual and I haven’t posted anything here as a way to compare to anyone else — only myself. 

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