Saturday, July 12, 2008

Dr Steve

Dr. Steve is my primary care physician. Because I do not pump and do not have an A1C over 8, my insurance will pay for one endo visit per year. The others are with the pcp.

Last Tuesday I was at the clinic for cholesterol bloodwork. I got there at 7:30 and knew that I was crashing - the really bad crash where you sweat buckets. The phlebotomist came to get me and I stood up but did not follow her - just stood there. I was able to explain that I was T1 and low. She said, "oh, my aunt has diabetes and she takes Glucophage" (what's that got to do with the price of eggs?).
She asked me my date of birth and I couldn't remember. She asked me how old I was and I guess I answered correctly. Then she had to peel all the little labels off my sheet and carefully attach each one to a tube. Finally the blood was drawn and she brought me a can of juice which I gulped in one swig. "You're feeling better now, right?" I stumbled out to the reception area and fell into a chair.

I got up to Internal Medicine and sat in the exam room for 50 minutes. I do not like sitting in exam rooms - I get freaked out and my mind races about illness and death. The copy of Ardhitectural Digest was of no interest. The nurse came and took my bp and it was 135/75. That upset me more. Plus, I was exhausted from the hypo and my hair was flat and stringy from the sweat.

Dr. Steve came in looking quite frazzled. He said my LDL was 118, up from last time and that in pwd it should be less than 100. "Let's get started on Zocor right away."

I respond how I usually do - started crying. I was upset and then started spewing off how I felt like I was always a bunch of numbers on a piece of paper and no one at the clinic treated me like a person. Poor guy, he did not deserve this. I have been eating poorly -making very unwise choices, using my mother's illness as an excuse. I was not surprised at the higher reading.

I need to cut the doc a little slack. After all, the numbers on the paper give him the information to make the proper decisions for my care.

He left with the agreement that I would try a small dose at night for 6 weeks and then we'd retest and reevaluate. No biggie.

Patients who have a high bp reading must at the end of their appointment go into another room and have three more readings done at 5 minute intervals by a machine. By then I'd calmed down and the average was 116/68. Good.

Yesterday I got the letter from Dr. Steve with all my results on paper.

Note how he altered the salutation...............that meant a lot to me.

Wednesday, July 02, 2008

Don't Blame the Bagels

When things go wrong on the db front due to me ignoring the facts, it's very tempting to put the blame outside of myself. DB is so hard to live with. I hate it. Blah blah blah.....

I work in an office of 90 people. It is an unwritten tradition that people bring treats on their birthday. Usually it's bagels, because Brueggers is nearby and they deliver for free (!!)

If asked the question re which food really plays havoc with my bg, bagels are near the top of the list. Those dang bagels. They always cause me to spike. It's not fair.

But it isn't really the bagsl's fault. A standard Brueggers bagel has over 60 grams of carb. I did not realize this until 10 years ago when I was in the hospital and the dietician was discussing what I usually had for lunch. I told her I brought my lunch to work but on occasion I'd go and get a bagel sandwich. She told me that a B. bagel had four carb exchanges. Yikes.

I am very sensitive to carbs in the morning and sometimes even delay breakfast until about 9 a.m. My ins/carb ratio is 1/5 at the beginning of the day, but by evening I'm at 1/20. Thinking from a logical standpoint, there is no way that I'm going to come through 60 grams of cho at 7:30 a.m. withput a spike. Rapid acting insulin is great, but it can only do so much.

So this morning when we got the "treats in the lunchroom" e-mail, I had to consciously remind myself that a better choice would be to take 1/2 of a bagel and save it for later in the morning. It worked. And involved only a small compromise.. Hopefully I can practice this enough times for it to become automatic, minus the self-pity.

To the collective bagel community, I apologize for casting you as the villain. Please forgive me.

Happy Independence Day. Enjoy the long weekend, travel safely, and cherish the freedom and opportunity this country affords us.