Tuesday, August 01, 2006

Facing the music, or the longest post ever

My CDE used to tell me I was the poster child for diabetes management. Well, not in so many words, but she did say something to the effect of wishing her other clients were as dedicated to the cause as I was.

This was, of course, when I was pregnant, when I had a specific goal in front of me: no big babyness, no birth defects, no excess amniotic fluid. I seem to be like that with most things. Specific deadline=dedication. Must be why I seem to excel in journalism. And also why I haven’t sat down to write The Great American Novel yet. . . no deadline.

After the baby was born I tried very, very hard to stay on track, but there is about a six to eight week gap in my paper log books because I simply quit testing, quit tracking. I more or less quit diabetes. And since then, no matter how I’ve tried to stay on task for more than a day or two, I revert back to bad habits (read: Taco Bell and king size Twix last week for dinner).

When I saw my endo for the first time, the baby was about four months old. He had good things to say to me and about my management—“What you’re doing isn’t broken,” he said. I was terrified, though, of what my A1C was going to be. It was 5.9. But since I hadn’t had it tested in over a year, I really didn’t know where I was coming from. (I asked my perinatologist somewhere in my third trimester if I ought to have it checked and he said the pregnancy would skew the results so it would be a worthless number.)

I was tempted to cancel my next appointment with my endo based on how poorly I had been managing my disease. I had recently learned that he is considered an expert in our area. When he entered the room I felt oddly like I was in the presence of greatness. And more oddly, I felt inferior—I stumbled over my words, made excuses for my behavior. It was like being in the principal’s office after putting stink bombs in the bathroom. You know it’s wrong, but you do it anyway because it feels good in the moment.

We talked about my eating habits and my meds and my post-meal numbers. And we talked about carbs. Check out our conversation in progress:

“I generally have about 40 to 60 carbs for lunch and dinner, about 30 to 40 for breakfast, and about 15 to 30 for snacks,” I relayed.

“Well, you really don’t need a snack do you?”

“Are you absolutely insane, man? No snack?! Haven’t you read my blog?”

Ok, so I didn’t say the last part, but, frankly, I’d rather take more insulin than give up any food.

After discussing Byetta (which I will likely start when No. 3 has finished nursing) and deciding to start me on Metformin, he sent me to the lab. **big sigh** Needless to say, I knew my A1C would definitely be higher than 5.9. But certainly, I thought, not higher than the 7 I was when I was diagnosed.

Surely, I thought, even the minimal management I was eeking out over the last three months was better than the no management I had pre-diagnosis. The dry, unemotional voice of my endo’s nurse telling me “7.3” proved me wrong. What I hadn’t considered was that my disease had progressed. Something I realized I would have to deal with forever.

I hadn’t really factored the increased insulin resistance into the equation either. I’m actually taking more Lantus now than I was at the end of my pregnancy. When Dr. C wrote the prescription for Metformin he told me to decrease my Lantus from 20 units to 15 units on the first day I took it. Well, after taking the first ½ pill and still getting a 168 after dinner, I kept my night time Lantus at 20 units. And the following night? I increased my Lantus to 23 units after clocking in at a lovely 330 after dinner. I think I’ve narrowed that one down—no more potatoes or milk for me. ((loud weeping sounds at the thought of no milk!))

For-ev-er. Like the kid in The Sandlot. It used to be such a far off thing, and I guess to a certain degree it still is. I mean, really, I remember when 30 seemed old. But the realities of this beast hanging around and being generally unpredictable are starting to set in. I’ve thought about this recently and decided that I likely had somewhat of an extended honeymoon period during my pregnancy. I was extremely diligent and in incredibly tight control (man, I really wish I would have had my A1C tested during my pregnancy) that I think I was still in a fog after the baby was born. I really think I thought that if I just kept on keeping on then things would be fine and dandy and that I would never have to increase the amount of medicine I was taking and never have to deal with any of the funky stuff The Big D hands out on a daily basis. I literally have had to learn things over again. I’m dealing now with all the emotions that I should have dealt with around the time I got pregnant (just two months after being diagnosed).

Dec. 5, 2005, was my first D deadline. That’s where I had to get to have a healthy baby. To have a healthy me? Every day has to be its own deadline.


At 4:03 PM, Blogger Scott K. Johnson said...

Hey Michko,

I hear you on this one.

This is probably the hardest thing about trying to manage diabetes.

The never ending of it.

The "work for what? - lack of punishment?" thing.

It really is hard.

We are all working to find the balance between a satisfactory happy life and satisfactory health.

If I ever find that balance, I'll be sure to let you know!

One thing we can do though, is to not be too hard on ourselves. Diabetes is hard enough.

At 7:45 PM, Blogger art-sweet said...

So true. And so damn hard.

At 8:08 PM, Blogger Rachel said...

what Scott said.


At 11:12 PM, Blogger Minnesota Nice said...

Wow. Sounds like you are way overwhelmed. Sometimes I feel like diabetes is a treadmill to nowhere, and I sure don't need any snippy doctors to enhance the journey. Staying on track for "one day or two" is a victory in its own right. Keep on, sister.


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