The Invisible Doctor

I have an appointment this morning.. Soon! The last time I was at this doctor, I bawled my eyes out. It’s kinda this tradition I have with the doctor’s office. Eeeeek. I hope that becomes a less visited tradition in the future. Recently, I have found that in all my spare moments–when my mind drifts at work, while I lie in bed, as I fold laundry–I have had many, many conversations with an invisible doctor. Defending myself, mostly. Telling him why I don’t need to eat 45 carbs at every meal, why I don’t write down records and fax them in weekly, why I make changes to my pump (little ones) without consulting them. I explain my personality and why this new approach is best. I talk about my life and how what I am doing fits better. I talk about all the small victories and lifestyle changes I have made! I do not want a “great” Dr. appointment because i turned my life upside down for three months, wrote everything down, and became a crazy diabetes nazi. My motivation has been a new and completely different lifestyle. I want a sustainable change. In my journey, it has not been writing everything down. It has been arming myself with knowledge and actually making changes. Finding things that work for my body and life and embracing them! I LOVE the pace I have taken. I LOVE the changes I have made. I also LOVE the results.

Today, I will be respectful. I will be composed. But I will not apologize for finally taking my health into my own hands and owning it! This is my everyday journey and I am really enjoying it! My health is not in his hands… It is in mine.

Okay, be strong Briana! You are doing things differently, but you are doing them best for YOU!

…..thanks for letting me get that out. I just needed to talk through it out loud one more time.

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The Perfect Doctor

… that’s all I need,

Someone who will answer all my questions, and care about me personally, and understand how my uniquely contradicting personality roles in diabetes care…

Yep.  He/She’s out there somewhere, and I just need to keep looking..

{We interrupt this search to bring you reality}

Last Wednesday, I drove to my NEW doctor in Willow Grove, filled with both calculated anticipation and trepidation.   This would be a step in the right direction, this would be the person who would understand me and politely listen and answer my questions.   I would have been better off hanging my hope for victory on a three-legged horse in the Kentucky Derby.  (Which I truly would love to visit for the sake of wearing a huge hat!)

I arrived early to my appointment at one of the quaintest little Dr. offices that I have ever seen.  It is part of a collection of cottage-looking professional offices set off the road surrounded by the color-stained Fall trees.  Idyllic.  THIS was the place where all my dreams would come true.  As I waited, I tried to think through a good explanation for why October was so horrendous for diabetes care… “I was SO busy, tired, etc…” “I usually do so much better, but…”

When I got sick of that, I just waited.

waited…

Finally, I was called back, weighed, blood-pressured, and what followed really doesn’t merit explanation.  It impersonal, rude, and condescending.

I bawled my eyes out in the parking lot like I have not cried for years.

Which is saying something.

So many emotions surging at once, how could I keep from crumbling under it? I had been hoping so high.  This would be the key.  The beginning of something wonderful.  But, it wasn’t.  Once again, a new doctor, and it wasn’t.

I called Ben and said things like, “I .. don’t.. want this!!” Waaa! “I feel so stupid” Waaa! “I will NEVER BE ABLE TO DO THIS.”  Waaa!  etc.. etc…

Somewhere in the middle there, I also said something like this, “I think all this was supposed to teach me that maybe a good doctor is not the answer.” (I’m still trying to hold on to the fact that good doctors might actually exist,.. but that is a conversation for another day.)  Couched in the lies I was telling myself about the situation was actually a bright beam of truth.   I thought about this truth during the days to follow, and it only became more concrete in my mind.

Who is the answer to great diabetes control?

I am the answer to great diabetes control.  I see a doctor every 3 months.  But I’m “in the trenches.” I’m the everyday go-to expert on myself–my motivations, my struggles, what helps me to be successful!  While other people join me–friends, family–the choices that I make, the food that I eat, the insulin I take, the carbs I count; these things are controlled by me.

Seriously, in the past week, I have been lovin’ the driver’s seat!  I have made intentional choices, intentional purchases, and intentional declines.

Who’s driving this thing?  This girl right here.

