Friday, 14 July 2017

Happy Dance #2

 Ever seen a physician speechless? I have now.

Three months ago I had my very first appointment with an endocrinologist after 12 years of not needing one. (Yay me!). But unfortunately in that 12 years, I got older (Well that sucks!) and so now I need and have a great one. If you have read my previous post, you'll notice I was beaming over my lab results. My A1C went from 9 to 6.6 mmols in 3 months.

Am I proud of that? Yup.

Did I make some changes? Yup.

Did the new meds do it? YUP!!!

So off I toddle to my appointment thinking, "I done good!". This being only my second appointment with the endo I wasn't sure if he'd be as happy as I was or if his goal for me would be tighter control. After all, he is an endo. I get there a few minutes early and walk in not really knowing what to expect. I know from my first appointment he's a quiet man, a good match for me since I'm a little on the anxious side but I hide that piece pretty well. I'm just hoping he's as pleased with the result as I am.

There we are. Me in the chair. He with his big-a** computer screen. He's pulling up my results. He tells me, they are good. I can see he's scrolling through them. He mentions I went from 9 to 6.6 in 3 months. He continues scrolling through the rest of my results, tells me they're all good. I'm watching him. He's talking to me but also to himself out loud as he's going through them a second time. I can see him making sure he's processing what he's seeing correctly. I almost wanted to giggle because this wasn't the reaction I expected. He also commented that I had lost 10 pounds in the time period. (Drs almost NEVER make a comment about a woman's weight, positive or negative. I'm so proud he noticed!!)

Then he asks me a question I didn't see coming: "What did you do?". In my head, I'm answering with a slight bit of sarcasm, "What I should be doing". Out loud I tell him I'm logging what I eat, tracking my carbs and I'm walking again.

My turn. I have questions about my lab work. My LDL cholesterol (the lousy one) went up slightly. It  is still in the tight range for a diabetic but I wanted to ask anyway. He told me for the slight rise, it was likely the Jardiance that did that. I didn't know that.

Should I be concerned, I ask? No.

Next I have questions about the kidney function results. As usual, good ol' Dr Google confused the h*** out of me as I tried to understand the creatinine value and the eGFR number. Which one was the more important? Oh I got an explanation on google for what each meant but not which was the important one to pay attention to. He tells me the eGFR is the important one. Great! That number is good and in the hoped for range.

Next, I ask about the meds on hold. About 2 weeks after I'd seen the endo for my first visit, I started to feel bad on the metformin again. When I called in, he told me to go off it and we'd talk about it at the next appointment. I wasn't having any trouble with the Jardiance or the injectable Trulicity. He also put the Coversyl (iACE) on hold at that time because my blood pressure was running low. The iACE is meant to protect your kidneys from the damage diabetes can do by lowering blood pressure. I presented him with my current blood pressures. Stay off the Coversyl, doesn't want me to pass out from low blood pressure (and my kidney function numbers are good so we know the kidney is already protected).

The metformin piece kinda threw him for a couple minutes. Let me explain. At that first appointment, I was asked to be part of research study that was looking at the results of Glucophage use. To be honest, I agreed to be a part of the study because the data needed for the study was done through chart review or the office submitting anonymous data. He asked me a couple times about being off the glucophage. I reminded him I called in and cleared that with him. I think he inadvertently took me out of the study when he put the drug on hold during my phone call. Lol. I think he realized then he was the one who did it. No big from the chair I sit in. I no longer felt sick. I'm pretty sure I'll be the statistic that dropped out of the study due to drug intolerance.

He headed for the door to go get my lab requisition for my next appointment saying, and I quote:

"I don't want to change anything. I might break you." LOL. LOL. LOL.

I had one final question when he returned. Obviously the weight loss is good. Since the med is doing it, how do I slow it down when I reached my goal weight in the next 10 lbs? He grinned at me and said that the med only contributes minimally to the weight loss and only for a short defined period of time. In other words, I did it, not the med. I'm so proud.

I'm doing my happy dance again!

Saturday, 1 July 2017

Happy Dance #1

It's time for me to celebrate. Just for a couple of minutes. Imagine you can see me doing my happy dance to Pharrell's Happy song. No, second thought...not a good image. LOL. A better image is me doing the Snoopy happy dance. Anyway, I think you get the idea that I have something to celebrate! I do!

In a nutshell, my A1C is now, (drumroll), 6.6! Three months ago it was 9. Three months before that it was also 9. So, what changed? A few things.

--I have embraced the fact that I'm diabetic again
--I now see an endocrinologist
--my meds were changed
--I have paid attention to my diet
--I have been walking

For a while, I ran away from my diabetes. I figured if I just ignored it, it would go away. I knew better but I was burning out. When I was ready to get back to dealing with it, life got in the way, which it often does. Diabetes had been silent for me up until 6 months ago so it was easy to ignore. Six months ago, I had all the classic symptoms of diabetes: the thirst that wouldn't quit, peeing up a storm knowing I hadn't taken in much fluid, nausea, generally feeling crappy. It got bad. Really bad. I scared myself when I realized I had the symptoms. So I started testing again. My numbers were high. I didn't tell my family how high my numbers were, I didn't want to worry them. But I also didn't have the capacity to change it. I was lucky my A1C wasn't higher than 9. When I'm testing and seeing 18's on a regular basis, I knew things weren't good. Then, life got out of the way and I could move forward.

I have the most incredible family doc who has supported me through all the ups and downs. When he made the decision with me to pass on my care to the endocrinologist and the cardiologist I knew then we had reached what he could do for me. We both knew I had a pretty important role in my own care and the outcomes. As I've written before, all three docs have been supportive and have gotten me back on track. And I got me back on track because I have a pretty big stake in how things turn out.

What else helped? The meds. I cannot state enough how impressed I am with the change in meds. Elimination of the one I struggled with (Metformin). Beginning Jardiance and Trulicity. I'm always a little nervous with new meds but I was scared enough and brave enough at the same time to take the leap of faith and start the new regiment. Stating for the record, I don't work for big pharma, nor am I connected to big pharma in any way except as a consumer. These two drugs have been amazing for me while I do my part at the same time.

I am concerned about potential side effects down the line. Hopefully I won't be subjected to the more serious ones. To be realistic, there are also some things I don't like about the plan too. I'm not thrilled with having to give myself a shot in the abdomen every Sunday. It is uncomfortable because of the pressure of the auto injection. It also stings for about 15 min after at the site. If I don't pay attention when I'm giving it I could have a bruise for a week or two. In the bigger picture, it's better than daily injections of other meds (not referring to the lifesaving insulin. I'd take that in a heart beat if I needed it.) The only drawback to taking the Jardiance in the morning is my disorganization trying to get out the door for work and my memory. I don't forget it often but I do struggle to take it on time. Now I carry a small quantity with me so when I do remember, I take it.

I see my endo on July 4, a couple days from now. I will walk in, head held high, proud of what I have accomplished. I have a 6.6 A1C! Snoopy, move over, I'm dancing beside you.


Wisdom Over Politics

Realize, I'm Canadian. Our health care system is very different than the system in the USA. I'm not here to talk about the two syste...