Friday, March 25, 2011

In The Words of My Endo

My day began with a clouded grey sky, chilling wind, and a mixture of flurries and freezing rain.

A day earlier, we hit a sunny 70 degrees in Indianapolis.

The fickle March weather perfectly describes how my Endo visit went on Thursday. One day back in December, the weather was great and my Christmas Endo visit revealed an A1C of 7.5 - down a whole percentage point from the start of that year.

But this recent visit, winter arrived and my diabetes management had gone chilly cold. To the point where my A1c jumped just as predicted, to a 7.9%.

Disappointing, but not at all surprising. A review of my Minimed Carelink blood sugar data the night before my visit affirmed what I'd already knew: that I have been slacking pretty hardcore lately in my D-Management. Only in range about 44% of the time and going High and Low. usually higher in the morning and evening with nearly picture-perfect BGs from 11a-7p.
Labwork from the day before proved conclusively that my thyroid level is low, affirming my suspicion that this is a key culprit in how I've been feeling lately - basically a tired and less social version of myself that is less passionate and productive than normal.

We had some discussion about relative medical and health topics, talked about my recent Funky Eye Exam where retinopathy came up, then we changed some basals and tried to examine why exactly I feel burnt out so often. One theory was that my recent three month trial run on a Loaner CGM gave me a lot of data and helped keep me attentive, but it also zapped my energy level with BG overload.

We talked about depression and burn out, I talked up the Diabetes Online Community and how it helps, and we agreed that it might help to talk to someone else. Like, for example: ANOTHER PWD, who happens to work in that very same office - a veteran Type 1 who works there as a diabetes educator. Though her CDE duties may involve basics, there's the simple D-Meetup and just regular talking and support that is possible. Maybe that will help me sort through this burn out, along with the thyroid improvement and more sleep and overall stress relief. So, I'm excited about!

In retrospect, there was a lot about this Endo visit that didn't go well. Not surprising, as I haven't been feeling all honkey dorey lately. This isn't the worst that I've seen, but it has felt like the kind of serious burn out that I haven't felt in a while. I've been angry with myself and those around me, and have felt selfish and focused on my own needs and wants. As a result, I've slacked on my overall care and that hasn't helped anyone.

I blamed myself, but my Endo's words came back and reassured me that there's a light at the end ahead:

"I'm not blaming or judging," she said. "We just need to figure out how to help make you as healthy as possible. We can do it."

That comment was assuring to me, transforming what felt like a mood of disappointment and blame into one of hope and progress for what's ahead. A guiding light that's so important, because it's the kind of support we need from our medical professionals as we navigate this lifelong ride.

11 comments:

Simon said...

Hey Mike
Down by a full percent is a great result.
Struggling with pinpointing the causes of feeling lethargic is also a cause of much angst for me. I too am having some thyroid issues.
Sometimes I think the most annoying part of Diabetes is not knowing if or if not it is the cause of other problems. It always seems to cry out to be noticed.
Another post I could relate to. Keep up the great work, it has been great to get to know you through your blog and on Twitter

Penny said...

A guiding light is sometimes all we need. Burn out happens, it's what you do with the burn out that challenges us all. Getting back on the horse eventually and getting yourself back on track is what makes us all the DOC. Here's to getting back on track and feeling better Mike!

Jules said...

Your endo sounds super supportive. "We can do it"...I'd love to hear something like that at our next appt!

Alissa @ Juvenile Diabetes said...

Hi,

Thanks for the blog comment - a proper 'Hello' to you too!

I hope that you get through your burn out phase - the last time I had one (at Christmas), I finally gave in and started a low carb diet (but not NO carb), and my sugar levels have been awesome -seriously! I hope too that when I next get my hba1c it will be much lower...but we'll see :)

Reyna said...

Hey Mike,

I wonder too...if part of the burnout stems from your thyroid being off? Not feeling your best from an actual physiological issue can definitely thwart your emotions and energy level. Things that you need to be at "peak" to deal with the day-in and out of "D" management rigors.

It sounds like you have a healthy attitude and you are taking steps to get the help and support you need.

Thanks for showing us that it is OK to be "human" and that burnout happens. It gives the rest of the Type 1s and Caregiver Type 3s permission to not beat ourselves up when we slip a bit too.

Chin up.

Sysy said...

When I got pregnant my thyroid function dropped just a tiny bit from where it always hangs in the very bottom of normal down to the high area of low and honestly, I couldn't even get out of bed easily or walk up stairs like a normal person. I just felt totally drained. I was so melancholy I didn't know what to do with myself. A few months later into the pregnancy my thyroid function went back up to normal and I suddenly felt SO much happier and energetic and motivated to do what I needed to do every day. All I'm saying is a tiny change in the thyroid function seems to feel BIG...and I had no clue before that experience. My sister is dealing with a new thyroid issue and she feels really different lately and her A1c went up past 8%. Hope you feel better soon. You sound good at the end of your post, I hope things turn up. Hang in there!

Allison Blass said...

I had a series of craptastic A1cs awhile back and I *finally* hit the under 8% mark after lots of "well, maybe if we try..."

Sigh. It's tough work. Hopefully getting your thyroid issues taken care of will make you feel more like yourself.

But your endo sounds pretty smart, so at least you have that to be grateful for.

Sarah said...

Isn't it awesome to have an endo that supports you no matter what?? That is so good to hear, Mike. :-)

HVS said...

It's so easy to get tired of it all (took me 3 years
to get to a 7.1, and three months to jump right
back up to a 8.8 this month) it's never-ending. I've had recent thyroid
issues as well (makes it hard to have the motivation to do anything). Hope you can get some IRL support & meds( ifneed be) to get to feeling better.

Wendy said...

Mike...I need to follow up with a doctor for an ongoing issue...but I've gained weight and I don't want to get on the scale -- SO I HAVEN'T GONE! I'm a whimp!

You, on the other hand, have displayed complete BAD-ASSNESS by facing your situation head on, and not allowing it to stand in your way.

I could learn a thing or 2 from you :)

Jen said...

Sounds like you have a wonderful and supportive Endo. Diabetes burnout seems inevitable..I know I feel it and I am just the caregiver..

My son just went on the Dexcom and as much as I love it..when it was time for sensor change this past week I left it off of him for a while..and it felt liberating to not be looking at all that data for a while. The CGM is certainly a mixed bag.

I am here routing for you Mike! Here's to getting back on track...