I wanted to be prepared. I didn’t want to go to my appointment with lofty expectations, so this morning I downloaded my Dexcom to see what the latest numbers said. The 14 day average was 154 mg/dl. The 30 day average was 166 mg/dl. Both of those numbers indicated that my A1C would be somewhere in the lows 7s. Better, but not quite all the way to where I’d hoped it would be.
This was my second attempt at finding an endocrinologist in Minneapolis. Although the first endo put me on Victoza, which has been working swimmingly, I didn’t mesh as well as I’d like. Another local D-friend, who just gave birth to her first baby, recommended her endo so I decided to give it a try.
I was very anxious when I arrived at the clinic because I really wanted it to go well with the doctor and I wanted a good A1c. On top of that, I had left my insurance card at home, and I was nervous the receptionist was going to lecture me or give me a hard time. But she was actually very nice about it and it worked out just fine. I had to wait quite awhile for the nurse to come get me, but she was also very nice. She didn’t ask me any silly questions about my diabetes, which was a relief.
My blood pressure was taken, and it was surprisingly on the low side. I had expected it to be a little higher because of the appointment but I was taking a lot deep breaths! She took the blood sample for the A1C and my Dexcom and PDM to download the data. Unfortunately their Dexcom system wasn’t working, but I wasn’t too bothered this time because my last sensor was a little on the wonky side and I didn’t think it would have been that valuable anyway.
Eventually the endo arrived, and she was very cheerful and smiley. We started off talking about where I was from, what I did, school, my previous work at DiabetesMine, my blog, that sort of thing. We started talking about my management, and then she realized that the nurse hadn’t brought back my A1C reading, so she went off to get that.
“It’s 6.6. Are you cold in here?” she said when she returned, adjusting the thermostat.
I couldn’t believe it. No, really, I couldn’t believe it.
“Wow… Are you sure your machine is accurate?”
She laughed. “Yes, it’s very accurate. It’s calibrated every day.”
“I’ve never been below 7% before…”
“Well, welcome to God’s country!”
I just about fell out of my chair. My A1C in June was 8%. Today, 6.6%. That’s a drop of 1.4%! Holy crap!
Of course, I attribute most of this to Victoza. I don’t know why it took me so long to start using it! Be ye not so stupid! Having Victoza has smoothed out a lot of my postprandial spikes, and I think that was the biggest reason why my A1C dropped so much. I also think it has made me more sensitive to corrections, so I don’t stay high for as long. I don’t really have any proof of this, but it’s a theory.
I also know that working with Jenny at Integrated Diabetes played a huge part in it. Even with Victoza, I still struggled with getting my rates settled. There were a lot of adjustments in the beginning, and I’m still making a lot of adjustments. As I lose weight and as my activity increases, my insulin needs change too. Sometimes it’s hard to keep up!
However, because I’m working with Jenny, the endo and I didn’t talk that much about my blood sugars. Jenny helps with a lot of my little tweaks, and lately things have seemed okay. Sure, there are a few highs and lows, but nothing that screams trend.
We did talk a lot about pregnancy and diabetes. She explained how their system works, and that since I don’t already have an ob-gyn, it would be good to have one in their network of clinics. She gave me a couple names of providers who she think would be good for me, which was super helpful. I hate having to find a doctor!
We also talked about my previous labs showing low thyroid and low Vitamin D. She decided that it would just be best to get new lab work done because it’s been over a year. I’m also getting tested again for celiac. It’s been a couple of years and from what I’ve heard, it’s good to get tested regularly for it because it can appear suddenly.
I felt very comfortable with this endo. There weren’t any warning bells as far as anything she said, and she was very nice and personable. She reminded me a lot of my New York endocrinologist, who I saw for six years. Despite having diabetes for 20 years, I’ve only had a handful of endocrinologists and the whole process of finding a new doctor is something I completely dread. I can definitely see myself walking through a pregnancy having her on my diabetes team. I’m really glad the second time was the charm!
Of course, pregnancy is not exactly right around the corner. We’re thinking it’s probably about a year away, maybe a little more. But having an A1C of 6.6% makes the whole becoming a mom thing seem a lot more real. For so long it’s been something that was in the far off future, because I didn’t know how or when I could ever get an A1C below 7%. Especially last fall when my A1C climbed from 7.2% to 7.7%, I felt like it was impossible. I was never going to figure it out. And now that I’m here, it’s like wow. This is really going to happen!