Thursday, October 2, 2008

Endo Visit #3....

So today was the big A1C day. The diabetes report card. I never really look forward to hearing the results, but am always curious. I was somewhat shocked by the results this time. Having been on MDI for two of the last three months, then the last month on the pump I figured it would be higher. I mean we've seen some pretty bad numbers the past month. Scary numbers. But he ended up at a 7.1% this time.....a .4% decrease. Now I wonder....Could he have been in the 6's if we continued on MDI??? I guess we'll never know.

I want to say that I absolutely love this endo. She is the only reason I continue to stay at this clinic. She treats me as a team player, not a subordinate. She listens and she doesn't talk down to me. She knows I'm the one that has to take care of J.J. 24/7/365 and doesn't get wrapped up in a numbers game. I really like her. That's saying a lot for me....I really don't like many doctors.

Right away she could tell that the "bolus wizard" we were using on the pump was not benefiting us. By using the older model pump we were having to override the "suggested dose" almost all the time. She told me to not use it because it sounds like I can do a better job doing the math on my own than relying on the pump to "suggeest" a dose. I don't know why, but that was totally liberating. The CDE made it sound like J.J.would have aweful numbers and we would get better results using the bolus wizard. I guess most people do......I'm not most people.

So I'm turning off the bolus wizard!!! YAY!! When we get a newer pump we may try the "wizard", but for now we'll stick with a using a good 'ol calculator and pad of paper.

Right away she noticed that we do great in the morning and early afternoon, but after that the numbers are whacky. She suggested not working with the basals anymore because we are really at a high percentage for his age. She said we need to tweak the correction and food doses. So we'll go for that. I think if I can get MDI back in my head, but use the pump for dosing, I'll be set.

As far as our high nighttime numbers she says they see it a lot in kids J.J.'s age. The problem is the growth hormone factor......which by the way he grew a little and gained a little......and the fact that his stomach takes a bit longer to process food. There's so much going on in that little body we can't begin to predict. What she suggested is being more aggressive with our first correction dose.....basically push the envelope.....and ditch the bolus wizard. She said putting him to bed at 150 and seeing him wake up at 150 right now is not feasible.......and here I was trying to obtain that. He is still in his honeymoon we don't know what his body is kicking out for insulin. She said until his pancreas is fully inactive we will have to deal with the instability.....but we should be thankful he still has some function and we shouldn't rush the process.

So other than the long drive and full day it was a good appointment. I just wish I could work with her all the time....ditch the CDE's!!! Just kidding....there are good CDE's out there!!!


Jill said...

Woww! Thats a great A1c number :) You're doing an amazing job :D!!! I agree with your mention of not having to work with the CDE's. We have 3 different ones at our doctor...then add the CNP and the doc in the mix and they all seem to be on different pages and they are all telling us something different. I try and request talking to the same one but we end up getting calls from all 3.

Good luck and Congrats on a great visit!!!

Lynnea said...

Jill--preach it sister!! You are so right about getting different and conflicting advice. I've noticed it happens ALL the time. Very frustrating. I told my husband today that I wished I could call this endo directly ALL the time!! That would be awesome! But I'm dreaming!:-)

Jill said...

I know what you mean! When you finally get a doctor that you feel comfortable and want them to be the one to soley take care of your child :) We got attached to one of the CDE's and now when I call I can never talk to her.

We're going thru the conflict with getting on the pump now. One CDE told me my doc wont allow it til Kacey is thru her honeymoon and the CNP that I spoke with the other day told me that was no true and my doc said once we see him in Jan then we could probably start pump classes then :D LOL! So I guess when we go in Jan then we will finally know which one is right.

Happy Tweaking :)

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