My diabetes health professional team consists mostly of one person, and one amazing person at that. So this one goes out to my beloved Endocrinologist who I will call Dr A, (short for Dr Amazing obviously!)
Dr A, I want you to know how much I honour you and your expertise. I have studied and worked in several different fields and I don’t think I could call myself an expert in any one of those. However you seem to know everything I need to know about my diabetes. And just when I think you couldn’t possibly bring anything else to the table after nearly 27 years of living with type 1 diabetes, you do. During my most recent appointment you suggested I adjust the BGL target range on my insulin pump. So I did, thinking that it really wouldn’t make much of a difference because I have learnt not to hold out hope for things like this… just in case they don’t work. (No expectations = no disappointment!) But is has, and there has been a very fruitful and positive flow-on effect to my overall control.
The focus of our bi-annual consult, (which fortunately lasts about 45 minutes each time) goes something like this:
– the general “how have you been” chat
– shoes off to get weighed
– up on the bed to check blood pressure, pulse, infusion sites, eyes and feet
– back at the desk to go through pathology results and break down the data from my pump and CGMS download
It’s during this last phase of the consult which, in my mind, is like an untouched page from a children’s colouring book. I simply don’t have time to let you know the “why’s” behind some dodgy looking temporary basal rates on some days, or slightly high post-breakfast BGL’s on others. So let me colour-in the picture for you with a few strategies I have developed to live my life as Kim; a woman, a wife, a mother of two, a passionate community volunteer, a part-time worker and a full-time lover of life. Because my diabetes doesn’t dictate the way I live my life. I do.
During week two of some months I require a certain temporary basal rate, and during week two of other months I require a different temporary basal rate. All I know is that I need an increased temporary basal rate, usually at the same time I get a little grumpy and headachey… funny, that! It’s not the same amount each month for so many different reasons including what sort of exercise I am managing to do at the time, what the weather is doing at the time, what sort of food we are eating as a family, (which is often directly related to the weather) and the list goes on. I wish I could program another basal pattern into my pump for that week each month, but my insulin requirements vary so much that it just doesn’t work. So I use the temporary basal rate function, and often have a temporary brain fade and forget to re-set it every 24 hours. Yes, I know it beeps every hour that the temporary rate is active, but if I’m wearing heavier clothes or sporting a gorgeous scarf, by pump could be shouting out like a gospel choir and I wouldn’t have a clue. So my BGL’s can be a little out of range because of this.
Some days I don’t bolus for breakfast until after I have completely finished eating. And even then, sometimes I forget until I get a little thirsty… You see, some mornings in my home can flow like an elegantly played piano concerto and I have time to make a coffee and eat food whilst helping to get my two kiddies ready for the day. Other days it could be one colossal disaster after another ranging from a nappy explosion for one, to a schoolies-tantrum over a lost library book for the other. That’s what can lead to those not-so-in-range post parandial BGL’s. However by doing this, by delaying my meal bolus at the beginning of the day, I can guarantee I won’t hypo while driving my precious cargo to the daycare centre and school because I didn’t get to finish my breakfast. I can guarantee that I won’t lose focus and get us involved in an accident which could harm our lives, or the lives of those unfortunate enough to be on the road at the same time as us.
I know our consult doesn’t allow for this sort of detail, and I don’t think I could be bothered telling you all of those little “why” stories that explain odd-looking things in my data download. And I also know that you don’t need to know. I know that you know I am doing the best I can. I know you trust me with what ever strategies I engage in to live my life. We both know it is my body, my health and my life. We both know I treasure every day that I am lucky enough to live through, so why would I go and mess that up.
Thanks, Dr A… you really are amazing… and I think I am too!
For more information on Diabetes Blog Week 2013, this topic or how to get involved, click here!