Three months ago, I set up my appointment with that seasonal celebrity of the Diabetes Community known as Santa Endo-Claus.
Like many mythical figures of the past and present and storybooks, this character varies for each Person With Diabetes and appears in whatever way he or she might best recognize. In my little corner booth of the world, Santa takes the form of Dr. P.
While I do like the Christmas season, I have been somewhat nervous about this appointment. That's because of my experience Inside the Endo's Office back in September when it was revealed my internal office A1C was 7.8%, a tenth of a percentage point higher than the last visit back in the summer. My results had been higher in the few months prior to that, and we both determined it actually may have been a bit closer to 8 thanks to some recent Lows possibly artifically-deflating the result.
We vowed to work together and bring it down by Christmas, and for a while that happened. Things were better. But in the past month, I've seen a wave of higher BGs and haven't been as cautious, careful, and attentive as I should have been. On that morning before my appointment, the 12-week average displayed on my Minimed Carelink program was 180 mg/dL. My meter showed me a 30-day average of 198 mg/dL. Using the formulaic self-calculation, that average translates roughly to a 8.5 on the A1C chart. My more short-term averages have been less worthy of even talking about. That's just not acceptable, and I really hoped my A1C wouldn't get that high after I'd kept my averages lower in the 160-average range in the first couple months.goo
In order to hit the 7.0 mark that had been my goal, I needed to have an average of about 154 mg/dL. That wasn't expected, but I was hoping that it would be down closer to that level than I'd been in the past year.
All of this is what brought on the hesitation for this pre-Christmas visit. But I knew, whether it was Up or Down, that Dr. P would be appearing in the form of Santa Endo-Claus to bring me either a gift or a lump of coal. No, she doesn't have a white beard. Her red jumpsuit has been swapped with a white lab coat. The big bag of goodies is instead a clipboard full of medical tidbits about each one - some Naughty, others Nice.
That day was a bit hectic with work, so I was a little worried about last-minute work issues surfacing and putting my visit in jeopardy. Fortunately, that didn't happen and my 11:30 a.m. visit went on without a hitch.
Arriving in the waiting room and settling into a seat among the five or so others already waiting, I snapped a couple photos of the waiting room that now had a Christmas Tree! Then, went in for the appointment and waited for Santa Endo-Claus to come down the chimney, er, exam room.
All was good. Weight was similiar to before. Cholesterol revealed I wasn't eating too many eggs. My heart beat was calm and not in "I just shoveled the driveway clear of wet heavy snow" mode. My eyes could see and my feet felt the little brush being moved about the skin.
When Dr. P (I mean Santa Endo-Claus) entered the room, we discussed how I was not pleased with my blood sugar control lately and just felt burnt out. Not a result of basals being off or anything, just my slacking in doing what's needed. She asked if I'd ever thought about pancreatic transplants or Symlin, to which I responded I wasn't really interested in either because of the likely side effects.
As she sat reviewing my numbers, an assistant popped her head in the door and said: "A1c: 7.5."
Well, hallelulah! A slight drop, from the 7.8 seen back in September which had been up from the 7.7 over the summer and even higher numbers before that.
Santa Endo-Claus concluded the drop was likely a result of my not having as many swings as I'd had before, either on the High or Low side. Even when I've gone into the 300s or 400s, it hasn't been for long and I've gotten things back down quickly. And I've taken more care into correcting correctly for Lows.
Personally, there's one additional point that must be credited for my drop in the past year: That is the Diabetes Online Community. I firmly believe that being involved so actively through the blogosphere, Twitter, Facebook, and just generally in the Diabetes Community, I have improved my health and become more motivated to put the work in. My burn out hasn't lasted as long, and I've found incredible support in conquering it more quickly and getting back on track. So, to everyone in the DOC: Thank You All!
So, it seems I'd gotten a Christmas Present and not a Lump of Coal, after all! Number is still higher than we'd like, but at least I'm moving in the right direction. We vowed to get under better "control" by the next visit in March.
While I didn't achieve the 7.0 or Under that I'd set as a goal at the start of 2010, I'm better off now than what I was when the year began. And there's a clear plan on improving in the coming year. So, bring it on 2011! Let's get this going!