First checkup of 2012 with the endocrinologist tomorrow.
And I’m not exactly excited about it.
Last visit was at the end of October, right before the wedding and honeymoon. Needless to say, I was a tad frazzled what with the pre-wedding jitters and mountain of details to tie up before the event of my young adult life. The last thing I wanted to worry about was my A1C results. Or thinking about how much insulin to bring on my honeymoon. Having enough needles to last the whole two-week trip. How the hell am I supposed to inject myself through a wedding gown?, I pondered. Not very romantic thoughts.
The stress of work and wedding planning had been driving me to eat, well, whatever was around. Regularly checking my glucose and counting carbs were not especially high on my to-do list. The mere thought of seeing a 200+ reading just added to my anxiety. I preferred to be ignorant. Alas, a visit to the endo is always a reality check. Nurse comes in and performs her routine: checks my weight; asks what medications and supplements I’m taking; takes my blood pressure (usually “corpse-like,” from what I hear…I guess I’m better under pressure than I think!); makes small talk, then leaves. A fidgety45 minutes waiting for the Physician’s Assistant to arrive (I only see my actually endo about once a year), and I finally get the news. My A1C that day is pretty good, as usual: a 5.8.
Phew. Crisis averted. Right?
Yes, crisis averted…for now. But 5.8 is higher than it’s been since I was diagnosed in 2009 with an A1C of 7. Lucky me, my diabetes was caught early while I still had some natural insulin production, so my sugars have never been extremely high (e.g. in the teens). But for a borderline control freak accustomed to having results in the low 5’s, approaching the 6’s made me very uncomfortable. It started to make me worry that perhaps I was not taking care of myself as best I should. As a bride-to-be, I had been spending the past several months preoccupied by many other things. My last concern was how well I was going to measure up on checkup day.
Maybe I am too hard on myself, but as the PA sent me off with a doctor’s note for the plane trip and prescriptions to cover me through the honeymoon, I felt defeated. A type 1 diabetic for over two years, and I’m still taking my relative health for granted. I should have been glad that my results can be considered “normal,” but instead I just felt disappointment and frustration. How could it be possible for me to put my health at the bottom of my list of priorities, feel like crap and get recurrent infections, and still be considered “normal” by my doctor? He might be impressed that my pathetic little pancreas can still squeeze out enough basal insulin to keep me from passing out from a blood sugar of 400, but I can’t help feeling a tinge of worry. If I’m not making radical life changes right now to prepare myself for the day when (not if) my pancreas eventually can’t keep up with my diet and stress – then when? When it’s too late? I don’t think so.
Don’t get me wrong, I am not ungrateful for being healthy enough to only have to take fast-acting insulin at meals. I am so thankful that my average sugars are so excellent. But I still see every victory as a reminder that I should be doing more. Other T1s don’t always have such a relatively easy transition with this disease. In some ways, having unusually good circumstances has made it harder to celebrate victories…when you’re used to near-perfect results, the slightest upset can get you down. Also, having a good overall track record makes it more perplexing when annoying hiccups come along seemingly out of the blue to disrupt your day-to-day. Like recurrent infections. Increased susceptibility to colds and other viruses. Feeling tired and irritable during highs, and shaky and nauseous during lows. Just when I’m feeling like my old, healthy-as-a-horse, invincible self – the self I had known for 21 years before I was diagnosed – something hits me. Not just a blow to my health, but a blow to my confidence.
And so, tomorrow, I am taking a different approach. My purview is much clearer now with the wedding over. I don’t care how “healthy” my doctor insists I am. He might be right, but I know I have to do better for me. Because I spent 21 years of my life thinking I was immune to all danger, and then diabetes appeared. Diabetes, no matter how severe, changes everything. I am determined not to let it scare me anymore. Instead, I will take my health into my own hands as much as I can, taking nothing for granted.