“Paging Dr. Cranky-Pants. . . “

It has taken me a few days to write about this experience because I was so taken off guard when it happened–I had a horrible, awful, no good, very bad doctor’s appointment on Wednesday. The strangest thing is that it only lasted about 7 minutes.  He came rampaging in the exam room, didn’t even look at me and said while leaning against the counter on the opposite wall, “I’m very disappointed–I’m SO disappointed.” He roughly took my vitals and said that  I must not be very serious about ever having kids, because at this point I never will.  He asked if I needed any prescriptions filled and quickly jotted down my Novalog request.  I was just kind of sitting there thinking, “What in the heck is going on here?  Isn’t this the doctor I love so much?”  Really, I was stunned.  It comes down to this: my A1C is not much improved from 3 months ago.  (Though it is better! Something that didn’t seem worth mentioning to Dr. Cranky-Pants.)  An A1C is the average blood sugar reading over the last 2-3 months.  I do have a list of reasons for my poor reading: My CGM broke on the way to Wisconsin for Christmas, which would have been extremely helpful.  I got the flu at Christmas; when I came home from Wisconsin, I left a few days later for fun in the sun in Florida.  The biggest struggle there is that it’s really hard to enjoy your Mom and Dad’s new hot tub with an insulin pump on, or I’d take it off and put it back on–think everything is great–and realize 2 hours later that I forgot to turn it on!  So both of my Christmases were difficult for control. No big deal, get back in the game. . . but then I got a sinus infection that had me laying on the couch for a week; I’m convinced the antibiotics and the sinus infection stayed in my body reeking havoc for about 3 weeks.  And cold medicine affects the CGM readings, so I just put in back on a week ago!  That series of events brought me right up to my appointment.  Anyway, I explained that to him in as few words as possible and he said, “Yeah, maybe that’s it.” Retorting, “I have you on file saying that you’ve made all these changes, but I don’t see it–It better be better next time. See you in 3 months.”  Exit stage left.  

In less than 10 minutes, I had been stunned, insulted, disrespected, accused of lying, and sent on a major guilt trip.  With much difficulty, I kept my composure.  For about 10 seconds.  While trying to schedule my next appointment, (that I was oh-so-much looking forward to at this point) I had tears streaming down my face and I was holding back that choking kind of crying that would have been really embarrassing.  Once safely in my car, I let the flow of emotion wash over my face and sink into my heart.  

I share this because this blog’s tagline is: Finding joy in my JOURNEY with diabetes.  This is part of the journey.  I don’t share it because “my life with diabetes is horrible and I want the world to know it.”  Talking through this is part of the process for me.  Thanks for letting me do that! 

Honestly, for about an hour it was very discouraging.  “I can’t do this!  I’ve tried really hard, and I CAN’T do this!!”

Here is the truth: I am NOT the same person that I was 3 months ago.  My thinking about diabetes is completely different than it was.  I may not have the numbers figured out, but I know that I have overcome some huge personal hurdles.  I am not taking care of myself because I want a doctor to be pleased with me. I’m not taking care of myself for any person to be pleased with me. 

 The guilt-driven decision never glorifies God.      

I spent 9 years of my life under the burden of guilt-driven diabetes management.  In those 9 years, never seeing victory.  Never able to embrace diabetes as a gift. Just guilt, wrapped up in resentment, with emotional trappings.  

Its hard for me even now to say that I’m thankful for that appointment.  But it helped me to take a deep breath and recognize that God has enabled me to change.  It’s always a battle in the mind first. Always. My mind, which was the territory of Satan’s lies for SO long, is now an open field, in which I toil to cultivate seeds of God’s truth.  I have taken claim of this ground that thrived with roots of disbelief and ungratefulness, hedged in stubbornness and watered with despair.  

I claim this ground.  

Pull out those weeds!

Break down that wall!

I know that I need to toil, I know it will take time–sowing seeds of truth causes blisters and aches–but I am committed to do that.  

…Even if Dr. Cranky doesn’t know that.  I’m not in it to please him.

 I’m here to glorify God.        

“For from Him and through Him and to Him are ALL things.  To Him be glory forever.  Amen!” 

Romans 11:36

One-eyed, One-Horned, Flyin’ Purple People Eater!

…well, that’s what I was expecting anyway!  

