Yesterday's endo appointment didn't go very well. I wasn't really expecting it to go great, but I didn't expect it to be as bad as it was. I had suspected that my A1c was going to increase from last time, but I figured I would land around my usual 6.5 that seems to follow me without much effort.
My appointment was at 8:30 AM across the interstate in downtown, so of course I visited the closest coffee shop on the way to grab an Americano for the hour-long drive. Armed with my Dexcom software graphs and coffee, I took a seat in the lobby and snapped a pic of the freakishly-empty waiting room. (For those who know my endo or go to him for his care, you know the waiting is usually very full!)
Not 20 minutes later, my name was called and the nurse led me to my room. She took my weight and my blood pressure. She was putting the sleeve back in its holster when I asked, "What was it?" "130/90," she said. Another elevated reading, this was something I was definitely going to bring up to my endo. She also took my blood sugar (168 mg/dL) and began spinning my A1c. What kills me about the A1c machines at me endo's office is that you can see the timer! I was tortured watching the 5-minute clock slowly make it's way down to 0:00 waiting for my number. During that time, the nurse downloaded my pump data and made sure all my medications were the same. Finally, the clock goes down to 0:00 and I see the number before she does: 6.8%.
I felt defeated. I couldn't help it. I know most people would be content, even happy, with this number. But for me, this number is way too close to that 7.0% threshold required for pregnancy. I immediately started thinking of changes I needed to make, but I barely had any time before the endo came in the room.
He shook my hand and took a seat beside me, and he starts going over my Dexcom graphs with me. This really surprised me, because my endo has been reluctant to the whole CGM thing so far. So it was nice to see him wanting to use the tool I wanted for so long. He said it looked like I was correcting too many times after a meal, resulting in a lot of lows. He thinks my overall basal rates were too low, so we increased my total amount by making my basal rate one rate for the whole day. I'm not sure I agree with this right now, but I know my basal rates are messed up, so it's best to start over with a single rate for now. He also wanted me to increase my IOB time by 2 hours and make my target BG 120 mg/dL. I compromised by increasing it to 1 hour and keeping my range at 100-120 mg/dL; I don't mind being at 120 mg/dL, but I refuse to treat 100 mg/dL as "low".
Then I addressed the elevated blood pressure reading with him. I told him I had been having a lot of appointments lately with my knee, and each time I was having elevated readings. He agreed that he doesn't like this trend, so he took a look at my history with his office over the past 4 years and notice another upward trend: my weight. I've never had a huge gain all at once, just a few pounds here and there. But a few pounds over a couple of years can sneak up on you. He said the best thing I could do to reduce my blood pressure was to lose 10 pounds, or else we'd have to do "something". I'm assuming he means I'll get put on blood pressure medication, which wouldn't be terrible because they could also protect my kidneys. But I don't like knowing that I didn't do all that I could to be healthy on my own.
So to recap: increased A1c, weight, and blood pressure. I debated calling Trey immediately after the appointment, because I knew it would result in tears. And it did. My poor husband can read me like a book, even over the phone. And when he said, "I know you're about to cry . . ." I lost it. "It's not the end of the world, Babe. You're still doing great. We just need to change some things." We agreed that we had been calling the local pizza place too many times over the last few months when we had no plans for dinner. And even though I've increased my physical activity over the past couple months, I need to bump it up. I've decided to give the spinning class a try (now that my knee is feeling better. Thank you, physical therapy.), and softball is about to start up again. Hopefully these things will help in the weight department.
I really don't know how to end this post other than to say I'm feeling very overwhelmed right now. Ten pounds seems so impossible, seeing as I'm struggling to keep 2 lbs off on a weekly basis. I can log my food with some consistency and keep up a reasonable workout routine, but more than anything I need encouragement. I need hope that this is not an impossible feat. I just need to find something that works for me, but first I need to know that everything will be OK. I need to stop freakin' crying about this and find some joy again.
Sorry, guys. I know this isn't how I wanted to end this post, but sometimes I need to be real. And I hate this, period.
DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.