The nutritionist actually ended up being a two-eyed, real, live, normal (as normal gets?) person!  She was kinda quarky and clearly much better at Math than I, and I liked her very much.  In my experience, I have not met so many encouraging, helpful diabetic support people.  Is Pennsylvania like a utopia of healthcare professionals?  Is Wisconsin a burying ground of sour-puss endocrinologists?  Maybe, just maybe, fault falls to the hearer–not the various tellers of information–for the previous negative experiences.  That hearer, of course, is this girl right here!  It is refreshing to be at a place in my heart where I can hear.  I know that this is the result of God’s loving, constant pursuit of my heart in this area.  I am truly thankful that He continues His work until it’s done!  (Phil. 1:7).  Thank you, Jesus!

Well, now that I am listening, what did I hear?  Is life as I know it done, or what?  Will I never look a chocolate cake in the face again? —- “Nutritionist” what a horribly super-negatively-charged title to have.

Dun.. dun… dun!

After I kinda laid out for her my history and my self-diagnosis, she proceeded to be very helpful.  YAY!  This is what we came to.  My doctor does not yet have a proper carbohydrate-to-insulin ratio for me.  When I eat food, my body has a special “sweet spot” (pun intended, I guess) when it comes to what I eat and how much insulin it takes to cover any given amount of carbs.   Carbs are like the holy grail to diabetics.  We live and die by this number.  What Lynn (this is how I will refer to my nutritionist for the remainder of the post) said was if  I could make some changes until we get that specific ratio figured out it would be very helpful.  At this point, she lost me a little with a lot of sciency-talk.  The goal is to eliminate as many variables as possible.  I cannot necessarily control stress or other contributing factors to glucose variation, but I can control the amount of carbs that I eat.  (Sometimes, I feel like I CAN’T, but I’m going with her theory on this!)  So, the game plan is this: for the next 2 weeks to a month I am going to eat the same amount of carbohydrates at each meal: 45.  This eliminates that variable.  As I follow this plan, my doctor and Lynn will be able to find my body’s specific ratios.  Then, whether I’m eating 20 carbs or 120 carbs, the ratio will be correct (theoretically).  This is not a forever thing, but it may be an until-the-end-of-the-year thing.  Of course, I’ll probably take a few vacation days during Thanksgiving and Christmas, but for the most part, day-in and day-out, I’m going to be eating 45 carbs at each meal.  (If for some reason you find yourself in possession of some great 45-carb per meal recipes, comment!)

This will not be easy.  It seems simple enough–but, oh boy, this will not be easy.  To break it down for you, my daily eating looks like this: small, if that, breakfast.  Lunch is kinda my dinner meal with Ben.  Dinner is usually those Lipton cup-o-soups, if anything.  Then because I don’t eat or eat little, 9:30 pm is a mad (bad) dash to the pantry to find anything salty and/or sweet.  Not a perfect break down, but sadly, accurate enough.

I told Lynn this and she gave me some pointers.  Since I don’t like to cook dinner for just me, and I don’t always make lunch, (lots of soup here, people!) she suggested making two BIG meals a week that I can re-purpose later in the week.  She said, “Buy a rotisserie chicken; buy rice in the bag that you can throw in the microwave for a minute; buy those steamer bags!”  She added, “Anything you make can be dressed up the next day as a salad, a pizza, or a sandwich!”  Creative leftovers, I can do that.  The biggest concern for her is that I can go days without multiple food groups.  I stick to lots of yogurt and soup.  I went months without buying bread.  I thought the goal was no/low carb, but she said people should have 130 carbs a day at least.  I don’t want to burden you down with all the food nitty-gritty (not nutter-butter) details.  Big picture: I need to try to include 3 food groups at least at each meal and each consistent carb totals.

My goals:

– make a list of 3 breakfasts @ 45 carbs

-make a list of 3 lunches @ 45 carbs.

-make a list of 3 dinners @ 45 carbs.

~~This is a BIG one~~

ACTUALLY EAT THOSE MEALS

We are still waiting to hear back from the Dexcom representative that I accidentally gave the wrong insurance information to.  I’m sure the end of the year is busy for them because people want to purchase equipment before the new years’ deductible rolls over, but that’s exactly what we’re looking to do as well.  Would you pray with us that this could be figured out soon and I could have a Dexcom before January?